The pandemic has resulted in the removal of little warm, daily forms of interaction such as handshakes, pats, hugs, squeezes and strokes which on their own do not amount to much. However, I don’t know about you, but I’m starting to miss them in daily life with people I don’t live with. Have you not wanted to hug the elderly 99-year old whose first trip out of his house for a year was to see you in clinic?
What is “skin hunger”?
It’s a term I came across while reading an article in one of the February editions of The Economist.
[You’ve lost that lovin’ feeling. The Economist, February 20th 2021, pages 50-51.]
It is basically a state in which people experience less touch than they want. The evidence seems to show that skin hunger or deprivation of touch is linked to loneliness, depression, stress, mood and anxiety disorders and aggression. There is evidence that touch is required for social cohesion.
[Feldman R, Singer M, Zagoory O. Touch attenuates infants’ physiological reactivity to stress. Dev Sci 2010;13(2):271-8.]
[Field T. Violence and touch deprivation in adolescents. Adolescence 2002;37(148):735-49.]
[Jablonski NG. Social and affective touch in primates and its role in the evolution of social cohesion. Neuroscience 2020;S0306-4522(20)30740-5.]
Early touch is extremely important too…
Yes, skin-to-skin contact immediately following delivery is common practice for babies born at term. There have been numerous studies showing that it improves heart and lung function, helps with early bonding and promotes breastfeeding.
[Stevens J, Schmied V, Burns E et al. Immediate or early skin-to-skin contact after a Caesarean section: a review of the literature. Matern Child Nutr 2014;10(4):456-73.]
The authors also comment on a study from 1986 in premature babies born in the US who were given massages for 10 days after birth. These babies gained weight more quickly and left intensive care sooner than those not massaged regularly. Their physical and cognitive development one year later was also better.
Children deprived of touch and who are not cuddled go on to develop a range of developmental problems and develop some cognitive skills later than their cuddled peers.
Why is touch so important?
Well, humans evolved to live in groups. The article goes on to explain that humans have developed a neurobiological system which is designed to respond to affectionate touch. Skin stimulation at a certain pressure and speed, like a caress, activates a dedicated nerve fibre in the skin which in turn lights up a specific area in the brain responsible for pleasure. This then releases a mixture of hormones such as dopamine, serotonin and oxytocin which make us feel happier and reduce anxiety.
But I’m not that bothered about not touching other people!
The article touches (haha!) on this too.
Certain societies are more reserved anyway and so may not have noticed any effect of the pandemic.
I thought it interesting to read about the observations of a psychologist at the University of Florida who observed the behaviour of couples in coffee shops around the world in the 1960’s. He noted that couples in Paris and Puerto Rico touched each other 110 to 180 times in one hour, whereas those in Florida just touched each other twice. Those in London didn’t touch each other at all!
Dr Tiffany Field, director of the Touch Research Institute at the Miller School of Medicine, University of Miami did a study in April 2020 which suggests that Americans were suffering from skin hunger before the pandemic started. Only one fifth of American adults admitted to touching their children frequently. Many American schools have banned teachers from touching pupils. In the UK, school teachers are not allowed to apply emollients or sunscreens to children either. Physical contact in offices is rare also, partly due to the MeToo movement. Many more people now live alone than ever before and we are all spending more and more time online.
So what can be done?
Before the pandemic, there were things like cuddle parties in the US, touch counselling in Japan where new mothers, nurses and nursery teachers were instructed in the art of “skinship” – clasping hands, hugging and stroking to “deepen the bond and trust with others.” There are also cuddle therapists around the world.
In the pandemic, this is obviously difficult. The authors discuss how cuddle therapists are trying to evoke the sensation of touch through words or imaginations. There have been huge surges in the sale of massage chairs in China and shirts have been developed which contain haptic sensors, which when activated, can give the sensation of a hug.
So if you haven’t given your children, partner, dog or bird a cuddle today, go do it now! If you’re alone, then you are in fact, not alone in this respect and there are things around that can help.
Dr Sandy Flann, Consultant Dermatologist.