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THE CONNECTING TOUCH


 


Las relaciones humanas son más llevaderas cuando hay música.

 

~ Andrés Obando ~

 

(Human relationships are more bearable when there is music.)

 

 

For human infants, thriving is not simply a matter of getting enough calories, warmth, and other necessities of life, but also requires emotional and social nourishment. Caregivers are needed to provide warm affection and kindness. The physical health of children depended on it. 


Humans are übersocial animals. Being socially connected is essential for health, well-being, and happiness. Being immersed in a social environment with friends and loved ones is a default assumption of the human mind. We are born to belong.

 

Today, the need to maintain social connections is born out in public health data. Astoundingly, the data shows that having only a few friends or close acquaintances is more likely to make you ill and cause your death than such obvious health risks as smoking and obesity. Relatedly, socially isolated adults are more likely to smoke, less likely to exercise, and eat fewer fruits and vegetables. A large-scale survey of nearly 7,000 adults in the San Francisco Bay Area found that over a nine-year period, the risk of all causes of death—that is, the chance of dying for any reason—was more than twice as high for people with the fewest social ties as those with the most. Similarly, people lacking social relationships, in the form of weak social support or in stressful marriages—are at greater risk for cancer, diabetes, and cardiovascular disease. 

Psychologist Julianne Holt-Lunstad at Brigham Young University has recently brought the ill effects of loneliness into national focus. In a ground-breaking 2010 study, she and her team assessed mortality data for more than 300,000 people followed for an average of 7.5 years. People with adequate social relationships—as in being integrated into a social network—had a 50 percent greater likelihood of survival during this period than people whose social relationships were lacking. On average, people with strong social relationships lived 3.7 years longer than less socially connected people. In fact, loneliness was found to be a greater mortality risk than smoking, excessive drinking, lack of exercise, obesity and air pollution. “The overall effect remained consistent across a number of factors, including age, sex, initial health status, follow-up period, and cause of death, suggesting that the association between social relationships and mortality may be general, and efforts to reduce risk should not be isolated to subgroups such as the elderly,” she and her colleagues wrote. Several years later, her team followed up with an analysis of 3.4 million people worldwide, again finding similar mortality rates. Across the globe, and across demographics, isolation killed. “We wanted to know: Does it vary by country (It does not!)? Does it vary by cause of death (Doesn’t matter!)? Is it stronger for men vs. women (Equally strong!)?” she said in an interview. “This was a snapshot of real life, right? With implications for real-life health outcomes.” 


Just like the infants in the foundling homes of the 20th century, adults in the 21st century are in deep need of care. Holt-Lunstad compared the devastation of social isolation to the paradigm shift that came with the discovery of hospitalism, its mechanisms, and its treatment through bonding and affection. “To draw a parallel, many decades ago high mortality rates were observed among infants in custodial care (i.e., orphanages), even when controlling for pre-existing health conditions and medical treatment. Lack of human contact predicted mortality. The medical profession was stunned to learn that infants would die without social interaction. This single finding, so simplistic in hindsight, was responsible for changes in practice and policy that markedly decreased mortality rates in custodial care settings. Contemporary medicine could similarly benefit from acknowledging the data: Social relationships influence the health outcomes of adults.” 


While Western, and especially American, culture may venerate rugged individualism and self-expression, people in contemporary society depend on other people to survive, just as it’s been through human history. The notion of “the individual” is a relatively modern invention, making its first stirrings in the writings of medieval Christian philosophers like St. Anselm and William of Ockham, and reaching its perhaps final form in free-thinking European Enlightenment. The word individualism itself was not coined until 1815. For the course of human history, the social group, the clan, the religious sanctums, the state—these have been the fundamental elements of society. Our lives depend on other people, not just on the nuclear family but the larger communal group. 


The isolated way of life due to lockdowns and social distances has been a boon in manifold ways and also a curse too. While it has helped us take stock of our priorities it has also robbed us of the very basic human needs – touch, warmth, being around those who matter and throughout this essay we shall explore rather lightly human ecology: how we fit into our environments and what they afford to us, the interplay of which is expressed in perception. Affordances are not only physical; they are also social. Other people offer possibilities for good (love, affection, support) and ill (threat, abuse, social anxiety). The brain reflects these social affordances. Through the course of evolution, the structures of social pain scaffolded off those for physical pain, providing one of the primary imperatives of our lives: the drive to belong and be loved. To be embodied means not only being able to hold a stone but also being able to hold a hand. The most intimate of social relationships are built through touch. 


The university of Wisconsin psychologist Harry Harlow began a seminal 1958 paper on the importance of touch by commenting on the huge disconnect between the centrality of love in everyday life and its lack of study within research psychology. In the 1950s, psychologists assumed that animals, including us, were motivated by basic biological drives (like hunger, thirst, and pain) that motivated behaviours needed for survival (like eating, drinking, and withdrawing from sources of pain). So, where does love come from and the desire for social affiliation? Psychologists at the time surmised that we learn affection by becoming attracted to the caregiver who provides sustenance. Infants desire milk, caregivers provide milk, and thus over time infants learn to desire caregivers, or so the story went. But this story did not sit well with what Harlow observed in his laboratory. In studies with infant macaque monkeys, he found that they grew attached to the cloth pads that lined their cages, hanging on to them and throwing tantrums when they were taken out to be cleaned. Conversely, a baby monkey raised on a barren wire-mesh floor “survives with difficulty, if at all” the first five days of their lives. This observation sparked the insight that contact comfort might be as important for infant health and well-being as basic biological needs. In what has become an iconic experiment, Harlow’s team built two artificial mothers that stood in for the infant monkeys’ real mothers. One mother was made of wood, covered by sponge rubber, and wrapped in terry cloth, with a light bulb radiating heat behind her. The other was made with wire mesh and a light bulb. One warm and fuzzy; the other warm and metallic. For four monkeys, the cloth mother possessed a nipple that lactated, whereas for four others, the wire-mesh mother had the lactating nipple. The striking finding: in both groups, the infant spent 12 or more hours a day on the cloth mother, for the full 160 days of testing, with less than one hour spent on the wire mother—even if she was the source of food. This flew in the face of what had become received psychological wisdom: that nourishment drove behaviour, with affection being an acquired outcome of feeding. Contrary to such views, it became abundantly clear that tactile comfort was deeply desired by infant monkeys regardless of whether it had been associated with food. “We were not surprised to discover that contact comfort was an important basic affectional or love variable,” Harlow observed. “But we did not expect it to overshadow so completely the variable of nursing; indeed, the disparity is so great as to suggest that the primary function of nursing as an affectional variable is that of insuring frequent and intimate body contact of the infant with the mother.” What is true for macaque monkeys must surely also apply to people, Harlow concluded, and hence he added: “Certainly, man cannot live by milk alone.” From the start, humans, like other primates, need to be touched and it is that very lack of to touch and be touched has resulted in a suffering of individuals during the pandemic, and the question is – will such people ever fully recover?


Over a good part of 2020 I observed people introducing pets into their homes at an alarming rate, but there is only so much a dog or cat can do, even if they think that it might be something that is saving them from the internal pandemic of lack of touch of a real person. I spoke to a friend in London and she said that ever since she has been home-bound, the most that she misses is the smell of her friends, the taste of her lover. “The human body has built all its models based on touch received from caregivers,” says Dr Katerina Fotopoulou, a professor of psychodynamic neuroscience at University College London. “We’re utterly reliant on the caregiver to satisfy the body’s core needs. Little can be done without touch.”

Nina is 40, and lives alone in south London. She experienced a protracted recovery after a spinal injury in 2018, requiring long periods of bed rest. People visited, but her pain levels meant that being touched was difficult. She felt she had good foresight for how to prepare for the first lockdown. “I thought I knew how it would play out,” she says over Zoom. “For example, I knew how strict I had to be about the routine of going for walks; you always feel slightly better having taken in different surroundings.” But after six weeks, her resolve started to crumble. “The isolation I’d already experienced made me more vulnerable than I’d realised. I tried to keep myself in a routine but …” she begins to cry. “At some point, not being able to have a hug was genuinely torturous. I don’t believe the government considered the impact of the first lockdown on people living alone.”

As adults, we may not comprehend the importance of touch even when it disappears. “We might begin to realise that something is missing, but we won’t always know that it’s touch,” says Prof Francis McGlone, a neuroscientist based at Liverpool John Moores University and a leader in the field of affective touch. “But when we talk about the problem of loneliness, we often ignore the obvious: what lonely people aren’t getting is touch.” 

Touch has a huge impact on our psychological and physical wellbeing, says Prof Robin Dunbar, an evolutionary psychologist at the University of Oxford. “With our close friends and family, we touch each other more than we realise,” he says. As adults, Dunbar’s research has found, we have a core set of, on average, five friends who we can call on as a shoulder to cry on. “We see exactly the same thing in primates,” he says. “Even in much bigger primate societies, groups of five best friends appear at every layer, who do all their grooming together – their form of social touch. In primates and humans, these intense coalitions act as a buffer; they keep the world off your back.” It is unsurprising, then, that of the 40,000 people from 112 countries who took part in a 2020 BBC and Wellcome Collection survey, the three most common words used to describe touch were: “comforting”, “warm” and “love”.

As the pandemic continues, many of us will be trying to cope with profound stress without the comfort of touch. We all have different needs and boundaries (McGlone says “not everyone suffers from a lack of touch; I don’t really like being cuddled, and drive my poor wife nuts”), but the total absence of touch, particularly when emotions are high, contravenes the hardwiring that regulates us from our preverbal years.

“Touch is a modulator that can temper the effects of stress and pain, physical and emotional. We have seen in our research that a lack of touch is associated with greater anxiety,” says Fotopoulou. “In times of high stress – the loss of a job, or a bereavement, for example – having more touch from others helps us cope better, particularly in calming the effects of [the stress hormone’ cortisol.” Even if we’re used to not being touched a lot, after a while the need can feel very physical – sometimes described as “skin hunger” or “touch hunger”.

While I can empathise with the exhausting monotony my friends with young families have described to me (and I know that the grass is always greener), I have felt the lack of belonging to a pack acutely. Claire Birke, a teacher from Edinburgh, has felt it, too: “I’m 37, and most of my friends are living with partners or children,” she says. “I have never felt more aware of my single status, nor the lack of intimate bodily contact, in my life.”

The number of people living on their own has only been swelling up around the world. The sliver of sociability that came with social bubbles being announced has felt life-saving. Smith has been “bubbling” with a couple who live together and says it has helped with her mood. But the days are long, and her friends “are not particularly tactile”.

“I realise how much I touch people without thinking,” she says. “I feel like I am holding all this emotion in my body with nowhere to put it.”

In high-stress states, it can feel as if our bodies can barely contain our emotion if there’s no one there to hold us. “Lots of studies support the theory that touch gives the brain a signal that it can delegate its resources for coping because someone else is there to bear the brunt. This relaxes the body, going some way to restoring the stress budget, if you like,” says Fotopoulou. But touch is not a single sense. The two square metres of skin that contain us are teeming with nerve fibres that recognise temperature, texture and itch, etcetera. One set of fibres exists purely to register gentle, stroking touch: the C tactile afferents (CTs). McGlone has been studying this since 1995, when it was discovered in humans. “These neurons, in the skin of all social mammals, transmit slow electrical signals to the emotional processing parts of the brain. They play a critical role in developing the social brain and our ability to withstand stress.”

The highest density of CTs across the body are in the parts we can’t “groom” ourselves, such as the shoulders and back. “If you love having your back rubbed it’s because there are more CTs there,” says McGlone. “Stimulation of these neurons releases oxytocin and dopamine, and has a direct impact on cortisol levels, which regulates our mood.” In 2017, Fotopoulou’s team published a study that showed even gentle, slow stroking from a stranger can reduce feelings of social exclusion. But in our normal lives, we’re not going round stroking each other all the time. “No, you don’t need that touch all day,” McGlone says. “We only need this gentle kind of touch intermittently.”

In these times of touch deprivation there is no real substitute for what we get from other humans, but there are ways to soothe ourselves. Fotopoulou’s lab will soon publish a study conducted during the pandemic that builds on the theory that, in the same way we think we can feel others’ pain, we may be able to experience touch vicariously, too. Researchers have found that seeing touch (on the telly or in films, for example) – particularly social, affective or pet touch – can give us some of the benefits of feeling touch. “This is called ‘vicarious touch’,” says Fotopoulou. “The brain codes multisensory experiences in multiple ways. We can also ‘feel’ the pain and pleasures of others just by ‘seeing’ them,” she says. “This is not a permanent or complete substitute, but a partial one.”

Products such as weighted blankets can help. Smith says that laying one across her chest and shoulders makes her feel “much calmer” – speaking, perhaps, to an instinctive need to stimulate the CTs. Interacting with animals is also settling. “My neighbour’s cat has decided to live with me half the time and having her sat on my chest, purring, is so soothing.”

This resonated: the warmth of my dog’s back under my hand has been the most grounding thing for me over the last 12 months. I know this feels good, but why? “When you’re stroking your dog, you’re engaging systems that would be activated if the dog was stroking you,” says McGlone. 


A hunger for touch is a signal that a primitive need is not being met. But evolution is on our side. Every scientist I spoke to was hopeful that, once we can come together again, we will adjust quickly. “It will differ between people, probably based on the duration people have been alone, and there may be a period of clumsiness and renegotiation,” says Dunbar. “But we have evolved to adapt.”

 

 

 

 

Some references from Perception - How Our Bodies Shape Our Minds by Dennis Proffitt, Drake Baer, and Hormonal: A Conversation About Women’s Bodies, Mental Health and Why We Need to Be Heard by Eleanor Morgan 

 

 


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