Are you missing out on touch?
Recently I was re-reading ‘The science of interpersonal touch’ by Gallace and Spence (2010) and several thoughts struck me. This excellent review considers the importance of touch for emotional wellbeing, child development, communication, stress reduction and the cultivation of relationships. A good chunk of work over the last 5 years in particular has shown that by design it seems, we touch and for very good reasons. We could even say that we need touch.
Consider the significant body of work that describes the purpose and benefits of social grooming. Primate studies tell us that being the groomer is distinctly healthy. Perhaps this is one reason why manual therapists (physiotherapists, osteopaths, massage therapists etc) enjoy their work with other people, within a greater purpose of contributing to someone’s life in a positive way.
So, with all this knowledge of benefit and the experiences to match, why is it that so many people are missing out on touch?
Why are people missing out on touch?
A number of reasons have been suggested. They include being isolated, the fear of accusations of inappropriate touch (e.g./ workplace, schools), use of devices for communication instead of in person, and in the population of people I see clinically, the concern about making the pain worse or a partner not knowing what they can do. Is it also the case that as we get older, in some cases physical contact between partners lessens?
An important caveat here is that touch per se is just that; an action with physiological underpinnings and responses. Then we have meaning and context, which is individual. My wife placing her hand on my knee and a stranger doing so are both examples of touch, yet the meaning and context is very different. The meaning is created by past experiences (priors) and learning over the years about touch: what have been my experiences of touch? What have they meant in the past? Soothing, comforting, expressions of love and compassion, or something else?
In our work as therapists and clinicians touch is common. It is expected in most cases — this is the context. However, we have to be aware that for some people touch has not been positive and is instead associated with trauma. Of course touch, bodywork and body awareness can play a role in addressing trauma, a very important topic beyond the scope of this article.
Reframing the question:
How can we promote touch as a healthy part of development, supporting and encouraging others and building relationships?
My approach to this problem begins by appreciating humans at their best, and hence asking a different question (above). We often focus on the problem rather than talking about what we envision as a successful outcome. Turning this on its head means that we immediately begin a dialogue to voice what works, what we can achieve and begin to turn the wheel of creativity towards a positive solution.
First of all we can do just that: have positive conversations when we talk about what touch can do for us. At a recent Pain Coach Workshop that I was running, in response to the section on touch, a participant who works as a physio on the wards was telling me about the use of touch post-operatively in the past. This appears to be disappearing as a mode of soothing and encouragement, being replaced instead with protocol. The question is: how can both be used together to benefit the patient?
Having positive conversations
There is a sizeable body of research on the effects of touch and the different types of touch — see the work of Tiffany Field and Francis McGlone for example. We can use this to understand the effects we see: people feeling calmer, moving with greater ease, changes in state and mood. I routinely incorporate different forms of touch therapy within sessions (chronic pain is the remit of my clinics), most often seeking to enable the person to experience their body in a positive state. We then build on this by practicing a range of exercises and techniques so that they can replicate these positive or resourceful states in their own world.
A further way to create good experiences and evidence of getting better is to involve partners and family. Often they do not know what to do, which can cause further stress — relationships are commonly strained in chronic pain. Creating a way that two people can work together towards a common goal is a positive step. Using touch as a means to bring people closer and re-discover intimacy that may have been lost typically elevates the energy and mood of both. There are simple ways of doing this each day, integrating it into other practices or using touch as a primer for other exercises, or merely for relaxation and soothing of an evening. Once the basic and simple principles are explained and practiced in-session, they can use their imagination.
Touch is a most human of activities that we are at risk of losing. Instead we should be promoting the use of touch as a means of healthy communication, compassion and self-compassion (self-touch) and of nurturing relationships. Physical therapists are in a great position to do so.
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