Sink in My Skin, Please – Reflections on Touch in Mental Health Practices

Must Read


Back in the day, while I was still grasping the abstraction of the hour changing into days, and the days changing into seasons, the world of adults seemed full of gibberish. Familiar tongues, constantly uttering realities, vivid and far gone. In the midst of what sometimes felt like chaos, my body remembers the comfort I would earn by touching someone’s feet and acknowledging their presence among a crowd. These blessings were like sigils, transforming from words to an expression of care and protection as soon as they placed their palm on my head. 

Another memory very much stored in my body, early remembrances of my being, of me recognizing that I exist and also that I do not matter. It typically began like the aftermath of a blackout, my father is holding me upside down, and my head hurts from the continuous banging on the floor. My father, my very own, is the one hitting me and is screaming, a scream so loud that no one dares to approach him, everyone with their frostbite. With all this banging, I can’t tell you what he is being so noisy about, otherwise, I would have told you all his secrets, secrets about why he abuses us all, why he is so hurt, hurt enough that he would never see the hurt in others. Fortunately, the last drawer of our showcase would never close properly, and there it is, a packet of gold glitter, stardust my mother had long forgotten about, a relic from her doll-making days. Past all these stares and the noise, and my mother’s howling, past the feeling that my skull would crack open, a profound feeling emerges, that this is who I am, hanging upside down, getting to look at the glitter…. I must be blessed that there is glitter.

Perhaps if we all can try enough, at least some of us, would be able to utilise our body memories as a score sheet, backdating the feeling of being picked up by the adults, resting our head on their shoulders, tucking our hands and feet under their bodies, cushioning on their bellies, running your fingers on their veins, placing your ear on their chest to listen to their heartbeat, feeling terrorised by an unexpected push or hit and the intense humiliation of a slap on one’s cheek.  Not all these scores are a win-win situation for us and they keep a tab in almost like a visceral existence, we cannot escape it and yet it doesn’t get primary focus. 

In my first year of being enrolled in a commerce college, I had almost stopped thinking about my father’s death, had very violent thoughts towards him (and myself), and just wanted to escape the suffocation of being associated with myself.  This was accompanied by a peculiar feeling in me, that I am queer. The very same year, while I was struggling to relate to my study in commerce, and with myself, I decided to attend a workshop on gender, bodies, and sexuality. I remained silent throughout the workshop, with nothing to offer as a participant, not even a single question. I was inspired by listening to another participant and getting to know that she was pursuing her education in psychology. Psychology, a subject I had never heard of before, and upon reading over the internet about it, I immediately felt the thrust to enrol in it, pursue the answers to my loneliness, and start afresh.

Skipping my very regular years of college, we are in 2023 now.  Even though I had finished my master’s in psychology in the year 2017 and another specialisation in child psychology in the year 2019, only now, in 2023, I feel reasonably confident to call myself a ‘Psychotherapist’. It’s not an accident that I was so tempted to learn more about bodywork. I could not see myself being a therapist before that. I was just looking for answers, and since the answers were not coming to me, I believed I can’t help another person answer questions they have from their journeys. ‘Healed people, heal people’, and I recognised that I was still a ‘hurt person, who would hurt people’.  I realised the need for personal therapy, and have been in ongoing therapy since 2019.

There is a lot of value in having someone listen to you. Listen to yourself enough that you start listening to yourself. After months in therapy, I cried for the first time. I cried, but couldn’t look in my therapist’s eyes. Before this, I don’t remember ever crying in front of another person, let alone an adult. Even though we are of similar age, I recognized that I perceive my therapist as an adult in my life, an adult figure I was craving for. I started asking myself, now that I have told her so many stories of my life, if tomorrow I decide to end my life, would she agree to my not being able to reason it out? Another year in therapy, this question didn’t occur to me. I don’t think I was ever told not to cry, but it’s something I learned to practise as everyone else would cry around me. I asked my therapist to not look at me while I cry, it was hard enough to put into words how lonely I felt, but to cry and let her witness how miserable I was, still is unacceptable for me.

She moved to another city, and I have not had an in-person session with her in the past 3 years.  Only recently she informed me, something I didn’t realise that I am craving, that she is moving to the same city and would be able to meet me for in-person sessions, at least once in a while. Therapy over video call has been good enough for me, but I have been wondering about something ‘awful’. Now that she is moving here, can I ask her to have consensual skin contact with me?  Not an awkward hug, or a handshake, but anything she would also be willing to provide, even if it’s for 5-10 seconds. I think I deserve compensation, compensation for her not being present in the same room as me. A contact which is willing, and warm. Often she would let me speak and be silent, but can she also crease my shoulder, and feel her hand sink in my skin, and tell me that I am not hollow from inside, that my body is mine, that I am not rotten or decay like my father and other adults?

Unless mutually consented to, I have never experienced touch as something that provokes any sexual urge in me. I very well acknowledge that this position has built over time, and an analyst in you could even theorise it in one way or another, I wouldn’t mind. If it’s not mutually consented to, how could it be sexual? It’s abusive and exploitative to the very least. Language, verbal or nonverbal, has equal, if not more, potential to be sexually suggestive, yet noble and experienced therapists actively train to be ethical in their approach to talk-based therapy. However, traditional talk therapy has also tabooed the value of touch in a therapeutic alliance. There is no consensus around  those rare instances when a client, or patient, would benefit from being touched by the therapist. 

This June of 2023, I had an opportunity to attend a residential course in Thai body massage, and Breathwork. Under the supervision of my teacher, I learnt how to be intentional with my touch, how to discuss and negotiate boundaries around pleasure and pain, and how to make the receiver of the massage an active participant in their healing. During multiple sessions of massage, there is a scope that certain areas of the body would shed some light on an experience that the receiver may or may not recall. This tendency of the body, especially that of the fascia, the connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fibre, and muscle in place, to hold and release trauma experiences, is far underutilised in traditional psychotherapeutic approaches. It is only when I gained confidence in my bodywork & massage sessions, and experienced part of my being which I had long forgone, is when I revisited my training as a psychotherapist, sought supervision for it, and started my practice again. 

Some clients, if not all, experience their heartaches, as an intense physical experience, often called “crumbling”. There is this tension in their neck and shoulders, it feels like concrete flows through their veins. Their breath doesn’t seem to be of their own unless there is palpitation and breathlessness. Part of their body, flickering in the resonance of a self long forgotten. And especially for clients, who can tell that it hurts, without the ability to point out exactly how much, where, and when, ethical touch is a window to explore this discomfort from a bottom-up approach, where a therapist is capable of holding this discomfort in their hand, and the treatment is not over-reliant on the client’s ability to mentalize. This can be particularly critical for societies like mine, where still many of us express our psychological issues through bodily pains and discomforts. The tradition of Thai massage goes further to essentially blur this mind and body divide, as the pain and discomfort in all its ways is held without any pressure for an inquiry around it. 

And now a dilemma confronts me- Will I disclose to my psychotherapy patients that I also provide Thai massage ? Maybe not, maybe I will wait until I have clarity about ways of integrating psychotherapy with bodywork. Also, I might be too scared to be called an “unethical therapist”.  I am not in any way suggesting that mental health professionals should aim at touching your client sooner or later, but suggest a need to acknowledge that there is a lack of talk when it comes to the pragmatics and efficacy of touch in psychotherapy. As therapists, we are constantly exposed to echoes of pain and possibilities of healing delivered to or by us in verbal and nonverbal ways and yet I would appreciate it if someone could rewrite the sensation I feel at the crown of my head, let me grab their wrist while I cry, and be okay with crossing a boundary without the fear of violating it.

Tapinder Singh

Tapinder Singh is an early career Thai Yoga Practitioner and Psychotherapist.


Please enter your comment!
Please enter your name here