1. Two Opening Quotations

Lilla Waston, an Indigenous Elder from Australia, says this: “If you have come to help me, you are wasting your time.  But if you have come because your liberation is bound up with mine, then let us work together.”

Similarly, Eduardo Galeano, a famous writer from Uruguay, writes: “I don’t believe in charity; I believe in solidarity. Charity is vertical, so it’s humiliating.  It goes from top to bottom.  Solidarity is horizontal.  It respects the other and learns from the other.  I have a lot to learn from other people.”

I have often thought about these words and how they relate to our efforts to be in caring relationships with one another.  They point out some of what I think is wrong with standard professional models of care and also highlight part of why snuggle therapy is such a great alternative.  Let me explain why in a little more detail.

2. Hierarchical (Imbalanced) Models of Care

A hierarchical model of care.

A hierarchical model of care.

Over my years working with people experiencing homelessness, poverty, oppression and various forms of marginalization, I have become increasingly uncomfortable with institutional and therapeutic models of care that are premised upon hierarchical relationships with deeply embedded imbalances of power.  Yet almost all of the contexts in which therapy or care take place take this for granted.  Not only that – they require that the care providers have considerably more power than the people seeking care.  This is as true in institutional settings (like hospitals, homeless shelters, or drop-ins) as it is in more therapeutic environments (like rehabilitations centres or meeting with a counselor or therapist of some sort).  Let’s briefly look in a little more detail at how a few of these imbalanced hierarchal relationships operate.

In the hospital, the medical team, centred around the doctors, has intimate knowledge of the history of the patient, if the patient has healthy or unhealthy habits, what the patient’s family medical history is, if the patient struggles with using any particular substances (like alcohol or illicit drugs), what medications the patien is taking, and can also become as intimately familiar with the naked body (or the insides of the body) of the patient as is deemed necessary for treatment.  The team, especially the doctors, can also come and go as they please through various locked doors in the hospital and can pull up patient information on password protected computers.  The patient, on the other hand, has little to no knowledge of the doctor or the rest of the team, cannot come and go as desired, and cannot access information off of the computers.  And if the patient so much as tried to touch the doctor (with a finger or a scalpel) in ways that the doctor can touch the patient, then assault charges would probably follow very quickly.  Hence, the doctors have considerable knowledge, no only about illnesses and cures, but also about the patient and have considerable power over the body of the patient and within the environment in which care takes place.  The patient on the other hand, lacks knowledge not only of the doctor but also of him- or her- or nemself.  The patient also has no power over the environment in which care takes place.  What the patient should do – if the patient is to be designated a “good patient” – is follow the doctor’s order and express gratitude for the care received.  If a patient is labelled as non-compliant (i.e. a “bad patient”), care can be terminated and the patient can be ejected from the environment.

Similarly, in homeless shelters – another institutional environment – the social workers, case managers, and community support workers all have considerable access to knowledge regarding the lives of the clients (certain services require clients to complete very comprehensive surveys that ask questions about everything from experiences of abuse as a child to one’s current level of satisfaction with one’s sex life).  These questions are incredibly invasive, yet taken for granted.  This is the case, even though completing such surveys can take quite a toll upon the client (for example, it’s not uncommon for clients to relapse or binge-use on alcohol or their drug of choice after completing the standardized admissions survey for rehabilitation centres in Ontario; the questions are extremely intimate and usually bring up past traumas and incredibly painful memories – and drugs and alcohol were a large part of how the client had been coping with those traumas and memories, so being forced to relive these things is often a factor in a lapse or relapse).  On the other hand, workers are told not to share details of their personal lives with clients.  So workers gain very intimate knowledge of clients but clients gain only superficial knowledge of workers.  Similarly, on the level of power, workers wield great power over clients.  Not only can they access rooms and files and computer systems that clients cannot access – they also have the ability to ban or bar or suspend clients from the shelter program if they decide the client is too non-compliant or threatening.  Hence, given that folks stay in homeless shelters when they have nowhere else to go, the worker has the power to make the client homeless.  The client, of course, has no such power over the worker.

Lastly, even in more therapeutic settings, these power and knowledge imbalances are in play.  When speaking with one’s therapist it is not unusual to talk about one’s sex life or sexual fantasies (to pick just one example) but it is certainly considered improper to try and turn the conversation around to the sex life or fantasies of the therapist.  Furthermore, the therapist knows where the client lives (listing your address is part of the application for therapy) but, with the exception of those who operate private practices out of their homes, clients are forbidden from knowing where their therapist lives.  And, of course, the therapist can choose to end sessions at any time regardless of the wishes of the client (who can also end sessions, unless they are ordered by a court of law, but the client’s choice to end sessions does not have the same impact on the therapist as the therapist’s choice to end sessions can have on the client).

Now, of course, there are many reasons why these imbalanced power hierarchies are structured into environments where care occurs.  Many of these reasons are good reasons that exist to protect not only care-providers but also to protect those seeking care.  I understand this… even though I often feel like this is playing to the lowest common denominator (i.e. allowing the least capable or least appropriate care-providers to define how the context of care can be structured, rather than structuring the environment in such a way as to ensure all workers are capable of providing excellent care).

3. Problems with Hierarchical Models of Care

However, there are several negative consequences to this way of structuring care provision.  I will name only a few.  First of all, there is the problem that hierarchies of power create spaces where some people are more than other people.  This happens even if the most egalitarian rhetoric is used.  Even if workers are always saying, “we’re all equal,” “everyone matters just as much as everyone else,” or “we don’t bring labels in here, we’re all just people” the actual practices of the environment show that this is not the case.  Equality is questionable in an environment where people don’t have equal access to knowledge of one another and where some people have the ability to terminate the care being provided to other people.

Secondly, in a situation of care where some people are more and some people are less, the provision of care inevitably ends up being tainted with something like condescension or paternalism.  Those with more stoop down to help up those with less.  Those with more are above.  Those with less are below.  This is not mutual aid – it is care provided by superiors to inferiors.  Of course, many care providers would object to this and claim that they do not ever intend to treat people in that way – but the intentions of the care providers in this case are overwhelmed by the context in which care takes place.  The context transforms their efforts to care into condescending paternalism regardless of their intentions.

Thirdly, this is reinforced by the one-sidedness of the care that is provided.  Care always flows one way in all of these situations – from the doctor or social worker or therapist to the patient or client or consumer.  This is so deeply structured into these environments of care that it is often improper (and against the rules in some settings) for care providers to except gifts as tokens of gratitude from the people who received care that was meaningful to them.  A worker in a homeless shelter is generally forbidden from accepting a thank you gift from a person who found a job or place to live with the assistance of that worker.  Now, again, I understand why this is the case, but one of the outworkings of this is that the people receiving care have feelings of insignificance and dehumanization reinforced.  They are so far less than human (or less than “normal people”) that they are not even permitted to give gifts to others.

4. An Alternative: Snuggling as Mutual Care


Where is the hierarchy here?

Now, I mention all of this because I think it highlights something that is particularly unique and important about snuggle therapy.  Snuggle therapy, more than any of these other contexts, resists hierarchical models of care and institutes a therapy that is based upon mutuality, mutual giving and mutual receiving.  Part of what is wonderful about snuggling and its therapeutic benefits is that it really does require two (or more) people coming together to make it happen.  The goodness of snuggling isn’t rooted in one person (say me, the “professional snuggler”) and then transferred to the other person.  Not at all!  Rather, the goodness of snuggling is something that is created when both parties come together and touch each other in a safe, platonic, affectionate manner.  When this kind of touch takes place, neither party can take credit for all the benefits that flow from it.  Both parties are being equally vulnerable, both parties are being equally intimate, and both parties are giving and receiving.  This is not a hierarchical, condescending, or paternalistic model of care – it is a much more properly egalitarian model of mutual care. It’s hard to feel superior or inferior to another person when cuddled up together in bed or on a coach or in a pillow fort.  And when it’s hard to feel that way what is it easier to feel?  It’s easier to feel lovely.  It’s easier to feel beloved.  It feels easier to feel like a good and wonderful human being in the presence of another good and wonderful human being – both of whom take joy in giving and receiving love.  Snuggling, in other words, has a lot more to do with solidarity than it has to do with charity.  Instead of being a one-sided form of helping, it recognizes that our liberation from the things that weigh upon us as individuals is found in us collectively working together.  Snuggling genuinely recognizes the agency, humanity, and dignity, of all the parties involved .  And it recognizes that when people come together and relate to one another in that way, wonderful things can happen.