Physical touch is fundamental to humans, and many other species. The current COVID-19 pandemic has put severe restrictions on touching, and it may have a long-term negative impact on our well-being.
Physical distancing and the widespread practice of non-touching has accompanied our response to preventing the spread of COVID-19. Beyond intimate relationships, even Platonic physical touch among friends virtually stopped. Hugs, high-fives, friendly pats on the back, shaking hands, kissing, and even sexual contact breached the physical distancing “rules ” recommended or even mandated by health professionals. People used to regular physical contact have altered their physical contact behaviors, including that at family gatherings, weddings, funerals and outdoor activities and church services. Some of that has slowly been reintroduced as the success of the COVID-19 vaccines took effect, but many people are still hesitant to resume physical contact.
It’s even more of a problem for COVID-19 patients, who are often put in isolation, separated from loved ones and devoid of physical contact with health care workers because of the requirement for Personal Protective Equipment.
Research has shown that positive human touch is an integral part of human interaction. “Human beings are wired to touch and be touched. When a child is born, that is how they bond with their mother — through touch,” said Asim Shah, M.D., professor and executive vice chair of the Menninger Department of Psychiatry at Baylor College of Medicine. “Our wiring system has touch everywhere, so it’s difficult for us not to think about physical contact.”
Around 1800, a creature was sighted running through the forests of Southern France. Once captured, scientists determined was a young boy aged 11, and had run wild in the forests for much of his childhood. One of the fathers of psychiatry in France at that time, Phillipe Pinel, observed the child — named “Victor” — and concluded, erroneously, that the Victor was of limited mental capacity. A French physician attending Victor, disagreed with Pinel, concluding that the child had merely been deprived of human physical touch, which had retarded his social and developmental capacities.
More than 200 years later, Romanian dictator Nicolae Ceausescu, the general secretary of the Romanian Communist Party from 1965 to 1989, and the second and last Communist leader of Romania, instituted a mandated program in which abortion and birth control were outlawed. He also demanded that all women bear at least five children in an effort to create a country of “worker bees” that would support the communist state. Invasive investigations of women were conducted at workplaces and elsewhere to track their individual progress in making babies. Ceausescu’s government arranged to raise the children whose parents were too poor or incapable of caring for them in a large number of orphanages. But many thought their babies would have a better life if given up — or that they had the option of collecting them later if they found the means to properly care for them.
At the age of three years the children were medically examined. Disabled and orphaned children were in huge numbers brought into orphanages or psychiatric hospitals, where they lived under inhumane conditions. Many children died within a few weeks because of disease or hunger.
After Ceausescu’s overthrow, the world was shocked to see severe underdevelopment, like the French boy Victor, in the orphans’ social skills and values. The commonality for all these orphans was a lack of human physical touch by adults, particularly of the loving, nurturing kind.
Fortunately Ceausescu’s brutal reign didn’t last, but the damage to large numbers of children and women had already taken place.
The lesson here was when physical contact becomes limited — or worse, eliminated — people can develop a condition called touch starvation or touch deprivation.
“When someone is [touch] starved, it’s like someone who is starved for food,” Shah said in a news release by the Texas Medical Center, “They want to eat, but they can’t. Their psyche and their body want to touch someone, but they can’t do it because of the fear associated with, in this case, the pandemic.”
Research studies have shown that touch starvation can trigger a cascade of negative physiological effects including stress, depression and anxiety. The body releases the hormone cortisol as a response to stress, activating the body’s “flight-or-fight” response. This can result in an increase heart rate, blood pressure, respiration and muscle tension. Touch starvation can also suppress the digestive system and immune system — increasing the risk of infection.
People who are stressed or depressed, perhaps because of lack of touch, will have problems sleeping, Shah said.“Every single medical disease including heart attack, diabetes, hypertension, asthma is altered if you are more anxious, more depressed or if you have more mental health issues.”
Long term, Shah added, going an extended period without positive physical touch can even lead to post-traumatic stress disorder.
Physical Touch Through The Ages
Humans throughout history have experienced cold feet at night when sleeping. During the Middle Ages, people solved this problem. They had large beds (particularly the nobility) that allowed a man, his wife, their children, and for the wealthy, some servants, and his knights to sleep together in the dead of winter to stay warm. Unknown to them it also provided positive reinforcement to aid in psychological and emotional health. Since then, with the improvements in heating our abodes, and having separate physical housing, various forms of interpersonal touch have become less and less common.
Even before COVID-19, we have increasingly viewed touch as unhygienic and even invasive, as in the case of sexual harassment, for example. And sequestering ourselves behind phones and laptop screens has only exacerbated the trend.
Given that interpersonal touch is increasingly becoming less common, it is important to ask how touch influences our lives. Why is touching and being touched by others so important to us? New research suggests that even fleeting forms of touch may have a powerful impact on our emotional and social functioning. For instance, people can communicate distinct emotions such as anger or sadness through touch. Moreover, people who are touched briefly on the arm or shoulder are more likely to comply with requests such as volunteering for charity activities.
What are the benefits of physical touch?
Our skin is the largest organ in the human body, covering us from head to toe.
A 2018 study by scientists at the Medical College of Wisconsin in Milwaukee found that skin communicates positive and negative touch stimuli to our sensory neurons.
The outermost layer of our skin, the epidermis, is predominantly made up of billions of a certain kind of cells which release a chemical called adenosine triphosphate (ATP), which activates receptors on the sensory nerve to convey the sensation of touch to the brain.
Also, when we feel a friendly touch on our skin, our brains release oxytocin, a neuropeptide involved in increasing positive, feel-good sensations of trust, emotional bonding and social connection, while decreasing fear and anxiety responses in the brain at the same time. For this reason, oxytocin is affectionately known as the “cuddle hormone.”
Our desire for physical contact starts at birth. “If a baby is born prematurely, the baby may be in the NICU [neonatal intensive care unit], but the mother is still asked to go to the NICU a few times a day to hold the baby and put the baby on her chest, even if they’re not breastfeeding,” Shah explained. “We know that this bonding, this human-to-human touch, is important for the growth of that child.” Even as adults, touch helps regulate our digestion and sleep, and even boosts our immune systems.
We know from child developmental research that the absence of physical bonding and healthy attachment between an adult and child may result in life-long emotional disturbances. James W. Prescott, an American developmental psychologist, proposed that the origins of violence in society were related to the lack of mother-child physical bonding.
In the early 1950s, American psychologist Harry Harlow provided a dramatic demonstration of the importance of touch. Using Rhesus monkeys, Harlow set out to study the effect that separation from their mothers has on their offspring. Harlow raised the baby monkeys in isolation in a cage that contained two surrogate “mothers” — one made of metal wire and the other wrapped in terrycloth.
The wire mother contained a bottle from which the monkeys could nurse, but when the monkeys were frightened the baby monkeys would cling to the terrycloth mother even when this led them to dehydrate and starve. Harlow’s monkeys were apparently hungry for something other than food: They were literally starving for a warm, comforting touch. With these studies, Harlow was the first to show that intimate body contact, and not feeding, was the most important factor in mother-child bonding.
Interpersonal touch can also induce oxytocin release among humans. For instance, in one experiment, couples who engaged in a warm touch exercise, during which they touched each other’s neck, shoulders, and hands, had more oxytocin in their saliva than couples who did not engage in this exercise. Likewise, women who report frequent partner hugs display higher levels of oxytocin in their blood than women who report few partner hugs The oxytocin-enhancing effects of touch may reduce the discomfort that people experience from everyday stressors, such as family turmoil or conflict at work.
Studies have shown that mothers’ nurturing touch was found to foster more secure attachment in low birth weight infants nine months later. Furthermore, infants who were tenderly held by their mothers and for longer periods of time were more securely attached than infants who were held reluctantly or awkwardly. Thus, early nurturing touch from caregivers plays a key role in shaping children’s emotional security.
The importance of the soothing effects of touch don’t disappear in adulthood. For instance, there is growing evidence that touch from a romantic partner buffers us against stress. Happily married women who are holding their husband’s hand have smaller threat-related neural responses than when they are holding the hand of a stranger or do not engage in handholding.
People may also obtain the comforting effects of touch from non-human animals such as pets. Even in animate objects appear to have an effect. Some fascinating experiments have shown that people recover more quickly from social rejection when they are holding a teddy bear on their lap
Some particularly provocative studies have examined the effects of touch on courtship behavior. One study took place in a French nightclub. During slow romantic songs, an attractive 20-year-old male went up to a young woman and said, “Hello. My name is Antoine. Do you want to dance?”. When he made his request, the man either touched the woman lightly on her forearm or refrained from touching her.
While 43% of the women who were not touched accepted the invitation, 65% of the women who were touched agreed to dance. In a parallel study, an attractive male tried to obtain phone numbers from young women on the street. Of the women who were not touched, 10% provided their phone number, compared to 19% of the women who were touched. These findings suggest that touch can be a powerful catalyst of romantic liaisons.
Of course now, with heightened awareness of the inappropriateness or dangers in uninvited physical contact, a replicated study today might look quite different.
Equally notable are findings that touch can motivate people to work harder on shared tasks. One recent study on this topic examined touches exchanged between members of basketball teams.
The researchers observed touch behaviors of 294 players from all 30 National Basketball Association (NBA) teams during one game that was played within the first two months of the 2008–2009 season. The focus was on touches among two or more players who were celebrating a positive play that helped their team, including behaviors such as high fives, head slaps, or team huddles. The researchers then related the frequency of these touches to basketball performance during the subsequent NBA season.
The results showed that early season touch predicted season performance. This relation held even when the researchers statistically controlled for player salary, preseason expectations, and early season performance. Indeed, the only measure that could account for the relation between touch and performance was the amount of cooperation that was observed during the game. These findings suggest that touch among basketball players is a strong indicator of trusting and cooperative attitudes, which may facilitate team performance.
Incorporating interpersonal touch in educational and health systems may sometimes be difficult. Educators and health professionals may fear malpractice and abuse charges. Moreover, some individuals may prefer not to be touched, even when they might derive benefits from it. Consequently, it seems useful to look for technological substitutes for interpersonal touch.
The emerging fields of mediated social touch and affective haptics study and design haptic devices and systems that can elicit, enhance, or influence people’s emotions. These efforts have produced devices that can mimic aspects of interpersonal touch, such as the “Huggy Pajama”, a haptic jacket that gives wearers the tactile sensations of a hug whenever a sender hugs a doll-shaped device.
Rather, haptic technology provides touch experiences for individuals who will otherwise remain touch-deprived. For instance, individuals with social anxiety, who find it awkward to be touched by people, may find it acceptable to wear a haptic jacket. Likewise, haptic technology may allow parents to hug their children while at work or traveling. New technological developments may thus enable greater numbers of individuals to reap the social and emotional benefits of interpersonal touch.
Sharon K. Farber, writing in Psychology Today contends “being touched and touching someone else are fundamental modes of human interaction, and increasingly, many people are seeking out their own professional touchers and body arts teachers — chiropractors, physical therapists, Gestalt therapists, Rolfers, the Alexander-technique and Feldenkrais people, massage therapists, martial arts and T’ai Chi Ch’uan instructors. And some even wait in physicians’ offices for a physical examination for ailments that have no organic cause — they wait to be touched.”
Daniel Keltner, the founding director of the Greater Good Science Center and professor of psychology at University of California, Berkeley, says “in recent years, a wave of studies has documented some incredible emotional and physical health benefits that come from touch. This research is suggesting that touch is truly fundamental to human communication, bonding, and health.”
Keltner cites the work of neuroscientist Edmund Ross, who found that physical touch activates the brain’s orbitofrontal cortex, which is linked to feelings of reward and compassion. Keltner contends that “studies show that touch signals safety and trust, it soothes. It activates the body’s vagus nerve, which is intimately involved with our compassion response and a simple touch can trigger release of oxytocin, aka “the love hormone.”
French psychologist Nicolas Guéguen reports in the journal Social Psychology of Education, that when teachers pat students in a friendly way, those students are three times as likely to speak up in class. Another recent study has found that when librarians pat the hand of a student checking out a book, that student says he or she likes the library more — and is more likely to come back.
Touch can even be a therapeutic way to reach some of the most challenging children: Some research by Tiffany Field suggests that children with autism, widely believed to hate being touched, actually love being massaged by a parent or therapist.
Whether we get a friendly slap on the back, a sensual caress, or a loving kiss –interpersonal touch has a powerful impact on our emotions. In fact, our skin contains receptors that directly elicit emotional responses, through stimulation of erogenous zones or nerve endings that respond to pain.
Josh Ackerman, a MIT psychologist, claims that people understand their world through physical experiences, and the first sense is through touch. He says that you can produce changes in peoples’ thoughts through different physical experiences. His study, published in Science magazine, is the latest in the growing field of research called, “embodied cognition,” a field of research that supports the concept of mind-body connection.
Will COVID-19 Mark the End of the Handshake and Hug?
In the midst of a global public health crisis in which hundreds of millions are avoiding physical contact to stop the spread of Covid-19, examining the need for something as ingrained as the handshake suddenly doesn’t seem quite so outlandish.
“When you extend your hand, you’re extending a bioweapon,” says Gregory Poland, infectious disease expert at the Mayo Clinic, one of the largest medical research institutions in the US. He calls it an “outmoded custom and it has no place in a culture that believes in germ theory,” the idea that certain diseases are caused by microorganisms invading the body.
But how can we stop doing something that’s so ingrained? Social distancing seemed impossibly hard to adapt to at first. Could the handshake actually die out? And if it does, what could replace it?
The Negative Impact of Social or Physical Distancing
All over the globe, authorities are encouraging citizens to avoid nonessential close personal contact because coronaviruses of all kinds can be easily spread through skin-to-skin touching. As a result, kisses hello has been temporarily discouraged in countries where they’re traditional; companies worldwide are discouraging and even banning handshakes between associates; places of worship are temporarily modifying traditions that involve interpersonal touching or the use of communal objects.
Why do we shake hands at all?
The handshake has been a practice dating back thousands of years from ancient Greece, Egypt and Babylonia, as depicted in the statues and epic stories. Tradition indicates people are often shown displaying an empty right hand to demonstrate to the other person they’re not carrying a weapon, and so they can be trusted. Other Classical art shows such a gesture being used in marriages, between rulers, and other situations that depict working together or cementing relationships.
Today, shaking hands has become a standard for greeting, particularly in business. “Even though handshakes aren’t literally used to ascertain whether or not the other person is holding weapons anymore, they’ve maintained their signal of showing good intentions,” says Juliana Schroeder, a professor at the University of California, Berkeley who studies psychology and organizational behavior.
“That’s a very important signal in business contexts, where people are often meeting with strangers in highly consequential settings.” Schroeder’s research has shown that people are more willing to work with others who extend their hands for a handshake at the beginning of negotiations than those who don’t. It signals a motive of trust, cooperation and follow-through. This symbol of trust and cooperation is why it’s used as a photo-opportunity at global summits such as the G20.
This is not true in all cultures and countries, however. For example, eople in Japan generally don’t engage in handshaking or hugging but rather use non-physical greetings like bowing. European countries like Italy and France often do the double or triple cheek-kiss (a tradition that’s also drawn scrutiny in the age of coronavirus), rather than the handshake.
But rituals can change as society changes. The Black Plague put a stop to French cheek-kissing for centuries– could handshaking meet the same fate?
Tiziana Casciaro, a professor of organizational behavior at the University of Toronto, says that “handshaking taps into a fundamental drive humans have to establish trust with each other.” But she understands that he is motivated by keeping people safe, and she thinks that after the pandemic, many people might be turned off by handshaking, at least for a while.
“English is the language — today — of business. Therefore, in business, a handshake is the convention,” says Kanina Blanchard, professor and lecturer in management communications at the University of Western Ontario. “[But] if we look at it mathematically, in China, in India, you have half the world’s population for whom, yes, many people shake hands — but everybody does something other than shake hands. Do the math. Other ways of greeting are actually more conventional [than shaking hands].”
Paul Zak, author of The Moral Molecule, conducted a “neuroeconomics” study, published in the journal Evolution and Human Behavior, in which he argues that hugs or handshakes are likely to cause the release of the neurochemical oxytocin, and increase the chances this person will treat you “like family”, even it you’ve just met him or her. Zak argues “We touch to initiate and sustain cooperation.”
Researchers at Carnegie Mellon University concluded based on their study that ugging can also help our bodies fight off infections. according to a 2014 study conducted by researchers at Carnegie Mellon University
Another study found that hugging might lower a person’s susceptibility to infection by viruses that cause the symptoms of a common cold. Touch is “hitting all of the right buttons to affect physiological processes that are critically important to keeping us healthy,” says John Capitanio, a psychologist and primatologist at the University of California, Davis, the main author of the study. The benefits are so great that in the past few years people have begun paying for platonic cuddle time, according to The Washington Post.
According to another research study conducted at the University of North Carolina, women who receive more hugs from their partners have lower heart rates and blood pressure and higher levels of oxytocin. “Hugs strengthen the immune system…The gentle pressure on the sternum and the emotional charge this creates activates the Solar Plexus Chakra. This stimulates the thymus gland, which regulates and balances the body’s production of white blood cells, which keeps you healthy and disease free,” the researchers concluded.
The research also showed the following benefits of hugging:
- It lowers blood pressure, particularly if you are feeling anxious.
- It lowers cortisol (the stress hormone), which enables a higher quality of sleep.
- It increases social connections and a sense of belonging.
- It increases serotonin, a neurotransmitter often associated with feelings of happiness and well-being.
- It helps you relax.
- It can reduce pain levels.
What is “Skin Hunger?”
For those quarantined alone, the lack of human touch can feel agonizing. A neurological phenomenon called “skin hunger” explains why.
“When you touch the skin,” explains Tiffany Field of the Touch Research Institute at the University of Miami, “it stimulates pressure sensors under the skin that send messages to the vagus [a nerve in the brain]. As vagal activity increases, the nervous system slows down, heart rate and blood pressure decrease, and your brain waves show relaxation. Levels of stress hormones such as cortisol are also decreased.”
Without touch, humans deteriorate physically and emotionally. “We know from the literature that lack of touch produces very negative consequences for our well-being,” says Alberto Gallace, a neuroscientist at the University of Milano-Bicocca. “Nature designed this sensory modality to increase our feelings of well-being in social environments. It’s only present in social animals that need to be together to optimize their chances of survival.”
Before the coronavirus pandemic, many developed nations were already at risk of becoming touch-free zones, with no-touch policies now common in schools and public institutions, for safeguarding and litigation reasons. Field’s Touch Research Institute has been working on a global airport study to observe how much people touch each other while waiting to board flights. (The research is currently on pause.) “We observed over 4,000 interactions,” Field says. “The data showed that, at least in public, there is virtually no touching — 98 percent of the time, people are on cell phones.”
“I’m very concerned,” says Field, “because this is actually the time we need human touch the most.” She explains that touch is instrumental in immune function because it reduces our cortisol levels.
Gallace is profoundly concerned: “We use touch for comfort,” she says. “When we are in danger or anxiety, being touched is a form of help.A lack of touch increases the stressfulness of situations.” She explains that studies have shown that people perform tasks better when they are clapped on the back beforehand. “It’s a form of reassurance that goes back to the touch of the caregiver when you were a child,” she says.
“I think we are likely to wash our hands more, and more carefully, for quite a long time to come,” Robert Dingwall, a professor of social sciences at the UK’s Nottingham Trent University, told me. “I don’t think physical distancing will persist,” he added, “although it was already increasing as a result of #MeToo. We probably won’t keep six feet away from others — but I don’t think we will hug them as often as five years ago.”
If the lockdowns last less than six months, the only long-term changes in social behavior might involve increased hygiene, says Texas A&M sociologist and former American Sociological Association President Joe Feagin. “If it lasts 18 months or more, as the more pessimistic forecasts suggest … more substantial changes are likely in both social distancing, social interaction and hygiene,” he says.
Touching in the Workplace
Can a pat on the back or even a hug between colleagues result in increased productivity?
“When that touching is appropriate and wanted, it certainly does,” says David J. Linden, professor of neuroscience at John Hopkins University and editor-in-chief of the Journal of Neurophysiology. His newest book, Touch: The Science of Hand, Heart, and Mind, explores the psychological and psychological basis of touch. “Friendly touching serves as social glue that binds people in the workplace and in the community. It engenders feelings of trust and cooperation. It makes coworkers have more team spirit and more empathy for each other.”
James Coan, a research psychologist at the University of Virginia, who studies the effect of touch on the brain’s response to stress, suggests touch is a way for us to communicate who’s on our team, as well as to “contract out” our stress management. At work, where stress is a constant threat to success, communicating with co-workers through touch might free up our brains — specifically our prefrontal cortexes — to worry about other things we tackle in the course of a day, like decision-making, planning, and finances.
Handshakes, high fives, fist bumps, and even back pats are all part of a healthy workplace, says Alexander Kjerulf, a consultant and author of Happy Hour is 9 to 5: How to Love Your Job, Love Your Life, and Kick Butt at Work. “Touching is very fundamental,” says Kjerulf, who leads workshops worldwide on how to make the workplace happier and more productive; He is also the “chief happiness officer” at Woohoo, the company he founded. “It helps create better relationships at work. It promotes closeness, inclusion, intimacy, and trust among a group of people when their daily interactions also allow them to touch.”
And while a handshake before a meeting is often blamed for spreading germs, recent research indicates there may be an opposite effect: a paper published in December in Psychological Sciencefound that social support can help gird the immune system and better fight off illness. In experiments, hugging accounted for 32% of that social “stress-buffering effect.”
Despite its benefits, touch is something that is often frowned upon in many workplaces — a view people like Kjerulf and Linden believe would change if only companies could understand how beneficial touch can be. While sweeping changes to societal preconceptions of workplace touch may take a while, here are some tips for those who are open to exploring the benefits of touch in their workplace now.
Because of the raised awareness of sexual misconduct, and it’s prevalence in working relationships, the issue of the appropriateness of touching in the workplace is now under close scrutiny. As David Swink pointed out in an article in Psychology Today, “In one observational study of conversations in outdoor cafes in London, Paris, and San Juan, Puerto Rico, the number of casual touches was counted. A total of 189 touches per hour were recorded in San Juan and 110 in Paris. In London, there were zero touches. One would expect to find touch counts that vary significantly between work groups and work professions as well. I have a client with offices in Washington, D.C., and Miami.”
Very little research has been conducted on touch in the workplace. The use of touch in the workplace has often been associated with negative outcomes involving harassment complaints and lawsuits. Unfortunately, the incidence of harassment complaints has not decreased over the last 20 years. While laws protecting employees from unwanted touch and other forms of harassment are necessary, in response, some people develop what researchers call “touch anxiety,” a form of walking on eggshells. This fear of touch can create an unnatural state of human interaction that can have a negative impact on morale and normal conversations, not to mention a reduction in productivity. Could there be a much more positive side to workplace touch?
It will be interesting to see the impact of the lack of touching in the workplace as a result of workers working part-time or full time remotely.
A New Social World?
It’s too early to tell whether the absence of human touch during the pandemic will have long-term consequences. Some groups are particularly vulnerable, like older people living alone, Dunbar says. Playwright Eve Ensler, who now goes by the name V, is worried about how the virus is changing the way we view our bodies. She fears that people are linking human touch with illness. “I think there’s something about going out and seeing people being afraid of each other and afraid of each other’s bodies. Touch is becoming something equated with sickness and death, and that scares me deeply.”
Since COVID-19 vaccinations have lifted some of the physical contact restrictions, we’ve witnessed videos an explosion of people, with pent-up demand for physical contact, return to the bars, stadiums, beaches and other social venues and enthusiastically (and perhaps unwisely) touching each other. With the fears of the return of the virus in the fall and future viruses, it remains to be seen if we’ll see any permanent negative effects from the loss of touch.
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