Hand-Based Psychotherapy

Hand-Based Psychotherapy

The image we have of the therapeutic set-up derives from Freud’s clinical practice. It consists of a patient lying on a couch with the therapist sitting behind her unseen. There is no physical activity apart from talking. It is as if patient and therapist are focusing exclusively on the mind with the body bracketed for the duration. We would never picture this set-up if we were considering physical therapy—here the body is likely to be moving quite a bit. The division is remarkably Cartesian, and not in a good way: we all know that mind and body interact in all sorts of ways, especially when it comes to pathologies. We have psychosomatic illness as well as psychic disturbance occasioned by bodily injury or disease. Shouldn’t both kinds of therapy be psychophysical? Shouldn’t we be treating the WHOLE PERSON? With this ideology in mind, I wish to urge the benefits of a type of psychotherapy dedicated to the hands—hence hand-based psychotherapy.[1] The theoretical background to this method draws upon the central role of the hands in human life and evolution, the extensive neurophysiological basis assigned to the hands, and the consequences of hand dysfunction. There is nothing particularly esoteric about any of this: it is just part of our shared knowledge of the hand as mature human beings. I am not asking you to swallow anything mystical or New Age or weird-science. And my aim is thoroughly practical: therapeutic efficacy rules, there are no magic crystals, it’s all out in the open. So, let me be blunt in my language and my specific proposals. The heart of hand-based therapy is what we might call “hand activation”, i.e., a series of hand exercises or skills or disciplines. An initial list will include throwing, drumming, hitting, gripping, stroking, and strengthening. Both hands will be worked on, especially the non-dominant hand. Games and sports of various kinds are encouraged, as well as playing musical instruments; these may be decided by therapist and patient together. (I personally would favor knife throwing, drumming, and tennis, but that’s just me.) The aim is to train the hands systematically, bringing out their full potential, particularly the non-dominant hand. Hand awareness and hand connectedness are thereby enhanced.

I envisage this form of therapy for depression, anxiety, and PTSD, as well as ordinary discontent. I follow it myself. It is perhaps not wise to try to delve into its rationale and empirical basis too deeply, because that way lies mystification and pseudo-science. The general idea is that our hands are a central part of our human nature and should be developed to a high level in order to realize that nature. Just imagine life without your hands—it doesn’t bear thinking about. A considerable part of the brain is dedicated to the hands. They are capable of amazing feats. Capitalist labor has alienated workers from their hands by insisting on repetitive motions. Many jobs involve minimal hand activity and creativity. Hand neglect is like brain neglect, and indeed entails brain neglect. Infants follow a regular pattern of hand development beginning at just a few months old, indicating a carefully orchestrated set of innate instructions (like language development). Healthy hand development is necessary to a happy successful life. Some people are afflicted with hand phobia (chiro phobia) while others suffer from Clenched Fist Syndrome (CFS). Some gesticulate wildly while others let their hands droop uselessly. Most people never give their hands a second thought, so don’t do anything to unlock their potential. I would advocate hand therapy for criminals languishing in jail. I think the pinched personalities of many academics would benefit from compulsory hand exercises. Healthy hands make for healthy and happy minds. The old regime of forcing children to fold their arms and not “fidget” is the opposite of healthy, depriving them of the natural action of their hands (“hand repression”). There should be social clubs devoted to hand activities. Hand wellness should be a societal priority. The soul-hand nexus should be celebrated. But here I risk lapsing into hand mysticism, hand obscurantism. Let me just say that it is high time we recognized the importance of hand development to human wellbeing.

I am not suggesting that we replace all other forms of psychotherapy with hand-based therapy (“chiro therapy”). It can certainly be used in conjunction with other forms of therapy (including rebirth therapy[2]). But I think it could be a valuable addition to other therapeutic approaches. Obviously, it would be desirable to undertake empirical studies to evaluate its efficacy, but this is notoriously difficult to arrange (most psychotherapies are lacking in empirical support). Still, I am confident that it could have beneficial effects, simply because it goes to the heart of our human nature. We are born handy creatures.[3]

[1] I intend this short essay as an offshoot and application of my (criminally neglected!) book Prehension (2015).

[2] See my “Foundations of Psychotherapy” for an account of rebirth therapy.

[3] This essay is obviously highly programmatic; much more needs to be said. For example, should the education system make room for dedicated hand development classes? Is writing a sufficient use of the hands for a healthy psyche? (No!) What is the relative psychological importance of finger dexterity and propulsive manual power? Should different types of ball be used therapeutically? (Yes.) Are drummers happier than singers? (Probably.) How much emphasis should be placed on eye-hand coordination? Is there such a condition as stiff hand dystonia? Should we talk less and use our hands more? How should the feet be integrated with the hands? Is hand behavior diagnostic of psychopathology? Is obsessive-compulsive disorder hand-centered? Should children be tested on their hand skills? What constitutes hand beauty? Are there national differences in hand sophistication? Should the elderly pay special attention to their hand-mind health? Et cetera.

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