Holding

1. Frantic and aggressive behaviour is a projection of internal fears/insecurity, frustration/confusion, distress or anxiety

The purpose of holding should be to help the child/person move into a calm and safe disposition from which he/she can identify fears and needs, and then find a way of meeting them and/or communicating this to others.
Holding should be presented from a kind and calm disposition. The restraint aspect of holding is secondary to kindness and loving support. If the person holding feels anxious or fearful this will be transmitted to the child and add to his her own feelings of fear and frustration

Holding a child because you fear what he she might do to you or others can only be helpful for as long as you have complete physical control. This is not very easy or very useful. Does one have to fear the child’s behaviour in order to justify holding? Or can it be as helpful as a smile or a question?
The author’s holding repertoire related to children ranges from a hand on the child’s shoulder to a whole body hold. The most useful hold is hand over hand with my thumb and forefinger around the child’s wrist. Holding both wrists has been successful with children who have been in a violent rage and would normally need a much stronger holding. Many children have chosen a continuation of a wrist holding as a comfort for many minutes, and they often stroke the holding hand/s during the holding. Thus, a gentle physical restraint has been received as comforting support. It can be a much more loving and appropriate response than strong verbal exchanges or consequential disciplinary action.
An abrupt jumping into or out of holding can cause additional distress, so where-ever possible, I try to move into and out of holding in gentle progressive stages. I don’t consider holding useful as a surprise tactic or an alternative to verbal communication. The Holding methods described previously are simply a continuation of the natural responses used intuitively by an adult when dealing with a small child who can easily be picked up and cuddled. When the child is too large and strong to be carried in the adult’s arms the following repertoire of holding has offered me a useful stage by stage approach to the child’s needs and responses.

Stage One
‘Free holding’: actions that can be used as an alternative or in conjunction with verbalised communication:-

1. Eye contact – if it is shared with kindness and encouraged without judgment or fear, it can be a wonderful healer for negative feeling. Ideally this should precede any physical contact, but in many circumstances one just has to be open and willing to receive eye contact as and when it feels natural.
2. One hand on the child’s shoulder giving guidance.
3. Each hand on both of the child’s shoulders giving guidance.
4. Other forms of physical contact that offer guidance .
5. Blocking: presenting one’s body between the child and their pending undesirable action. Physically taking hold of any object being used to facilitate anti-social behaviour, or physically organizing a safe area or restricting access to any area the adult cannot appropriately or easily supervise.

Holding actions can be used to backup previous verbal communications or in conjunction with verbal explanation. However, an explanation that links holding with past behaviour e.g. “I am holding you because you hit Anna,” is not helpful because it presents holding as a punishment for what has been done, rather than a way of helping the child organize better future behaviour. Holding must be considered a positive way forward, e.g. “We’re going home now to find a quieter space; this toy is too noisy for me to manage right now…I need to hold your hand for a few minutes while you find something to play quietly,” (i.e. without fighting….. etc.) A positive explanation of what the adult is going to do is very important, even when the child does not appear to hear or understand.

I try not to use any negative words within my explanation, thus I would avoid words that reflected negative behaviour such as fighting, bad, or not allowed. It is better to reflect what has happened than to state negative judgements about the behaviour, “……Paul is upset about losing his ball…”It is important everything is presented as positively as possible within the context of being authentic and appropriately illustrating care and concern for the child who has been treated unfairly. Sometimes, I can however, reflect negative behaviour from a simple, kind and non-judgemental disposition, which gives the child a chance to reflect consciously on his/her actions and review the behaviour from a witnessed perspective.

Stage two
Established good observation and listening skills together with a calm and assertive attitude would normally give approaches discussed in stage one time to successfully release serious levels of tension. I have only rarely needed to use the stage two strategies because I generally integrate the stage one options within normal social interaction, as a preliminary response. I would only use anything in stage two when stage one options were obviously not possible or had notably failed to pacify the situation.

‘Physical restraint’: –

1. Gently and firmly hold one or more wrists and with a warm hearted disposition give information using calm assertive body language and minimal verbal language. Holding one wrist; without using strength or pressure this can remain a strong and FIRM hold. Holding both wrists may be necessary if the child is trying to inflict harm on anyone or anything while being held by one wrist.
2. Holding the child in front of me, with his/her back against the front of my body, my arms are then going around the child’s body and holding the child’s wrists one in each hand.
3. As before, but with the child’s arms crossed, holding the child’s left hand and wrist in my rights and his/her right hand in my left.
4. As above and also sitting with my back against something solid and placing my legs one each over the child’s legs.  This position is thought to help calm the child because of its resemblance to when the child was being carried in the womb. This holding position and wrap around cuddling can be supportive and comforting even to adolescents.  If another adult is available ask that he/she holds the child’s feet, keeping the child’s knees bent. The adults should not speak but remains warmly receptive to any opportunities for eye contact and spoken communication. This will help the child feel a comforting link with the outside world.  Some children like to be stroked e.g. on the hand, arm, head or forehead.  If however any of the above suggestions are received with resistance it is best to offer a calm and assertive holding for as long as necessary.

 

Helena’s note to readers: I have worked with children all my life, many of whom have been troubled or challenged by their circumstances, however, I have only used this form of holding on a few rare occasions. I feel this is because the first level of physical restraint, that of holding one wrist, continues to give the child freedom of movement and he/she quickly learns that my calm assertiveness will successfully change the external environment. Meanwhile I remain positively focused on ‘being with the child’ and their needs. I also illustrate to the child my willingness to follow their movements whenever these actions are going towards a more positive situation. Also I do not react in any way to any aggressive behaviour towards myself. I believe my commitment to helping the child find a better way of coping has to include total responsibility and acceptance of any adverse personal consequences.

During all the above holding techniques it is important to keep all external stimulus to a minimum.  Talking to the child usually adds further distress, and will disrupt the association with womb like security. With the young children it can be helpful to do a very gentle rocking movement, a classic hush-hush sound is thought to represent the sounds heard in the womb, and sometimes quiet and gentle humming can help the child relax.

It is also important to move out of all the above examples of different holding techniques VERY SLOWLY, releasing from the holding very gradually. Further resistance from the child illustrates that he/she is not ready to be on their own without the security of the holding; or the release process was too abrupt. (This is often caused by the adult feeling reluctant to continue with the holding due to their own needs.) Releasing from the holding slowly and very gently, gives the child time to assess how he/she is feeling and indicates his/her needs without going for a full RE-run. At this point a lesser degree of holding is probably going to be sufficient.