Monday 1 February 2021

Lost touch: how a year without hugs affects our mental health

 Humans are designed to touch and be touched – which is why so many who live on their own have suffered during the pandemic. Will we ever fully recover?

There’s only so much a dog can do, even if that is a lot. I live alone with my staffy, and by week eight of the first lockdown she was rolling her eyes at my ever-tightening clutch. I had been sofa-bound with Covid and its after-effects before lockdown was announced, then spring and summer passed without any meaningful touch from another person. I missed the smell of my friends’ clothes and my nephew’s hair, but, more than anything, I missed the groundedness only another human body can bring. The ache in my solar plexus that married these thoughts often caught me off guard.


The need for touch exists below the horizon of consciousness. Before birth, when the amniotic fluid in the womb swirls around us and the foetal nervous system can distinguish our own body from our mother’s, our entire concept of self is rooted in touch. “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.”


‘At some point, not being able to have a hug was genuinely torturous.’ Illustration: Sergiy Maidukov/The Guardian



Nina Smith 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.”


I feel like I am holding all this emotion in my body with nowhere to put it


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 in the UK living on their own went up by 16% to 7.7 million between 1997 and 2017. 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, etc. 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.”


When you’re stroking your dog, you’re engaging systems that would be activated if the dog were stroking you


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 TV 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 names have been changed


(Source: The Guardian)

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