Originally published in Massage & Bodywork magazine, January/February 2009. Copyright 2009. Associated Bodywork and Massage Professionals. All rights reserved.

Attitudes toward touch affect us all. The way a culture understands the role of touch in human lives has a profound impact on the way its people grow, develop, and engage with their physical and social environments. Is touch a necessity or an indulgence? What impact does it have on our physical and psychological health? Is the desire for tactile contact healthy, dysfunctional, or even dangerous?

At various points in time, different societies have come up with very different answers to those questions. For those of us trained as massage therapists and bodyworkers, popular perspectives on touch have a powerful impact on both our personal and professional lives. In this article, we’ll take a close look at human touch from a historical and physiological perspective, exploring a range of views that have held sway in the past and the facts we now know about the role of touch in the human life cycle.

American Attitudes Toward Touch

A critical milestone in this country’s perspective on touch was the 1894 publication of The Care And Feeding Of Children: A Catechism for the Use of Mothers and Children’s Nurses (Appleton and Company). In this book, pediatrician Luther Emmett Holt decried “old-fashioned,” hands-on methods of caring for babies. As Holt’s theories became popular, doctors began to discourage mothers from “spoiling” their infants with too much handling and cuddling. Babies were put on strict feeding schedules; they skipped sleeping in the mother’s bed or even a cradle and went right to their own enormous cribs; they spent most of their days alone; and they were touched only as often as necessary to keep them clean and fed. At most, parents might bestow a kiss on the forehead at bedtime and shake hands in the morning. In the common perception, this was the only way to raise children who would be strong and independent enough to cope with a hard, cruel world. These basic principles remained popular, especially among the upper classes, until around the mid-1950s.

We know now that this approach to child rearing did far more harm than good. As a result of this long-lived fad, generations of people have grown up in this country deprived of loving human touch. Those hardest hit by such misunderstandings were the most vulnerable of human beings: infants.

At the end of the 19th century, orphanages were an everyday part of the American social landscape. Unwanted babies were deposited in these institutions, where modern antiseptic procedures and adequate food seemed to guarantee them a fighting chance for a healthy life. However, about 99 percent of those babies died before they were seven months old.¹ The large majority of them ended up wasting away, but not from infectious diseases or malnutrition. Sterile surroundings didn’t cure them, and having enough food made no difference. These babies died from a completely different kind of deprivation: lack of touch. When babies were removed from these large, impersonal institutions and placed in environments where they received physical nurturing along with formula, the condition reversed. They gained weight and finally began to thrive.

Today, medical authorities recognize that touch is vital for survival in the very young.

We know now that it is not only OK, but actually important to pick up and comfort a crying baby. Nonetheless, we’re still dealing with the repercussions of years and years of “hands-off” training, and our culture continues to struggle with the meaning of touch and the contexts in which touch can be appropriate. As a start, it is helpful to understand how our sense of touch develops, as well as the various ways that healthy touch can influence our early development.

The Role of Touch in Human Development

The sensation of touch actually begins in the womb. The skin, derived from the same cells as the nervous system, is a perfect instrument for collecting information about our surrounding environment long before birth. A fetus will withdraw from the touch of a probe at less than eight weeks of gestation, showing that the link between touch and survival is one of the first and most important protective mechanisms to develop.

In contrast to most other mammals, human babies are born before they are developmentally and physiologically ready—not only are they unable to move around in their environment, they also cannot see clearly or differentiate sounds. As a result, human infants must communicate with the world almost entirely through the skin. Even older babies, who are not yet crawling, use their skin as a way to get information about the world. Watch a baby explore a new toy: the first place it goes is into the baby’s mouth. The baby is not really interested in how the rattle tastes. It happens that a huge number of sensory neurons are in the skin of the lips and tongue, and this is where a baby gets his or her information. Babies put toys in their mouths to find out what they feel like.

Some of the most important messages conveyed by the skin have to do with safety and well-being. Studies show that all babies—perfectly healthy ones and others who suffer from colic, cocaine exposure, AIDS, or abuse—benefit from regular touch. Changes in blood chemistry indicate a reduction in stress, and the babies end up crying less, sleeping more, and being generally easier to soothe. In some hospitals, sick and premature infants who are isolated in sterile environments are given gentle massage therapy for 15 minutes, three times a day. Sometimes they are simply held and rocked by hospital volunteers. Although these babies are given exactly the same amount of food as others, they grow faster, gain more weight, and leave the hospital sooner than their untouched counterparts.

Cross-species studies demonstrate that it’s not just humans who require touch for proper development. For instance, rodents and other lower mammals must be licked by their mothers after birth to stimulate their first bowel excretions; without this stimulation, the babies die. Research also shows that separating baby rats from their mothers causes measurable brain damage: cells in the central nervous system actually degenerate and fall apart without their mothers’ touch. Furthermore, baby rats that are removed from their mothers will in turn not mother their own offspring: early nurturing through touch is vital to the survival of the species.

Consistent nurturing touch in infancy seems to influence later coping skills as well. When placed in a novel situation, young monkeys who have been nurtured tend to show curiosity and a kind of tentative courage. When introduced to a new enclosure, for instance, they will explore it by degrees, frequently retreating to hug the mother’s leg for reassurance. Then they will venture forth again and again until they feel comfortable in their new surroundings. In contrast, baby monkeys that are raised without comforting, nurturing touch are easily overwhelmed by new experiences. Placed in an unfamiliar environment without a sense of safety, they simply collapse in hysterical screams. They can’t cope with challenging or threatening situations in the same way that their touched and comforted counterparts can.

Although we can’t conduct studies on touch deprivation with human babies, we can look at the differences in cultural attitudes toward infants and how those attitudes are reflected in patterns of adult behavior. Cultural statistics show that children who are welcomed with lots of physical touch and tactile stimulation tend to grow into well-adjusted, capable, and loving adults, while children who are touch-deprived in infancy show tendencies toward aggressiveness and violent behavior. Naturally, there are countless other variables that influence human behavior besides how we are touched as babies. But it does make sense that during this most vulnerable time of our lives, we would form strong expectations about how the world works—specifically, about how safe and valued we are in the world—through our skins.

How Touch Affects Adult Physiology

Of course, the importance of touch does not end in infancy or childhood. Human touch has a powerful effect on the way the body functions throughout the lifespan. From heart rate to blood pressure to the efficiency of the digestive system, healthy touch can make the body work better.

When our skin comes into contact with other human skin—or with any other tactile stimulus—sensory information races to the brain. The brain interprets that information and creates a corresponding response in the body. If the stimulus is soothing and welcome, the effect will be relaxing and pleasurable (a parasympathetic nervous system response); if it is perceived as threatening, the effect will be anxiety-provoking and upsetting (a sympathetic nervous system response). A parasympathetic response from being touched will lower our blood pressure, increase digestion, deepen our breathing, and generally make us feel more at ease, while a sympathetic response will have the opposite effect. So, typically, a person’s body will tense up when slapped and relax when given a foot rub. However, there is often wide variation in individual responses to particular sorts of contact. It all comes down to how the stimulus is interpreted.

Interpreting a tactile stimulus is a complex matter. When we receive touch, we go through largely unconscious processes to determine the meaning of that specific contact. According to research done by Heslin and Alper, a variety of different factors influence our response:²

• What part of the body touched me.
• What part of my body is touched.
• How long the touch lasts.
• How much pressure is used.
• Whether there is movement after contact is made.
• If anyone else is present to witness the touch, and if so, who.
• The relationship between myself and the person who touched me.
• The situation we are in.

There are several other components that Heslin and Alper didn’t mention that are probably important as well:

• The verbal exchange that accompanied the touch.
• Any other nonverbal behaviors.
• My prior experiences with touch or with the person who has touched me.

We all like to be touched by some people but not by others. While one person’s touch makes us feel warm, cared for, and safe, another’s may make us feel cold, queasy, and threatened. Most of us have had the experience of unexpectedly feeling violated by a person’s touch. This holds true for friends, coworkers, acquaintances, healthcare providers, and touch practitioners.

Thus, it is quite a complicated process that we each go through simply to determine if a touch is a positive or negative experience. Add to this equation the familial, ethnic, and even regional differences in norms regarding touch, and then combine prevailing cultural and gender differences, and it is easy to see how “touchy” this experience is for us. (In a future article, we’ll look at how confusion about intimacy and sexuality creates even further complications.)

Finding The Right Touch

Though it may sometimes be challenging for an individual to find the right type of touch to bring support, relaxation, and healing, the rewards are worth the effort. Study after study shows that receiving touch that is pleasurable, safe, and appropriate reduces sickness, depression, and aggressive behaviors. In fact, as time goes on, we may find that therapeutic touch and massage hold more answers than we ever imagined. Dr. James Prescott, a developmental neurophysiologist at the National Institute of Child Health and Human Development says, “I am convinced that deprivation of sensory pleasure is the principal root cause of violence, and, further, that there exists a reciprocal relationship: the presence of one inhibits the existence of another ... I believe that the deprivation of body touch, contact, and movement are the basic causes of a number of emotional disturbances which include depressive and autistic behaviors, hyperactivity, sexual aberrations, drug abuse, violence, and aggression.”³

As bodyworkers and massage therapists, we have a vital role to play in communicating the value of therapeutic touch and making it more widely available to those who could benefit from it. We can also use what we know to help the people we care about most—making sure that nurturing touch is an integral part of life for our infants, our children, our teenagers, our elders, and ourselves. With every step we take in this direction, we’re advancing not just individual physical and psychological health, but the health and well-being of our society as a whole.

Ben E. Benjamin, PhD, holds a doctorate in education and sports medicine. He is founder of the Muscular Therapy Institute. Benjamin has been in private practice for more than 45 years and has taught communication skills as a trainer and coach for more than 25 years. He teaches extensively across the country on topics including SAVI communications, ethics, and orthopedic massage, and is the author of Listen to Your Pain, Are You Tense? and Exercise Without Injury and coauthor of The Ethics of Touch. He can be contacted at bbby@mtti.com

Ruth Werner is a writer and educator who teaches several courses at the Myotherapy College of Utah and is approved by the NCTMB as a provider of continuing education. She wrote A Massage Therapist’s Guide to Pathology (Lippincott Williams & Wilkins, 2009), now in its fourth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com.

Daphne Chellos, MA, LPC, was named a pioneer in the field of sexual ethics by the Bodywork Entrepreneur in 1991. She is a faculty member at Naropa University and has a psychotherapy practice in Boulder, Colorado.

NOTES

1. Deane Juhan, Job’s Body: A Handbook for Bodyworkers (Barrytown, NY: Station Hill Press, 1971), 43.
2. Richard Heslin and Tari Alper, “Touch: A Bonding Gesture,” in J.M. Wiemann & R.P. Harrison (eds.) Nonverbal Interaction (Beverly Hills, CA: Sage, 1983), 47–75.
3. Ashley Montagu, Touching: The Human Significance of the Skin (New York: Columbia University Press, 1971), 225.