Bryan Post


Martha G. Welch

Martha Welch, MD, is a major figure in Attachment Therapy, who for a time served on the board of ATTACh (Association for the Treatment and Training in the Attachment of Children), the trade organization for Attachment Therapists. She became widely noticed with her 1989 book, Holding Time (in English, Finnish, Italian, Japanese, and German). She has used various other terms for Holding Time, which include Welch Method Regulatory Bonding, Direct Synchronous Bonding, and Prolonged Parent Child Embrace (PPCE). These methods are more commonly known as both Holding Therapy and Compression Therapy.

A child psychiatrist and assistant clinical professor at Columbia University, Welch first gained notice by claiming Welch Method Regulatory Bonding was an effective treatment for autism, which she said she “pioneered” in the 1970s while at the Albert Einstein College of Medicine in New York City. Her ideas were initially supported by Nobel Laureate Nikolaas Tinbergen.

As the use of Holding Time (i.e., Holding Therapy) waned as an autism treatment, Welch continued to promote it for “attachment” between parent and child, and between other family members. The therapist’s role in her model is to supervise holding sessions. Welch also encouraged mothers to use these techniques frequently at home to prevent problems, as well as treat a host of conditions such ADHD and sundry learning disorders.

In 2003, the Acting Chairman of Columbia’s Psychiatry Department disclaimed any connection between Holding Time and his department: “…Dr. Welch does not utilize bonding therapy or related techniques in her work as part of the Department of Psychiatry. Her efforts here are devoted to non-clinical research. Her work on bonding therapy is conducted outside of her departmental activities.”

The first (and to date) only published research on Holding Time (referred to as PPCE) appeared in 2006 as a pilot study (see mentions below). Among other questionable things in that research, Welch and her associates used Elizabeth Randolph’s unvalidated Attachment Disorder Questionnaire (RADQ) for outcome measures.

Meanwhile, Welch’s Holding Time approach has been embraced by the “gay-to-straight” movement. Richard Cohen, in his 2000 book, Coming Out Straight, suggested that therapists can cure homosexuality — or parents could avoid it in the first place — with Welch’s method: “I recommend the use of Attachment/Holding Therapy as taught by Dr. Martha Welch. My family and I did some healing work with Dr. Welch. If I had experienced holding time with my parents several decades ago, I would not have needed to process through my thoughts and feelings with so many therapists and groups.”

In Her Own Words

— Most Telling —

— Compression Therapy —

— “Holding Time” —

— The Promise of “Biological Synchrony” —

— “New Idea of Child Development” —

— Holding Time as a Panacea —

— Starting with Infants —

— Holding Time for Mother —

— Holding Time for the Working Mom —

— Using the Notion of Catharsis —

— Requiring Eye Contact —

— Holding Time as Diagnostic —

— Holding Time for Autism —

— On Autism —

— Group Holds —

— “Needs Cycle”? —

— For Mothers Only —

— Other Beliefs —

— What Results? —

— “Research” —

  • A typical PPCE [Prolonged Parent-Child Embrace] interaction between mother and child consisted of the mother embracing the child face to face for 20-90 min. Such an interaction progressed through a sequence of four stages (with associated emotional states):
    1. Confrontation (discomfort, irritability);
    2. Conflict (expressing fears, anger, or hurt);
    3. Resolution of conflict (reciprocal embrace, caressing, kissing, conversation);
    4. Synchrony (attunement, reciprocity, state of calm arousal).
    …A successful PPCE cycle ended in stages 3 and 4…

    — (with Robert S. Northrup, Thomas B. Welch-Horan, Robert J. Ludwig, Christine L. Austin, and Judith S. Jacobson) “Outcomes of Prolonged Parent-Child Embrace therapy among 102 children with behavioral disorder,” Complementary Therapies in Clinical Practice, Feb 2006, 12(1):3-12


  • PPCE Therapy [for this study] was funded through state aid, private insurance, subsidies, and self-payment.

    — “Outcomes…” (2006)


  • The intensive component of the intervention consisted of two consecutive days of PPCE Therapy in a single large room. Four to seven families were treated simultaneously but independently in each session on separate cushioned mats with coaching from the therapist teams and mentor families. Up to 60 people attended each session, including therapists, mentor families, identified patients, parents, siblings, grandparents, and others close to the child.

    — “Outcomes…” (2006)


  • Parents in each family completed one or two baseline written measures. … These measures included the Achenbach CBCL and Randolph Attachment Disorder Questionnaire (RADQ).

    — “Outcomes…” (2006)


  • The RADQ is a 30-item instrument encompassing the most common adverse symptoms of the CBCL associated with this study’s population. It is widely used by therapists treating families with adopted children diagnosed with RAD

    — “Outcomes…” (2006)


  • Parents tended to fill out the shorter RADQ measure (30 questions) as opposed to the lengthier CBCL measure (120 questions).

    — “Outcomes…” (2006)


  • …[T]he intervention proved to be effective from the parents’ perspective.

    — “Outcomes…” (2006)


  • PPCE Therapy appears to replicate or reinstate the effects of normal early nurturing on the infant…

    — “Outcomes…” (2006)


    • ACT Home AT Proponents Disclaimer