Our punch bag has seen some action this week, as clients have been getting in touch with their emotions and their body. This seems such a simple and straight forward therapeutic exercise that many therapists may only consider for anger work/issues, however there are many different ways that a punch bag can be useful therapeutically, and its not just all about hitting it as hard as you can for as long as you can, unless you need to release some anger or negative energy. Using a punch bag can help with control, relaxation, release, breathing, grounding, communication, personal space, trauma resolution, emotional literacy etc, as well as provide the therapist with diagnostic information about the client.
Considering the simple yet complicated process of doing any bag work with clients, this blog post will form part of a series of blogs, each focussing on the various aspects of working with clients using a punch bag . The blogs will be primarily aimed at counsellors and psychotherapists already in practice, and trainees learning about this type of work with clients. This post will be looking at setting the scene for therapeutic work on the punch bag, and how this work can be helpful diagnostically through information gathering through the clients body and behaviour. The next post will start to explore the different types of therapeutic work that can be done through bag work, starting with anger work.
Setting the scene to any bag work is of paramount importance; firstly to establish its therapeutic benefit for the client prior to offering it as an exercise, explaining the purpose and any aims/outcomes etc; and secondly, before any therapeutic work takes place, to establish some basic ground rules; no harm to self, no harm to others, and no harm to the environment. You may want to consider how you would propose such an exercise to the client, following an assessment of it’s therapeutic value beforehand, considering their diagnosis (e.g. personality adaptation/s, historical considerations etc), and the contract in hand. Also considering what your own reasons are for proposing the exercise ensuring you are not acting on any personal transference issues.
There are many considerations before doing any bag work with clients, namely of safety, relevance, and capability (have you addressed your own body script through therapy yourself?). The latter two would depend on the client, the therapist, and the therapeutic relationship, the former will need to be addressed regardless:
No harm to self
There are many ways that clients could harm themselves using a punch bag, wanting to prove themselves and hit the bag much harder than they need to, and for longer than they need to, often resulting in pulled muscles, over extension of joints, harsh jolts to the body etc, so any competitive traits within the client that may compromise their safety may need to be addressed first. Hitting the bag with a straight fist (instead of the front two knuckles) can also result in damage to the wrist, so importance is given to aligning the wrist, elbow, shoulder, and hip together on each punch. Boxing gloves are essential to prevent any bruising to the hand. Many people hold their breath when they punch, which can be harmful to the body, so breathing out on every punch is very important and can be combined with making noise (grunts, words etc) as long as it does not put strain on the vocal cords. Safe alternatives to the punch bag can also be discussed, as not everybody has a punch bag at home or at their place of work. It is important to put safety first when doing any prescribed homework around release, anger, stress management etc, so if using a bed mattress/sofa/cushions to ensure that there is no danger of harm to self through lack of padding, too narrow an area to hit, awareness of breathing etc.
No harm to other
The punch bag is to remain the focus, physical aggression towards others is ‘a not-okay behaviour’ both inside the therapy room or outside of it. Often its important to point out the differences between fantasy thought and what happens in the real world, so although it can be therapeutic to focus on a person during the use of a punch bag in order to express anger, its not appropriate to carry the same action out with the actual person following the session. Time needs to be allocated following a punch bag session to unpack and reflect, making a clear contract to make their way home consciously and safely following the session, and to bring any ‘leftovers’ to the next session, rather than acting on them with others around them. Again if prescribing anger/stress management/release activities as homework, to ensure the safety of others would mean informing anybody in the immediate area of what is happening, so they do not become concerned or worried, which would constitute as harm to other.
No harm to environment
Again the punch bag is to remain the focus. Respect of the immediate environment is to be asked for, inviting clients to become aware of their body position in the room and keeping a safe distance from breakables, you may need to prompt the client now and again if they are in danger of moving away from the bag, depending on how focussed they become during any punch bag exercise. When acting out stress/anger/release as homework, it is important not to damage anything in the environment, an example using a client who got a lot of immediate relief from throwing crockery around, had homework of smashing plates against a wall after buying sets of plates from a local car boot sale, standing at a good distance with protective gear on such as goggles and gloves (safety to self), ensuring that nobody or any animals can access the area (safety to others), and picking a wall that will take a few plates being hurled at it without damage to it or the surrounding area (this particular client used an empty garage). If safety conditions can’t be met then an alternative method be found.
Once these ground rules are established then the therapeutic work can begin. The client will be invited to initially get a feel for the bag and the boxing gloves, this also gives the therapist opportunity to gather some diagnostic information about the client:
- How is their stance? Feet positioning, too far apart, too close together, placing body off balance? Information can indicate how ‘grounded’ the client is in life, how they position themselves in the world.
- Do they lean forward or back? Are they aggressive or passive? This can be linked with the clients active or passive involvement in the world, or specific circumstances such as dealing with conflict.
- Where do they focus? Do they focus on the bag, look away, consistently glance at the therapist etc? This can be linked to early attachment, child development stages, concentration levels, confidence levels etc.
- How hard are they hitting the bag? Is it focussed, competitive, performance related? This can be linked to adapted behaviour, competitiveness, confidence etc.
- How close are they to the bag? This can give information about their personal space preferences.
- How do they breath? Shallow, deep, holding, erratic etc? Information gathered here can be around how they hold their tension in their body, indicators of their thinking processes, and emotional literacy.
Overall the therapist will be noting both gross and fine motor skills of the client, as well as facial expressions, language, tonality, breathing etc, to establish insight into possible early body scripts, life scripts, personality adaptations, injunctions, early decisions, behavioural/thinking/emotional patterns, ego state diagnosis (structural and functional) etc. This information can be essential to the work you will be doing with the client, and can involve fine tuning the bag work exercise to enable safe therapeutic practice and effective outcomes, or perhaps result in a postponement of the bag session in favour of exploring therapy issues that need to be addressed first.
So a lot of the preparation for using a punch bag, is in fact done before the exercise itself. As there are many ways to use the punch bag therapeutically we will now need to go into these in turn in order to understand the therapeutic value, and examine ways of interpreting what actually happens within each exercise, and how to use this information to inform your practice and subsequently direct the therapy.
In the next post I will be talking about using the punch bag as an exercise for clients to deal with anger, as a way to both release and understand (emotional literacy) their experience.