The session ends. You and your client rise and you move holding the door open……………………………………
………………….at that moment of passing through she suddenly turns, slides her arms around you, buries her head on your shoulder and says “Doctor I am just so grateful for all you have done” and begins to cry, her tears staining your new Zegna silk tie.
Welcome to the ambush hug. As we are fond of saying in Australia, “bugger”.
So do you
Quickly turn to the side gently breaking her grip with your well honed martial art skills and push her hands to her side and say, “This behaviour is inappropriate. Please do not do this again”, all the while thinking how I will get those tear stains out of my silk tie.
Do the half hug. Hands usually go somewhat awkwardly around the shoulders with the hips pushed away (to avoid any hint of sexualising). The muscles usually somewhat tensed in case the client attempts to move closer saying,” I not sure this is appropriate and thinking what if somebody sees us.”
Give into the hug. Briefly holding the client in a true relaxed hug before moving away and saying, ”It is important we talk about what has just happened at our next session.”
The ambush hug makes for an interesting tension between boundary issues and relationships issues.
Option A gives primacy to the boundary issue, resetting the boundary as quickly as possible and warning against future infringements. However there may be a significant breaching of the therapeutic alliance as the client feels rejected. This may be difficult to repair as often these hugs come out of session where the client has been feeling particularly vulnerable.
Option B is a compromise between still keeping a boundary while maintaining the relationship. Everybody usually feels awkward and tense with this option.
Option C The clinician gives the relationship paramountcy. Recognising that the boundary has already been breached the therapist responds briefly as any person might before moving away.
In choosing any of the options what has occurred must be processed with the client at the next session.The vast majority of clients know that touching is inappropriate So the processing of the hug needs to deal as much with the patients need or impulse as it does with the guilt they may feel for having transgressed a boundary. In choosing the option to return the hug a number of follow on behaviours should occur. It should be recorded in the notes and it should be raised in supervision.