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2019年12月06日

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On RN, this is The Body Sphere, with Amanda Smith.

When it's welcome, it's lovely.

When it's not welcome, it's horrible. There's no doubt that these days we're very touchy about touch, especially around children, and for very good reason. But are taboos around physical contact leaving us touch deprived? Well, you could go to a Cuddle Party—that's a thing for adults—if you're feeling a lack of physical contact. And more on what a Cuddle Party is later here in The Body Sphere.

Also ahead, what's tickling for?

Robert Provine: Tickling is an extraordinary behaviour that deserves a lot more attention than it's gotten. With tickling we have evidence about one of the most ancient, difficult and important issues in all of philosophy.

Amanda Smith: Wow, who knew tickling held the key to a philosophical conundrum? More on that too later.

But first, what happens if children don't get enough physical contact?

Tiffany Field is the director of the Touch Research Institute at the University of Miami School of Medicine, and she's the author of a book called Touch.

Now Tiffany, you do studies to scientifically establish and understand the benefits of touch (and we'll talk about all that later) but what you can't do, really, is clinically study touch deprivation, not in humans at least. Back in 1958 though there was that very revealing, now classic experiment done at the University of Wisconsin with baby monkeys and surrogate mothers. Tell us about that.

Tiffany Field: Harry Harlow did that study, and what he compared was the effects of a terrycloth simulated mother versus a wire mesh mother that had a bottle…

Amanda Smith: Okay, so one mother was sort of soft to touch but had no food, the other one was hard, wiry but had food, yes?

Tiffany Field: That's right, and the babies preferred the terrycloth mother.

Amanda Smith: Even though it had no food.

Tiffany Field: Even though it had no food, right. And his student Steve Suomi went on to show an interesting phenomenon with monkeys: that if you put a plexiglass barrier between two infant or child monkeys, they can hear each other, they can see each other, they can smell each other but they can't touch each other, they become extremely aggressive towards each other because of the touch deprivation.

Amanda Smith: I guess the most profound recent example of touch deprivation in humans in a non-clinical setting, which is really the only way you can study it, that's been with children in orphanages in Romania, as came to light in the post-Ceausescu 1990s. What do those children tell you, Tiffany, about the link between lack of touch in human children and what is known I think as ‘failure to thrive’?

Tiffany Field: Yes, I've actually visited those orphanages and they are extremely depressing, as you might imagine, because you see children…the caregivers will tell you their age, and they are very clearly half their expected height and they are extremely developmentally delayed due to their not being touched enough, because there are many children to very few caregivers. And while they do get adequate nutrition, they are generally looked after, yes, but they don't get very much touch.

Amanda Smith: Even with this sort of knowledge that those children demonstrate, these days teachers and childcare workers are not supposed to touch children, are they, or have limited physical touch. I'm sure that's as true in the United States as it is in Australia.

Tiffany Field: Yes, it very definitely is. We have mandates and we've had them for almost two decades now in schools, that teachers are not allowed to touch children and peers are not to touch each other. That was a mandate that came about because of child abuse by some workers in schools. And it has not really benefited anyone. In fact the child abuse rates are just as high, the crazies are still out there despite these mandates.

Amanda Smith: Yes well, it is understandable, because intimacy with another person is all about touch, sex is all about touch, so touch around children is a touchy subject. As an advocate for the medical benefits of touch, tell me more about your view on the touch taboos we've instituted.

Tiffany Field: Well, in as much as we know that touch, and particularly in the form of massage, helps immune function, so that people are not getting ill. And if they are diseased or have any kind of clinical condition it improves with touch. We can imagine that children are more often sick because of the touch taboos, but we also know that they become more aggressive and violent because of the touch deprivation. We actually did a study comparing children in Paris with children in Miami, and the children in Paris received a lot more physical affection, both from each other and their parents and their teachers than the children did in Miami, and they were physically and verbally less aggressive than the children in Miami.

Amanda Smith: Do you also do any advocacy work in relation to those taboos around touch with children to try to relax those policies?

Tiffany Field: Yes, I try very hard. I was on the Oprah Winfrey show, for example, and was pitted against the president of the National Education Association who had a very strong policy of no touching in the school system. We had a huge debate about that, and there were teachers there who had gotten in trouble for touching and other teachers who didn't believe in touching, and parents who wanted their kids to be touched and parents who didn't want their kids to be touched. And I think that was a forum that should be replicated in other places, and we try to do that mostly through the press, spreading the word that touch deprivation is not good, that these mandates are not good, and that everyone needs a healthy dose of touch.

Joshua: My name's Joshua and I work in the after-school care program for a primary school. I'm at university doing an arts degree and I'm 23.

Amanda Smith: All right, so tell me about what the rules and policies are that operate at your school, Joshua, as far as physical contact with the children goes?

Joshua: As far as physical contact, there should be none. These are pretty clear regulations that detail our policy, our touch policy and things like that. And yes, they are particularly rigid in the sense that the only place that you can touch a kid is between the shoulder blades on the top part of the back, and that's a comforting mechanism if they were to, say, hurt themselves, but there's no hugging and touching of any other manner allowed.

Amanda Smith: And that's a policy of the school?

Joshua: These are actually government regulations, but the interesting thing is that schools can decide whether or not they want to actually enforce them on a school to school basis. I happen to know some people who work in another primary school in another area and the policies that are applied to me do not apply to them at all and they can, say, give piggyback rides and such like that.

Amanda Smith: So you can't give the kids piggyback rides?

Joshua: No, we definitely can't, but I definitely think it is not up to me to decide what is better. But it is interesting to see that there are both systems.

Amanda Smith: So are there times when you find it difficult to be so hands-off with these children?

Joshua: I definitely find it difficult, mainly when they approach you with physical contact. Obviously I don't ever want to do it on my own accord but if, say, a child is hurt and actually extends their arms out for a hug, it's what they want and you have to say to them, 'No, sorry, there, there,' pat on the back. That's kind of sad.

Like a child who'd hurt himself in the schoolyard, he'd fallen over and he had grazed his knee and I came over, just squatting next to him, I was just trying to comfort him and say that it was okay. And with tears streaming from his eyes he reached his arms out wide. And I had to just say, 'No, I'm sorry, we can't do that'. I pulled some silly faces and I made him forget about it in another way, but in that moment it was kind of heartbreaking that there was an easy solution that wasn't acceptable. And as well I feel like it's disappointing that you should have to reinforce the idea to children that showing affection is not allowed, is not a good idea. Obviously there are limitations, but having such rigid rules about…for them, it seems mean to tell them no, you can't hug people.

Before I actually worked at the job, things like this had never occurred to me. I'm an older brother, I've recently had new cousins, I love being around little kids, and it's something that never used to bother me until I started working at the school and it has completely actually changed the way that I now interact with children. Yes, it's definitely something that has become much more at the forefront of my mind, which can sometimes ruin the experience.

Amanda Smith: The children must know that your physical contact with them is sort of being circumscribed.

Joshua: Well, they definitely know about the rules, and what's interesting is that they don't care. Even though children know that they are not allowed to sit on our lap, they have to sit on their own chair, you constantly have to tell them to get off your lap, you constantly have to tell them…like I said, the worst one is when you have to prise their arms from around your waist and say, 'No, you can't hug me,' that one.

Amanda Smith: Because little kids love to be physically affectionate.

Joshua: Yes, they really do.

Amanda Smith: On-air on RN, and online at abc.net.au/rn, this is The Body Sphere, on the touchy subject of touch. Amanda Smith with you, and coming back now to Tiffany Field, who's the director of the Touch Research Institute at the University of Miami. Now, this was the first of its kind in the world, studying and evaluating the benefits of touching and being touched by another human being. So Tiffany, what's the focus of your latest research?

Tiffany Field: We've been studying mostly massage across various conditions; autoimmune conditions, immune conditions, pain syndromes and so forth. Currently we are studying prenatal massage to prevent prematurity by decreasing the resistance on the intrauterine artery, which is the artery that carries the oxygen and the nutrients to the foetus, and that way we hope to prevent intrauterine growth deprivation and prematurity.

We are also studying premature babies and we are trying to understand the underlying mechanisms for how it is that they gain more weight when they are massaged. We could save $4.7 billion in the US in hospital costs if every premature baby was massaged, in the US.

And a third study we are currently conducting involves teaching mothers to massage their newborns.

Amanda Smith: What do you understand is the benefits of massaging newborns?

Tiffany Field: Massaging newborns, if they are not premature, that is a full-term newborns, you can reduce their irritability and facilitate sleep, which are the two most common complaints that are made to paediatricians by parents of full-term infants.

Amanda Smith: Does massaging your baby benefit the one giving the massage, the mother presumably, as well?

Tiffany Field: Yes, the mother and the father. And what we found in these studies is that the parents were benefiting just like the infants in that they were more relaxed and less stressed.

Amanda Smith: And that's not just the parents, is it, you did a study with older people as volunteers massaging premature babies. Tell us about that.

Tiffany Field: Yes. And they ask that we not refer to them as elderly, rather that we call them grandparents.

Amanda Smith: They weren't necessarily their biological grandparents.

Tiffany Field: No, they were not. And these older folks were as touch deprived as the little babies who were in incubators, because their significant other had died and they weren't living close to relatives, so we figured they would benefit from that. So we compared them being massaged with them giving massage, and we actually found that they did better giving the infants massage rather than receiving massage themselves. And things like their stress hormones were reduced, they spent more social time, they had fewer trips to the doctor's office and so forth.

Amanda Smith: So what do you think is going on there?

Tiffany Field: Basically what we know so far is that if you stimulate pressure receptors under the skin - that means you need to move the skin, so you need to apply moderate pressure - what happens is a whole chain of reaction that is a relaxation response. The vagus nerve, which has many, many branches in the body, slows heart rate, slows blood pressure, help digestion, so that appears to be happening. Also at the same time there is a reduction in stress hormone, namely cortisol. There is an increase in serotonin, which is found in anti-pain medications and antidepressants and so forth. So there's a lot of activity going on with various pathways that are related to other pathways. It's very complex, and we can't really measure all these pathways but we can measure their end products and then make deductions about what is going on.

Amanda Smith: You mention moderate pressure, and I guess it's hard to say exactly what moderate pressure is, but you have established that light pressure is not effective.

Tiffany Field: It's not that it's not effective, it's just arousing. It has a different kind of response. If you lightly stroke someone, their heart rate will increase, their blood pressure will increase, it's an arousing stimulus, sort of like tickling. But the moderate pressure is a pacifying, calming, soothing kind of stimulation. We have measured it using sound meters, but basically if you are looking at the skin while you are using moderate pressure massage you will see that you are moving the skin as opposed to lightly moving your hands across the surface of the skin.

Cuddle Party facilitator: [Excerpt from An Idiot Abroad] Touch can be very healing and sometimes things come up we don't expect, so that means that if you are cuddling and you become aroused, that's okay, that's a beautiful thing to acknowledge, speak with your partner, you can excuse yourself and have grapes. Again it's about using your voice and communicating, right...

Amanda Smith: Now, this is from an episode of An Idiot Abroad, the British TV series created by Ricky Gervais and Stephen Merchant. The 'idiot'—Karl Pilkington—gets sent to places he's never been before, like to a Cuddle Party in the USA.

Karl Pilkington: [Excerpt from An Idiot Abroad] Are people paying to be here? Right, that's what it's about then. So of course she's going to say, 'Yeah, a cuddle is good for you.' Of course she's doing the sell job to us. She's not going to go, 'It's a load of old bollocks this, but don't tell anyone.' But good on her. I always think, don't have a go at people for coming up with a business venture. But this wouldn't happen in England, this wouldn't work. In America they love all this [bleep].

Amanda Smith: Well, it happens in Australia. Anne Hunter was the first qualified Cuddle Party facilitator in the southern hemisphere. She also has a background in therapeutic massage. Anne's into touch, you might say. So what's the idea behind these cuddle parties?

Anne Hunter: Cuddle parties are set up as safe spaces for people to explore their needs and boundaries around touch. So the idea is that we all need a certain amount of what we call safe, welcomed, nurturing, nonsexual touch every day for health, and most of us don't get it.

Amanda Smith: Okay, you did mention within that 'non-sexual', so that's definitely a part of a cuddle party?

Anne Hunter: Absolutely. They are very, very clearly nonsexual parties. Rule number one is clothes stay on the whole time and that is part of how we keep it nonsexual.

Amanda Smith: Touch we do associate with intimacy. What's the benefit of hugging complete strangers?

Anne Hunter: It's amazing how most touch in our society is sexualised in the sense that it is only permitted in the context of a sexual relationship. Or, maybe a familial one like parents cuddling children and things like that. So why people come to a cuddle party is because they often just don't get enough touch. They might be single. They might have a partner who has different touch needs to them, or they may be really afraid to ask for what they want. They may be afraid that their boundaries won't be observed, they may not know what their boundaries are. So a lot of people come to a cuddle party…one of the rules is you don't have to touch anybody ever at a cuddle party. You can come to as many cuddle parties as you like and never touch anybody.

Amanda Smith: You talk about boundaries. Human touch, when it's welcome, is lovely. When it's not welcome, it's awful. So what I get from what you are saying is that part of the thing of a cuddle party is that you do actually learn how to handle unwelcome touch.

Anne Hunter: Yes, and how to say no without…a lot of us don't reject unwelcome touch because we don't want to hurt somebody, we don't want to upset somebody. And so one of the things that we set up with Cuddle Party is a safe space where everybody else is able to manage their own emotional responses, where there are people like me there, the facilitator is there to support people in dealing with that, where you do not have to worry about somebody else's response. You simply have to work out what it is you want and don't want.

Amanda Smith: Okay, so tell me more about then what happens at a cuddle party, what the procedure and process is, and more about your role as the facilitator.

Anne Hunter: So we start with a welcome circle, and that's where we get to know each other. We do a number of exercises. One of the ones we do straight up is the 'no' exercise where you just turn to somebody and ask for anything and their job is to say no. So we learn not to take 'no' personally. And we practice a couple of exercises, hug exercises to get people into cuddling, but a lot of what we do is talk about our experience of touch. So, after we've had the welcome circle, then there is usually a couple of hours of free cuddle time, and in the free cuddle time we may do puppy piles…

Amanda Smith: What's a puppy pile?

Anne Hunter: A puppy pile, I love puppy piles! As it sounds. Have you ever seen a pile of puppies all piled on top of each other? That's what a puppy pile is. And I like being on the bottom, in the middle. For me the feeling of being surrounded by body heat and pressure is just gorgeous, and it's so relaxing.

But often what people do is talk. For example, I ran one last week and there were about four or five people who came to it who were very nervous at the beginning. As is understandable, because touch is a highly charged area for most of us, and many of us have had negative touch. So a few of those spent more time talking than they spent actually making contact with anybody. But we also had a whole bunch of people who were really confident cuddlers who were spooning in a long line on the mattresses in the middle. Yes, so they are the things that can happen.

Amanda Smith: I mentioned that you had a background in therapeutic massage. What got you into wanting to run cuddle parties?

Anne Hunter: I did find when I was working as a therapeutic masseur there were a lot of people who came to me for massage, and I'm sure that the primary reason that they were paying full fee for a massage was just to get the touch. Because they were not getting enough touch in their lives and did not know how to express that or ask for what they needed. So, they would pay me for the touch.

So when I heard the term 'cuddle party', I just went 'that's me'. But I've always been fairly touch positive. I was very interested in the infant massage information, babies die without touch, and adults don't die but they certainly suffer deeply when they don't get enough touch. And Cuddle Party just sounded perfect to me.

Amanda Smith: You're listening to The Body Sphere, with Amanda Smith.

When was the last time you tickled someone, or someone tickled you? Was it enjoyable? Or too much? Tickling is that form of light touch that's both fun but also borders on excruciating. Robert Provine is the author of Curious Behaviors, a book about mostly-ignored bodily actions like yawning, sneezing, itching, and tickling. He describes tickling as a ‘benign form of sadomasochism’, but also as more important than you might think.

Robert Provine: Well, tickling is an extraordinary behaviour that deserves a lot more attention than it has gotten. It's probably the ancestral stimulus for laughter. It's also my candidate for the most ancient joke would be feigned tickle, you know, 'I'm going to get you,' as opposed to actually tickling someone, simply threatening to do so.

But beyond its link to laughter, I think the most exciting thing is with tickle we have evidence about one of the most ancient, difficult and important issues in all of philosophy, psychology and neuroscience. It's how do we decide what's us and what's not. The key issue with tickle is you can't tickle yourself. Try as you might, stroking your ribs is not going to generate the ha-ha. It takes another person. So this issue of self and other, one of the most important issues in human behaviour, tickle holds the secret. We should ask ourselves what life would be like if we could tickle our self. We'd be going through life in a giant chain reaction of goofiness. Every time we would touch something we would startle ourselves and start to laugh. That's not happening. We cancel out self-produced stimulation. So it takes another person. So in looking at tickle, again we have the basis of self and other, also we have insights into how to build better robots.

Amanda Smith: Ah, well, now, can we get onto that in a moment? Can I just ask first, just describe to me…I mean, there are differences really in the nature of tickling with babies and children as opposed to adults and adolescents. With babies and children it's a form of play, a non-verbal communication.

Robert Provine: Yes, with children we see the neurological program for physical play. When one child stimulates another, a child may laugh and withdraw but also will retaliate. You have tickle battles. And so in the give-and-take of tickling we have a neurological program that binds us together in play. But there's always this back and forth. When we remove the back and forth that's when tickle becomes unpleasant. It's when you can't reciprocate. So, people having memories of some evil brother that tickled you until you peed in your pants or some such stuff, that's no fun. It's ignoring the reciprocity or ability to retaliate. So this give-and-take is binding people together in groups.

Through adolescence and later adulthood, tickle also indicates the process that binds people together in the give and take of foreplay and sexual play. And obviously a stranger tickling you would be an occasion to call the police.

So when you have tickle haters, they are basically responding to things that we would all dislike; tickle by people we don't have a close relationship with or tickle that's not reciprocal.

Amanda Smith: All right, so why is it important in robotics to build ticklish robots?

Robert Provine: It's important to distinguish between you touching something and something touching you, that's why we can't tickle ourselves. But just as we wouldn't be very effective organisms if we were constantly startling ourselves, we don't want robots to startle either. I've suggested that the next generation of robots, higher performing robots, would be those that cancel out the source of self-stimulation. More primitive generations of robots don't make that distinction. But when you program robots to inhibit self-produced stimulation, you not only have a robot that's going to perform better, we also have the basis of programming selfhood into machines. So just as we can distinguish self and other, programming tickle into robots would help robots to evolve a sense of personhood.

Amanda Smith: The ticklish robot. And Robert Provine is professor of psychology and neuroscience at the University of Maryland, Baltimore County, USA, and the author of Curious Behavior. There are details for his book, as well as Tiffany's Field's book Touch on The Body Sphere website. Also, if you want to know more about cuddle parties, there's a link there for the website for Cuddle Parties in Australia. Go to abc.net.au/rn, and from the drop-down list of programs choose The Body Sphere.

You can post a comment there too, if you'd care to share your thoughts and experiences of touch, good and bad.

I'm Amanda Smith.

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