Physical
Restraint as
Catharsis?
Therapeutic
Childcare:
Hopefulness in a
Changing
Landscape
14 October 2014
Laura Steckley
CELCIS/Glasgow School
of Social Work
Ground to cover today
•  Catharsis
•  Relationship between catharsis and
physical restraint
•  Need for containing environments
Catharsis
•  General notion of intense expression of and/or
purging of emotion
•  Aristotle wrote of catharsis related to the function of
tragedies (Greek plays) to purge the audience of
pity and terror
•  The concept/phenomenon has been explored from
traditions of literary criticism, anthropology,
sociology and psychology
Catharsis: in and out of favour
Freud & Breuer (psychotherapy): founders of
modern catharsis theory. Initially excited by
perceived therapeutic potential of catharsis, but
later became disillusioned. (cited in Scheff, 1979)
Cathartic interventions peaked somewhere in the
1980’s, with their use increasingly declining since.
Key concerns: possibility of retraumitization, shortlived nature of insights, and danger of ‘addiction’.
(Klopstech, 2005)
Catharsis: Some Definitions
Bushman (experimental psychology): Catharsis
theory -- venting one’s anger will produce a positive
involvement in one’s psychological state. Bush
makes strong links to the media.
3 Studies
1. Confirmed pro-catharsis messages increased
desire;
2. Pro-catharsis message, followed by punching bag
yielded increased aggression in participants;
3. Angered participants who ruminated while
punching bag had higher levels of aggression and
did not report positive mood afterward (Bushman,
1999; 2002)
Catharsis: Some Definitions
Klopstech (body psychotherapy): the process that
brings something from the inside (emotional upset)
to the outside (expression) causing a dramatic
emergence into consciousness (insight). The
process also accounts for quantitative and
qualitative changes for the better (release of
tension and revival).
(Klopstech, 2004)
Scheff’s theory of catharsis
Underlying premise:
•  Emotional expressions, such as crying, are
instinctive, biological necessities
•  Yet in many modern societies, several emotional
expressions are socialised through punishment
and/or disapproval
•  Unresolved emotional distress gives rise to rigid or
neurotic patterns of behaviour (and this unresolved
emotion can accumulate)
•  Catharsis can dissipate these patterns.
Physical Restraint and Catharsis
Funded by Save the Children, Scotland
Aim to explore experiences of staff and young people
in residential child care of physical restraint
41 Staff & 37 young people participated in in-depth
interviews
20 establishments involved in study
–  Care homes, secure settings, and residential
schools
–  Local authority, voluntary and privately funded
organisations
Physical Restraint and Catharsis
Some young people and over half of the staff
made connections between restraint, the
release of emotion and repeated restraints.
– ‘seeking’ restraint for touch-related needs
was also cited by young people and staff –
often related to the need to release
emotion and sometimes related to
repeated restraints
Young person
. . . there’s times where you need to be
restrained and you feel yourself, there’s
some boys in here in the, even, see in
[name of establishment] there’s boys
that speak to each other and, like, say,
‘Aye, I feel like I like getting restrained
to take my anger out away.’
Staff
At the other end of the scale I’ve held a kid that’s,
look it’s been the best thing for him, right, because
they’ve been needing to let out what’s coming out
and the only way they could do it was going over
here, where being held and being safe for that 10
minutes . . . . And you come out of that and you’re
very much, ‘Phew’. You feel as though that’s done
them the world of good . . . again, it never does you
the world of good. I don’t care what the
circumstances is, I always feel sick.
Some kids just need to be held to comfort them. (young
person) As a comfort thing? (interviewer)
Yeah. (young person)
So sometimes do they get held when they haven’t, when
they’re not putting anybody at risk, but they just need the
comfort of being held? OK. (interviewer)
Well they won’t, but like you have to mad before they can
do it.
Oh, I see. So maybe a kid really just needs the comfort, but
they have to kind of go into that ‘putting at risk’ place to
be able to get the hold. Aye? That, what do you think
about that? (interviewer)
Well I’ve done it a few times. (young person)
Yeah? That’s really honest. If there was a way to be able to
get that need met without having to go mad, would you
have liked to have had a way to do that?
Hmm [affirmative]. (young person)
Yeah? (interviewer)
I don’t know how to for, [pause] you don’t, you need to get
all your anger out and then you just go mad and then you
need to be held. (young person)
Question
Can/do extreme expressions of emotion
have a therapeutic effect or can/do they
reinforce destructive behaviour and
emotions?
Is catharsis a good thing or a bad thing?
Scheff’s theory of catharsis
According to Scheff, catharsis has
two components:
•  Somatic-emotional, motoric
discharge
•  Achieved at optimal distance
Scheff’s theory of catharsis
Emotional State
Grief
Fear
Embarrassment
Anger
Catharsis (at
optimal distance)
Sobbing with tears
Shaking with cold
sweat
Spontaneous
laughter
Hot sweat or
spontaneous laughter
Optimal Distance
Derived from the notion of aesthetic
distance
Participant
Observer
Balance of thought and feeling
Balance of emotional resonance and
control
Dredging up the past?
(Scheff’s theory of catharsis)
Verbal recall is neither necessary nor
sufficient for catharsis
– Emotional discharge without verbal
recall is effective
– Sometime a ‘somatic discharge’ is
necessary before recall can happen
Scheff’s theory of catharsis
Within this model, there is an important
distinction between emotions as distress
and emotions as discharge
Evidence of greater levels of therapeutic gain
amongst emotive patients and especially
amongst patients who exhibit cathartic
release.
Klopstech stresses the key components
for catharsis to be beneficial:
•  Integration of the cathartic experience after
cathartic experience,
•  In the context of the therapeutic relationship,
•  All towards promoting the development of
self-regulation.
So when has ‘catharsis’ been a bad
thing? (some reflections)
•  When it hasn’t been cathartic – over or under
distanced or not catharsis at all;
•  (e.g.Bushman, 2002)
•  When the emotion has simply been a sign of
distress and not a sign of discharge (perhaps
related to degree of distance);
•  When it’s the ‘wrong’ expression…perhaps,
for example, expressions of anger do little to
resolve repressed, accumulated grief.
Catharsis and Containment
If the expression of emotion (some of which may be
intense expressions of emotion), has a biological
imperative and facilitates growth and healing under
the right circumstances, we need models that
promote such circumstances.
Containment theory resonates with Scheff’s theory of
catharsis and holds promise for conceptualising
environments that can provide the right
circumstances for (extreme) expressions of
emotion.
Containment
“Containment is thought to occur when one
person receives and understands the
emotional communication of another without
being overwhelmed by it, processes it and
then communicates understanding and
recognition back to the other person. This
process can restore the capacity to think in
the other person” (Douglas, 2007, p.33).
Some key concepts in containment
theory
•  Making the unmanageable, unbearable,
uncontainable – containable, manageable,
bearable;
•  Absorption: A settled shift isn’t always
indicative of a good shift
•  Based in care and relationship
•  Can involve a component of making sense
(integration)
•  Staff’s needs for containing processes
Conclusions
•  Catharsis and non-cathartic discharges of emotions
are very likely to be happening regularly in
residential child care and other settings that work
with kids who are in pain.
•  The concepts of emotional discharge & optimal
distance and the distinction between emotion as
distress and emotion as discharge are useful in
considering how we support the expression of
emotion and catharsis in residential child care and
other settings that work with kids who are in pain.
Conclusions
•  Containment theory is useful in guiding efforts to
provide optimal circumstances for discharge of
emotion – one that does not require physical
restraint
•  Staff’s need for expression of emotion and even for
their own catharsis warrants consideration
–  Overlooking or ignoring this may contribute to
unnecessary physical restraints
Bibliography/References
Bion, W. R. (1962). Learning from experience.
London: Karnac.
Bushman, B. J. (2002). Does venting anger feed or
extinguish the flame? Catharsis, rumination,
distraction, anger, and aggressive responding.
Personality and Social Psychology Bulletin, 28(6),
724-731.
Bushman, B. J., Baumeister, R. F., & Stack, A. D.
(1999). Catharsis, aggression and persuasive
influence: Self-fulfilling or self-defeating
prophecies? Journal of Personality and Social
Psychology, 76(3), 367-376.
Bibliograhpy/References
Douglas, H. (2007). Containment and reciprocity:
Integrating psychoanalytic theory and child
development research for work with children. Hove,
East Sussex: Routledge.
Klopstech, A. (2005). Catharsis and self-regulation
revisited: Scientific and clinical considerations.
Bioenergetic Analysis, 15, 101-133.
Kahn, W. A. (2001). Holding environments at work.
The Journal of Applied Behavioural Science, 37(3),
260-279.
Pert, C. B. (1997). Molecules of emotion. London:
Simon & Schuster.
Bibliograhpy/References
Scheff, T. J. (1979). Catharsis in healing, ritual and
drama. Berkeley: University of California Press.
Sutton, D. F. (1994). The cartharsis of comedy.
Lanham, Maryland: Rowman & Littlefield.
Szczeklik, A. (2005). Catharsis: On the art of
medicine (A. Lloyd-Jones, Trans.). Chicago:
University of Chicago Press.
Ward, A. (1995). The impact of parental suicide on
children and staff in residential care: A case study
in the function of containment. Journal of Social
Work Practice, 9(1), 23-32.
Further reading on the restraint study
Steckley, L. (2012). Touch, physical restraint and therapeutic
containment in residential child care. British Journal of
Social Work, 42(3), 537-555.
Steckley, L. (2010). Dispelling the myth. Response to parris by
laura steckley and further rejoinder to parris. Relational
Child and Youth Care Practice, 23(2), 6-14.
Steckley, L. (2010). Containment and holding environments:
Understanding and reducing physical restraint in residential
child care. Children and Youth Services Review, 32(1),
120-128.
Steckley, L. (2009). Therapeutic containment and physical
restraint in residential child care [Electronic Version]. The
Goodenoughcaring Journal, 6, n.p.
Further reading on restraint study
Steckley, L., & Kendrick, A. (2008). Physical restraint in
residential child care: The experiences of young people and
residential workers. Childhood, 15(4), 552-569.
Steckley, L., & Kendrick, A. (2008). Young people's
experiences of physical restraint in residential care: Subtlety
and complexity in policy and practice. In M. A. Nunno, D. M.
Day & L. B. Bullard (Eds.), For our own safety: Examining
the safety of high-risk interventions for children and young
people. Washington, D.C.: Child Welfare League of
America.
Steckley, L., & Kendrick, A. (2008). Hold on: Physical restraint
in residential child care. In A. Kendrick (Ed.), Residential
child care: Prospects and challenges (pp. 152-165).
London: Jessica Kingsley.
CYC-Online
Monthly Journal
Steckley On Containment
November 2010
December 2010
March 2011
October 2013
November 2013