Miracles leader Smokey Robinson wrote this song while thinking about Sam Cooke's "Bring It On Home To Me." Cooke would sometimes perform at Robinson's church with his group the Soul Stirrers, and Smokey was a big fan. Cooke's song finds the singer apologizing to his girl after casting her off, promising to treat her right if she comes back. "You've Really Got A Hold On Me" is the same sentiment but with the roles reversed: the girl mistreats the guy, but he loves her unconditionally.
Smokey Robinson wrote this song when he was in New York City negotiating a publishing deal, and not pleased with the way the talks were going. He says that he wrote the song in his hotel room with the intention of writing something controversial, which he accomplished with the first line: "I don't like you, but I love you." Such a conflicted and unhealthy sentiment was rarely heard in songs of this era.
When Motown was growing into a dominant label in 1962, they set up a tour where many of their acts performed together around the United States. For many people, this was their first look at Motown acts like The Supremes, Stevie Wonder and Marvin Gaye. This was the biggest Motown hit at the time, so The Miracles closed the shows with it.
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