Indispensable contact. By Laura Crucianelli

Laura Crucianelli, Research Fellow in Neurosciences at the Karolinksa Institute of Stockholm

Touch is the first sense through which we encounter the world and the last to desert us on leaving it. “Touch comes before sight, before speech,” writes Margaret Atwood in her novel The Blind Assassin. “It is the first language and the last, and it always tells the truth.” Our biology bears this out. Human foetuses are covered in soft, fine hair, called lanugo, which appears around the fourth month of pregnancy. Some researchers maintain that these delicate filaments heighten the pleasurable sensations produced by the mother’s amniotic fluid as it flows gently over the skin, anticipating the warm, soothing feeling that the newborn child will experience when hugged.
Touch has always been my favourite sense: a trusted friend, something I can rely on to cheer me up when I am down and fill me with joy when I am lighthearted. As an Italian living abroad for over ten years now, I have often suffered from a sort of “tactile hunger” which has affected my mood and my general wellbeing. In the north of Europe people use social touch much less than they do in the south. Small wonder then that, as a scientist, I have spent the last few years studying touch.
For quite a while, though, touch has been placed, so to speak, off limits: it has not been an easy time for this most important of senses. The pandemic has made it taboo, along with coughing and sneezing in public. While those infected by Covid-19 can lose their sense of smell and taste, touch is the sense that has been snatched from nearly all of us – whether positive or not, symptomatic or not, hospitalized or not. Touch is the sense which has paid the highest price.
But if physical distance is a means of protecting us, it is also a hindrance when treating us. Taking care of another human being almost inevitably means touching them: from looking after their basic needs, such as bathing and dressing them, lifting, assisting and nursing them (contact known as “instrumental touch”) to more affective tactile exchanges, designed to communicate, give comfort and offer support (“expressive touch”). Research in the field of osteopathy and manual therapy, where practioners are working closely with neuroscientists on affective touch, suggests that the beneficial effects of massage therapy go well beyond the specific manoeuvres performed by the therapist: there is something special in the very act of placing one’s hands on the patient’s skin. Without touch there can be no cure.
The current tactile abstinence has come at a time when people had already grown wary of touching each other. Technology has tended to compound this distancing because social networks have become the main source of interaction for children and adolescents. A recent survey has shown that 95 per cent of adolescents have access to a smartphone and 45 per cent admit to being “almost constantly” online.

Touch has been one of the vectors of the pandemic, but it is also part of the cure
This diffidence towards touch also stems from a widespread and growing awareness that it can be used by men to impose their power over women. The #MeToo movement has highlighted the practice: women are expected to allow themselves to be fondled as the price for being given access to certain opportunities. Which is why doctors, nurses, teachers and salesmen are instructed to reduce touch to a minimum. And yet studies suggest that touch improves the quality of our encounters with these professionals and leads us to assess the experience more positively. For example, we may well give a more generous tip to the waiter who touches us on the shoulder when taking our order than to one who keeps his distance.

The cuddle hormone
What makes touch unique among the senses is that it is a shared experience. We can look without being looked at, but we cannot touch without being touched. Right from the start of the pandemic, nurses and doctors talked of how the reciprocity of touch has helped them communicate with their patients. When their protective clothing has prevented them from talking, smiling, or even being seen, they could always pat a shoulder, hold a hand or squeeze an arm so as to reassure patients that they were not alone. Touch is one of the vectors of the pandemic, but, paradoxically, it is also part of the cure. It is the most important means of social bonding, and the good news is that we are born fully equipped to make the best use of it.
Science is now starting to account for why touch is so important. Touching the skin can reduce stress factors such as heart rate, blood pressure and cortisol levels, in adults and children. It prompts the release of oxytocin, a hormone which calms, relaxes and induces a feeling of being at one with the world. Every time we hug a friend or stroke a pet this hormone is released into our body, producing a feeling of wellbeing. So oxytocin seems to strengthen our resolve to make contact and keep in touch with others, thus fostering the development of the socially-oriented human brain. It also plays a key role in our relations with ourselves.
Touch is the first sense to develop and it is mediated by the skin, our largest organ. Very few mammals are born at such an early stage of their development as humans: our motor system is not yet fully developed; we are unable to feed ourselves; we cannot regulate our temperature beyond a certain threshold, and so our survival depends upon others. As babies, being cared for mainly involves physical contact and being held. All the basic activities entail touch: changing nappies, being bathed and fed and, naturally, cuddled. Even after we are over the first months of life, tactile social interaction is crucial for our deveopment. For example, it is well known that postnatal depression impacts negatively on newborns, but the maternal touch can have a positive effect. So encouraging tactile interplay between mothers with depression and their babies can reduce negative outcomes for the infants later on. And the benefits are two-way: skin contact between the newborn and its parent raises oxytocin levels in the mother, the father, and the infant, producing a feeling of wellbeing, promoting a healthy relationship and helping to synchronize the interaction between parent and child.

Recognition through skin contact
Many neuroscientists and psychologists believe that we have a system dedicated exclusively to perceiving social and affective touch, distinct from the one which comes into play when we touch objects. This first system seems to be able to distinguish a touch which is similar to a caress. This is then processed in the insula, an area of the brain concerned with the retention of a sense of self and an awareness of our body. A caressing touch is important not only for our survival but for our cognitive and social development: for instance, right from our earliest years it can affect the way we learn to recognize other people. A study conducted on four month old infants has shown that babies who were delicately caressed by their parents learned to recognize a previously seen face more easily than infants who had been subjected to non-tactile stimulation. It would seem that delicate physical contact can incline a child to pay particular attention to social stimuli such as faces.
In childhood, it is not merely the quantity of tactile stimuli that is important, but their nature and quality. In a recent study, my colleagues and I have shown that babies just twelve months old can distinguish the way in which their mothers touch them in their day-to-day dealings, such as playing together or while sharing a book. Mothers less attuned to the needs of their offspring tended to employ a rougher touch. And the offspring tended to respond likewise.
It is no exaggeration to say that touch is a type of language, one we learn, like our spoken language. We use touch every day to convey our feelings and to tell people that we are frightened, happy, in love, sad, sexually aroused, and much else besides. For our part, we are fairly good at reading other people’s intentions and feelings according to how they touch us. In a recent study, we asked a group of volunteers to try to recognize the emotions and intentions which the experimenter was attempting to communicate by means of touch. The participants were touched at different speeds: more slowly, as generally happens between parents and children, or between lovers; or more quickly, as is usually the case between strangers. We found that the slow, caressing touch tended to communicate love, even when it came from a stranger, while participants were unable to assign any particular significance or emotion to the more hurried contact.

At any age, to feel good we need to touch and be touched.
Exchanging communicative tactile gestures is not just a way of forging social links; it also serves to establish power relationships. In the West, in professional contexts, when people meet for the first time they usually exert a certain pressure in shaking hands. A firm handshake signals competence and trust; we feel the touch of the other person and we wonder: “Do I trust him or her enough to offer them a job?” or “Am I prepared to take this person on as a babysitter for my children?” A study has shown that a firm handshake is the sure sign of a successful job interview, perhaps because it is the first real opportunity to close the physical gap between the two parties.
The language of touch also affects the way in which we relate to ourselves and to our bodies, and this has profound implications for our psychological wellbeing.
This finding, together with the results of other studies, suggests that there is a close link between social touch and mental health. Whatever our age, we need to touch and be touched if we are to feel well.

Digital manipulation
So what happens to our tactile capacity when touching becomes taboo? It is at times when we are most fragile that we have the greatest need to be touched. Everything we know suggests that social touch ought to be encouraged, not inhibited. We need to appreciate the distinctions in order to recognize the dangers, but avoiding all physical contact would be disastrous. The pandemic has given us an idea of what life without touch would be like. Fear of contagion has brought home to us just how much we miss those impulsive embraces, those handshakes, those pats on the shoulder. Physical distancing leaves invisible scars on our skin. It is no accident that most people say that the first thing they want to do once the pandemic is over is “hug their loved ones”.
Touch is so vital that even the language of digital communication is awash with tactile metaphors. We ask to “keep in touch” and confess to being “touched” by the kindness of others. Some researchers have suggested that technology could improve our physical connection with others by prompting new kinds of interpersonal tactile relations by means of hug blankets, kiss screens and caress devices. For example, a team from University College London is looking into whether digital practices such as clicking “likes” and sending emoji – social feedback signals that indicate emotional states – might be extended to include the remote manipulation of different textures and materials. Two people, distant from one another, could each have a device capable of detecting and transmitting tactile feedback: for instance, my sensor could become warm and soft when my partner on the other side of the world is available and wants me to be aware of his or her presence; conversely, it could turn cold and rough if my partner needs to feel my presence. These devices could have multiple applications, especially for people who have difficulty making contact, like the elderly, or people living alone, or children in orphanages. 15 per cent of human beings worldwide live alone, often far from their loved ones, and according to statistics an increasing number of people die alone. It would make a real difference if we were able to feel physically close, even though far apart.
However, these devices should complement, and not be a substitute for, skin-to-skin contact. Nothing can compare with the magic of a moment of intimacy with someone, when touch is often accompanied by a series of other sensory signals such as smell, sound, body temperature. Touch is a pledge of physical and temporal proximity; it says, “we are close and we are here now together”. Unlike other senses that can be digitalized – we can see someone’s face and talk to them via Zoom – to touch we need to be in the same place, at the same time, with another human being. A digitalized version of touch would not allow this sharing of a particular moment in time and space, though it would offer a more limited experience of a true embrace. If I were in a position to hit the pause button and withdraw from someone who is sending me a digital caress, that “feeling of being together with another person”, which is the hallmark of touch, would be lost.
As things stand at the moment, is the idea of a “renaissance of touch” only for the brave and the foolish? I do not believe so, and scientific evidence is clear on this point. Depriving ourselves of touch means losing a lot. We are renouncing one of the most sophisticated languages. We are missing opportunities to make new relationships, and we might even be jeopardizing those we already have. If social relations start to deteriorate, we begin to lose touch even with ourselves. The need for people to be able to touch one another should be recognized as a priority when we come to define the “new normal” in the wake of the pandemic. A better world is often only an embrace away. As a scientist, but also as a human being, I claim the right to touch and to dream of a status quo in which no one will be deprived of physical contact anymore.

(from “ INTERNAZIONALE “, 11 February 2021)