YOUCHING THE HUMAN SIGNIFICANCE OF THE SKIN SECOND EDITION

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TOUCHING

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TOUCHING

The Human Significance
of the Skin

SECOND EDITION

ASHLEY MONTAGU

1817

HARPER & ROW, PUBLISHERS

NEW YORK HAGERSTOWN
SAN FRANCISCO LONDON

TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN (Second Edition). Copyright
1971, 1978 by Ashley Montagu. All rights reserved. Printed in the United States of
America. No part of this book may be used or reproduced in any manner whatsoever
without written permission except in the case of brief quotations embodied in critical
articles and reviews. For information address Harper & Row, Publishers, Inc., 10 East
53rd Street, New York, N.Y. 10022. Published simultaneously in Canada by Fitzhenry
& Whiteside Limited, Toronto.

Designed by Eve Kirch Callahan

Library of Congress Cataloging in Publication Data

Montagu, Ashley, date

Touching.

Includes bibliographical references and index.

1. Touch. 2. Skin. 3. Nonverbal communication.
4. Personality. 5. Child psychology. I. Title.
BF275.M66 1977 152.1 '82 77-3762
ISBN 0-06-012979-4

79 80 10 9 8 7 6 5 4 3 2

To the memory of
James Louis Montrose

V

KANSAS O>"f '.'---'-.; ".<. M'C LIBRARY

CONTENTS

Preface to the First Edition ix

Preface to the Second Edition xi

ONE The Mind of the Skin 1

TWO The Womb of Time 37

THREE Breastfeeding 59

FOUR Tender, Loving Care 76

FIVE Skin and Sex 158

SIX Growth and Development 186

SEVEN Culture and Contact 231

Envoi 317

Appendix: Touch and Age 320

References 323

Index 371

PREFACE
TO THE FIRST EDITION

This book is about the skin as a tactile organ very much in
volved, not alone physically but also behaviorally, in the growth
and development of the organism. The central referent is man,
and what happens or fails to happen to him as an infant by way
of tactile experience, as affecting his subsequent behavioral de
velopment, is my principal concern here. When I first started
thinking about this subject in 1944 there was very little experi
mental evidence available bearing upon these matters. Today a
considerable amount of such evidence has been made available
by a large variety of investigators, and my lonely paper of 1953,
'The Sensory Influences of the Skin" (Texas Reports on Biology
and Medicine, vol. 2, 1953, pp. 291-301), is no longer alone.
This book draws upon many sources of information, and notes
citing these sources have been gathered in the Reference sec
tion, where they are identified by the numbers of the pages and
the line or lines on the pages where references or quotations
occur. (This system seemed preferable to using note numbers
which interrupt the text. When notes are amplifications, sugges
tions, or comments, however, rather than simple source cita
tions, they are keyed to asterisks and appear on the same pages
as the passages to which they refer.)

The skin as an organ, the largest organ of the body, was very
much neglected until quite recently. But it is not as an organ
as such that I am here concerned with the skin; rather, in

X PREFACE

contrast to the psychosomatic or centrifugal approach, I am
interested in what may be called the somatopsychic or centripe
tal approach. In short, I am interested in the manner in which
tactile experience or its lack affects the development of behav
ior; hence, "the mind of the skin."

AM.

Princeton, N.J.
8 February 1971

PREFACE
TO THE SECOND EDITION

The first edition of this book has gratifyingly found a large
audience. The present edition incorporates much new informa
tion concerning the vital importance of touch from birth to old
age.

One regret that every writer must have is that there does not
exist a word which specifically refers to both sexes. In this
edition I first attempted to remedy the situation by employing
"it" as a substitute for the customary masculine pronouns. The
result was an unacceptable impersonality which, combined
with the awkward repetitiveness of "he or she" and "his or
hers," rendered the change repellent. I, therefore, have adhered
to customary usage. It is, of course, to be understood that in all
instances both sexes are implied. This book is about human
beings, not objects, and no baby is an "it" to its mother, nor
should it be to anyone else.

Most of all, I have to thank Louise Schaeffer of the Biology
Library, and Terry Caton and Terry Wiggins of the Psychology
Library, all of Princeton University.

I have also to thank Louise Yorke of the Library of the
Medical Center, Princeton.

To my friend Dr. Philip Gordon I am indebted for his careful
reading of proof.

To Elisabeth Jakab, my editor, many thanks for her sympa
thetic interest and concern for the continued welfare of this
book.

AM.

Princeton, N.J.
20 September 1977

TOUCHING

ONE
THE MIND OF THE SKIN

The greatest sense in our body is our touch sense. It
is probably the chief sense in the processes of sleep
ing and waking; it gives us our knowledge of depth
or thickness and form; we feel, we love and hate, are
touchy and are touched, through the touch corpus
cles of our skin.

J. Lionel Taylor, The Stages of Human Life,

1921, p. 157.

The skin, like a cloak, covers us all over, the oldest and the most
sensitive of our organs, our first medium of communication,
and our most efficient of protectors. The whole body is covered
by skin. Even the transparent cornea of the eye is overlain by
a layer of modified skin. The skin also turns inwards to line
orifices such as the mouth, nostrils, and anal canal. In the
evolution of the senses the sense of touch was undoubtedly the
first to come into being. Touch is the parent of our eyes, ears,
nose, and mouth. It is the sense which became differentiated
into the others, a fact that seems to be recognized in the age-old
evaluation of touch as "the mother of the senses/' Touch is the
earliest sensory system to become functional in all species thus
far studied, human, animal, and bird. Perhaps next to the brain,
the skin is the most important of all our organ systems. The
sense most closely associated with the skin, the sense of touch,

2 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

is the earliest to develop in the human embryo. When the
embryo is less than an inch long from crown to rump, and less
than six weeks old, light stroking of the upper lip or wings of
the nose will cause bending of the neck and trunk away from
the source of stimulation. At this stage in its development the
embryo has neither eyes nor ears. Yet its skin is already highly
developed, although in a manner not at all comparable to the
development it is still to undergo. In the womb, bathed by its
mother's amniotic fluid and enveloped by the soft walls of the
womb, "rocked in the cradle of the deep," the conceptus* leads
an aquatic existence. In this environment its skin must have the
capacity to resist the absorption of too much water, the soaking
effects of its liquid medium, to respond appropriately to physi
cal, chemical, and neural changes, and to changes in tempera
ture.

The skin in common with the nervous system arises from the
outermost of the three embryonic cell layers, the ectoderm. The
ectoderm constitutes the general surface covering of the embry
onic body. The ectoderm also gives rise to the hair, teeth, and
the sense organs of smell, taste, hearing, vision and touch
everything involved with what goes on outside the organism.
The central nervous system, which has as a principal function
keeping the organism informed of what is going on outside it,
develops as the inturned portion of the general surface of the
embryonic body. The rest of the surface covering, after the
differentiation of the brain, spinal cord, and all the other parts
of the central nervous system, becomes the skin and its deriva
tives hair, nails, and teeth. The nervous system is, then, a
buried part of the skin, or alternatively the skin may be re
garded as an exposed portion of the nervous system. It would,
therefore, improve our understanding of these matters if we
were to think and speak of the skin as the external nervous
system, an organ system which from its earliest differentiation

* Conceptus, the organism from conception to delivery. Embryo, the orga
nism from conception to the end of the 8th week. Fetus, from the beginning
of the 9th week to delivery.

The Mind of the Skin 3

remains in intimate association with the internal or central
nervous system. As Frederic Wood Jones, the English anato
mist, put it, "He is the wise physician and philosopher who
realises that in regarding the external appearance of his fellow-
men he is studying the external nervous system and not merely
the skin and its appendages." As the most ancient and largest
sense organ of the body, the skin enables the organism to learn
about its environment. It is the medium, in all its differentiated
parts, by which the external world is perceived. The face and
the hand as "sense organs" not only convey to the brain a
knowledge of the environment, but convey to the environment
certain information about the "internal nervous system."

Throughout life the skin is in a continuous state of renewal
by the activity of the cells in its deep layers. In different parts
of the body the skin varies in texture, color, scent, temperature,
innervation, and in other features. Furthermore, the skin, as we
know from human faces, carries its own memory of conditions
experienced in the remote and immediate past.

The skin's growth and development proceed throughout life,
and the development of its sensitivities depends largely upon
the kind of environmental stimulation it receives. Interestingly
enough, in common with chick, guinea pig, and rat, in the
newborn human the relative weight of the skin, expressed as a
percentage of the total body weight, is 19.7, nearly the same as
in the adult, 17.8, suggesting what should be obvious: the en
during importance of the skin in the life of the organism.

In othej animals it has been found that "skin sensitivity is
apparently earliest and most completely developed during
prenatal life." There is a general embryological law which states
that the earlier a function develops the more fundamental it is
likely to be. The fact is that the functional capacities of the skin
are among the most basic of the organism.

It is that part of the skin which is most immediately exposed
to the environment, its most superficial layer, the epidermis,
that houses the tactile system. The free nerve endings in the
epidermis are almost entirely concerned with touch, as are the
nerve plexuses known as Meissner's corpuscles. The larger

4 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

nerve plexuses, known as Pacinian corpuscles, are the specific
end organs that respond to mechanical stimuli of pressure and
tension. These are particularly numerous under the digital pads
of the fingers. A plexus of free nerve endings distributed among
the epidermal cells of each hair follicle renders tactile stimula
tion through mechanical displacement of the hair a very impor
tant mechanism in producing tactile sensations.

The surface area of the skin has an enormous number of
sensory receptors receiving stimuli of heat, cold, touch, pres
sure, and pain. A piece of skin the size of a quarter contains
more than 3 million cells, 100 sweat glands, 50 nerve endings,
and 3 feet of blood vessels. It is estimated that there are some
50 receptors per 100 square millimeters, a total of 640,000
sensory receptors. Tactile points vary from 7 to 135 per square
centimeter. The number of sensory fibers from the skin entering
the spinal cord by the posterior roots in well over half a million.

At birth the skin is called upon to make many new adaptive
responses to an environment even more complex than that to
which it was exposed in the womb. Transmitted through the
atmospheric environment, in addition to air movements, are
gases, particles, parasites, viruses, bacteria, changes in pressure,
temperature, humidity, light, radiation, and much else. To all
these stimuli the skin is equipped to respond with extraordinary
efficiency. By far the largest organ system in the body, about
2,500 square centimeters in the newborn and about 18,000
square centimeters, or approximately 18 square feet, in the
average male, in whom it weighs about 8 pounds, the skin
constitutes some 6 to 8 percent of the total body weight. The
skin ranges in thickness from l/10th of a millimeter to 3 or 4
millimeters. It is generally thickest on the palms of the hands
and soles of the feet, and usually thicker on extensor than flexor
surfaces.

Physiologically the skin has seven primary functions: (1) as
a protector of underlying parts from mechanical and radiation
injuries, and invasion by foreign substances and organisms; (2)
as a sense organ; (3) as a temperature regulator; (4) as a meta
bolic organ involved in the metabolism and storage of fat, and

The Mind of the Skin 5

in water and salt metabolism by perspiration; (5) as a reservoir
for food and water; (6) as a facilitator of the two-way passage
of gases through it; and (7) as the seat of the origin of the
anti-rachitic vitamin D.

One would have thought that the remarkable versatility of
the skin, its tolerance of environmental changes, and its aston
ishing thermo-regulatory capacities, as well as the singular effi
ciency of the barrier it presents against the insults and assaults
of the environment, would have constituted conditions striking
enough to evoke the interest of inquirers into its properties.

Strangely enough, until relatively recent years, this has not
been the case. Indeed, most of what we know about the func
tions of the skin has been learned since the 1940's. Though
much knowledge has been acquired, of both the structure and
the physical functions of the skin, much more remains to be
learned. Today the skin no longer languishes for want of inter
est.

Somewhat surprisingly, the one repository of so much of the
sensitive human spirit in which one might have expected to find
a sophisticated insight into the functions of the human skin,
namely poetry, is found to be disappointingly barren. Poems
have been written in celebration of every part of the body, but
the skin, unaccountably, appears to have been slighted, as if it
did not exist. In prose literature the case is otherwise: there are
many references to the skin, perhaps the most notable being
Gulliver's mortifying account of the diminutive Lilliputians'
animadversions on the unprepossessingness of his skin, with its
blotches, pimples, and other disfigurations.

That the importance in human behavior of the tactile func
tions of the skin has not gone wholly unrecognized is evident
from the many expressions in common parlance in which these
functions appear. We speak of "rubbing" people the wrong
way, and "stroking" them the right way; of "abrasive" and
"prickly" personalities. We say of someone that he has "a
happy touch," of another that he is "a soft touch," and of still
another that he has "the human touch." We get into "touch"
or "contact" with others. Some people have to be "handled"

6 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

carefully ("with kid gloves"). Some are "thick-skinned," others
are "thin-skinned," some get "under one's skin," while others
remain only "skin-deep," and things are either "palpably" or
"tangibly" so or not. Some people are "touchy," that is, over
sensitive or easily "irritated." Others are "out of touch," or
"have lost their grip." The "feel" of a thing is important to us
in more ways than one; and "feeling" for another embodies
much of the kind of experience which we have ourselves under
gone through the skin. A deeply felt experience is "touching."
Pleasure in a work of art gives some of us "goose pimples." We
say of some people that they are "tactful," and of others that
they are "tactless," that is, either having or not having that
delicate sense of what is fitting and proper in dealing with
others (see p. 228). Through "feeling" we frequently refer to
emotional states, such as happiness, joy, sadness, melancholy,
and depression, and by that term often imply a reference to
touching. We speak of an "unfeeling," unpitying person as
"callous," which is the English for the Latin callum, meaning
"hard skin," and from which the word both for the unfeeling-
ness and the thickened skin is derived. We speak of a person as
having grown so "callused" that he has become insensitive to
human feeling.

When we speak of someone as removed from reality, we say
that he is "out of touch with reality," and when we describe the
contemporary unrelatedness of people to each other, we speak
of them as "disengaged," "out of touch," and not wishing to be
"touched." One "keeps one's distance." "We reach out" to
others. We "pat each other on the back." We are "held" by an
appealing performance. A voice makes one's skin "tingle." A
dread fear makes one's skin "creep." The skin, in fact, does
creep it contracts, and this is the reason why one's hair some
times stands on end (the pilomotor reflex). We hold the world
in our "grasp," and "clutch" our loved ones to our bosom. As
Bertrand Russell pointed out long ago, it is the sense of touch
that gives us our sense of reality. "Not only our geometry and
our physics, but our whole conception of what exists outside us,
is based upon the sense of touch. We carry this even into our

The Mind of the Skin 1

metaphors: a good speech is 'solid/ a bad speech is 'gas,' be
cause we feel that a gas is not quite 'real.' "

Although the skin has constantly occupied the forefront of
human consciousness, it is strange that it should have elicited
so little attention. Most of us take our skin entirely for granted,
except when it burns and peels, or breaks out in pimples, or
perspires unpleasantly. When we think of it at other times, it
is with a vague wonder at so neat and efficient a covering for
our insides: waterproof, dustproof, and miraculously until we
grow old always the right size. As we grow older we begin to
discover qualities of the skin, color, firmness, elasticity, texture,
we had failed to notice at all before we began to lose them. With
the accumulation of years we are apt to regard our aging skin
as a rather dirty trick, a depressing public evidence of aging,
and a somewhat unwelcome reminder of the passage of time.
No longer the good fit it once was, it grows loose and baggy,
and is often wrinkled, dry and leathery, even parchment-like,
sallow, splotched, or otherwise disfigured.

But these are all superficial ways of looking at the skin. As
we study the observations of numerous investigators, and put
together the findings of physiologists, anatomists, neurologists,
psychiatrists, psychologists and other investigators, adding to
the brew our own observations and knowledge of human na
ture, we begin to comprehend that the skin represents some
thing very much more than a mere integument designed to keep
the skeleton from falling apart, or merely to provide a mantle
for all the other organs, but rather that it is in its own right a
complex and fascinating organ. In addition to being the largest
organ of the body, the various elements comprising the skin
have a very large representation in the brain. In the cortex, for
example, it is the postcentral gyrus, or convolution, which re
ceives the tactile impulses from the skin, by way of the sensory
ganglia next to the spinal cord, then to the posterior funiculi in
the spinal cord and medulla oblongata, to the venteroposterior
nuclei in the thalamus, and finally the postcentral gyrus. Nerve
fibers conducting tactile impulses are generally of larger size
than those associated with the other senses. The sensorimotor

8 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

areas of the cortex are situated on each side of the central gyrus.
The precentral gyrus is largely sensory while the postcentral
gyms is mainly motor. Horizontal connecting fibers across the
central fissure connect both gyri. Since it is a general rule of
neurology that the size of a particular region or area of the brain
is related to the multiplicity of the functions it performs (and
to the skill, say, in the use of a muscle or group of muscles),
rather than to the size of the organ, the proportions of the
cerebral tactile area underscore something of the importance of
tactile functions in the development of the person. Figures 1
and 2 are drawings of sensory and motor homunculi, or "little
men," designed to show the proportionate representations of
tactile functions in the cortex. From these figures it will be seen
how large is the representation of the hand, especially the index
finger and the thumb, and the enormous representation of the
lips.

Consider: as a sensory system the skin is much the most
important organ system of the body. A human being can spend
his life blind and deaf and completely lacking the senses of smell
and taste, but he cannot survive at all without the functions
performed by the skin. The experience of Helen Keller, who
became deaf and blind in infancy, whose mind was literally
created through the stimulation of her skin, shows us that when
other senses fail, the skin can to an extraordinary degree com
pensate for their deficiencies. The sense of pain, mediated from
the skin to the brain, provides an essential warning system
designed to compel attention. The condition known as cutane
ous alagia, in which the individual can feel no pain in his skin,
is a serious malady. Those affected by this disorder have been
known to sustain severe burns before becoming aware of any
danger. Such persons are in jeopardy of their lives.

The continuous stimulation of the skin by the external envi
ronment serves to maintain both sensory and motor tonus. The
brain must receive sensory feedback from the skin in order to
make such adjustments as may be called for in response to the
information it receives. When a leg "falls asleep" or grows
numb, the sensory cutoff results in difficulty in initiating leg

The Mind of the Skin 9

movement because the impulses from the skin, muscles, and
joints are not adequately reaching the postcentral gyrus of the
brain. The feedback from skin to brain, even in sleep, is continu
ous.

As a student and teacher of human anatomy I was, in the
course of the years, repeatedly struck by the largeness of the
tactile area of the brain as shown, usually in green, in textbook
illustrations. No one seemed to have made any significant com
ment on this. It was not until the middle 1940's, when I com
menced to draw together the data bearing on the development

J Lower lip

I Teeth, gums, and jaw

l_ Pharynx

__ Infra-abdominal

FIGURE 1. The sensory homunculus drawn upon the profile of one
hemisphere. The underlying solid lines indicate the extent of cortical
representation.

10 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

of human behavior,* that the recurrence of stray bits of evi
dence from a large variety of different sources impressed upon
me the importance of the skin not only in the development of
physical functions, but also in the development of behavioral
ones. I delivered a lecture on this subject at the University of
Texas Medical School at Galveston in April 1952. This was
subsequently published in the journal issued by the School. The
response to the lecture and to the published article encouraged
me to proceed with the collection of the findings which are
presented in this book, and which serve, I hope, to throw some
light on an aspect of human development that has been largely
underappreciated.

What is this aspect? It is quite simply the effect of tactile
experience upon human behavioral development.

Our approach to the skin in this book is quite the opposite
of that which psychosomatic medicine has so illuminatingly
made, the demonstration that what goes on in the mind may
express itself in the skin in many different ways. The psychoso
matic approach constitutes an invaluable contribution to our
understanding concerning the influence of the mind upon the
body for the purposes of discussion we may preserve the artifi
cial separation of mind and body and of the extraordinary
sensitivity of the skin in reacting to centrally originating ner
vous disturbances. That distressing thoughts may break out as
boils in the skin, that urticaria, psoriasis, and many other skin
disorders may originate in the mind, is no longer the novel idea
it was when, some fifty years ago, I read of this relationship in
W. J. O'Donovan's pioneering little book, Dermatological Neu
roses. Since 1927, when O'Donovan's book was published, con
siderable progress has been made, much of it admirably set out
in Maximillian Obermayer's book, Psychocutaneous Medicine.
The psychosomatic approach to the study of the skin may be

*Delivered as a course on socialization at Harvard University in 1945, anc
subsequently published in my book, The Direction of Human Developmen\
(New York: Harper & Bros., 1955; revised edition, New York: Hawthorr
Books, 1970).

The Mind of the Skin

11

regarded as centrifugal; that is, it proceeds from the mind out
wards to the integument. What we shall be concerned with in
the present book is the opposite approach, namely from the skin
to the mind; in other words, the centripetal approach.

The question we are most concerned to ask and answer in this
book is, What influence do the various kinds of cutaneous

FIGURE 2. The motor homunculus. While there is a close correspon
dence between sensory and motor representation, the correspondence
is not complete. The representation of sensation refers to specific areas
and parts, whereas the motor representation refers to the movements
of those parts. (From W. Penfield and T. Rasmussen, The Cerebral
Cortex of Man. New York: The Macmillan Co., 1950, p. 214. By
permission.)

12 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

experiences which the organism undergoes, especially in early
life, have upon its development? Primarily we are concerned to
discover: (1) What kind of skin stimulations are necessary for
the healthy development of the organism, both physically and
behaviorally? and (2) What are the effects, if any, of the want
or insufficiency of particular kinds of skin stimulation?

One of the best ways of discovering whether or not a particu
lar kind of experience is necessary or basic to any particular
species and its members, is to determine how widely distributed
it is in the Class of animals (in the present instance, the mam
mals) to which the species under investigation belongs; what is
phylogenetically basic is likely to be physiologically significant,
and significant perhaps in other functional respects as well.

The specific question to which we seek an answer is: Must the
member of the species Homo sapiens undergo, in the course of
early development, certain kinds of tactile experiences in order
to develop as a healthy human being? If such experiences are
necessary, of what kind are they? For some light on these
questions we may first turn to the observations made on other
animals.

RATS AND SERENDIPITY. What started me thinking about the
skin was the serendipitous reading, in a totally different connec
tion, of a 1921-1922 paper by the anatomist Frederick S. Ham-
mett, of the Wistar Institute of Anatomy in Philadelphia. Ham-
mett was interested in discovering what would be the effects of
total removal of both the thyroid and parathyroid glands from
albino rats of the genetically homogeneous Wistar stock. Ham-
mett noted that following the operation some of the animals did
not, as they ought to have done, die. It had been thought by
many investigators that such a thyroparathyroidectomy must
invariably prove fatal, presumably owing to the action of some
toxic substance upon the nervous system.

Upon inquiry Hammett found that the rats that had under
gone the thyroparathyroidectomies had been drawn from two
separate colonies, and that the greater number of the survivors
came from what was called the Experimental Colony. In this

The Mind of the Skin 1 3

colony the animals were customarily petted and gentled. In
contrast, the animals exhibiting the higher mortality rate were
drawn from what was called the Standard Stock, a group whose
only human contact was that incidental to routine feeding and
cage-cleaning by an attendant. These animals were timid, ap
prehensive, and high-strung. When picked up they were tense
and resistant, and frequently exhibited fear and rage by biting.
'The picture," as Hammett put it, "as a whole is one of con
stant high irritability and neuromuscular tension."

The behavior of the gentled rats was strikingly different from
that of the Standard Stock animals. The former had been gen
tled for five generations. When handled, the gentled animals
were relaxed and yielding. They were not easily frightened. As
Hammett noted, "They give a uniform picture of placidity. The
threshold of the neuromuscular reaction to potentially disturb
ing stimuli is almost prohibitively high."

With human beings it was very evident that the gentled rats
felt secure in the hands not only of those who fondled them, but
of everyone. The laboratory attendant had raised them under
conditions in which they were frequently handled, stroked, and
had kindly sounds uttered to them, and they responded with
fearlessness, friendliness, and a complete lack of neuromuscular
tension or irritability. The exact opposite was true of the ungen-
tled rats, who had received no attention whatever from human
beings, except that involved in feeding and cage-cleaning. These
animals were frightened and bewildered, anxious and tense in
the presence of people.

Let us see what happened when thyroid and parathyroid
glands were removed in the 304 animals operated from both
groups. Within forty-eight hours of operation 79 percent of the
irritable rats died, while only 13 percent of the gentled rats died
a difference of 66 percent of survivals in favor of the gentled
animals. When the parathyroids alone were removed, within
forty-eight hours 76 percent of the irritable rats died while only
13 percent of the gentled rats died, a difference of 63 percent.

Standard Stock rats, placed at weaning in the Experimental
Colony and gentled, became tame, cooperative and relaxed, and

14 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

resistant to the effects of the parathyroid gland removal.

In a second series of experiments, Hammett investigated the
mortality rate in parathyroidectomized wild Norway rats that
had been caged for one or two generations. The wild Norway
rat, it is well known, is a notoriously excitable creature. Of a
total of 102 wild Norway rats, 92 animals, or 90 percent, died
within forty-eight hours, most of the survivors succumbing
within two or three weeks of operation.

Hammett concluded that the stability of the nervous system
induced in rats by gentling and petting produces in them a
marked resistance to the loss of the parathyroid secretion. In
excitable rats this loss usually results in death from acute para
thyroid tetany in less than forty-eight hours.

Subsequent experience and observation at the Wistar Insti
tute showed that, the more handling and petting rats receive,
the better they do in the laboratory situation.

Here, then, was something more than a clue to the under
standing of the role played by tactile stimulation in the develop
ment of the organism. Gentle handling of rats could make all
the difference between life and death following the removal of
important endocrine glands. This discovery was striking
enough. But what was equally remarkable was the influence of
gentling upon behavioral development. Gentling produced gen
tle, unexcitable animals; lack of gentling resulted in fearful,
excitable animals.

These important findings, it seemed to me, were worth fol
lowing up. There were innumerable unanswered questions,
principally involving the mechanism, the physiology, by which
handling or gentling could produce such significant differences
in organismal and behavioral responses as Hammett had re
corded. Since, apart from the Wistar Institute observations by
Hammett and his colleagues, there was literally nothing in print
that could throw any light on such questions, I began to make
inquiries among animal breeders, among people who had been
raised on farms, veterinarians, husbandrymen, and the staff's of
zoos the results were illuminating.

The Mind of the Skin 1 5

LICKING AND LOVING. Reading the Wistar Institute studies of
Hammett, it occurred to me that the "washing*' the mammalian
mother gives her young, virtually from the moment they are
born, in the form of licking, isn't washing at all, but something
fundamentally very different and very necessary; that "wash
ing" in the sense of cleaning was not the real function of licking,
but that licking served very much more profound purposes. It
seemed a reasonable hypothesis that, as Hammett's observa
tions suggested, the proper kind of cutaneous stimulation is
essential for the adequate organic and behavioral development
of the organism. It seemed likely that the licking mammalian
mothers give their newborn, and which they continue for dura
ble periods thereafter, probably serves a basic series of func
tions, since it is universal among mammals with the exception
of man. In that exception, I reasoned, there probably also lay
an interesting story, and indeed there does, as we shall later see.

As soon as I commenced my inquiries among persons with
long experience of animals I found a remarkable unanimity in
the observations they reported. The substance of these observa
tions was that the newborn animal must be licked if it is to
survive, that if for some reason it remains unlicked, particularly
in the peiineal region (the region between the external genitalia
and the anus), it is likely to die of a functional failure of the
genitourinary system and/or the gastrointestinal system.
Breeders of chihuahua dogs were particularly insistent upon
this, for according to them the mothers often make little or no
attempt to lick their young. Hence there is a high mortality rate
among these puppies, caused by failure to eliminate, unless
some substitute for maternal licking, such as stroking by the
human hand, is provided.

The evidence indicated that the genitourinary system espe
cially simply would not function in the absence of cutaneous
stimulation. The most interesting observations on this matter
soon became available in the form of an unpremeditated experi
ment carried out by Professor James A. Reyniers of the Lobund
Laboratories of Bacteriology of the University of Notre Dame,
Indiana. Professor Reyniers and his colleagues were interested

16 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

in raising germ-free animals, and in 1946 and 1949 they pub
lished their findings in two separate monographs. In the early
days of their experiments these workers' labors came to naught
because all the experimental animals died of a functional failure
of the genitourinary and gastrointestinal tracts. It was not until
a former zoo-worker brought her own experience to bear upon
the solution of this problem, advising the Notre Dame group
to stroke the genitals and perineal region of the young animals
with a wisp of cotton after each feeding, that urination and
defecation occurred. In response to an inquiry, Professor
Reyniers wrote me:

With respect to the constipation problem in hand-reared new
born mammals the following may be of some interest: Rats,
mice, rabbits, and those mammals depending upon the mother
for sustenance in the early days of life apparently have to be
taught to defecate and urinate. In the early period of this work
we did not know this and consequently lost our animals. The
unstimulated handled young die with an occlusion of the ureter
and a distended bladder. Although we had for years seen moth
ers licking their young about the genitals I thought that this was
a matter largely of cleanliness. On closer observation, however,
it appeared that during such stimulation the young defecated
and urinated. Consequently, about twelve years ago, we started
to stroke the genitals of the young after each hourly feeding with
a wisp of cotton and we were able to elicit elimination. From this
point on we have had no trouble with this problem.

Failure of the genitourinary tract to function when newborn
mammals were removed, immediately after birth, from contact
with their mothers was soon also demonstrated by McCance
and Otley. These investigators suggested that normally the lick
ing and other attentions of the mother stimulated an increase
in the excretion of urea as a consequence of the change in blood
flow to the kidney.

Motherless kittens and other animals have been successfully
raised by the appropriate cutaneous stimulation administered
by a surrogate "mother." In an engaging account of his rescue
of a newborn abandoned kitten from the bushes, Larry Rhine

The Mind of the Skin 1 7

tells how he called up the A.S.P.C.A. after feeding the kitten
from a doll's bottle, and having announced that Moses, as he
had named him, was eating quite normally, received the reply,
"Of course he is. Your problem is not with the eating. You see,
a kitten's first eliminations are stimulated by the mother cat.
Now, if you'd like to do the same with a cotton swab dipped
in warm water you might be able to ..." And for the next few
days Mr. Rhine was up every two hours, with a cup of warm
water and a cotton swab, feeding, swabbing and sleeping and
Moses, who, appropriately enough, had been found in the
rushes, flourished.

Observation of the frequency with which the mother licks
different parts of the kitten's body reveals a definite pattern. The
region receiving most licking is the genital and perineal region;
next in order comes the region around the mouth, then the
underbelly, and finally the back and sides. The rate of licking
seems to be genetically determined, about three to four licks a
second. In albino rats the rate is six to seven licks a second.

Rosenblatt and Lehrman found that, during a fifteen-minute
observation session, maternal rats lick their newborn pups for
an average of two minutes and ten seconds in the anogenital
region and lower abdomen, for about twenty-five seconds to the
rear end of the back, about sixteen seconds on the upper abdo
men, and about twelve seconds on the back of the head.

Schneirla, Rosenblatt, and Tobach mention, among the crite
ria defining maternal behavior in the cat, exaggerated licking of
self and of young. We shall return to a consideration of the
significance of self-licking later. These observers found that
between 27 and 53 percent of the time was spent in licking; no
other activity approached licking in the amount of time devoted
to it.

Rheingold, in reporting her observations on a cocker spaniel,
a beagle, and three Shetland sheep dogs (Shelties), states that
licking started on the day of birth and occurred infrequently
after the forty-second day. The area most commonly licked was
the perineal region.

Turning to the order of mammals to which man belongs, the

18 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

primates, Phyllis Jay reports, on Indian langurs observed in the
field under natural conditions, that langur mothers lick their
young from the hour of their birth. The same appears to be true
of baboons under natural conditions. "Every few minutes she
explores the newborn infant's body, parts its fur with her
fingers, licks, and nuzzles it."

Interestingly enough, the great apes lick their young immedi
ately after birth, but not much thereafter. The ubiquity of the
practice among the mammals testifies to its basic nature.

The self-licking in which many mammals indulge, in the
nonpregnant or parturitive state, while having the effect of
keeping the animal clean, is probably more specifically designed
to keep the sustaining systems of the body the gastrointesti
nal, genitourinary, respiratory, circulatory, digestive, reproduc
tive, nervous, and endocrine systems adequately stimulated.
What this means in actual end effects is perhaps best illustrated
by the developmental failure which follows any significant re
straint of self-licking. A striking behavioral feature of both the
pregnant rat and the pregnant cat is intensified self-licking of
the genito-abdominal region as pregnancy progresses. The sig
nificance of this self-licking may be conjectured as serving to
stimulate and improve the functional responses of the organ
systems especially involved in the pregnancy during labor, de
livery, and parturient periods. It is known that after the birth
of the infant or litter, suckling and other stimulation of the
genito-abdominal regions of the body serve to maintain lacta
tion and cause the growth of the structures of the breast and
mammary glands. There is, however, no evidence that sensory
stimulation contributes to mammary development during preg
nancy. Drs. Lorraine L. Roth and Jay S. Rosenblatt inquired
into this matter experimentally. In a series of ingenious experi
ments these investigators put neck collars on pregnant rats in
such a manner that they were prevented from licking them
selves. It was found that the mammary glands of collared rats
were about 50 percent less developed than those of control
animals.

Since collars would undoubtedly produce some stress effect,

The Mind of the Skin 19

other uncollared pregnant rats were subjected to stress effects,
while still others were fitted with notched collars which allowed
them to lick themselves. In none of these, nor in the normal
uncollared groups, was the inhibition of mammary develop
ment anywhere nearly as great as in the collared group.

Birch and his collaborators have shown that when the female
rat is fitted with a light collar that prevents self-licking of the
abdomen and posterior erogenous zone, even though the collar
is removed permanently for delivery and thereafter, such
females make very poor mothers. They carry materials but fail
to build regular nests, spreading the materials around very
loosely instead. They do not nurse their young to any extent,
but seem to be disturbed when the newborn pups happen to
reach them, and tend to move away. The pups would invariably
die were it not for artificial interference by the experimenter.
Hence, depriving the pregnant female of the self-stimulation of
her body, which provides a normal preparation for maternal
behavior, seems also to deprive her of orientations that would
otherwise promote the fluid-licking, afterbirth-eating, and
other activities underlying the transition to the after-care pe
riod.

From such experiments it is clear that cutaneous self-stimu
lation of the mother's body is an important factor in contribut
ing to the development of the optimum functioning of her
sustaining systems, not only before and after pregnancy but
equally so during pregnancy. The question immediately arises
whether this may not also be the case during these same periods
in the human female? It is a question to which the answer sedfns
to be in the affirmative.

It is evident that in mammals generally cutaneous stimula
tion is important at all stages of development, but particularly
important during the early days of the life of the newborn,
during pregnancy, during labor, delivery, and during the nurs
ing period. Indeed, the more we learn about the effects of cu
taneous stimulation, the more pervasively significant for
healthy development do we find it to be. For example, in one
of the most recent studies reported, it was found that early

20 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

infantile cutaneous stimulation exerts a highly beneficial influ
ence upon the immunological system, having important conse
quences for resistance to infectious and other diseases. The
study indicated that rats who had been handled in infancy
showed a higher serum antibody titre (standard) in every case,
after primary and secondary immunization, than those who
had not been handled in infancy. Thus the immunological re-
sponsivity of the adult appears to be significantly modified by
early cutaneous experience. Such immunological competence
may be produced through the mechanism of conductor sub
stances and hormones affecting the thymus gland, a gland
which is critical in the establishment of immunological func
tion, and also through the mediation of that part of the brain
known as the hypothalamus.

Indeed, the evidence showing the greater resistance to disease
of subjects given early cutaneous stimulation is striking, but is
perhaps complicated by the fact that the cutaneously stimu
lated animal enjoys a great many other correlated advantages,
which undoubtedly also play a role in contributing to the higher
resistance of the stimulated organism. As many investigators
have confirmed, handling or gentling of rats and other animals
in their early days results in significantly greater increases in
weight, more activity, less fearfulness, greater ability to with
stand stress, and greater resistance to physiological damage.

In sheep, although active maternal assistance is not essential
in order for the newborn lamb to find the teats and suck for the
first time, the process is facilitated by licking and by directional
orientation of the ewe toward the lamb. In a series of experi
ments Alexander and Williams found that it was the combina
tion of the two factors, the licking and the directional orienta
tion that is, the standing of the ewe facing the kid that
significantly facilitated the progress of the kid toward successful
sucking. Neither orientation nor licking alone, which these in
vestigators later refer to as "grooming," facilitated the drive
toward sucking to any significant extent. Licking and maternal
orientation in every case resulted in substantially greater teat-
seeking activity, and also in a tendency towards an earlier in-

The Mind of the Skin 2 1

crease in weight than in unlicked lambs.

The importance of intercutaneous or reciprocal cutaneous
stimulation, or physical contact, between mother and young,
among birds as well as mammals, has been demonstrated by
many investigators. Blauvelt has shown that, in goats, if the kid
is removed from the mother for only a few hours before she has
a chance to lick it and the kid is then restored to her, "she seems
to have no behavioral resources to do anything further for the
newborn." In sheep Liddell found the same thing, and interest
ingly enough, Maier observed that the same held true of hens
and their chicks. Maier found that when broody hens are pre
vented from having physical contact with their chicks, even
though all other visual clues are left intact, and they are situated
in adjacent cages, the hens' broody response quickly disappears.
Furthermore, Maier found that hens kept in close physical
contact with their chicks and unable to leave them remained
broody for a longer period of time than those hens who were
free to leave their chicks whenever they chose.

Physical contact, then, appears to act as a principal regulator
of broodiness. Stimulation of the skin apparently constitutes an
essential condition in causing the pituitary gland to secrete the
hormone most important for the initiation and maintenance of
broodiness, namely prolactin. This is the same hormone as
sociated with the initiation and maintenance of nursing in
mammals, including the human mother.

Collias showed that, in goats and sheep, mothers establish
the identity of their own young immediately after birth, largely
by contact, and thereafter vigorously repel any alien young that
may approach them. The findings of many independent re
searchers indicate that there exist certain types of normal spe
cies-specific behavior dependent upon particular experiences
during critical periods in the life of the individual animal. It has
been found that changes in the natural environment at these
times often result in the development of abnormal, species-
atypical behavior. Hersher, Moore, and Richmond separated
twenty-four domestic goats from their newborn kids five to ten
minutes immediately following birth, for periods ranging from

22 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

a half hour to an hour. Two months later these mothers were
observed to nurse their own kids less and alien kids more than
nonseparated mothers. A most interesting and unforeseen re
sult of this experiment was the appearance of "rejecting" behav
ior, that is, nursing neither their own nor other kids, among
mothers of the nonseparated group. Separation of these highly
gregarious animals seems to have influenced the structure of the
herd as a whole, "changing the behavior of 'control' animals
whose early postpartum experiences had not deliberately been
disrupted, but whose environment had been affected in turn by
abnormal maternal and filial behavior produced in the experi
mental members of the group."

In an ingenious experiment designed to determine whether
the critical period for the development of individual specific
maternal behavior could be prolonged in sheep and goats,
Hersher, Richmond, and Moore found that this could, indeed,
be achieved by enforced contact between dam and young and
the prevention of butting behavior.

In the domestic collie, McKinney has shown that, immedi
ately after whelping, removal of the pups for little more than
an hour seriously retards the recovery of the mother, a recovery
which is accelerated by the rooting, nuzzling, and nursing of the
young. McKinney suggested that similar undesirable effects
may be produced in human mothers as a consequence of the
practice of removing their babies from them at birth without
permitting the continued contact that is so urgent a need in the
newborn. This suggestion has been fully confirmed by recent
research.

In the rhesus monkey Harry F. Harlow and his co-workers,
on the basis of their direct observations, "postulate that con
tact-clinging is the primary variable that binds mother to infant
and infant to mother." Maternal affection, they find, is at a
maximum during close bodily face-to-face contacts between
mother and infant, and maternal affection appears to wane
progressively as this form of bodily interchange decreases.

Maternal affection is defined by these authors as a function
of many different conditions, involving external incentive stim-

The Mind of the Skin 23

ulation, different conditions of experience, and many endo-
crinological factors. External incentives are those relating to the
infant, and involve contact-clinging, warmth, sucking, and vi
sual and auditory cues. Experimental factors relating to the
maternal behavior probably embrace the mother's entire experi
ence. Here it is probable that her own early experiences are of
special importance, as well as her relationships with each indi
vidual infant she bears, and her cumulative experiences gained
from raising successive infants. Endocrinological factors relate
both to pregnancy and parturition, and to the resumption of a
normal ovulatory cycle.

Indeed, the mother's early experiences are of considerable
importance for the subsequent development of her own off
spring, right into adulthood. In a series of elegant experiments,
Drs. Victor H. Denenberg and Arthur E. Whimbey showed
that the offspring of handled rats, whether in relation to the
natural or to a foster mother, exhibited a higher weight at
weaning than pups reared by mothers that had not been han
dled in infancy; they also defecated more and were significantly
less active than the offspring of nonhandled mothers.

Ader and Conklin found that the offspring of rats that had
been handled during pregnancy, whether they remained with
their natural mothers or were cross-fostered to other females,
were significantly less excitable than the offspring of unhandled
rats.

Werboff and his co-workers found that handling of pregnant
mice throughout the gestation period resulted in an increased
number of live fetuses and surviving offspring. The decrease in
weight these workers observed may, as they suggest, be due to
the increased litter size.

Sayler and Salmon found that young mice raised in a commu
nal nest, in which females combined their litters, showed faster
rates of growth during the first twenty days than young raised
by single females, even when the ratio of mothers to young was
the same. The investigators think that the differences in body
weight are most likely related to the nutritional benefit of addi
tional and higher quality milk provided by more than one

24 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

mother. They also think that tactile stimuli may be operative,
as well as thermal ones, the presence of additional littermates
and mothers serving to insulate the pups so that more metabolic
energy could be devoted to growth. Mice normally spend a
great proportion of time in bodily contact with other mice;
when isolated from such contact for durable periods of time
they show an increased sensitivity to tactile stimuli, but not to
photic ones.

Weininger found that male rats gentled for three weeks fol
lowing their weaning at twenty-three days had, at forty-four
days, a mean weight twenty grams higher than the ungentled
control group; furthermore, the growth of the gentled was
greater than that of the ungentled rats. In an open-field test
gentled rats ventured significantly closer to the brilliantly lit
center of the open-field setup, thus showing more of a tendency
to ignore the natural habit of their species to cling to walls and
avoid light. Rectal temperatures were significantly greater in
the gentled rats, suggesting a possible change in the metabolic
rate of these animals.

When exposed to stressful stimuli (immobilization, and total
food and water deprivation for forty-eight hours) and autopsied
immediately thereafter, the gentled rats showed much less dam
age to the cardiovascular and gastrointestinal systems than the
ungentled rats.

Cardiovascular and other organic damage under prolonged
stress, as Hans Selye and others have abundantly demonstrated,
may be considered an end product of the action of the
adrenocorticotropic hormone (ACTH); that is, the hormone
secreted by the pituitary gland which acts upon the cortex of
the adrenal gland to cause it to secrete cortisone. This interac
tive relationship is sometimes called the sympathetico-adrenal
axis. Weininger suggests that the relative immunity to stress
damage exhibited by the gentled animals was probably due to
their lesser output of ACTH from the pituitary in response to the
same alarming situation with which the ungentled animals were
confronted. If this were in fact the case, it would be expected
that the adrenal glands of gentled and ungentled rats following

The Mind of the Skin 25

stress would show those of the ungentled rats having been
stimulated by more ACTH output, to be heavier, and upon ex
amination this was, indeed, found to be the case. "A major
change in hypothalamic functioning, involving reduction or
inhibition of massive sympathetic discharge in response to an
alarming stimulus (and hence decreased ACTH output from the
pituitary), is predicted to account for the results mentioned
above."

The process is much more complicated than that, but, re
duced to its essential elements, the relation between the pitui
tary-adrenal secretions in gentling and stressful situations holds
true. Gentled animals respond with an increased functional
efficiency in the organization of all systems of the body. Ungen
tled animals fail to undergo organization expressing itself in
functional efficiency, and are therefore in all respects less able
to meet the assaults and insults of the environment. Hence,
when we speak of "licking and love," or skin (cutaneous tactile)
stimulation, we are quite evidently speaking of a fundamental
and essential ingredient of affection, and equally clearly of an
essential element in the healthy development of every organism.

Fuller found that puppies isolated from all contact shortly
after birth, and subsequently stroked and handled by human
beings, did better on tests following their emergence from isola
tion than puppies that had been neither stroked nor handled.

The workers at the Cornell Behavior Farm found that, with
no licking at all (although licking for one hour after birth is
sufficient) many newborn lambs fail to stand and subsequently
die. While it is possible for some lambs to stand without licking,
it is notable that when the newborn makes an effort to rise its
mother will often keep it down with her foot until she has licked
it. Barron found that lambs that had been dried off with a towel
(the equivalent of licking) rise on their four feet before lambs
who have not been dried off.

The very real effects of early tactile experience have been
impressively demonstrated by a series of independent experi
ments. Karas, for example, found that rats handled during the
first five days showed a maximal effect of emotionality, as mea-

26 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

sured by avoidance conditioning, as compared with animals
handled at other times during infancy. Levine and Lewis found
that animals handled during days 2 to 5 after birth showed a
significant depletion of adrenal ascorbic acid in response to
severe cold stress at twelve days of age, as compared with
nonhandled animals and animals handled after the first five
days, who did not show a significant depletion reaction to stress
till the sixteenth day of life. Bell, Reisner, and Linn found that
twenty-four hours after electroconvulsive shock blood sugar
level was significantly higher in nonhandled animals and ani
mals handled at times other than the first five days, than in
animals handled during the first five days. Denenberg and
Karas observed that rats handled during the first ten days of life
weighed the most, learned best, and survived longest.

The manner in which the young of all mammals snuggle up
to and cuddle the body of the mother as well as the bodies of
their siblings or of any other introduced animal strongly sug
gests that cutaneous stimulation is an important biological
need, for both their physical and behavioral development. Al
most every animal enjoys being stroked or otherwise having its
skin pleasurably stimulated. Dogs appear to be insatiable in
their appetite for stroking, cats will relish it and purr, as will
innumerable other animals both domestic and wild, apparently
enjoying the stroking at least as much as they do self-licking.
The supreme note of confidence offered a human by a cat is to
rub itself against your leg.

The touch of a human hand is very much more effective than
the application of an impersonal mechanical apparatus, as for
example in milking, where it is well known among experts and
dairy farmers that hand-milked cows give more and richer
terminal milk than machine-milked cows. Hendrix, Van Valck,
and Mitchell have reported that horses exposed to human han
dling immediately after birth developed unusual adult behavior.
Among the adult traits observed in these handled horses were
responsible behavior in emergencies without loss of cooperative
tractability at other times, and inventive behavior for equine-to-
human communication in situations of urgency.

The Mind of the Skin 27

Dolphins, as I know from personal observation, love to be
gently stroked. At the Communications Institute in Miami I
enjoyed the opportunity of making friends within a few minutes
with Elvar, an adult male dolphin who occupied a small tank
all to himself. Because Elvar playfully habitually splashed
them, visitors were customarily provided with oilskins. Elvar
adjusted his splashes to the size of the visitor: small children
would receive small splashes, middle-sized children middle-
sized splashes, and adults, large ones. For some reason I re
ceived no splash at all. Dr. John Lilly, the director, stated that
this had never happened before. Approaching Elvar with all the
affection, interest, and respect he deserved, I proceeded to
stroke the top of his head. This was very much to his liking.
During the remainder of the visit Elvar proceeded to expose
every part of his body for me to stroke, leaning over sidewards
so that I could stroke him under his flippers, which he seemed
particularly to enjoy. It is sad to have to record that some
months afterwards Elvar caught cold from a human visitor and
died.

Drs. A. F. McBride and H. Kritzler of the Duke University
Marine Laboratory at Beaufort, North Carolina, have re
corded, of a two-year-old female dolphin, that she "became so
fond of being caressed by the observer that she would frequently
rear cautiously out of the water to rub her chin on the knuckles
of his clenched fist." The same observers recorded that "dol
phins are very fond of rubbing their bodies on various objects,
so a backscratcher, constructed of three stout sweeper's brushes
fixed to a slab of rock with the bristles directed upward, was
installed in the tank. The young dolphins took to rubbing them
selves on these brushes as soon as the adults discovered their
purpose."

Similar behavior has been reported in gray whales in the
waters of Laguna San Ignacio, west coast Baja California, 430
nautical miles south of the California border. Here a group of
friendly whales, and especially an adult female, sought out a
group of small boats and their occupants in order to be
scratched. They would scratch themselves against the boats,

28 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

and then rise out of the water to be scratched by hand or with
a long-handled neck brush. "The pleasure of a touch-stimulus,"
writes Raymond Gilmore, the author of this fascinating report,
"through body-contact is obvious among gray whales." The
nine color photos illustrating this speak for themselves.

Quite fascinating is an observation made by Mr. A. Gunner
relating to the fleas carried by hedgehogs. He writes:

I have kept and observed hedgehogs for some fifty or sixty years
and am convinced that de-fleaing hedgehogs is not good for
them. There is some essential factor which the fleas provide. It
may be and I think it is a skin circulation stimulus that is
missing in an animal unable to nudge, massage, scratch, rub or
otherwise stimulate the skin to keep its labyrinth of capillaries
properly active.

A zoologist friend assures me that I may be right, as the
Australian echidna, some armadillos, and particularly that
mammalian curiosity the pangolin tolerate insect populations in
the overlaps at crevices of their armoured bodies and that the
cleaned up and deloused animal does not long survive.

In attempting to follow up this observation I regret to say I
could obtain no further information of any kind on the subject,
but, like the zoologist friend of Mr. Gunner, I rather suspect
that his observation is a sound one. The close (commensal)
association of birds with other animals, from crocodiles whose
teeth they pick, to sheep on whose backs they often alight,
picking debris and insects from their bodies with the obvious
approval of their hosts, the "grooming" of monkeys and apes,
or the loving embrace all these forms of behavior indicate that
a basic and complex need is involved.

What emerges from the observations and experiments re
ported here and there are many more with which we shall
deal in subsequent pages is that cutaneous stimulation in the
various forms in which the newborn and young receive it is of
prime importance for their healthy physical and behavioral
development. It appears probable that for human beings tactile
stimulation is of fundamental significance for the development

The Mind of the Skin 29

of healthy emotional or affectional relationships, that "licking,"
in its actual and in its figurative sense, and love are closely
connected; in short, that one learns to love not by instruction
but by being loved. As Professor Harry Harlow has put it, from
the "intimate attachment of the child to the mother, multiple
learned and generalized affectional responses are formed."

In a series of valuable studies Harlow has demonstrated the
significance of physical contact between the monkey mother
and her infant for the subsequent healthy development of the
latter. During the course of his studies Harlow noticed that the
laboratory-raised baby monkeys showed a strong attachment to
the cloth pads (folded gauze diapers) which were used to cover
the hardware-cloth floors and cages. When an attempt was
made to remove and replace the pads for sanitary purposes the
infants clung to them and engaged in "violent temper tan
trums." This is, of course, similar to the "security-blanket"
behavior of many small children (see pp. 276-277). It had also
been discovered that infants raised on a bare wire-mesh cage
floor survive with difficulty, if at all, during the first five days
of life. When a wire-mesh cone was introduced, the baby did
better; and when this was covered with terry-cloth, husky,
healthy babies developed. At this point Harlow decided to build
a terry-cloth surrogate mother, with a light bulb behind her
which radiated heat. The result was a mother, "soft, warm, and
tender, a mother with infinite patience, a mother available
twenty-four hours a day, a mother that never scolded her infant
and never struck or bit her baby in anger."

A second surrogate mother was built entirely of wire mesh,
without the terry-cloth "skin," and hence lacking in contact
comfort. The remainder of the story is best told in Harlow's
own words. He writes:

In our initial experiment, the dual-mother surrogate condition,
a cloth mother and a wire mother were placed in different cubi
cles attached to the infant's living cage. . . . For four newborn
monkeys the cloth mother lactated and the wire mother did not;
and for the other four, this condition was reversed. In either

30 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

condition the infant received all its milk through the mother
surrogate as soon as it was able to maintain itself in this way, a
capability achieved within two or three days except in the case
of very immature infants. Supplementary feedings were given
until the milk intake from the mother surrogate was adequate.
Thus, the experiment was designed as a test of the relative im
portance of the variables of contact comfort and nursing com
fort. During the first 14 days of life the monkey's cage floor was
covered with a heating pad wrapped in a folded gauze diaper,
and thereafter the cage floor was bare. The infants were always
free to leave the heating pad or cage floor to contact either
mother, and the time spent on the surrogate mothers was auto
matically recorded. Figure 3 shows the total time spent on the
cloth and wire mothers under the two conditions of feeding.
These data make it obvious that contact comfort is a variable of
overwhelming importance in the development of afFectional re
sponses, whereas lactation is a variable of negligible importance.
With age and opportunity to learn, subjects with the lactating
wire mother showed decreasing responsiveness to her and in
creasing responsiveness to the nonlactating cloth mother, a
finding completely contrary to any interpretation of derived
drive in which the mother-form becomes conditioned to hunger-
thirst reduction. The persistence of these differential responses
throughout 165 consecutive days of testing is evident in Figure
4.

We were not surprised [writes Harlow], to discover that con
tact comfort was an important basic afFectional or love variable,
but we did not expect it to overshadow so completely the vari
able 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. Certainly, man cannot live by milk alone. Love is
an emotion that does not need to be bottle- or spoon-fed, and we
may be sure that there is nothing to be gained by giving lip
service to love.

By far the most important of Harlow's observations was the
finding that his infant monkeys valued tactile stimulation more
than they did nourishment, for they preferred to cling to
"mothers" who provided physical contact without nourish-

The Mind of the Skin

31

FED ON CLOTH MOTHER

o > CLOTH MOTHER
^---^ WIRE MOTHER -

6-10 11-15 16-20

DAYS OF AGE

FED ON WIRE MOTHER

CLOTH MOTHER
> WIRE MOTHER

6-10 11-16 16-20

DAYS OF AGE

FIGURE 3. Time spent on cloth and wire mother surrogates. (From H.
F. Harlow and R. R. Zimmermann, "The Development of Affectional
Responses in Infant Monkeys," Proceedings, American Philosophical
Society, 702:501-509, 1958. By permission.)

ment to wire ones who did supply nourishment. Harlow goes
so far as to suggest that the primary purpose of nursing is to
ensure frequent body contact between infant and mother. Such
contact may not be the primary function of nursing, but it is
certainly a fundamentally important one, a matter we shall
discuss in greater detail later.
Finally, Harlow concludes:

We now know that women in the working classes are not needed
in the house because of their primary mammalian capabilities;
and it is possible that in the foreseeable future neonatal nursing
will not be regarded as a necessity, but as a luxury to use
Veblen's term a form of conspicuous consumption limited per
haps to the upper classes.

As we shall see (pp. 59-75), Harlow thoroughly underesti
mates the importance of breastfeeding in both animals and
man, but this does not in the least affect the validity of his
conclusions concerning the value of body contact between
mother and infant. As Harlow and his co-workers have shown,
in their normal nursing-couple (mother and infant) rhesus mon
keys, nutritional and nonnutritional nipple contacts endure for
some three months. These nipple contacts undoubtedly play an

32

TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

important role in the development of the individual.

When a baby is born a mother is also born. There is con
siderable evidence that at this time, and for months the
reafter, her needs for contact exceed those of the infant. The
Harlows observed that during the first few months in the
rhesus monkey the mother's need for intimate contact sur
passed that of the infant, and served to produce maternal
protection. In the human mother the need for intimate con
tact is undoubtedly much greater and considerably more
prolonged than it is in other mammals, serving not only im
portant psychological functions, but also many physiological
ones, such as arresting of the postpartum hemorrhage, con
traction of the uterus, detachment and expulsion of the pla
centa, improved circulation, etc.

A striking finding of Harlow and his fellow investigators

FED ON CLOTH MOTHER

en
u 12

CLOTH MOTHER
O O WIRE MOTHER

_ o O O

O _

1-5 20-25 80-85 120-125

DAYS OF AGE

160-165

FED ON WIRE MOTHER

^

I8
QL

LjJ

Q. 12

> CLOTH MOTHER
O---O WIRE MOTHER

_ 0---0 --------

-

1-5 20-25 80-85 120-125 160-165

DAYS OF AGE

FIGURE 4. Long-Term Contact Time on Cloth and Wire Mother
Surrogates. (From H. F. Harlow and R. R. Zimmermann, "The
Development of AfFectional Responses in Infant Monkeys," Proceed
ings, American Philosophical Society, 7(92:501-509, 1958. By permis
sion.)

The Mind of the Skin 33

was that when the five utter failures as mothers had their
histories traced back to their early experiences it was found
that they had been denied the opportunity to develop nor
mal maternal-infant relationships, that they had never
known a real monkey mother of their own, and had also
been denied normal infant-infant relationships, subsequently
having only limited physical association with other monkeys.
Two of these mothers were essentially indifferent to their in
fants, and three were violently abusive. "Failure of normal
gratification of contact-clinging in infancy may make it im
possible for the adult female to show normal contact rela
tionships with her own infant. Likewise, maternal brutality
may stem from inadequate social experience with other in
fants within the first year of life." Furthermore, these inves
tigators found that none of the motherless-mother animals
ever showed normal female sex behavior, such as posturing
and responding. They became mothers in spite of them
selves. As we shall see, the parallel with such interrelated
behaviors in humans is virtually complete, and the signifi
cance of these behaviors is virtually identical.

Maternal behavior in mammals is not entirely dependent
upon either hormones or learning, but it is more readily and
effectively developed by stimulation received by the mother
from the young. Roth has shown that maternal behavior is
delayed when pups are presented in wire baskets attached to
the inside of the female's cage where the female cannot lick
or contact them in other ways. Terkel and Rosenblatt found
that maternal behavior can be induced more rapidly, in
about two days, by confining virgin female rats in narrow
cages where they are forced to remain in contact with pups
continuously rather than sporadically as in the larger stan
dard cages. Maternal responsiveness to the young varies
with the amount of stimulating contact she has with them
which permits the various stimuli from the young to exert
their effects.

Rosenblatt has proposed the concept of "synchrony" to
denote the fact that the mother's behavior is adapted to the
needs and behavioral capacities of the young, and that her

34 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

behavior changes as these capacities develop in the young.
Synchrony however is a term which refers to the simul
taneity of events in time, and I would suggest that inter
dependence more accurately describes the relationship and
the significance of the reciprocal interstimulation that occurs
between mother and offspring in the neonatal period. Of
course, there is a marvelous synchrony about these recipro
cal changes, but their very reciprocity underscores their in
terdependence. It is the reciprocal interstimulation between
mother and infant that leads to the development in each of
the changes, somatic and behavioral, which in the absence
of such interstimulation will not occur. Hence, the impor
tance of the interstimulation of the nursing couple can
hardly be overestimated.

Harlow and his co-workers comment upon the "extremely
powerful social response observed throughout the monkey
kingdom," namely, that of grooming. This response to their
young increased throughout the first thirty days following the
birth of the infant, and they suggest that this perhaps represents
an intensification of the specific psychological bond between
mother and infant.

Phyllis Jay reports that "from the hour of its birth" the
mother langur monkey "inspects, licks, grooms, and manipu
lates the infant. When the newborn is nursing quietly or sleep
ing, she grooms and strokes it softly without disturbing or
waking it. For the first week of life the newborn is never away
from its mother or another adult female."

Tactile communication forms an elaborate medium of com
munication among primates. Sexual presenting, mounting
without sex, lip smacking (ear flattening), embracing, genital/
stomach nuzzling, rump nuzzling, mouth/head kissing, rump
fingering, hand touching, biting, have been widely observed
among primates, and, as Peter Marler, summarizing the evi
dence, has said, "It would be difficult to overestimate the im
portance of such tactile signals in maintaining peace and cohe
sion in primate societies."

The Mind of the Skin 35

As an order, primates are, as Hediger has remarked, con
tact animals. The young are carried on their mothers' bodies
for long periods of time. There is much clinging, riding, and
contact with other members of the group. Young animals,
and often adults, tend to sit and even sleep together in close
contact. There is a great deal of touching and, most charac
teristically, grooming. Primates groom each other. Groom
ing not only serves to keep the body free of parasites, dirt,
and the like, but it constitutes, as Allison Jolly puts it, "the
social cement of primates from lemur to chimpanzee." An-
thoney has described the development of grooming in the
dog-headed baboon, Papio cynocephalus, from the infant's
suckling the nipple, to grasping the specialized sucking fur,
to grooming. The reciprocal pleasure enjoyed in this relation
is quite probably related to the later pleasure of grooming
and being groomed.

In addition to grooming, primates exhibit a large variety of
other contact behaviors, such as patting and nuzzling, espe
cially in greeting behavior. Chimpanzees will not only pat each
others' hands, faces, groins, and other parts of the body, but will
lay a hand on each others' backs in reassurance, will kiss in
affection, and in their passion for being tickled will draw the
tickler's hand to their bodies.

Grooming with the hands, which is usual among monkeys
and apes, or, as among lemurs, with the specialized comb-
like teeth, presents an interesting seriation, for as Jolly has
pointed out, the lemurine form of grooming with the teeth
really represents a form of licking. This view of grooming
may be extended to the finger-picking variety, and finally to
the stroking of human beings. In short, it may well be that
there has been an evolutionary development from licking, to
tooth-combing (as among lemurs), to finger-grooming, to
handstroking or caressing, as in chimpanzee, gorilla, and
Homo sapiens, and that therefore handstroking is to the
young of the human species virtually as important a form of
experience as licking is to the young of other mammals.

36 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

This is a matter into which we shall inquire further. Mean
while, it would seem evident that one of the elements in the
genesis of the ability to love is "licking" or its equivalent in
other forms of pleasurable tactile stimulation.

TWO
THE WOMB OF TIME

There are many events in the womb of time, which
will be deliver'd.

SHAKESPEARE, Othello, 1, iii.

As we have seen in the preceding chapter, licking, or tooth-
combing, or grooming of the young soon after they are born and
for an appreciable period thereafter, appears to be an indispen
sably necessary condition for their survival. Such stimulations
seem to be equally necessary for the healthy behavioral develop
ment of the young. If this is so, why then is it that human
mothers neither lick, toothcomb, nor groom their young?

Human mothers do none of these things. Extensive inquiries
over many years yielded only two cultures in which mothers
sometimes washed their young by licking. In regions in which
water is scarce, among the Polar Eskimos and in the Tibetan
highlands, mothers sometimes resort to licking their older
young children as a substitute for washing them with water
drawn from other sources. The fact is that human mothers do
not lick their young, though traditional wisdom has not been
insensible to the likeness between what the good human mother
does and what the mammalian mother of other species does.
The parallel is recognized in such phrases as un ours mal leche,
"an unlicked cub." The French phrase is often employed to
describe an ill-mannered person, "a boor," one who is

38 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

"gauche," awkward in his relations with others. Although the
notion behind this phrase originally referred to the belief that
the young of some animals were born in so undeveloped a form
that they had to be licked into shape by the mother,* later usage
conferred upon the phrase a meaning implicitly recognizing the
importance of the mother's gentle ministrations in the develop
ment of what might be called "relatability." George Sarton, the
distinguished Belgian- American historian of science, for exam
ple, wrote in his private journal, "I have now discovered that
the first of August is the saint's day of the Spaniard Raymond
Nonnatus (1200-1240). He was called Nonnatus because he
was 'not-born,' but removed from his mother's womb after her
death. My own fate was not very different from his, because my

mother died soon after my birth and I never knew her Many

of my shortcomings are due to the fact that I had no mother,
and that my good father had no time to bother much about me.
I am indeed 'an unlicked bear' (un ours mal leche). "

The question we have to answer here is: What, if any, are the
equivalents of "licking" which the human mother gives her
child in order to prepare sustaining systems for adequate func
tioning?

I suggest that one of the equivalents for "licking" is repre
sented by the long period of labor that the parturient human
female undergoes. The average duration of labor with the
firstborn is fourteen hours; with subsequent-born children the
average duration of labor is eight hours. During this period the
contractions of the uterus provide massive stimulations of the
fetal skin. These uterine contractions serve much the same
functions and end effects that licking of the newborn does in
other animals. In the womb the fetus has been constantly stimu
lated by the amniotic fluid and by the growing pressures of its
own body against the walls of the uterus. These stimulations are

*Pliny the Elder (A.D. 23-79) writes in his Natural History, Book VIII,
126, "Bears when first born are shapeless masses of white flesh a little larger
than white mice, their claws alone being prominent. The mother then licks
them gradually into proper shape."

The Womb of Time 39

greatly intensified during the process of labor in order to pre
pare the sustaining systems for postnatal functioning in ways
somewhat different from those which were necessary in the
aquatic environment in which the fetus has thus far spent its
life. This intensification of cutaneous stimulations is especially
necessary in the human fetus because, contrary to general be
lief, the period of gestation is not completed when the baby is
born. It is only half-completed. It will be necessary for us to
discuss this matter further, in order to gain some insight into
the precarious condition in which the young of human kind is
born, and why it is necessary that the human neonate undergo
certain kinds of cutaneous stimulation.

THE MEANING OF NEONATAL AND INFANT IMMATURITY IN

HUMANS. Why are human beings born in a state so immature
that it takes eight to ten months before the human infant can
even crawl, and another four to six months before he can walk
and talk? That a good many years will elapse before the human
child will cease to depend upon others for his very survival
constitutes yet another evidence of the fact that humans are
born more immature, and remain immature for a longer period,
than any other animal.

The newborn elephant and the fallow deer are able to run
with the herd shortly after they are born. By the age of six
weeks, the infant seal has been taught by his mother to navigate
his watery realm for himself. These animals all have long gesta
tion periods, presumably because animals that give birth to
small litters are unable to protect them as efficiently as preda
tory animals, and must therefore give birth to young who are
in a fairly mature state. A long gestation period serves to allow
for such maturation.

The elephant, which has a gestation period of 515 to 670
days, gives birth to a single infant. In animals such as the fallow
deer, which gives birth to a litter of two or three, the gestation
period is 230 days. In the seal, which produces only a single pup
at a birth, the gestation period varies from 245 to 350 days.
Predatory animals, by contrast, are very efficient in protecting

40 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

their young, and have a short gestation period. Their litters may
vary from three at a birth upwards; the size of the young may
be small at birth, and the young may be born in a somewhat
immature state. The lion, for example, which generally has a
litter of three cubs, has a gestation period of 105 days. Humans
have a gestation period of 266*/2 days, which is distinctly in the
class of long gestation periods. Since this is so, what can be the
explanation for the extremely immature state in which humans
are born? This is a somewhat different question from that which
refers to the prolonged immaturity of the young of human kind.

Apes are also born in an immature condition, but remain in
that state for a much shorter period than human infants. The
average duration of gestation in the gorilla is about 252 days,
in the orang-utan about 273 days, and in the chimpanzee 23 1
days. Labor in the apes generally lasts not more than two hours,
which contrasts strikingly with the average of fourteen hours
for the firstborn and eight hours for the subsequent born in the
human female. Like humans, the apes are monotocous, that is,
one infant is usually conceived and born at term, but compared
with that of humans the development of the young ape is some
what more rapid, so that the infant ape takes about one-third
to two-thirds of the time the human infant does to develop such
traits as lifting the head, rolling, worming along, sitting alone,
standing, and walking. Ape mothers tenderly care for their
young for several years, and it is not uncommon for breastfeed
ing to continue for three or more years. Human immaturity in
infancy, therefore, may be regarded as an extension of the basic
infant immaturity characteristic of all anthropoid forms, char
acteristic, that is, of the great apes and probably earlier forms
of humankind. Among anthropoids the care, feeding, and pro
tection of the young fall exclusively to the females. Only when
the females and the young are endangered do the males act to
protect them.

While the length of the gestation period lies within the same
range in anthropoids and in humans (see Table I), there is a
marked difference in the growth of the fetus in the two groups.
This is seen in the great acceleration in the rate of growth of

The Womb of Time 41

the human fetus, as compared with the anthropoid fetus, to
wards the end of the gestation period. This is most strikingly
seen in the increase in size of the human fetal brain, which by
the time of birth has acquired a volume of between 375 and 400
cubic centimeters. Total body weight of the human newborn
averages 7 pounds. In the chimpanzee total body weight of the
neonate is, on the average, 4.33 pounds (1,800 grams), and the
brain volume is about 200 cubic centimeters. In the gorilla the
total body weight of the newborn is about 4.75 pounds (1,980
grams), and the brain size at birth would appear to be not much
more than in the chimpanzee.

TABLE I. LENGTH OF GESTATION, POSTNATAL GROWTH
PERIODS, AND LIFE SPAN IN APE AND HUMAN

Eruption of Completion

First and Last

of General

Life

Gestation

Menarche Permanent Teeth Growth

Span

Genus

(days)

(years)

(years)

(years)

(years)

Gibbon

210

8.5

7-8.5

9

30

Orang-Utan

273

?

3.0-9.8

11

30

Chimpanzee

231

8.8

2.9-10.2

11

35

Gorilla

252

9.0

3.0-10.5

11

35

Human

266 Vi

13.5

6.2-20.5

20

75

The smaller size of the anthropoid newborn is probably cor
related to some extent with the shorter duration of labor in the
anthropoid female. In humans, however, the large body size,
and especially the large size of the head at 266 V4 days of fetal
age, necessitate the birth of the child at that time. If it were not
born then and it continued to grow at the rate at which it is
geared to grow, it could not be born at all with lethal conse
quences for the continuation of the human species.

As a result of the evolution of the erect posture in humans,
the pelvis has undergone major rearrangement in all its parts.
Among these changes has been a narrowing in the pelvic outlet.
During parturition the pelvic outlet enlarges somewhat with
the relaxation of the pelvic ligaments, enough to permit the

42 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

head of the child, with a certain amount of molding and com
pression, to pass through the birth canal. In adaptation to this
situation the skull bones of the human infant, in relation to the
membranes in which these bones develop, grow much less than
those of the ape infant of the same gestation age. Thus the
human infant's skull bones allow for a considerable amount of
movement and overlapping in adaptation to the compressive
forces that will act upon them during the process of birth. The
human infant, then, is born when it is because it must be born
at that time; otherwise the rapid rate at which its brain grows
would make it impossible for it to be born at all. The brain
growth of the anthropoid infant presents no such problems,
particularly in view of the mother's generous pelvic arrange
ments.

Not only does the prolonged period of behavioral immaturity
of the human infant reveal how undeveloped and dependent it
is at birth, so too does its biochemical and physiological im
maturity. For example, a variety of enzymes remain un
developed in the newborn human. In this the human shares a
trait common to a number of other mammals, except that in the
human infant, unlike most other mammalian infants thus far
investigated, most of these enzymes are not present at all. In
guinea pigs and mice, for example, the liver enzymes develop
during the first week of life, but require some eight weeks for
full development. It appears that in all mammals some factor
is present in the uterine environment which represses the for
mation of liver enzymes in the fetus. In the human infant some
liver and duodenal enzymes (amylase) do not appear until sev
eral weeks or months have passed. Gastric enzymes are present
which are fully capable of dealing with the ingested colostrum
and milk from the maternal breast, but these enzymes cannot
effectively metabolize foods normally consumed by older chil
dren.

All the evidence indicates that, while the duration of the
gestation period in humans differs by only about a week or two
from that of the great apes, a large number of other factors, all
combining to lead to the considerably more prolonged develop-

The Womb of Time 43

ment of the human infant, cause it to be born before what is
generally believed to be its gestation has been completed. One
would think that a creature developing at the rate of the human
fetus in the later stages of uterine development and during
childhood, should, developmentally, enjoy a much longer pe
riod of gestation within the womb. In humans, as compared
with apes, every one of the developmental periods infancy,
early childhood, later childhood, adolescence, young adult
hood, later adulthood or maturity, and terminal age with the
exception of the developmental period within the womb, is
greatly extended in duration. Why not also the period of gesta
tion?

The explanation seems to be that the fetus must be born when
its head has reached the maximum size compatible with its
passage through the birth canal. This transmigration consti
tutes no mean accomplishment. Indeed, the passage through
the 4 inches of the birth canal is the most hazardous journey
a human being ever takes. The evidence suggests that the
human fetus is born before its gestation is completed. The rate
of growth of the brain is proceeding at such a pace during the
last month of pregnancy that its continuation within the womb
would render birth impossible. Hence, the survival of the fetus
and the mother requires the termination of gestation within the
womb when the limit of head size compatible with birth has
been attained, and long before maturation occurs.

The process of evolution by which the increase in the length
of human developmental periods has been accomplished is
known as neoteny. The term refers to the process whereby the
functional and structural features of the young (fetal or juve
nile) of ancestral forms are retained in the developmental stages
of the maturing individual, from infancy to adulthood. Man's
large head, flat face, roundheadedness, small face and teeth,
absence of brow ridges, thinness of skull bones, late suture
closure, relative hairlessness, thin nails, prolonged period of
educability, playfulness, love of fun, and many other traits all
constitute evidence of neoteny.

The gestation period, then, is also greatly extended in hu-

44 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

mans, except that its latter half is completed outside the womb.
Gestation, as we have usually understood it, is not it would
seem completed at birth, but is continued from gestation within
the womb, uterogestation, to gestation outside the womb, ex-
terogestation. Bostock has suggested that the limit of exteroges-
tation be set at the stage of the beginning of effective crawling
on all fours, a suggestion which has considerable merit. Inter
estingly enough, the average duration of exterogestation, taking
its limit here to be when the infant commences to crawl, lasts,
on the average, exactly the same time as uterogestation, namely,
266 l /2 days. In this connection it is also of interest to note that
while the mother continues to nurse her infant, pregnancy will
be delayed for some time. Nursing the child at the breast causes
the suppression of ovulation for variable periods of time, and
thus constitutes a natural, although not altogether dependable
method of child-spacing. It also suppresses menstrual bleeding.
Menstrual bleeding tends to be heavier and longer-lasting when
the mother does not breastfeed, and, as a consequence of the
heavier bleeding, the mother's reserve energies tend to be some
what depleted. The premature cessation of breastfeeding would,
then, result in distinct disadvantages, especially when a mother
already has other children who require her attention. Hence
breastfeeding confers benefits not only upon the baby but also
upon the mother, and therefore upon the group. This is to
mention only the physical benefits of breastfeeding. Even more
important are the psychological advantages which are recipro
cally conferred upon infant and mother in the nursing situation,
especially in a species in which the mother is symbiotically
designed to continue the gestation of her child outside the
womb.

To learn what the child must learn in order to function as an
adequate human being, he must, then, possess a large ware
house in which to store all the necessary information, a brain,
in short, of considerable storage and retrieval capacity. It is a
striking fact that by the time the human child has attained its
third birthday it has virtually achieved full adult brain size. The
average brain volume of the human three-year-old is 960 cubic

The Womb of Time 45

centimeters, while the brain volume of the human adult, at
tained at the age of twenty years, is 1,200 cubic centimeters;
that is to say, after the end of its third year the human brain
will grow by only another 240 cubic centimeters to attain its full
size, and that 240 cubic centimeters will accumulate by small
increments over the next seventeen years. In other words, at the
end of three years of age the human child has achieved 90
percent of its brain growth. Significantly, the infant brain more
than doubles in volume by the end of its first year to about 750
cubic centimeters, or 60 percent of its adult size. Almost two-
thirds of the total growth of the brain is achieved by the end
of the first year. It will take an additional two years to add
almost another third to the volume attained at the end of the
third year (see Table II). In its first year, therefore, the infant's
brain grows more than it ever will again in any one year.

TABLE II. GROWTH IN BRAIN AND CRANIAL
CAPACITY IN HUMANS (BOTH SEXES)

Cranial

Volume Capacity

Weight (cubic (cubic

Age (grams) centimeters) centimeters)

Birth 350 330 350

3 months 526 500 600

6 months 654 600 775

9 months 750 675 925

1 year 825 750 1,000

2 years ,010 900 ,100

3 years ,115 960 ,225

4 years ,180 ,000 ,300
6 years ,250 ,060 ,350
9 years ,307 ,100 ,400

12 years ,338 ,150 ,450

15 years ,358 ,150 ,450

18 years ,371 ,175 ,475

20 years 1,378 ,200 ,500

SOURCE: Growth and Development of the Child, Part II, White House Confer
ence (New York: Century Co., 1933), p. 110.

46 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

It is important that most of the brain growth be accom
plished during the first year, when the infant has so much to
learn and do. Indeed, the first year of life requires a great deal
of unobtrusive packing for a journey that will continue for the
rest of the traveler's life. To perform this packing safely, the
infant must possess a brain much larger than 375 to 400 cubic
centimeters, but quite clearly he cannot wait until he has grown
a brain of 750 cubic centimeters before being born. Hence, he
must be born with the maximum-sized brain possible, and do
the remainder of his brain growing after birth. Since the human
fetus must be born when its brain has reached the limit of size
congruent with its admission into and extrusion through the
birth canal, such maturation or further development as other
mammals complete before birth, the human mammal will have
to complete after birth. In other words, the gestation period will
have to be extended after birth.

When the uterogestation period is extended beyond the ex
pected date of delivery for more than two weeks, the pregnancy
is said to be postmature. Some 12 percent of births are delayed
two weeks beyond the due date, and some 4 percent are delayed
three weeks. All the evidence indicates that postmaturity is
increasingly unfavorable for the fetus, as well as for its postnatal
development. The perinatal mortality rate is more than twice
as high for postterm infants as it is for term infants, and the
incidence of primary cesarean section done because of head-
pelvis disproportion is double that in term infants; severe con
genital abnormalities occur in about a third more of these post-
term children, and they are generally characterized by a
reduced capacity to adapt. All of which underscores the impor
tance of being born at term.

The human infant is almost, if not quite, as immature at birth
as the little marsupial which, born in an extremely immature
state, finds its way into its mother's pouch, there to continue its
gestation until it is sufficiently matured. The human infant
remains immature much longer than the infant kangaroo or
opossum, but whereas the marsupial infant enjoys the protec
tion of its mother's pouch during its period of immaturity, the

The Womb of Time 47

human infant is afforded no such advantage. However, the
human infant comprises part of a symbiotic unit; the mother,
having given it shelter and sustenance within the womb, is
elaborately prepared throughout the period of pregnancy to
continue to do so, once the baby is born, outside the womb,
considerably more efficiently than the marsupial mother. The
biological unity, the symbiotic relationship, maintained by
mother and conceptus throughout pregnancy does not cease at
birth; indeed, it is naturally designed to become even more
intensively functional and mutually involving after birth than
during gestation in the uterus.

If this interpretation of the gestation period is correct, then
it would follow more than ever that we are not at present
meeting the needs, in anything approaching an adequate man
ner, of the newborn and infant young, who are so precariously
dependent upon their new environment for survival and devel
opment. Although it is customary to regard the gestation period
as terminating at birth, I suggest that this is quite as erroneous
a view as that which regards the life of the individual as begin
ning at birth. Birth no more constitutes the beginning of the life
of the individual than it does the end of gestation. Birth repre
sents a complex and highly important series of functional
changes which serve to prepare the newborn for the passage
across the bridge between gestation within the womb and gesta
tion continued outside the womb.

Because the human infant is born in so precariously imma
ture a condition, it is especially necessary for the parental gener
ation of the human species fully to understand what the im
maturity of its infants really signifies: namely, that with all the
modifications initiated by the birth process, the infant is still
continuing its gestation period, passing, by the avenue of birth,
from uterogestation to exterogestation in a continuing and ever
more complex interactive relationship with the mother, the one
person in the world who is best equipped to meet its needs.
Among the most important of the newborn infant's needs are
the signals it receives through the skin, its first medium of
communication with the outside world. In preparation for its

48 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

functioning in the postnatal world to afford it, as it were, a
womb with a view the massive contractions of the uterus
upon the body of the fetus play an important role. It is this that
we have now to consider.

ON BEING STROKED THE RIGHT WAY. The relatively short
labor experienced by nonhuman mammals is usually insuffi
cient to activate such sustaining systems as the genitourinary
and gastrointestinal systems, and in part the respiratory system;
hence mothers must activate them by licking their young. This
they are designed to accomplish by an inbuilt series of reactive
behaviors to odors, wetness, touch, temperature, early experi
ence, and the like. Such inborn reactive responses are feeble in
human mothers. The human mother's responses to her new
born will to a large extent depend on her own early experience
as an infant and child and to some extent upon learning and
maturation. If the mother has not enjoyed such experience or
learned how to behave as a mother she is very likely to prove
inadequate, endangering the continued survival of her baby.*
Hence, a basic assurance that the baby will be adequately pre
pared for postnatal functioning must be physiologically auto
matic. This basic assurance must not be dependent upon any
postnatal behavior such as "licking," necessary as that may be
for further development in other species. This insurance in the
human species is secured by the prolonged contractions of the
uterus upon the body of the fetus. The stimulations thus re
ceived activate, or tone up, the sustaining systems for the func
tions they will be called upon to perform immediately after
birth. In short, it is here being suggested that in the human
species the prolonged uterine contractions during labor repre
sent, in addition to their other vital functions, a series of mas
sive cutaneous stimulations calculated to activate and ensure
the proper functioning of the sustaining systems.
When we ask what the function is of the ordinary uncom-

*For a further discussion of this subject see A. Montagu, The Reproductive
Development of the Female (Littleton, Mass: PSG, 1978).

The Womb of Time 49

plicated process of labor and birth, the answer is: preparation
for postnatal functioning. The process of preparation takes
some time, for there are many changes which must be induced
in the fetus about to be born if he is successfully to negotiate
the brave new world of his immediate postnatal existence. The
bridge the process of birth forms between prenatal and postna
tal life constitutes part of the continuum of individual develop
ment. The initiation of the birth process is associated with a fall
in oxygen saturation of the placenta and of the fetal circulation,
followed by the onset of labor, that is to say, the beginning
uterine contractions which average about one a minute, and the
breaking of "the bag of waters." All this, and much more that
is involved in these bare words, means that a baby is to be born,
to which must be added that it is to be born prepared to adjust
successfully to the next series of events in the developing con
tinuum of its life. That series of events cannot be broadly sub
sumed under the words "postnatal existence," for "postnatal
existence" refers to the whole of life outside the womb, and
clearly no newborn is ever prepared to deal with the whole of
that postnatal life over which, only after many years, if at all,
it will achieve some sort of mastery. What the fetus must be
prepared to deal with during the birth process is the immediate
neonatal period of the first few hours, then days, weeks, and
months of gradual adjustment and habituation to the require
ments of early postnatal existence. Towards this end the neo-
nate must be readied with all its sustaining systems, as well as
its muscular system, prepared to function.

The sustaining systems are the respiratory system, which
controls the intake of oxygen as well as the utilization and
elimination of carbon dioxide; the circulatory system, which
conveys the oxygen through the blood vessels to the capillaries
to supply the cells, and, in turn, to take up the gaseous waste
products and return them to the lungs; the digestive system,
which is concerned with the ingestion and chemical breakdown
of solid foods and liquids; the eliminative systems, which carry
the waste products from the alimentary tract, from the urinary
tract, and from the skin through the sweat glands; the nervous

50 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

system, which enables the organism to make the appropriate
response to the stimuli it receives through that system; and the
endocrine system, which, in addition to the important role it
plays in growth and development and in behavior, assists in the
functioning of all these systems. The response of the respiratory
center to the biochemical changes induced by the lack of oxy
gen and the accumulation of carbon dioxide initiates the whole
complicated process of respiration. The circulation becomes
autonomous, the foramen ovale in the septum between the two
atria of the heart which, in the fetus, permits blood to pass
directly from the right into the left atrium, begins to close, and
the ductus arteriosus, which connects the aorta with the pulmo
nary trunk directly below, begins to undergo occlusion. Blood
is now carried by the pulmonary arteries to the lungs, there to
be aerated, and returned to the heart by the pulmonary veins,
and then from the left ventricle through the aorta into the
general circulation. This is a very different arrangement from
that which existed in the fetus. It now involves the functioning
of the muscles of the chest and abdomen, the diaphragm, and
the heart, as well as such organs as the lungs, and the whole of
the upper respiratory tract in quite novel ways. In addition, the
temperature regulation of the body now begins to be taken over
by the newborn, the experience of birth initiating the stimula
tion of the temperature-regulating centers.

Contraction of the uterus upon the body of the fetus stimu
lates the peripheral sensory nerves in the skin. The nervous
impulses thus initiated are conducted to the central nervous
system where, at the proper levels, they are mediated through
the vegetative (autonomic) nervous system to the various or
gans which they innervate. When the skin has not been ade
quately stimulated, the peripheral and autonomic nervous sys
tems are also inadequately stimulated, and a failure of
activation occurs in the principal organ systems.

It has been an age-old observation that when the newborn
infant fails to breathe, a hearty slap or two on the buttocks will
generally be sufficient to induce breathing. The profound physi
ological significance of this remarkable fact appears to have

The Womb of Time 51

escaped attention. Reasoning from the physiological relations
already indicated, it seemed to me likely that under similar
conditions, that is, when the baby failed to breathe immediately
after birth, stimulation of the respiratory center and the respira
tory organs could perhaps be achieved by subjecting the baby
to immersion, alternately, in hot and cold baths. Upon inquiry
I found that this was, indeed, an old-established practice. In
such cases it would seem reasonable to assume that it is the
cutaneous stimulation which activates the autonomic nervous
system, with the autonomic nervous system acting in turn upon
the respiratory centers and viscera. The effect of a sudden cold
shower upon respiration is well known, and is indicative of a
similar series of events.

The short, intermittent stimulations of the skin over a pro
longed period of time that are produced by the contractions of
the uterus upon the body of the fetus thus appear to be perfectly
designed to prepare it for postnatal functioning.

How can we be sure that this is in fact one of the functions
of the prolonged cutaneous stimulation? One of the things we
can do is to inquire into what happens when there is inadequate
cutaneous stimulation of the fetus, as in the case of precipitately
born children. This often occurs in prematurity, and also in the
case of many cesarean-delivered infants. In such cases what we
should expect to find, according to our theory, would be dis
turbances in the gastrointestinal, genitourinary, and respiratory
functions. Investigations made without any knowledge of or
reference to our theory, but which are directly relevant to it,
substantially support the theory. For example, Dr. C. M. Dril-
lien studied the records of many thousands of prematures and
found that during the early years of postnatal life they exhibited
a significantly higher incidence of nasopharyngeal and respira
tory disorders and diseases than normally born children. This
difference was especially marked during the first year.

In 1939, Mary Shirley published the results of a study on
premature children of nursery school and kindergarten age
conducted at the Harvard Child Study Center in Boston. Shir
ley found that premature children exhibit a significantly higher

52 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

sensory acuity than term children, and in comparison are some
what retarded in lingual and manual control, as well as in
postural and locomotor control. Control of bowel and bladder
sphincters, significantly enough, was found to be achieved later
and with difficulty in the premature children. The attention
span is short; such children are inclined to be highly emotional,
jumpy, anxious, and usually shy. Summarizing her findings,
Shirley observed that in the preschool period, the prematures
present significantly more behavior problems than fullterm
children. These problems include hyperactivity, later acquisi
tion of bowel and bladder control, enuresis, excessive distracti-
bility, shyness, thumb-sucking, negativism and hypersensitivity
to sound. In interpreting this prematurity-syndrome Shirley
pointed out that

premature births often are cataclysmic; unduly prolonged or
precipitant, both of which conditions subject the baby to birth

trauma Thus, it seems possible that, through a less favorable

prenatal environment or through the too early loss of intrauter-
ine media, or through the lack of adequate time for the birth
preparatory responses, or through birth injuries that are some
times so slight as to be unrecognized or through a combination
of these factors, the premature may be predisposed toward the
development of a higher degree of nervous irritability than the
term child.

The "lack of adequate time for the birth preparatory re
sponses" is the critical passage here, and the finding of the later
and more difficult learning of control of bowel and bladder
sphincters the significant observation.

Cesarean-delivered babies suffer from a number of disadvan
tages from the moment they are born. Their mortality rate, to
begin with, is two to three times as great as that which follows
vaginal delivery. At full term the rate is twice as great in cesa-
rean-delivered babies as in vaginally delivered ones. In elective
cesarean deliveries, that is to say, in nonemergency cesareans,
the mortality rate is 2 percent higher than for vaginally deliv
ered babies. In the emergency cesareans the mortality rate is 19

The Womb of Time 53

percent higher than in vaginal deliveries.

Death from the respiratory disorder known as hyaline mem
brane disease is ten times more frequent in cesarean-delivered
than in vaginally delivered babies.

It may be conjectured that the disadvantages, among other
things, from which cesarean-delivered babies suffer, compared
with vaginally delivered babies, are to a significant extent
related to the failure of adequate cutaneous stimulation which
they have suffered.

Pediatricians have noted that cesarean babies tend to be char
acterized by greater lethargy, decreased reactivity, and less fre
quent crying than the vaginally delivered.

In the hope of throwing some light on the developmental
history of the cesarean-delivered infant, Dr. Gilbert W. Meier
of the National Institutes of Health conducted a series of ex
periments on macaque monkeys (Macaca mulatta). He com
pared thirteen cesarean-delivered with thirteen vaginally deliv
ered infants for the first five days of their lives. He found that
the vaginally delivered infants "were more active, more respon
sive to the situation, and more responsive to additional stimula
tion within that situation." Vocalizations, avoidance responses
the beginnings of true learning responses and activity
counts were on the average about three times more frequent in
the vaginally delivered than in the cesarean-delivered infants.

Quite possibly, had the cesarean-delivered babies been given
an adequate amount of caressing for some days after they were
born, a significant change might have been observed in their
behavioral and physical development. All the evidence clearly
points in that direction.

Drs. Sydney Segal and Josephine Chu of the University of
British Columbia studied twenty-six vaginally delivered and
thirty-six cesarean-delivered babies, and found that the latter
showed a smaller crying vital capacity than the former, a differ
ence that persisted for the six days of their stay in the baby
nursery.

A number of biochemical differences have been found be
tween cesarean-delivered and normally delivered babies, such

54 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

as higher acidosis, lower serum proteins, lower serum calcium,
and higher potassium in the cesarean-delivered.

A most significant finding relates to the production of sugar
in newborn infants. Normally when a small amount of gluca-
gon, a substance thought to be secreted by the pancreas, is
introduced into the digestive system, the system responds by
producing sugar. In cesarean-delivered infants the amount of
sugar produced in response to this glucagon factor is much less
than in vaginally delivered infants, in the absence of labor.
When, however, labor occurs before cesarean delivery, this diff
erence is obliterated. The basic importance of labor in the
preparation of the infant for postnatal functioning is thus strik
ingly confirmed.

In contrast, in their studies of rats, Grota, Denenberg, and
Zarrow found no differences between cesarean-delivered and
vaginally delivered young in survival until weaning, or in wean
ing, weight, and open-field activity.

Both Shirley and Drillien observed that prematures as chil
dren presented more frequent and greater feeding problems
than children born at term. Such observations, abundantly
confirmed by other observers, suggest the possibility that inade
quate cutaneous stimulation plays a role here, and, in some
cases at least, results in a greater susceptibility to infection and
disorder of the respiratory, gastrointestinal, and genitourinary
systems. Further contributory evidence is to be seen in the
meconium plug syndrome. This is the condition in which a plug
formed of loose cells, intestinal gland secretions, and amniotic
fluid produces intestinal obstruction, resulting in a marked
delay in the emptying of the stomach and the passage of food
through the intestines. In such cases there is an apparent failure
of the pancreas to secrete the protein-splitting enzyme trypsin,
leading to inadequate peristaltic action of the intestines. Hence
there is both a failure and a breakdown in the movement of the
meconium. The whole syndrome strongly indicates a failure of
action of the necessary substances upon the gastrointestinal
tract.

Dr. William J. Pieper and his colleagues studied the case data

The Womb of Time 55

from the files of a state child-guidance clinic, which enabled
them to compare 188 pairs of normally delivered and cesarean-
delivered children matched for age, sex, ethnic group, ordinal
position, and father's occupational level. Comparisons were
made in 76 variables. In most of these variables these two
groups of children were indistinguishably similar, but in a small
number they were significantly different. Thus, cesarean-deliv-
ered males and all cesareans eight years of age or older were
more likely to have a speech defect, to have a speech defect at
the time of the diagnostic examination, and to have a mother
rated as behaving inconsistently in the mother-child relation
ship. The other six differences were as follows: normally born
males were found to have more unspecified other somatic com
plaints; cesarean-delivered males were more likely to be rated
by the psychologist as showing evidence of organic involve
ment; cesareans under eight years of age were more likely to
present the symptoms of fear of school and unspecified other
personality difficulties; and cesareans over eight years of age
were more likely to present the symptoms of restlessness and
temper.

Clearly, the differences found by Pieper and his colleagues
between cesarean-delivered and normally delivered children
were largely of an emotional nature, the cesarean-delivered
children being somewhat significantly more emotionally dis
turbed than the normally delivered children. It would be diffi
cult to attribute such differences to the absence or inadequacy
of a single factor in the development of these cesarean children,
but, as we shall see, it is quite probable that inadequate cutane
ous stimulation during the perinatal period, that is, the period
shortly before and shortly after birth, may have been one of the
factors involved.

Dr. M. Straker found a significantly higher frequency of
emotional disturbance and anxiety in cesarean-delivered in
dividuals than in normally delivered ones. Liberson and Frazier
found that the electroencephalographic patterns in cesarean
newborns show evidence of greater physiological stability than
in the normally born. This finding, however, is difficult to evalu-

56 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

ate as an evidence of greater or lesser general physiological
stability. It is referred to here simply to make it clear that the
evidence does not all point in the same direction. One would
hardly expect it to.

That postpartum cutaneous stimulation can to some extent
compensate for a lack of skin stimulation during the birth
process is supported by Dr. Donald H. Barron's observation of
twin kids delivered without the occurrence of labor, by cesarean
section. If one newborn kid is left wet in a warm room, while
the other is completely dried off with a towel, cleaning it well,
the kid that has been dried gets up before the other. This
difference in response, Barron remarks, points to the great sur
vival value of cutaneous stimulation. "I have the impression,"
he states, "that the drying, licking, and the grooming are impor
tant in raising the general level of neural excitability in the kid,
and thereby hasten his ability to rise on his knees, to orient
himself, and to stand."

Since the head of the human term fetus is, within the womb,
larger than it has ever been, and since it lies in the head-down
position in the narrowest part of the womb, the stimulations
received from the contracting uterus by the face, nose, lips, and
remainder of the head are very considerable. This facial stimu
lation corresponds to the licking of the muzzle and oral region
given by other animals to their young, and presumably pro
duces much the same effect, namely, the initiation of sensory
discharge into the central nervous system and the raising of the
excitability of the respiratory center. As Barron has shown,
there is a rise in the oxygen content of the blood associated with
licking and grooming, in the newborn of goats: "Raising the
excitability of the respiratory center in turn increases the depth
of the respiratory effort, increases the level of oxygenation of
the blood, and so enhances the capacity for further muscular
movement and strength."

Insofar as the higher oxygenation of the blood is concerned,
these observations have been confirmed in the normally new
born human, as compared with the cesarean-delivered and the
premature. McCance and Otley have shown that when the

The Womb of Time 57

newborn rat is removed from its mother immediately after birth
its kidneys remain relatively functionless for the first twenty-
four hours of its life. They suggest that normally the attentions
of the mother cause an increase in the excretion of urea owing
to some reflex change in the blood flow to the kidney.

The skin and the gastrointestinal tract meet not only at the
lips and mouth, but also at the anal region. Hence it is scarcely
surprising, in the light of what we have already learned, not
only that gastrointestinal function will be activated by stimulat
ing this region, but that respiratory function will also often be
activated by such stimulation. This method of inducing respira
tion in the newborn often works when other methods fail.

That the skin and the gastrointestinal tract are often interac
tive has been suggested in clinical reports for many years. Dis
orders and diseases simultaneously affecting both the gastroin
testinal tract and integument have been observed in many cases.

That the benefits of maternal-infant cutaneous contacts are
reciprocal is evident from the fact that when the newborn is
placed in contact with its mother's body the uterus will be
stimulated to contract. This fact constituted part of the folk-
wisdom of many peoples for centuries. It is, for example, re
ported from Brunswick, in Germany, that it is the custom not
to allow the child, during the first twenty-four hours after its
birth, to lie by its mother's side, "otherwise the uterus can find
no rest and scratches about in the woman's body, like a large
mouse." Folk-wisdom, while recognizing the fact, failed when
it came to drawing the correct conclusion from it, namely, that
the contractions of the uterus were beneficial to the mother.

The evidence surveyed in the preceding pages, sparse as it is,
nevertheless lends strong support to the hypothesis that an
important function of the prolonged labor and especially the
contractions of the uterus, in the human female, is to serve
much the same purpose that licking and grooming of the new
born serve in other animals. This purpose is to further the
infant's development for optimum postnatal functioning of its
sustaining systems. We have seen that in all animals cutaneous
stimulation of the infant's body is in most cases an indispensa-

58 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

bly necessary condition for the survival of the young. We have
suggested that in a species such as Homo sapiens, in which
gestation is only half completed at birth, and in which maternal
behavior is dependent upon learning rather than upon instinct,
the selective advantage would lie with a reflex initiation and
maintenance of uterine contractions functioning for the fetus as
an automatic, physiologically massive stimulation of its skin,
and through its skin of its organ systems. The evidence, as we
have seen, tends to support this hypothesis, that the uterine
contractions of labor constitute the beginning caressing of the
baby in the right way a caressing which should be continued
in very special ways in the period immediately following birth
and for a considerable time thereafter. This we may proceed to
discuss in the next chapter.

THREE

BREASTFEEDING

I will lift up mine eyes unto the hills:
From whence cometh my help.

PSALMS 121.1.

Whether or not we accept the psychoanalytic view that life in
the womb is normally a supremely pleasurable experience, a
blissful state rudely shattered by the ordeal of birth, there can
be little doubt that the process of birth is a disturbing one to
the birthling. Having spent its prenatal life in a supporting
aquatic environment, within a medium in which the second law
of thermodynamics is perfectly satisfied by the constancy of the
temperature and the pressure, that is to say within the amniotic
fluid surrounded by the amniotic sac, the fetus is said to live a
Nirvana-like existence. This blissful existence is rudely inter
rupted largely owing to a fall in the levels of the pregnancy-
maintaining hormone progesterone in the mother's blood
stream, resulting in the turbulent series of changes which the
fetus begins to experience as the birth process. The contractions
of the uterus in labor act as compressive forces upon its body,
so that it is pushed against the birth canal where the repeated
thrusts of its head against the maternal bony pelvis produce the
swelling beneath its scalp known as the caput succedaneum. It
is doubtful whether the fetus quite appreciates that this appar
ently gratuitous assault upon its person is designed entirely for

60 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

its benefit. Providentially, the oxygen available to it at this time
is gradually undergoing reduction, so that such consciousness,
such awareness of pain as it may be capable of, is probably
reduced. This may well be the function of the anoxia or
hypoxia, as this reduced state of oxygenation is called. The
contracting uterus completes its parturitive functions with the
expulsion of the fetus from the uterus. With birth the newborn
moves into a wholly new zone of experience and adaptation,
from an aquatic solitary existence into an atmospheric and
social environment.

At birth, atmospheric air immediately rushes into the lungs
of the newborn, thus inflating them, and causing them to press
against and to produce gradual rotation of the heart. There is,
as it were, a competition for space between the heart and the
lungs. The ductus arteriosus between the arch of the aorta and
the upper surface of the pulmonary trunk, which in the fetus
made it possible to bypass the systematic circulation involving
the lungs, begins to contract and close. The cupolae of the
diaphragm begin to rise eccentrically up and down, the chest
wall to expand, all of which could hardly be described as adding
up to a pleasant experience for the newborn exterogestate.
What the newborn is looking forward to, and has every right
to expect, is a continuation of that life in the womb to a womb
with a view before it was so catastrophically interrupted by
the birth process. And what it receives in our highly sophis
ticated societies in the Western world is a rather dusty answer.

The moment it is born, the cord is cut or clamped, the child
is exhibited to its mother, and then it is taken away by a nurse
to a babyroom called the nursery, so called presumably because
the one thing that is not done in it is the nursing of the baby.
Here it is weighed, measured, its physical and any other traits
recorded, a number is put around its wrist, and it is then put
in a crib to howl away to its heart's discontent.

The two people who need each other at this time, more
than they ever will at any other in their lives, are separated
from one another, prevented from continuing the develop
ment of a symbiotic relationship which is so critically neces-

Breastfeeding 61

sary for the further development of both of them.

During the whole of pregnancy the mother has been elabo
rately prepared, in every possible way, for the continuation of
the symbiotic union between herself and her child, to minister
to its dependent needs in the manner for which she alone is best
prepared. It is not simply that the baby needs her, but that both
need each other. The mother needs the baby quite as much as
the baby needs its mother. The biological unity, the symbiotic
relationship, maintained by mother and conceptus throughout
pregnancy does not cease at birth but becomes indeed, is natu
rally designed to become even more intensified and interoper-
ative than during uterogestation. Giving birth to her child, the
mother's interest and involvement in its welfare is deepened and
reinforced. Her whole organism has been readied to minister to
its needs, to caress it, to make loving sounds to it, to nurse it
at the breast. From the breast it will not only take in the
wondrous colostrum, the lemony-yellowish fluid which confers
such immunological and other physiological benefits upon the
child, but the child will also, by its nursing, confer vital benefits
upon the mother. The psychophysiological benefits which
mother and child, the nursing couple, reciprocally confer upon
one another in the continuing symbiotic relationship are vitally
important for their further development. This is a fact which
is only very slowly coming to be recognized in our highly
sophisticated, technologized, dehumanized Western world, a
world in which breastfeeding is considered by many to be be
neath human dignity. As one expensively educated young
woman remarked to me when I asked her whether she was
going to'breastfeed her baby, "Why, only animals do that. None
of my friends do." It is a world in which there are pediatricians
who assure mothers that a bottle formula is every bit as good
as, and even better than, breastfeeding. Indeed, as James Crox-
ton has remarked, "Humans are the only mammals that raise
their infants as though they were not mammals."

It is a world in which breastfeeding, except in private, is
considered indecent. In May 1975 the Associated Press re
ported an incident from Miami, Florida, involving a group of

62 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

young mothers, some of them nursing their babies, who were
ordered from the park by a park official who told them they
could no longer use the park for picnics on the ground that the
sight of women breastfeeding their babies was inappropriate,
"especially in a public park where kids play." One of the breast
feeding mothers happened to be a leader of the La Leche
League in Florida (the international organization which has
been largely instrumental in encouraging a return to breastfeed
ing). When she and the president of the league appeared on a
well-known TV show in June 1975, they were greeted with a
surprising amount of hostility from some women in the audi
ence who felt that nursing should only be done in private.

We live in the logical denouement of the Machine Age, when
not only are things increasingly produced by machine but also
human beings, who are turned out to be as machine-like as we
can make them, and who therefore see little wrong in dealing
with others in a similarly mechanical manner; an age in which
it is considered a mark of progress when whatever was formerly
done by human beings is taken out of their hands and done by
machine. It is reckoned an advance when a bottle formula can
be made to substitute for the contents of the human breast and
the experience of the human infant at it, especially in an age
when many women have so unhappily taken over the values of
the masculine world.

In the widely read official manual Infant Care, issued by the
U. S. Children's Bureau of the Department of Health, Educa
tion and Welfare, a work mainly edited by women, the 1963
edition refers to an apparently not uncommon negative attitude
toward the tactile experience of breastfeeding. "You may feel,"
the editors write, "some resistance to the idea of such intimacy
with an infant who, at first, seems like a stranger. To some
mothers it seems better to keep the baby at arm's length, so to
speak, by feeding plans which are not so close."

These sentences reflect a widespread failure to understand
the meaning and importance of the intimacy which should
exist, from the moment of birth, between mother and infant.

During the birth process mother and infant have had a some-

Breastfeeding 63

what trying time. At birth each clearly requires the reassurance
of the other's presence. The reassurance for the mother lies in
the sight of her baby, its first cry, and in its closeness to her
body. For the baby it consists in the contact with and warmth
of the mother's body, the support in her cradled arms, the
caressing, the cutaneous stimulation it receives, and the suck
ling at her breast, the welcome into "the bosom of the family."
These are words, but they refer to very real psychophysiological
conditions.

Within a few minutes after the baby is born the third stage
of labor should be completed; that is, the placenta should be
detached and ejected. The bleeding of the torn vessels of the
uterus should begin to be arrested, and the uterus should com
mence its return to normal size. When the baby is put to nurse
at the mother's breast immediately after birth, and even before
the cord is clamped, if the cord is long enough, the baby's
suckling will serve to accelerate all three processes. By suckling
at the breast the baby sets up changes in the mother; its suckling
increases the secretion of oxytocin from the pituitary gland,
producing massive contractions of the uterus, with the conse
quence that: (1) the uterine muscle fibers contract upon the
uterine vessels; (2) the uterine vessels undergo constriction at
the same time; (3) the uterus begins to undergo reduction in
size; (4) the placenta becomes detached from the uterine wall;
and (5) is ejected by the contracting expulsive uterus. In addi
tion, the secretory functions of the breast are greatly augmented
by the induced secretion of prolactin from the pituitary gland.
Physiologically, the nursing of her babe at her breast produces
in the mother an intensification of her "motherliness," the plea
surable care of her child. Psychologically, this intensification
serves further to consolidate the symbiotic bond between her
self and her child. In this bonding between mother and child
the first few minutes after birth are crucial.

The benefits to the mother of immediate breastfeeding are
innumerable, not the least of which after the weariness of
labor and birth is the emotional gratification, the feeling of
strength, the composure, and the sense of fulfillment that

64 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

comes with the handling and suckling of the baby.

For the newborn, what better reassurance can there be than
the support of its mother and the satisfaction of suckling at her
breast, what better promise of good things to come? The cu
taneous stimulation the baby receives from the mother's caress
ing, from the contact with her body, its warmth, and especially
the perioral stimulations, that is, the stimulations received dur
ing suckling about the face, lips, nose, tongue, mouth, are im
portant in improving the respiratory functions and through this
means the oxygenation of the blood. As an assistance in suck
ling, the newborn is equipped with a median papilla on its upper
lip which enables it to gain a firm hold on the breast. At the
same time, at the breast the baby is ingesting the valuable
colostrum, the best of all the substances it could possibly im
bibe. The colostrum lasts one to five days and, among other
things, acts as a laxative; it is the only substance that can
effectively clean out the meconium in the baby's gastrointestinal
tract. Colostrum constitutes the most powerful insurance
against the baby's development of diarrhea. Babies ingesting
colostrum do not develop diarrhea. The fact, indeed, is that the
only known successful treatment for diarrhea in babies is
breastfeeding. Colostrum is richer than true milk in lactoglobu-
lin, which carries the factors that immunize the baby against a
number of diseases. Years ago Dr. Theobald Smith of New
York showed that colostrum conferred upon calves immunity
to colon bacillus septicemia. In 1934 Dr. J. A. Toomey demon
strated that similar immunizing factors against this bacillus
were present in human colostrum, as well as immunizing fac
tors against other bacteria that infect the gastrointestinal tract.
Colostrum encourages the growth of desirable bacteria and
discourages the growth of undesirable bacteria in the gastroin
testinal tract of the newborn.

In many ways the newborn calf is more mature than the
human newborn. Like the calf, the human newborn has an
undeveloped immunological capacity at birth; that is, it has no
antibodies and little ability to make its own as defenses against
foreign invaders. The antibody-rich colostrum from its

Breastfeeding 65

mother's breast, which is some fifteen to twenty times richer in
gamma globulin than maternal serum, provides the newborn
with such antibodies, and confers a passive immunity upon him
for the next six months, by which time he will gradually have
acquired his own antibodies.

Thus breastfeeding provides a number of correlated benefits
for the newborn, immunological, neural, psychological, and
organic. Over the five or more million years of human evolu
tion, and as a consequence of seventy-five million years of mam
malian evolution, breastfeeding has constituted the most suc
cessful means of ministering to the needs of the dependent,
precariously born human neonate.

While I am in this book principally concerned with the stim
ulation of the skin as an important factor in the development
of the individual, and not with the immunological and nutritive
properties of the substances ingested during breastfeeding, it is
fundamentally important for us to understand that the colos
trum which postnatally lasts for some five days, the transitional
milk which lasts for some eight days, and the permanent milk
which comes in about the fourteenth day, are all designed to
meet the gradually developing metabolic needs of the infant in
adjustment to its developing capacities to deal with the various
substances it ingests. The baby's enzyme systems take some
days to develop sufficiently to be able to deal with these sub
stances, mostly proteins. The colostrum, transitional, and per
manent milk, coming in as gradually as they do, are perfectly
timed and adjusted to the physiological development of the
infant's digestive system.

The facts, indeed, indicate that breastfeeding constitutes a
fundamental requirement for the human newborn. Not that the
newborn cannot survive in the absence of breastfeeding, but
that he will not develop in as healthy a manner as the breastfed
baby, and finally, that the breastfed baby, at any rate, will get
a much better start towards healthy development than the non-
breastfed baby.

The development of colostrum and of transitional milk will
occur in the absence of a suckling baby, but the giving of these

66 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

substances to the baby will depend upon the suckling of the
baby. The link between making milk and giving milk is called
the letdown reflex. When the baby begins to suckle at the breast,
the cutaneous stimulation the mother receives initiates nervous
impulses that travel along neural circuits to the pituitary gland,
which then releases the hormone oxytocin into the blood
stream. The oxytocin, reaching the glandular structures of the
breast, stimulates the basket cells that surround the alveoli and
milk ducts, resulting in expansion of the ducts. This, in turn,
results in a greater flow of milk down into the sinuses behind
the nipple, and from thirty to ninety seconds after the baby has
begun to suckle the letdown reflex is completed, and the flow
into the baby of the rich substances in the mother's breast will
continue as long as she perseveres in breastfeeding.

That mother and child are designed for maximum contact in
the early development of the infant has been convincingly
shown by Blurton Jones. He cites such evidence as Ben Shaul's
studies on the composition of milk in relation to feeding
schedules in different species. In rabbits and hares, for example,
feeding occurs every twenty-four hours, and they have milk
with very high protein and fat content. The tree shrew, Tupaia
belangeri, which feeds every forty-eight hours, has an even
higher protein-fat milk content. Apes and humans, on the other
hand, who have continuous access to the breast, have very low
protein-fat milk content. The rule is that wide-spaced scheduled
feeders have high protein-fat milk content, whereas short-
spaced, on demand, almost continuous feeders have low pro
tein-fat milk content. This indicates that the human mother,
like the ape mother, is designed to carry her baby with her
wherever she goes.

Ape and monkey babies who are so carried and fed on de
mand seldom or never vomit or burp. When, however, they are
reared by hand and fed on a two-hour schedule, they frequently
vomit. So the evidence suggests that frequent breastfeeding of
the infant has more than a nutritional purpose, that it has the
additional important purpose of bringing mother and child into
as continuous physical contact as possible.

Breastfeeding 67

Albrecht Peiper has remarked that among civilized peoples
the breastfed infant becomes a crib infant who, if he is breastfed
at all, returns to his mother's body only at feeding times. He
points out that among nonliterate peoples mothers carry their
children around with them on their bodies, as monkey mothers
do. "It is an unnatural achievement," he writes, "for the human
baby to have to spend his life in a crib. He is in no way adjusted
to the crib; rather, his wish to be carried around becomes
clearly evident again and again. Calming by rocking or pacifiers
is reminiscent of the time when mother and child were physi
cally more closely associated.'*

It is from the breast that "the milk of human kindness" flows.

While breastfeeding is maintained, pregnancy will not usu
ally occur for at least ten weeks after the birth of the child, and
often much longer, depending upon the intensity of the breast
feeding the greater the frequency the longer the contraceptive
effect lasts. This is largely due to the anovulatory effect of
prolactin which is released from the pituitary gland as a result
of suckling. Thus during the breastfeeding period a kind of
natural birth control will be in effect. The advantages of breast
feeding to the baby are enormous. In one pilot study of 173
children followed from birth to the age of ten years, including
both breastfed and non-breastfed children, it was found that the
children who had not been breastfed had four times as many
respiratory infections, twenty times more diarrhea, twenty-two
more miscellaneous infections, eight times as much eczema,
twenty-one times more asthma, and twenty-seven times more
hay fever.

Similarly, Drs. C. Hoefer and M. C. Hardy in a study of 383
Chicago children found that breastfed children were physically
and mentally superior to those who were artificially fed, and
that those fed from four to nine months were in these respects
more advanced than those breastfed for three months or less.
The artificially fed ranked lowest in all the physical traits mea
sured. They were nutritionally the poorest, the most susceptible
to the diseases of childhood, and slowest in learning to walk and
talk.

68 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

Early weaning is a subject on which we have no data for the
human species. But we do have some data on rats. Dr. Jiri
Krecek of the Institute of Physiology of Prague, at an interna
tional symposium held at Liblice, Czechoslovakia, on "The
Postnatal Development of the Phenotype," stated the thesis
that the period of weaning in mammals is a critical one, inas
much as several basic physiological processes are being reor
ganized at this time, particularly those involving salt balance,
general nutrition, and fat intake. Defining weaning as with
drawal from breastfeeding at sixteen days of age, other workers
reported that rats who were weaned early elaborated a condi
tioned reflex less rapidly than those weaned at thirty days of
age, and also that the adult of these animals showed deficiencies
in ribonucleic acid, a basic constituent of all cells. It was also
found that the principal electrolyte-regulating steroid was detri
mentally affected by early weaning, and that even the male
hormones, the androgens, are adversely affected. At the same
symposium Dr. S. Kazda described a pilot study of human
adults indicating that reproduction and certain kinds of pathol
ogy may be affected by early weaning.

The advantages of breastfeeding during the first year of life
on subsequent development and into adulthood have been
demonstrated by a number of investigators. The evidence indi
cates that the infant should be breastfed for at least twelve
months, and terminated only when the infant is ready for it, by
gradual steps in which solid foods, which can begin at six
months, commence to serve as substitutes for the breast. The
mother will generally sense when the baby is ready for weaning.

Drs. Francis M. Pottenger, Jr., and Bernard Krohn, in a
study of 327 children, found that the facial and dental develop
ment of children who had been breastfed for more than three
months was better than those who had been breastfed less than
three months or not at all. They conclude their report with the
following words: "These findings in our 327 cases indicate that
it is advisable to nurse a child at least 3 months, and preferably
6 months. This will stimulate optimal malar [cheekbone] devel
opment. We have also observed that patients who were well

Breastfeeding 69

nursed had better-developed dental arches, palates, and other
facial structures than patients who were not nursed."

A breastfeeding mother holds the child at alternate breasts
for feedings, thereby giving equal stimulation and exercise to
both sides of the infant's face and head, as well as other parts
of the body. On the contrary, the bottlefeeding mother tends to
hold the child in whatever position is comfortable, and it has
been generally observed that this tends to be almost always in
the same position on the same left side. Holding the infant on
one side most of the time may not be altogether to the advan
tage of the child. But this is a mere speculation, and requires
researching. With the bottle instead of the breast, and with toys
rather than its mother's caressing hands, the infant is encour
aged to manipulate things rather than to "handle" people. As
Philip Slater says, in his book Earthwalk, such training is useful
for the mastering and relating to machines, rather than for
interrelating warmly with others.

Sometimes a baby, when put to nurse at the mother's breast,
will fail to suckle and appear unable to grasp the nipple. This
usually occurs when the baby is wrapped in a towel or some
other material. When it is removed and the baby's skin allowed
to come into contact with the mother's skin, the baby will
usually begin to suckle.

Suckling, it should be noted, is usually preceded by pro
longed licking of the nipple and areola, lasting several minutes.
The licking serves to ready the breast for suckling, to familiar
ize the baby with "that most sacred fountaine of the body, the
educatour of mankind," as William Painter so aptly put it some
four hundred years ago.

Frances Broad, in two surveys covering 319 white New Zea
land children five to six years of age, found that the breastfed
were in all aspects of speech development clarity of articula
tion, tonal quality, reading ability, as well as general confidence
superior to the bottlefed. Girls have clearer speech than boys
of the same ages. The improvement was especially marked in
breastfed boys as compared with the bottlefed.

These findings are not surprising, for as Miss Broad points

70 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

out, the organs of suckling and articulation are the same, hence,
it might be expected that conditions influencing the develop
ment of the suckling response would have an effect on the
structures required for speech. Further, since the incidence of
infections in infancy is reduced by breastfeeding and the ability
to speak is adversely affected by infections of the respiratory
tract that quite often lead to infections of the auditory appa
ratus, and since the ability to speak in turn depends upon the
ability to hear, this may explain the greater incidence of defec
tive speech qualities in bottlefed as compared with breastfed
children. In which case the solution, she suggests, is a rapid
return to breastfeeding.

Much else could be said on the advantages of breastfeeding
accruing to both mother and child; the aim is, of course, to give
the child something rather more than an adequate diet, to
provide it, in sum, with an emotional environment of security
and love in which the whole creature can thrive. Breastfeeding
alone will not secure this. It is the mother's total relatedness to
her child that makes breastfeeding significant.

The experience of breast and touch can be seen, within the
framework of a concept drawn from gestalt psychology, as a
figure/ground perception, with body always there as ground,
and reaching for the breast as figured stimulus. This figure/
ground experience initiates not only the letdown reflex, but the
ongoing process of socialization of two human beings.

It is highly probable that the development of the skin itself
as an organ is greatly benefited by the experience at the breast.
While I know of no experimental data on this, there does exist
some evidence from other sources and on other animals tending
to support this view. For example, Truby King, the distin
guished New Zealand pediatrician, was much impressed with
the statements on this subject made to him by a merchant
dealing in wool and hides. The piece is worth quoting in its
entirety. Truby King having spoken to the merchant of the
advantages of breastfeeding, the latter replied, "I don't need
convincing as to what mother's milk must mean for the child

Breastfeeding 71

I know it already from my own business. Why, I can tell you
how your boots were fed!" He then proceeded to elaborate.

In the trade we know the highest grade of calf-skins as Paris
Calf. That is because calves reared on their mother's milk to
provide the finest veal for Paris, have also incidentally set the
standard for the whole world as to what is best in the way of
calf-skins for tanning.

Suppose the hair has not been removed, it is smooth and
glossy, not harsh or dry, and it all lies the right way. Or take the
leather, it isn't patchy. The whole hide is more or less uniform,
smooth and fine-grained. When you feel and handle it you find
that it has a certain body and firmness, and yet it is pliable and
elastic. It's nice to touch and handle there is a kindly feeling
about it. Why (pausing to think of an illustration) it's like the
face of a sleek child that is doing well, compared with one that's
not flourishing.

"What about the other kind?" Truby King inquired.

"Oh, you mean the 'bucket-feds,' " replied the merchant. "Of
course there is every grade and degree; but speaking generally,
the hide is patchy it's not all over alike. It tends to be harsh
and dry, and has a more or less dead feeling. There is not the
same body in it, and it hasn't the fine grain and pliancy of Paris
Calf. It's not kindly to the touch. Why, look here, when handling
a first-rate calf-skin we say to one another in the trade: 'By Jove,
that's a good piece of stuff why, that's milk-fed.' "

While there can be small doubt that the "kindliness" of the
milk-fed skin is in large part due to the nutrients ingested by
the calf from its mother's milk, some of its quality, we will not,
I am sure, be far wrong in concluding, is probably also due to
the cutaneous stimulation received by the calf from the mother.

The observation on "the face of a sleek child that is doing
well, compared with one that's not flourishing," is significant,
for while I know of no observations bearing on the matter
there can be little doubt that the character of the skin of a
breastfed infant differs in many ways from that of a bottlefed
infant.

72 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

The quality of the tactile stimulation received stands in direct
relation to the qualitative development of the organism in all its
organ systems. As we have already noted, since the introduc
tion of the mechanical milking of cows it has been observed that
hand-milked cows give more and richer terminal milk than
machine-milked cows. This appears to be true also in the lactat-
ing human female. Usually, as we know, the tactile stimulation
provided by the baby's suckling at the nipple initiates the let
down reflex and the full flow of milk. But in cases in which the
breast-milk is for some reason insufficient, systematic massage,
starting at the abdomen and carried up to the breasts, is gener
ally sufficient to stimulate an abundant flow of milk.

Sir Truby King states,

The value of massage of the breasts, and sponging them twice
a day with hot and cold water alternately, has been abundantly
demonstrated for some years at the Karitane Harris Hospital,
New Zealand. It is found that these simple measures, along with
an abundance of fresh air, bathing, daily exercise, due rest and
sleep, regular habits, suitable feeding and drinking of extra
water, rarely fails to re-establish breastfeeding in cases where the
supply has been falling off indeed where suckling has been
entirely given up for days or even for weeks.

It is known that in the absence of suckling stimulation the
hormone which initiates the secretion of milk, namely prolac-
tin, will not continue to be produced by the pituitary gland in
adequate quantities, and ovulation, failing to be inhibited, will
resume. In order to test whether the production of prolactin
would continue in the absence of suckling, but in the sight,
sound, and body contact with the young, Moltz, Levin, and
Leon surgically removed the nipples from female rats who were
subsequently impregnated and allowed to give birth normally.
When compared with unoperated control groups from whom
the young had been removed twelve hours after birth, it was
found that the control females began to ovulate after an average
of seven days, a sham-operated group ovulated at sixteen days,
while the experimental group ovulated at twenty days. The

Breastfeeding 73

exteroceptive stimuli of sight, sound, odor, and perhaps "feel"
of the young, this investigation suggests, even in the absence of
suckling, are able to promote the output of prolactin in amounts
sufficient to inhibit ovulation for sixteen to twenty days.

The inter-cutaneous stimulation of the nursing couple has
evolved quite clearly as a reciprocating developmental arrange
ment designed to activate and to keep tonally at their optimum
the various bodily functions of both mother and child. The
areola and the nipple possess very sensitive reflexogenic capaci
ties. When uterine irritability is at its maximum, during and
shortly after labor, stimulation of the nipple causes pro
nounced, often violent, contractions. The center of this reflexo
genic mechanism is believed to be in the hypothalamus, which
stimulates the release of the hormone oxytocin from the pitui
tary gland. It is this hormone that is involved in the onset of
labor, and together with various other conditions, in the onset
of the birth itself. As we have already seen, oxytocin is also the
hormone which is released in abundance as a result of the
baby's suckling at the breast, a reflex activity resulting in the
letdown reflex and the flow of milk.

We see, then, how beautifully designed the suckling of the
baby at the mother's breast is, especially in the immediate
postpartum period, to serve the most immediate needs of both,
and from this to grow and develop in the service of all their
reciprocal needs. What is established in the breastfeeding rela
tionship constitutes the foundation for the development of all
human social relationships, and the communications the infant
receives through the warmth of the mother's skin constitute the
first of the socializing experiences of his life.

It is quite remarkable that in a pre-Freudian age, Erasmus
Darwin Charles Darwin's grandfather in an extraordinary
book entitled Zoonomia, or the Laws of Organic Life, first pub
lished in 1794, should have suggested a relationship between
breastfeeding and subsequent behavioral development. In his
book Darwin wrote as follows:

74 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

All these various kinds of pleasure at length become associated
with the form of the mother's breast; which the infant embraces
with its hands, presses with its lips, and watches with its eyes and
thus acquires more accurate ideas of the form of its mother's
bosom, than of the odor and flavor of warmth, which it perceives
by its other senses. And hence at our maturer years, when any
object of vision is presented to us, which by its waving or spiral
lines bears any similitude to the form of the female bosom,
whether it is found in a landscape with soft gradations of rising
and descending surface, or in the forms of some antique vases,
or in other works of the pencil or chisel, we feel a general glow
of delight, which seems to influence all our senses; and if the
object be not too large, we experience an attraction to embrace
it with our arms, and to salute it with our lips, as we did in our
early infancy the bosom of our mother.

It may well be that the psalmist who wrote the words, "I will
lift up mine eyes unto the hills: From whence cometh my help,"
was responding to the influence of such early experiences.

Erasmus Darwin traces the origin of the smile to the experi
ence of the infant at its mother's breast. He writes,

In the action of sucking, the lips of the infant are closed around
the nipple of his mother, till he has filled his stomach, and the
pleasure occasioned by the stimulus of this grateful food suc
ceeds. Then the sphincter of the mouth, fatigued by the con
tinued action of sucking, is relaxed; and the antagonist muscles
of the face gently acting, produce the smile of pleasure: as cannot
but be seen by all who are conversant with children.

Hence this smile during our lives is associated with gentle
pleasure; it is visible on kittens, and puppies, when they are
played with, and tickled; but more particularly marks the human
features. For in children this expression of pleasure is much
encouraged, by their imitation of their parents, or friends; who
generally address them with a smiling countenance: hence some
nations are more remarkable for the gaiety, and others for the
gravity of their looks.

It is as good a theory of the origin of smiling as any that has
been offered, and it is to be noted that it does not escape Dar-

Breastfeeding 75

win's attention that the readiness with which people smile is to
a large extent culturally conditioned. The fact that the smile
universally constitutes an evidence of pleasure, of friendliness,
may at least partly be due to the origins of smiling in the infant's
oral-tactile pleasures at the maternal breast.

The meaning of skin contact with the mother, especially at
her breast, is recalled most beautifully by Kabongo, a Kikiyu
chief of East Africa. He was eighty years of age when he spoke
these words:

My early years are connected in my mind with my mother. At
first she was always there; I can remember the comforting feel
of her body as she carried me on her back and the smell of her
skin in the hot sun. Everything came from her. When I was
hungry or thirsty she would swing me round to where I could
reach her full breasts; now when I shut my eyes I feel again with
gratitude the sense of well-being that I had when I buried my
head in their softness and drank the sweet milk that they gave.
At night when there was no sun to warm me, her arms, her body,
took its place; and as I grew older and more interested in other
things, from my safe place on her back I could watch without
fear as I wanted and when sleep overcame me I had only to close
my eyes.

"Everything came from her." These are the key words. They
imply warmth, support, security, satisfaction of thirst and hun
ger, comfort, well-being, the very satisfactions that every child
must experience at its mother's breast.

It is through body contact with the mother that the child
makes its first contact with the world, through which he is
enfolded in a new dimension of experience, the experience of the
world of the other. It is this bodily contact with the other that
provides the essential source of comfort, security, warmth, and
increasing aptitude for new experiences.

FOUR
TENDER, LOVING CARE

I was a child beneath her touch, a man

When breast to breast we clung, even I and she,

A spirit when her spirit looked through me,

A god when all our life-breath met to fan

Our life-blood, till love's emulous ardours ran,

Fire within fire, desire in deity.

D. G. ROSSETTI, "The Kiss," from The House of Life.

In that seminal book, Psychosocial Medicine, James L. Halliday
writes:

As the first few months following birth may be regarded as a
direct continuation of the intrauterine state, there is need for
continuance of close body contact with the mother to satisfy the
requirements of the kinesthetic and muscle senses. This requires
that the baby be held firmly, nursed at intervals, rocked, stroked,
talked to, and reassured. With the disappearance of the "shaley
wife" and the introduction of the perambulator the need for
adequate body contact is often forgotten. How readily the infant
reacts to the absence of the contact is seen when a baby is laid
on a flat surface such as a table without support. Immediately
it reacts with a startle and a cry. Mothers who are anxious (from
whatever cause) tend when holding a child to hold it loosely or
insecurely instead of firmly and confidently, and this to some
extent explains the saying that "anxious mothers produce anx
ious babies," the insecurity of the mother being, as it were,

Tender, Loving Care 77

sensed by the child. The absence of accustomed mother contact
has a bearing on the problem of "fretting" such as is seen when
an infant is removed from a hospital. Many of us who have been
resident medical officers in a fever hospital used to be somewhat
skeptical of the importance of fretting, but recent observations
have shown its reality and its practical importance, in that in
fants deprived of their accustomed maternal body contact may
develop a profound depression with lack of appetite, wasting,
and even marasmus leading to death. As a result of these findings
volunteer women now attend some of the children's hospitals to
provide infants that are fretting with periods of handling, caress
ing, rocking, etc. (The results are said to be dramatic.)

The results are, indeed, dramatic and thereby hangs a fasci
nating tale.

During the nineteenth century more than half the infants in
their first year of life regularly died from a disease called maras
mus, a Greek word meaning "wasting away." The disease was
also known as infantile atrophy or debility. As late as the sec
ond decade of the twentieth century the death rate for infants
under one year of age in various foundling institutions through
out the United States was nearly one hundred percent. It was
in 1915 that Dr. Henry Dwight Chapin, the distinguished New
York pediatrician, in a report on children's institutions in ten
different cities made the staggering disclosure that in all but one
institution every infant under two years of age died. The various
discussants of Dr. Chapin's report, at the Philadelphia meeting
of the American Pediatric Society, fully corroborated his
findings from their own experience. Dr. R. Hamil remarked,
with grim irony, "I had the honor to be connected with an
institution in this city of Philadelphia in which the mortality
among infants under one year of age, when admitted to the
institution and retained there for any length of time, was 100
percent." Dr. R. T. Southworth added, "I can give an instance
from an institution in New York City that no longer exists in
which, on account of the very considerable mortality among the
infants admitted, it was customary to enter the condition of
every infant on the admission card as hopeless. That covered all

78 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

subsequent happenings." Finally, Dr. J. H. M. Knox described
a study he had made in Baltimore. Of two hundred infants
admitted to various institutions, almost 90 percent died within
a year. The 10 percent that survived, he stated, did so appar
ently because they were taken from the institutions for short
times and placed in care of foster parents or relatives.

Recognizing the emotional aridity of children's institutions,
Dr. Chapin introduced the system of boarding out babies in
stead of leaving them in the charnel houses the institutions had
become. It was, however, Dr. Fritz Talbot of Boston who
brought the idea of "Tender, Loving Care," not in so many
words but in practice, back with him from Germany, where he
had visited before World War I. While in Germany Dr. Talbol
called at the Children's Clinic in Dusseldorf, where he was
shown over the wards by Dr. Arthur Schlossmann, the director,
The wards were very neat and tidy, but what piqued Dr. Tal-
bot's curiosity was the sight of a fat old woman who was carry
ing a very measly baby on her hip. "Who's that?" inquired Dr
Talbot. "Oh, that," replied Schlossmann, "is Old Anna. Wher
we have done everything we can medically for a baby, and ii
is still not doing well, we turn it over to Old Anna, and she is
always successful."

America, however, was massively under the influence of the
dogmatic teachings of Luther Emmett Holt, Sr., Professor o
Pediatrics at New York Polyclinic and Columbia University
Holt was the author of a booklet, The Care and Feeding
Children, which was first published in 1894 and was in its 15tl
edition in 1935. During its long reign it became the suprem<
household authority on the subject, the "Dr. Spock" of its time
It was in this work that the author recommended the abolitioi
of the cradle, not picking the baby up when it cried, feeding i
by the clock, and not spoiling it with too much handling, and
while breastfeeding was the regimen of choice, bottlefeedinj
was not discounted. In such a climate the idea of tender, lovinj
care would have been considered quite "unscientific," so tha
it wasn't even mentioned, although, as we have seen, in place
like the Children's Clinic in Dusseldorf, it had already receive*

Tender, Loving Care 79

some recognition as early as the first decade of the twentieth
century. It was not until after World War II, when studies were
undertaken to discover the cause of marasmus, that it was
found to occur quite often among babies in the "best" homes,
hospitals, and institutions, among those babies apparently re
ceiving the best and most careful physical attention. It became
apparent that babies in the poorest homes, with a good mother,
despite the lack of hygienic physical conditions, often overcame
the physical handicaps and flourished. What was wanting in the
sterilized environment of the babies of the first class and was
generously supplied to babies of the second class was mother
love. Recognizing this in the late twenties, several hospital
pediatricians began to introduce a regular regimen of mother
ing in their wards. Dr. J. Brennemann, who for a time had
attended an old-fashioned foundling home where "the mortal
ity was nearer 100 percent than 50 percent," established the
rule in his hospital that every baby should be picked up, carried
around, and "mothered" several times a day. At Bellevue Hos
pital in New York, following the institution of "mothering" on
the pediatric wards, the mortality rates for infants under one
year fell from 30 to 35 percent to less than 10 percent by 1938.

What the child requires if it is to prosper, it was found, is to
be handled, and carried, and caressed, and cuddled, and cooed
to, even if it isn't breastfed. It is the handling, the carrying, the
caressing, and the cuddling that we would here emphasize, for
it would seem that even in the absence of a great deal else, these
are the reassuringly basic experiences the infant must enjoy if
it is to survive in some semblance of health. Extreme sensory
deprivation in other respects, such as light and sound, can be
survived, as long as the sensory experiences at the skin are
maintained.

Cases capable of throwing considerable light on the impor
tance of cutaneous stimulation in the absence of other kinds of
stimulation are represented by those few instances in which
either the loss of such senses as vision and hearing occurred at
or shortly after birth, or where the child has been kept in a dark
room with a deaf-mute mother. The most dramatic instances of

80 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

the first sort are the cases of Laura Bridgman and Helen Keller.
Their stories are too well known to be retold here, except to
draw attention to the fact that, having lost both vision and
hearing, these two children were, after much effort, reached
through the skin and eventually learned to embrace the whole
of the human world and to communicate with it upon the
highest levels entirely through the skin. Until each of these
children had learned the finger alphabet in other words, com
munication through the skin they were cut off virtually com
pletely from interactive social relations with other human be
ings. They were isolated, and the world in which they lived held
little meaning for them; they were almost completely unsocial-
ized. But after the patient efforts of their teachers had suc
ceeded in enabling them to learn the finger alphabet, the world
of symbolic communication was opened to them, and their
development as social human beings proceeded apace.

Equally interesting is the case of Isabelle. She was an illegiti
mate child, and for that reason she and her mother were se
cluded from the rest of the mother's family in a dark room
where they spent most of their time together. Born in Ohio in
April 1932, Isabelle was discovered by the authorities in No
vember 1938. She was then six and a half years of age. Lack of
sunshine and poor nutrition had produced severe rickets. As a
result Isabelle's legs were so bowed that when she stood erect
the soles of her shoes came nearly flat together, and she moved
about with a skittering gait. When found, she resembled a wild
animal more than anything else, mute and idiot-like. She was
at once diagnosed by a psychologist as genetically inferior.
However, a specialist in child speech, Dr. Marie K. Mason, put
her through an intensive and systematic training in speech, and
in spite of all prognostications to the contrary succeeded not
only in teaching her to speak normally, but to achieve with
speech all the usual associated abilities. In two years she cov
ered the stages of learning that normally require six years. She
did very well at school, participating normally in all school
activities.

The case of Isabelle conforms to the type picture of the

Tender, Loving Care 81

isolated child with malnutrition, idiocy, and muteness, who
nevertheless, under intensive training, became a thoroughly
normal socialized being. Malnutrition did not do any noticeable
damage to the nerve cells of her brain, and her development to
perfectly normal social adjustment strongly suggests that she
probably received a great deal of attention from her mother,
mostly of a tactile nature, during the years of their isolation
together.

Laura Bridgman and Helen Keller communicated through
the sense of touch. We are told that Isabelle also communicated
with her mother in this manner and by gesture. Isabelle's
disabilities and her nonsocialization were entirely due to her
prolonged isolation. Her ability to recover from its effects was
almost certainly due to the fact that she had been adequately
loved by her mother, handled, held, caressed, and fondled.

It is recorded of Frederick II (1194-1250), Emperor of Ger
many, in his own time called stupor mundi, "wonder of the
world," but referred to by his enemies in less flattering terms,
that

he wanted to find out what kind of speech and what manner of
speech children would have when they grew up if they spoke to
no one beforehand. So he bade foster mothers and nurses to
suckle the children, to bathe and wash them, but in no way to
prattle with them, for he wanted to learn whether they would
speak the Hebrew language, which was the oldest, or Greek, or
Latin, or Arabic, or perhaps the language of their parents, of
whom they had been born. But he laboured in vain because the
children all died. For they could not live without the petting and
joyful faces and loving words of their foster mothers. And so the
songs are called 'swaddling songs' which a woman sings while
she is rocking the cradle, to put a child to sleep, and without
them a child sleeps badly and has no rest.

These are the words of the thirteenth-century historian
Salimbene.

"For they could not live without the petting . . ." This obser
vation constitutes the earliest known pronouncement on the
importance of cutaneous stimulation for the development of the

82 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

child. Undoubtedly awareness of the value of caressing the
child is much older than that.

As Dr. Harry Bakwin, among the earliest pediatricians to
recognize the importance of mothering the hospital child, has
written, "Most important to the young baby appear to be the
skin sensations and the kinesthetic sense. Babies are readily
soothed by patting and by warmth, and they cry in response to
painful stimuli and to cold. The quieting effect of keeping babies
outdoors may be due, in part, to the movement of the air on the
skin."

The reference to warmth and to air points to some very
important influences in the immediate postpartum experience
of the newborn. The baby's temperature in utero is probably
about the same as its mother's, but during the birth process and
in the perinatal period the baby's temperature is somewhat
higher than the mother's, varying between 97.5 and 102.0
Fahrenheit with a mean of about 100. Temporary exposure to
cold air will stimulate the baby to cry, but is in no way damag
ing unless the exposure to cold is prolonged. Babies respond
pleasurably to warmth and with distress to cold. Neonatal cold
injury can lead to death. Normally the warmth of the mother's
body flowing through to the baby will comfort him, and the
absence of the warmth will distress him. When, in later life, we
speak of the "warmth" of a person, as compared with those who
are "cold," these are not, we may suspect, mere figures of
speech. As Otto Fenichel has said,

Temperature eroticism in particular is often combined with early
oral eroticism and forms an essential part of primitive receptive
sexuality. To have cutaneous contact with the partner and to feel
the warmth of his body remains an essential component of all
love relationships. In archaic forms of love, where objects serve
rather as mere instruments for gaining satisfaction, this is espe
cially marked. Intense pleasure in warmth, frequently manifes
ted in neurotic bathing habits, is usually encountered in persons
who simultaneously show other signs of a passive-receptive ori
entation, particularly in regard to the regulation of their self-
esteem. For such persons, "to get affection" means "to get

Tender, Loving Care 83

warmth." They are "frozen" personalities who "thaw" in a
"warm" atmosphere, who can sit for hours in a warm bath or
on a radiator.

The human newborn, even if he is born before term, has
considerable ability to regulate his own temperature, but the
range of thermal environment in which he remains comforta
ble, his range of thermal neutrality, is of lesser amplitude than
in the adult, because he has the disadvantages of a relatively
large surface area from which to exchange heat and a small
body mass to act as a heat sink (a mass which absorbs heat),
Hey and O'Connell have examined the neutral thermal zone in
clothed babies, and concluded that a draught-free environment
of 75 F is necessary to provide neutral thermal conditions for
most cot-nursed babies in the first month of life. The clothed
baby is at an advantage over the naked baby. The bare face and
head, and especially the face, will not only provide the impor
tant sweating areas for the dissipation of heat, when that
becomes necessary, but will also serve to receive the cool air
which will act as a stimulus to respiration. Glass and his co-
workers have shown that blanketing symptom-free low birth-
weight infants not only simplifies their management but also
enhances their immediate and longterm ability to resist acute
cold stress.

A source of warmth, as Dr. J. W. Scopes has remarked, not
often considered in our sophisticated society is the baby's
mother. Swaddling the baby against the mother's bare skin
provides a warm and thermostatically controlled micro-cli
mate.

The newborn baby produces its own heat from a series of sites
distributed over various parts of its body. These sites are as
sociated with a brown adipose tissue and occur on the back
between the shoulder blades, in the posterior triangle of the
neck, and around the muscles of the neck extending under the
collar bones to the armpits, in islands around the trachea,
esophagus, and the large vessels between the two lungs and the
arteries accompanying the ribs and the internal mammary ar-

84 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

teries. In the abdomen the largest collection of brown adipose
tissue is situated around the adrenal glands and kidneys, with
smaller masses around the aorta. Blood draining from the inter-
scapular pad into the vertebral plexus of veins around the spinal
cord may play an important role in the temperature regulation
of the newborn baby.

There is reason to believe that there exist two systems of
temperature sensitivity, one for warmth and one for cold, and
to these the newborn is particularly sensitive. Like adults, the
infant tolerates high external temperatures better than he does
low ones, and prefers warmth to cold, but precisely what role
the early experience of differences in temperature plays in his
subsequent development, except in the matter of cold injury, we
do not know; we may surmise that it is not inconsiderable.

The temperature sense or senses present many complexities
which are far from being well understood. The metabolic re
sponse to sudden changes in temperature can be very threaten
ing. For example, as Hey and his co-workers have shown, while
a baby may be born into a draught-free room warmed to a
temperature of 82-86 F, when an exchange transfusion is per
formed under these conditions, the deep body temperature of
the baby will fall progressively unless active steps are taken to
warm the donor's blood. There is good reason to believe, as
these investigators suggest, that the use of cold blood could
precipitate circulatory collapse during exchange transfusion.
The same is often true when it is necessary to give adults a rapid
transfusion of stored blood.

Cold has a constricting effect upon the blood vessels and also
tends to slow down the flow of blood, with resulting accumula
tion of deoxygenated blood in the capillaries, leading to cyano
sis, that is, blueness of the skin, and this is greatly affected by
temperature, being accelerated by warmth and decelerated by
cold.

The practice of bathing babies shortly after they are born
often exposes them to heat loss and cold, especially when the
cheeselike coating, the vernix caseosa as it is called, is removed.
The vernix caseosa is composed of sebum secreted from the

Tender, Loving Care 85

baby's own skin glands and shed epithelial cells from its skin.
In the liquid medium of the womb, this serves as an insulating
layer which protects the baby's skin from maceration. Follow
ing birth the vernix caseosa serves as an insulation against loss
of heat and the penetration of cold. For this reason the practice
of washing away this cheeselike substance is considered unde
sirable by some authorities. This would be particularly true
where the surrounding temperature is less than 80 F. In general
it might be a good idea to leave this substance undisturbed and
the baby placed with the mother until she is ready to nurse it.*

The baby's sucking pressure at the breast is lower at 90 F
than at 80 F, according to the findings of Elder on twenty-
seven fullterm healthy infants. Cooke found that caloric intake
in infants decreased as environmental temperature increased
from 81 F to 90 F, and that caloric intake increased when
temperature decreased from 91 F to 80 F. Such findings sug
gest that the common hospital practice of heavily wrapping
infants at feeding time might benefit from review.

The obvious efforts of mothers among the mammals to keep
their young warm, and broody behavior among birds, suffi
ciently testify to the great importance of warmth for the devel
opment of the young. The strong drive of the young to huddle
together in the absence of a broody or warming mother further
serves to underscore the importance of a necessary condition
which can best be produced in the young through body contact.

The suggestion has been made that the basic factor in
changes induced by handling may be temperature. SchaefFer
and his co-workers, for example, found that rats whose temper
ature had been lowered showed the same drop in ascorbic acid
in the blood as handled rats. The conclusions of these investiga
tors have been criticized on various methodological grounds,
without denying that temperature may be a variable in produc
ing manifold effects in different animals.

The touch of a cold hand is not pleasant the touch of a

*Since the vernix caseosa tends to dry rapidly upon exposure to air, it
presents no particular problems.

86 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

warm one is, an observation which brings us to the considera
tion that cutaneous sensation cannot be a matter simply of
touch or pressure, but must in part be a response to tempera
ture. Caressing with an ice-cold hand would scarcely be re
ceived by the recipient as comforting, but rather as an unpleas
ant, if not outright painful experience. "Cold comfort" is
something less than comforting. Clearly, it is the quality of
cutaneous stimulation that conveys the message, and this is
made up of a complex of different factors. A sharp, painful slap
conveys a very different message from a tender, gentle caress,
and differences in skin pressure may make all the difference
between a painful and a pleasurable sensation. It is probably in
something of this manner, by the evaluation of such factors as
pressure, intensity, rhythm, duration, firmness, and the like,
that infants are able to discriminate between those who, when
holding them, care for them and those who do not.

It is the messages the infant picks up through its own muscle-
joint receptors from the manner in which it is held, rather than
mere pressure on the skin, that tell the infant what the holder
"feels" about it. The skin belongs to the class of organs called
exteroceptors because they pick up sensations from outside the
body. Receptors that are stimulated principally by the actions
of the body itself are called proprioceptors. It is both through
its skin and the proprioceptors that the infant receives the
messages from the muscle-joint-ligament behavior of the person
holding it.

The infant makes the proper discriminations in much the
same way that adults do when they draw inferences about the
character of a person from the quality of his handshake. At
least, those individuals who have not been desensitized in their
capacity to do so are able to draw such conclusions with a high
degree of accuracy. Every baby is clearly born with this kines-
thetic sense, and the evidence we have experimental, observa
tional, experiential, and anecdotal all tends to support the
view that, just as we learn to speak by being spoken to, and will
speak as we have been spoken to, so we learn to respond to
exteroceptive skin stimulation and proprioceptive muscle-joint

Tender, Loving Care 87

stimulation largely as a function of our early experience or
conditioning in these senses.

It is quite probable that something of the manner in which
the individual comes to carry himself, to hold his head, his
shoulders, and to move his limbs and torso, is related to his
early conditioning experiences. It is well known, for example,
that the anxious individual, whether infant, child, or adult,
tends to rigidify his movements, to tense his muscles, to over-
elevate his shoulders, and even to glare with his eyes. These
conditions are not infrequently associated with pallor and dry-
ness of the skin, not to mention other cutaneous disorders.

Thoughts and feelings are often communicated in nonverbal
ways, through movements of the body. The study of this subject
is known as kinesics. Kinesics is concerned with the exploration
of the various adjustments, without their necessarily being
aware of the fact that they are making them, which human
beings are constantly engaged in in relation to the presence and
activities of other human beings. Our leading student of kines
ics, Ray L. Birdwhistell, is convinced that kinesic behavior is
learned, systematic, and analyzable. "This," he writes, "does
not deny the biological base in the behavior but places the
emphasis on the interpersonal rather than the expressional as
pects of kinesic behavior."

It is in the interpersonal relationship with the mother, ex-
teroceptively and proprioceptively, as well as interoceptively,
especially involving the receptors of the gastrointestinal tract
and this is very important that' the child establishes its first
communicative relationships. Quite probably during this period
conditioning conducive to the formation of hypertensive habits
takes place. These hypertensive habits later show up in hyper
tensive conditions affecting the gastrointestinal tract in the
form of colitis, hypermotility, ulcers, and the like, affecting the
cardiovascular system in the form of psychogenic cardiovascu
lar disturbances, affecting the respiratory system in the form of
asthmatoid conditions, and, of course, affecting the skin in a
large variety of disorders.

Dr. P. Lacombe has described a remarkable case of a severely

88 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

neurotic female patient who manifested depressive violent be
havior and neurodermatosis. The grandmother of the patient
gave the latter's mother minimal tactile attention as a child, and
the patient's own mother failed her in this respect also. La-
combe sees this patient's disorder as the expression of a loss of
the infant-mother attachment resulting in a fixation on the
mother. Loss of the mother equals loss of ego, and loss of
maternal skin as point of contact reappears in the patient as
weeping skin areas. The patient's pet dog also suffered from
skin problems, which Lacombe interprets as due to the identifi
cation of the dog with its mistress. The ego, says Lacombe, "is
the perception of the bodily self, and what one feels and knows
of the body is the skin."

A striking example of specific cutaneous conditioning during
the first two weeks of life, and subsequent regression to this very
early age level, is illustrated by a case of trichotillomania, that
is, pathological hair-pulling, reported by Dr. Philip F. Durham
Seitz in a child under three years of age.

A 2 1 A year-old white, female child was referred for psychiatric
study by a dermatologist because of scalp hair loss of one year's
duration. Dermatologic examinations had failed to reveal an
organic basis for the alopecia. The scalp exhibited an over-all
thinning and shortness of hair, more marked on the right side.
During the initial psychiatric interview, it was observed that
the child cuddled herself in the arms of her mother and sucked
milk from a nursing bottle. While sucking the nipple of the
nursing bottle, which was held in the left hand, she searched her
scalp with the right hand for remaining hairs. When a hair or
group of hairs was found, she pulled these out with a twisting
motion of her fingers. The hairs were then carried in her fingers
to her upper lip, where she rolled them against her lip and nose.
This process was continued as long as she nursed from the bottle,
but ceased promptly when the nipple was removed from her
mouth. The mother pointed out that the child pulled her hair
only when sucking from the nursing bottle, and that invariably
sucking was accompanied by hair pulling and nose tickling. The
author went to the home of this family in order to observe the
child, and also observed her during play in his office. Hair pull-

Tender, Loving Care 89

ing and nose tickling were found to occur only, and then invari
ably, when the child sucked milk from a nursing bottle.

Further interviews with the mother elicited the following in
formation: The girl was the first and only child of lower middle-
class parents, both of whom exhibited somewhat precarious
emotional adjustments. The father was a Salvation Army musi
cian, and both parents were devoutly religious. They had been
married for five years, considered themselves entirely compatible
marital partners, and had both wanted the child at the time she
was conceived. However, because of the difficulty they had ex
perienced with her, they employed contraceptives to avoid fur
ther pregnancies. The girl was born at term, delivery being une
ventful. For the first two weeks the mother nursed her baby at
her breast, but discontinued this abruptly during the third week
because she believed her lactation to be insufficient. The child's
growth and development during the first year and one-half ap
peared to be normal. She sat at three months, stood at seven
months, walked at ten months, began to talk at eighteen months.
She was weaned from the bottle when she was one year old, after
which she ate solid foods and drank liquids from a cup.

When the child was eighteen months old, a punitive program
of toilet training was instituted, which involved scoldings and
spankings whenever she soiled herself. In retrospect, the mother
realized it was following onset of this toilet training program
that the child began to refuse solid foods, insist upon milk from
a nursing bottle, and pull out her hair and tickle her nose while
sucking. In addition, she had become difficult to manage, re
sisted all efforts to teach her toilet habits, and cried a great deal,
would not mind, and demonstrated a desire to splash water on
herself.

From observation of the child Dr. Seitz reasoned that her
refusal to eat solid foods and her continued nursing from a
bottle suggested an unconscious desire to return to an earlier
suckling stage. Her hair pulling and nose tickling suggested that
somehow she wished in some way to duplicate the original
suckling situation. This raised a question: Was her nose tickled
while she was at the breast? The nose tickling suggested that
hair on the mother's breast might have been responsible. With

90 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

this in mind the mother's breasts were examined and revealed
"a ring of long, coarse hairs surrounding each nipple."

In order to test the hypothesis suggested by this association,
a nipple was constructed with a ring of coarse human hairs
projecting around its base. This arrangement provided an auto
matic tickling of the child's nose whenever the nipple was held
in the mouth. When sucking at the nipple she would slowly turn
the bottle, brushing the upright hairs against her nose and
upper lip. Hair pulling did not occur. The automatic nose tick
ling apparently satisfied the need to regress to the early experi
ence at the breast.

The importance of this fascinating case lies in its demonstra
tion of early psychocutaneous conditioning, within the first two
weeks of life. Nursed at the hairy breast of her mother for two
weeks, and then abruptly withdrawn from it, this little girl
attempted to reinstate the conditions at the breast by providing
herself with hair from her own head with which to stroke her
nose and lip while sucking at a rubber nipple at the end of a
glass bottle.

"To what other neurotic traits," asks Dr. Seitz, "and psycho
somatic reactions may an individual be predisposed in later life
by specific cutaneous conditioning of this type? Psychocutane
ous disorders of the nose? Nose picking? Hay fever, or allergic
rhinitis?" These are good questions.

NOSING, NURSING, AND BREATHING. Psychocutaneous disord-
ers of the nose should be a fertile field for exploration, but I
know of no significant studies in this area. Yet it is clear from
the many diflferent ways in which people treat their noses that
early conditioning may very well have played a part in deter
mining or influencing their kinesic behavior towards this part
of their anatomy. People pull at their noses, stroke them, flatten
them, compress them, wrinkle them, put their bent fingers
"under them, place their index finger against them, scratch them,
rub them, massage them, breathe heavily or lightly through
them, or flare their nostrils. It would hardly be warranted to
attribute all such habits to early conditioning, but there can be

Tender, Loving Care 91

little doubt that in many cases such habits are in some way
related to early cutaneous conditioning. The nose, it has been
said, is the gateway to life and death. This, of course, refers to
its respiratory functions. As we have already seen, it is probable
that the proper development of the respiratory function is to
some extent dependent upon the amount and kind of cutaneous
stimulation the infant experiences. It is not unlikely that per
sons who have received inadequate cutaneous stimulation in
infancy develop as shallow breathers, and become more suscep
tible to upper respiratory tract and pulmonary disorders than
those who have received adequate cutaneous stimulation. There
is some reason to believe that certain types of asthmas are, at
least in part, due to a lack of early tactile stimulation. There is
a high incidence of asthma among persons who as young chil
dren were separated from their mothers. Putting one's arm
around an asthmatic while he is having an attack may abort or
alleviate it.

Margaret Ribble has pointed out the importance of tactile
experience in breathing.

Respiration [she writes], which is characteristically shallow, un
stable and inadequate in the first weeks after birth is definitely
stimulated reflexly through sucking and through physical con
tact with the mother. Infants who do not suck vigorously do not
breathe deeply and those who are not held in the arms suffi
ciently, particularly if they are bottle-fed babies, in addition to
breathing disturbances often develop gastrointestinal disorders.
They become air-swallowers and develop what is popularly
known as colic. They have trouble with elimination or they may
vomit. It seems that the tone of the gastrointestinal tract in this
early period depends in some special way on reflex stimulation
from the periphery. Thus, the touch of the mother has a definite
biological implication in the regulation of the breathing and
nutritive functions of the child.

To continue with the subject of breathing for a moment,
before returning to the nose through which that breathing
mainly takes place, it has already been pointed out that immedi
ately following upon exposure to atmospheric air the newborn's

92 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

previously unexpanded lungs fill with air and the various
changes in pressure which occur at the moment of birth help
to initiate the postnatal type of respiratory movements that
continue throughout the life of the person. The need to breathe
is so compelling that a three-minute denial of it is often suffi
cient to cause death. The urge to breathe is the most imperative
of all man's basic urges, and the most automatic. The process
of learning to breathe is an anxious one. Every breath we take,
even as adults, is preceded by a faint phobic stir. Under condi
tions of stress many persons go into labored breathing reminis
cent of breathing at birth. Under such conditions the person
often regresses to fetalized activities and assumes fetal posi
tions. In fear or anxiety one of the first functions to be affected
is breathing. Yet, in spite of its automaticity, breathing or respi
ration is under voluntary control and under conscious control
for short periods of time, as any person who has ever taken
singing lessons knows, and for very durable periods of time, as
every Yogi knows. This control is actually exerted during the
ordinary activities of everyday life, such as speaking, swallow
ing, laughing, blowing, coughing, and sucking. Breathing, in
deed, is not simply a physiological process but a part of the way
in which an organism behaves.

That many of the elements of breathing are learned is evident
from the fact that there are significant class differences in the
manner of breathing. Heavy or stertorous breathing, like noisy
soup- or coffee-sipping, occurs very much more frequently
among members of the lower classes than among members of
the upper classes. Differences in the rate of breathing and oxy
gen-combining capacity of the lungs, as Dill has shown, are
closely correlated with occupational status. Inadequate, shal
low breathing, associated with chronic feelings of fatigue in
later life, as compared with healthy deep breathing, are also for
the most part learned habits, and may well have some connec
tion with early cutaneous experiences.

To return to the nose: It could be that the various forms of
handling the nose in later life, including nose picking, may be
related to early experiences in the feeding situation, especially

Tender, Loving Care 93

the breastfeeding situation. In nursing at the breast the baby's
nose is frequently in contact with the mother's breast, and it is
quite possible that the rhinal experiences there enjoyed or unen-
joyed may have something to do with these various later
manipulations of the nose. Most monkeys and apes pick their
noses, and often eat the debris they remove therefrom. Some
small children do likewise, and even adults have been known
to do so. The association of picking one's nose and eating in
such cases suggests the possibility of some form of early condi
tioning, and that nose picking alone may be a form of self-
gratification regressive to such an early period of experience.
"The private life is above everything . . . just sitting at home and
even picking your nose, and looking at the sunset," wrote V. V.
Rozanov, the Russian writer.

Allowing for the fact that most people carry bacteria of
various sorts in their noses and that these are often irritating,
and therefore induce a great deal of handling of the nose, never
theless nose handling and especially nose picking can scarcely
be altogether attributed to pruriginous bacteria. It would be a
matter well worth further investigation.

As the prominent peninsula it is, the nose affords a conve
nient piece of the main upon which to make a landfall with
one's hand, and to which one can cling stroking or otherwise
manipulating it with that reassured feeling that comes from
being able to establish contact, even though it be only with
oneself. The nose seems to be a particularly favored part of the
body, for purposes of reassurance. We often recognize this kind
of manipulation as a nervous gesture in others without being
conscious of it in ourselves.

Why should "making a nose at" or "thumbing one's nose at"
another be regarded as gestures of disdain?

From fish to humans the oral region is the earliest part of the
body to become sensitive to cutaneous stimulation. The lips are
established as erogenous zones, that is, as pleasure-giving struc
tures, long before the baby is born. Fetuses at five months and
earlier have been observed in the womb sucking their thumbs.
The experience at the breast or the bottle, very different as it

94 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

is in each case, further reinforces the erogenicity of the lips.
Sucking is the major activity of the baby during the first year
of his life, and his lips, presenting the externally furled exten
sion of mucous membrane that lines his mouth, constitute the
instruments with which he makes his first most sensitive con
tacts, and incorporates so much that is vital to him of the
external world. It is, therefore, not surprising that the lips
should be more fully supplied with sensory nerve endings than
any other part of the body, with the possible exception of the
fingertips. Lips, mouth, tongue, the sense of smell, vision, and
hearing, are all intimately bound up with each other and the
experience of sucking. If it is at the breast, it constitutes suck
ling; if it is at the rubber nipple of a bottle, it is sucking two
very different kinds of experiences. Research findings are some
times contradictory concerning the advantages of breastfeeding
as compared with bottlefeeding and the effects of each kind of
regimen upon subsequent behavior. What is, however, quite
clear is that it is not so much the type of feeding that is impor
tant for subsequent behavior as the over-all behavior of the
mother during the feeding. Cold mothers who breastfeed do not
do as well in influencing the later behavior of their children as
warm mothers who bottlefeed. Such, for example, were the
findings in a study conducted by Dr. Martin I. Heinstein on
some 252 Berkeley, California, children.

As we have already had occasion to see, the infant very
quickly responds to the mother's behavior towards it, and what
is most important to its own behavioral development is not so
much the material with which it is fed as the manner in which
it is fed. It is precisely this kind of experience that will be picked
up by the skin and the specialized mucous membranous struc
ture we call the lips. Whether children who have had cold
mothers or inadequate nursing will seek further gratification in
lip stimulation, and will exhibit more of it than those who have
had warm mothers and have been adequately nursed, is a ques
tion for which I know of no research answers. The variability
in this, as in other matters, is undoubtedly considerable and
probably quite complex. Many children do spend a great deal

Tender, Loving Care 95

of time manipulating their lips with their fingers, often while
making a humming-murmuring sound to accompany the
manually stimulated lip movements. They obviously enjoy
doing this. I suggest that in thumb-sucking or finger-sucking it
is not simply the sucking that is gratifying, but that a certain
amount of satisfaction is also obtained from the stimulation of
the lips. The hand of the baby often rests on its mother's breast
during suckling or upon the bottle during artificial feeding; the
baby's eyes follow every movement of its mother's eyes and
face, and it grows accustomed, as well, to the sounds that both
she and it make in the nursing situation. It is not difficult to
understand how all these factors become closely integrated in
a developing neuro-psychic complex. Hence, when in later life
the individual becomes a victim of the smoking habit, he may,
again at least in part, be conjectured to have become so addicted
as a regression to the complex of similar pleasures he ex
perienced during the earliest period of his life. The sucking, the
lip stimulation, the handling of the cigarette, cigar, or pipe, the
pleasure of blowing and seeing the smoke, of inhaling it, of
smelling and tasting it, it is all very gratifying even though the
longterm effects may be lethal. Part of the pleasure of chewing
gum is probably derived from the constant oral-lip stimulation.

Many writers on the subject have considered that the early
experiences at the lips and mouth constitute the gateway to
much of our understanding of later developments. The distin
guished American psychologist G. Stanley Hall believed the
first center of psychic life to be the mouth and the sense of taste,
accompanied by a "tactile pleasure truly aesthetic which arises
from bringing smooth things to the lips and hard things to the
toothless gums."

Freud makes the activity of the infant's lips at the breast a
foundation stone of his theory of sexuality. He writes:

It was a child's first and most vital activity, his sucking at his
mother's breast, or at substitutes for it, that must have familiar
ized him with this pleasure [of rhythmic sucking]. The child's
lips . . . behave like an erotogenic zone, and no doubt stimulation

96 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

by the warm flow of milk is the cause of the pleasurable sensa
tion. The satisfaction of the erotogenic zone is associated, in the
first instance, with the satisfaction of the need for nourishment.
. . . No one who has seen a baby sinking back satiated from the
breast and falling asleep with flushed cheeks and a blissful smile
can escape the reflection that this picture persists as a prototype
of the expression of sexual satisfaction in later life. The need for
repeating the sexual satisfaction now becomes detached from the
need for taking nourishment a separation which becomes inev
itable when the teeth appear and food is no longer taken by
sucking. . . .

Though much that has been attributed to the oral phase of
development has not been adequately investigated, there can be
not the least doubt of the existence of a profound relationship
between oral experiences in infancy and later sexual competen
cies. Nor can there be any doubt of the intimate connection
between the skin and all its appendages, including hair, glands,
neural elements, and sexual behavior. A French wit has re
marked that love is the harmony of two souls and the contact
of two epidemics.* And indeed, it is in the sexual act that, next
to the perinatal experience of labor, the individual experiences
his most massive cutaneous stimulations, with the lips and
tongue and mouth usually actively involved. Nor can there be
any doubt that eating and love become closely interwoven in
such a manner that in later life eating often becomes a substitute
satisfaction for love, obesity frequently constituting an evidence
of a failure to obtain love. The offering of food is often more
than a perfunctory evidence of the tendering of love.

The psychoanalyst Sandor Rado has suggested that an im
portant element in early sucking lies in the achievement of a
pleasant feeling of satiety and a diffuse feeling of sensual pleas
ure in which the whole organism participates, and he describes
this as an "alimentary orgasm."

*A variation of Chamfort's "Love as it exists in society is merely the
mingling of two fantasies and the contact of two skins." S. R. N. Chamfort,
Products of the Perfected Civilization (New York: The Macmillan, Co., 1969),
p. 170.

Tender, Loving Care 97

That the mother experiences something akin to sexual stimu
lation by the baby's suckling is well known, and that the baby
experiences sensations which, endowed with meanings, later
become perceptions of something resembling sexual gratifica
tion, is highly probable. We have already noted on an earlier
page that inadequate mothering may seriously affect the subse
quent sexual behavior of the offspring. The Harlows, to whom
we owe this observation, have also shown that while rhesus
monkeys raised by live mothers were more advanced in social
and sexual behavior than those raised by surrogate mothers
constructed of terry-cloth covered wire, the surrogate-raised
infants developed perfectly normal social and sexual behavior
if they were permitted each day to play in the stimulating
environment of other infant monkeys. The Harlows rightly
point out that the role played by infant-infant relationships as
determiners of adolescent and adult adjustments should not be
underestimated. It is more than possible, the Harlows suggest,
that the infant-infant affectional system "is essential if the ani
mal is to respond positively to sheer physical contact with a
peer, and it is through the operation of this system, probably
both in monkey and man, that sexual roles become identified
and, usually, acceptable."

It is, indeed possible, even probable, as the Harlows suggest,
that infant-infant contacts are necessary for the full develop
ment of social and sexual competence, but that, in the absence
of any kind of mother at all, such behavior would, even in the
presence of other-infant contacts, not develop as well as in
mothered infants. Certainly it is clear that, in humans, good
mothering without peer contacts has not seriously detrimen
tally affected the social and sexual development of innumerable
individuals. Indeed, there exists an extensive literature showing
how enormously important the mother's behavior is for her
infant's subsequent social and sexual development. We may be
reasonably sure, when all the evidence is in, that however valu
able the infant-infant affectional relation may prove to be, it will
never equal the influence of the affectional relationship that
exists between the nursing couple, always with the understand-

98 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

ing that the mother is genuinely affectionate. There can be little
doubt that peer interaction in the social growth and develop
ment of the child is of considerable importance, for it is in the
give and take between peers that children try out and learn
many of the modulations of interpersonal behavior.

As Yarrow, in an excellent survey of the evidence, puts it,
'The mother as a social stimulus provides sensory stimulations
to the infant through tactile, visual, and auditory media, i.e.,
through handling, cuddling, talking and playing with the child,
as well as by simply being visually present." Deprivation of
such sensory stimulations from the mother are serious in their
effects.

It was mentioned on the first page of this book that it is in
the region surrounding the mouth that the human embryo first
responds to tactile stimulation. It is not surprising, therefore,
to find that the first communications with the outside world are
established by the infant through the lips, and this very gradu
ally. It has been shown that stimulation of the newborn in the
lip region triggers the oral orientation reflex, that is, opening of
the mouth and rotation of the head in the direction of the
stimulus. This will occur when only one lip is stimulated. When
both lips are stimulated the grasping or prehension of the stimu
lus will occur. This stimulus is normally the nipple and then the
areola of the mother's breast. Rooting, that is, digging with the
nose and mouth to find the breast, will occur thereafter when
ever the baby is brought into contact with the breast or any
thing resembling it. These two reflex activities, oral orientation
and lip grasping, are regarded as two stages in the development
of rooting behavior. The integration of these two reflexes into
"oral grasping" in suckling represents one of the first develop
mental advances made by the newborn toward grasping the
world, in general as well as in particular. In other terms these
two reflexes are known as the searching pattern on the one
hand, and the orienting or suckling pattern on the other. The
clinging behavior of the lips around the nipple and areola, and
later the kneading, clinging, and resting of hands and fingers on

Tender, Loving Care 99

the breast, represent, as Spitz has pointed out, the precursors
and prototypes of object relations.

"To smack one's lips" represents an old expression for satis
faction. It is interesting that lip smacking should be used by
mother baboons to pacify their young as well as others. "The
mother," writes Irven DeVore, "makes almost no sound except
that resulting from soft lip smacking as she grooms her infant.
Lip smacking, initiated at birth by the mother, is one of the
most frequent and important of all baboon gestures. For both
sexes at all ages this gesture serves to reduce tension and pro
mote tranquility in social interactions." Ordinarily the direct
approach of an adult male is very frightening to other members
of the troop; it is therefore of great interest to observe that when
an adult male approaches an infant who is with its mother he
will do so with vigorous lip smacking. To call the infant, who
may have climbed a tree, the mother will stare intently in its
direction and smack her lips loudly.

Human mothers will often make pacifying sounds to their
babies in similar ways or by pursing their lips and producing
a variety of sounds. Babies almost invariably respond with
pleasure to such pacifying sounds. Making such sounds to ba
bies, especially soft lip-sucking ones, constitutes one of the most
effective means of inducing them to laugh through their tears,
even to the point of hiccups. At six months or even earlier an
infant's attention will be immediately arrested by such sounds,
and in the absence of all else will exercise a tranquilizing effect
upon him. This strongly suggests that the infant identifies the
sounds and the lips from which they emerge with pleasurable
experiences.

The mother's caressing, comforting, and bestowal of affec
tion through kisses with the lips constitute experiences in which
the infant is repeatedly conditioned.

Raven Lang's observation that mothers usually speak to their
babies in a high-pitched voice has drawn attention to the fact
that babies prefer sounds in the high-frequency range, and fe
male voices to those of males.

100 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

TOUCHING AND FEELING. The baby's rooting behavior is ex
ploratory, scanning, and has for its purpose and consummation
the finding and engaging of the nipple and areola between the
lips. While rooting will soon be abandoned for visual scanning,
the rooting is nonetheless important in that it constitutes,
among other things, a re- verification and a reaffirmation of the
existence of a pleasure-giving other, pleasure-giving by virtue of
nothing more than the other's existence, her tangibility. Her
tangibility is the ultimate reassurance, for in the final analysis
we do not believe in the reality of anything unless we can touch
it; we must have tangible evidence. Even faith rests ultimately
upon a belief in the substance of things to come or of past events
experienced. What we perceive through the other senses as
reality we actually take to be nothing more than a good hypoth
esis, subject to the confirmation of touch. Observe how often
people will respond to a sign reading "Wet Paint." Quite fre
quently they will approach and test the surface with their
fingers for themselves. The sign acts upon them as a signal to
touch, to verify. Touch attests to "objective reality" in the sense
of something outside that is not myself. As Walter Ong has
written, "And yet, by the very fact that it attests the not-me
more than any other sense, touch involves my own subjectivity
more than any other sense. When I feel this objective something
'out there,' beyond the bounds of my body, I also at the same
instant experience my own self. I feel other and self simultane
ously." Dr. Abraham Levitsky has pointed out that by its very
nature, "touch is close and sight is far. We permit contact with
those things and people we trust and enjoy. We withdraw from
contact with what we don't trust and what we fear."

Withdrawing from what we do not trust and from the
things we fear reminds us that the dark often possesses a tan
gibility and an eeriness which the light never has. The very
idea of a ghost or a monster during daylight is laughable, but
with the loss of contact that ensues with darkness the world
becomes the scene of possible improbabilities. The ghosts we
deride in daylight provoke our skins to creep at night. The
imagination renders the intangible tangible, and we draw the

Tender, Loving Care 101

bedclothes over us to keep the phantoms out.

"It is clear," observes Ortega y Gasset, "that the decisive
form of our intercourse with things is in fact touch. And if this
is so, touch and contact are necessarily the most conclusive
factor in determining the structure of our world." And Ortega
goes on to point out that touch differs from all the other senses
in that it always involves the presence, at once and inseparably,
of the body that we touch and our body with which we touch
it. Unlike vision or hearing, in contact we feel things inside us,
inside our bodies. In tasting and smelling the experiences are
limited to the surfaces of the nasal cavity and palate. Thus, it
comes about that our world is composed of presences, of things
that are bodies. And this they are because they come into
contact with the closest of all things to man, to the "I" that each
man is, namely, his body.

From the tangible evidence of the mother's body, the clinging
of the lips, of hands and fingers to the breast, with the world
at his fingertips in a very real sense, the infant will develop an
awareness of his own and his mother's body which will consti
tute his first object relations. And what cannot be too often
emphasized here is that, while much else is involved, it is
through the primacy of the skin in his experience that the infant
gropes his way to this establishment of object relations.

Around suckling, as the cutaneous or tactile composite of
experiences, the earliest perceptions are organized. As Kibble
has remarked, "As a result of mothering the child gradually
combines and coordinates sucking, or food intake, with sense
intake looking, listening, and grasping and thus a fairly
complicated behavior complex is established." Movements of
lips upon the mother's breast, the developing scanning of her
face and eyes, hand and finger movements in relation to the
mother's body, the feeling tone associated with these experi
ences, enable the infant to establish in its mind a code by means
of which it can reconstitute and reduplicate all these and the
associated experiences, and by making the proper signals, as
figure upon the ground of the maternal body, evoke the appro
priate responses. What it has learned by the exploration of the

102 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

mother's body, through skin, lips, tongue, hands, and eyes, the
infant utilizes as a basis for further learning about its own body,
exploring it mostly with its hands. Indeed, the earliest strivings
towards the reintegration of self are commenced through the
oral experiences at the mother's breast. In these the tongue
plays a prominent role, for the tongue is a significant tactile
organ, in addition to the fact that the newborn is as capable as
the adult of clearcut taste discriminations.

What is the meaning of sticking one's tongue out at another
as a gesture of defiance? Can it be a signal of disappointed
rejection, meaning "I don't love you," or "I don't care for you,"
the very opposite of the feelings enjoyed through one's tongue
at one's mother's breast? Oral-genital contacts, however, repli
cate the breastfeeding experience.

It is of interest to note that in the brain the area devoted to
the lips, on the central gyrus of the cortex, is disproportionately
large by comparison with that devoted to other related struc
tures. (See Figure 1, p. 9.) This is equally true of each of the
four fingers and the thumb, which brings us to the considera
tion of the hand and fingers in the development of the sense of
touch. The very phrase "the sense of touch" has come to mean,
almost exclusively, feeling with the fingers or hand. Indeed,
when one considers the various ways in which the word touch
is employed in speech, it becomes apparent that the variety of
meanings are for the most part extensions of the meaning "to
touch with the hand or a finger or fingers." Interestingly
enough, when one consults a dictionary for the various mean
ings of the word one finds that the entry under "touch" is likely
to represent the most extensive in the volume. It is by far the
longest entry fourteen full columns in the magnificent Ox
ford English Dictionary. This in itself constitutes some sort of
testimony to the influence which the tactile experience of hand
and fingers has had upon our imagery and our speech.

Originally derived from the Old French louche, the word is
defined by the Oxford English Dictionary as "the action or an
act of touching (with the hand, finger, or other part of the
body); exercise of the faculty of feeling upon a material object."

Tender, Loving Care 103

Touching is defined as "the action, or an act, of feeling some
thing with the hand, etc." The operative word is feeling. Al
though touch is not itself an emotion, its sensory elements
induce those neural, glandular, muscular, and mental changes
which in combination we call an emotion. Hence touch is not
experienced as a simple physical modality, as sensation, but
affectively, as emotion. When we speak of being touched, espe
cially by some act of beauty or sympathy, it is the state of being
emotionally moved that we wish to describe. And when we
describe someone as being "touched to the quick," it is another
kind of emotion that we have in mind. The verb "to touch"
comes to mean to be sensitive to human feeling. To be "touchy"
means to be oversensitive. "To keep in touch" means that how
ever far we may be removed we remain in communication. That
is what language was originally designed to do, to put and to
keep human in touch with human. The experiences the infant
undergoes in contact with his mother's body constitute his
primary and basic means of communication, his first language,
his first entering into touch with another human being, the
genesis of "the human touch."

Of "touch" the Oxford English Dictionary says that it is "the
most general of the bodily senses, diffused through all parts of
the skin, but (in man) specially developed in the tips of the
fingers and the lips." It is through the lips that the infant grasps
reality, as well as the body-building substances that it ingests.
It is for a time the only means of judgment the infant has. That
is why, as soon as it is able, it puts things to its lips in order
to judge them, and continues to do so long after it has arrived
at other means of perception and judgment. The other means
of perception and judgment at which it ultimately arrives are
through the tips of its fingers and the palm of its hand, a hand
that has rested upon its mother's palpably and recurringly reas
suring breast. At birth none of the infant's senses are as well
developed as its sense of touch. While all its senses are operative
and play an increasingly significant role in its perception and
communication with the external world, especially with the
mother, none are as basic as touch. It is the sense of touch upon

104 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

which it depends: lips, and generalized body contact, and then
fingertips to whole hand.

The beginning development of self commences with the re
sponses to the conditions of life which the infant experiences.
When, as he does, he takes action at the breast to get what he
wants, this constitutes a decisively critical experience in his
development. He feels encouraged to act on his own knowing
that he will continue to reach his goal with the encouragement
of the (m)other. As Bruno Bettelheim has pointed out, it is for
this reason so potentially destructive to schedule feedings by the
clock, not merely because they mechanize and routinize the
experience of feeding, but because they deprive the infant of the
feeling that it was his own signals that resulted in the satisfac
tion of his hunger. Disregard of his signals discourages, and he
tends to lose the impulse to develop the mental and emotional
techniques for handling the environment, and thus for the ade
quate development of self and personality. The signal, the ges
ture, the communication that goes unanswered at any age can
be a painful experience. At an early age it is especially so, and
may result in a virtually complete cessation of the attempt to
communicate.

The baby who is adequately satisfied receives the feeling that
the world is his for the asking. At the breast the world is at his
fingertips, and while it may be an exaggeration to say, as Bettel
heim does, that all his later ability to do things on his own may
be the consequence of this early conviction, it is probably near
enough, for all practical purposes, to the truth. Reva Rubin,
chairman of the Department of Obstetrical Nursing at the Uni
versity of Pittsburgh, found a definite progression and an or
derly sequence in the nature and amount of contact a mother
makes with her baby. She found that from small areas of con
tact the mother gradually moves to more extensive ones, at first
using only her fingertips, then her hands including palms, and
then much later her arms as an extension of her whole body.

The initial contacts made by the mother with her child are
exploratory in nature. Fingertips are used also, but somewhat

Tender, Loving Care 105

stiffly. This is not necessarily a graceless gesture. At this point,
the mother will usually run one fingertip over the baby's hair,
rather than her hand, to discover that his hair is silky. She will
trace his profile and contours with her fingertip. If she turns his
head toward food, she uses fingertips; if she has to support his
head in bathing, she uses the index finger and thumb (no palm);
if she has to turn him over, she seems to contact parts of him
with her fingertips. She does use her arms and her hands to
passively receive him, but her arms are not active participators
in touch at this stage. Later, her arms will hold firmly, but just
now she carries the baby as though he were a bouquet of flowers,
in arms held so stiffly that she becomes fatigued.

In fingertip exploration, Reva Rubin points out, involvement
is tenuous. As in courtship, in making contact one is not sure
how one will be received. This is true in the courtship stage of
tentative advances, before the handholding stage of reciprocal
confidence and commitment has been established. In maternal
touch the fingertip stage precedes that of commitment.

Commitment seems to await some personally evocative re
sponse of the infant. Sometimes it is a burp, more often it is the
particular way he cuddles or, still more often, the way he ex
presses unbounded pleasure (three months later). This response
must come from the baby, no one else, if the sense of partner
ship, of mutuality, in this kind of relationship is to progress.
The particular sign that satisfies the mother's requirements may
vary. It should also be pointed out that she is very vulnerable
at this time to signs of rejection. But if the young mother has
an essentially strong ego, she will search out, somewhat op
timistically, positive signs of mutuality for a progressive rela
tionship.

The next stage of maternal touch arrives gradually and is
superimposed on the earlier stage. The whole hand is now used
for maximal contact with the infant's body. The mother is more
likely to support the infant's buttock with the palm of her hand.
The hand on its back will be in full contact with it. Both hands
will be relaxed and comfortable, coinciding with her feeling
about her child, a message which the baby receives with the

106 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

sense of security that is thus conveyed to it as its responsiveness
to her firm comforting support creates a feeling it obtains
through touch and the interoceptive sensations it experiences in
this feedback relationship.

It is sometime between the third and fifth days that the
mother will advance from fingertips to the whole cupped hand
to stroke her baby's head. Her own body language progresses
gradually from bathing its anogenital region at fingertip dis
tance, that is, from the exploratory information-seeking phase
to that of a more intimate involvement in the use of her whole
hand.

Recalling here our discussion of cutaneous stimulation in
mammals in the perinatal period as contributing to the im
proved maternal abilities of nonhuman mammals (pp. 22-23),
Reva Rubin's remarks, following, are of the greatest interest.

Mothers who have had a very recent experience of appropriate
and meaningful bodily touch from a ministering person, as dur
ing labor, delivery, or the postpartum period, use their own
hands more effectively. This is true of both . . . firsttime mothers
and . . . mothers who have had more than one child. Conversely,
if the mother's most recent experiences of contact in relation to
her own body have been of a remote and impersonal nature, she
seems to stay longer at this stage in her own activities with the
baby.

These are most important observations, which should lead us
to consider seriously whether it would not be a good idea to
institute the practice of regular body caressing by the husband
of his wife during pregnancy, labor, and after the birth of the
baby. On purely theoretical grounds this would appear to be
advisable. We have in addition the experimental evidence and
the backing of such observations as Reva Rubin's to suggest not
only that such stimulation should be given by the husband to
his wife, but that this might become standard obstetrical prac
tice.

At a round-table meeting held in October 1974, Ms Raven
Lang, lay midwife from Vancouver, said that she teaches the

Tender, Loving Care 107

husbands of pregnant women during delivery to massage the
mother's perineum. This method she has found very elBfective
in avoiding perineal tearing and the need for episiotomies.

In parenthesis it is interesting to learn what young nursing
students think of touching the skin of pregnant women. Reva
Rubin tells us that in most cases the students feel that touching
the body of another constitutes an intrusion into areas that are
not to be violated. Their inability to time the contractions of the
mother in labor was due to their reluctance to apply more than
their fingertips to the mother's abdomen. Nothing that the
women in labor themselves or their instructors tried helped
thaw the students' hands, which were, according to Professor
Rubin, "stiff, awkward, cold, and useless." Skin, the students
told her, is a strange thing; "it is soft and rubbery; smooth and
firm like marble, only warm."

But with unhampered growth and experience beginning
nurses, like the beginning mothers, will develop their skills of
gathering information through touch as a means of discriminat
ing diagnosis and a vehicle of personally meaningful communi
cation.

They will be able to read and recognize, through touch, the
amount of body heat produced by a local or general body task;
the kinds of perspiration produced by physical or psychological
work. They will discern skin textures and recognize change,
favorable or unfavorable. They will recognize another's appeal
for contact, controls, or guidance, and be able to provide appro
priate dosages for touch for each of these. And since touch is
always individualized, the interpersonal communications
effected through touch will tend to be significant in a way that
verbal language cannot achieve.

Klaus and his co-workers studied maternal behavior in
twelve normal mothers at the first postnatal contact with their
normal fulltenn undressed infants one half hour to thirteen and
a half hours after birth, and in nine other mothers during their
first three tactile contacts with their premature infants. An
orderly progression was observed in the mothers of fulltenn

108 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

infants. They commenced with fingertip touching of the infants'
extremities and proceeded in four to eight minutes to massag
ing, and encompassing palm contact on the trunk. The rapid
progression from fingertip to palm-encompassing contact
within a period often minutes does not quite agree with Rubin's
observation to the effect that palm and close contact develop
only after several days. In the first three minutes fingertip con
tact was 52 percent, with 28 percent palm contact. In the last
three minutes of observation fingertip contact decreased to 26
percent and palm contact increased to 62 percent. An intense
interest in eye-to-eye contact was observed at first contact.

The mothers of normal infants permitted to touch them in
the first three to five days of life followed a similar sequence,
but at a much slower rate.

Dr. H. Papousek has stated that mothers who did not want
their pregnancy touch more and longer with the fingertips, and
this correlates with the amount of crying in their babies. In
wanted pregnancies the mothers choose more palm contact and
the babies are calmer in the first days.

The observations of Rubin, Klaus, Kennell, and others sug
gest that there exists a species-specific behavior in human moth
ers at first contact with their infants. "Because this period of life
appears so critical," write Klaus, et al, "modern social and
hospital practices which now separate the mother from her sick
or premature infant for prolonged periods require a very thor
ough re-evaluation." Indeed, such reevaluation is long overdue,
for the evidence now available renders it clear that separation
is permanently damaging to the premature and fullterm infant
as well as to the mother. Early events have long-lasting effects.

There is good evidence that premature babies do much better
when their mothers are allowed to handle them, after proper
instruction in handwashing, masking, and gowning. Barnett
and his co-workers at the Stanford University School of Medi
cine encouraged forty-one mothers to handle their premature
infants at any time of the day or night, with considerable benefit
to everyone involved: infants, mothers, nurses, and doctors.
There was no increase in the much feared infections and no

Tender, Loving Care 109

complications of any sort. Similar observations have been made
by other observers. In commenting upon these findings, an
editorial in the British MedicalJournal (6 June 1970) observes:

It may well be that the immediate postpartum period is the most
important time for the initial contact between mother and child,
as it is in animals. Many (but certainly not all) mothers feel the
urge to have skin contact with the baby immediately he has been
born; they think that it is important that they should be fully
conscious, and not under an anaesthetic at the time of delivery;
and they want to put the baby to the breast immediately.

No one has proved that it is desirable for the mother or the
premature baby that this close contact should be established
immediately after birth or later during the period in hospital or
that absence of contact does any harm. One cannot prove every
thing, and not everything is worth trying to prove. Great ex
penditure of time and effort may go into trying to prove some
thing for the sake of proving it: something which, though
important in itself, is not worth trying to prove, perhaps because
the answer seems obvious. There are occasions when one has to
make medical decisions on the basis of common sense and on
what seems natural and normal.

Enlightening in this connection is a report, published in 1975,
on 614 drug-induced labors, all of which were unnecessary, and
most of which resulted in untoward effects either upon infant
or mother or both. Sheila Kitzinger, who wrote the report,
states that

It was not only the sight or sound of the baby, but physical
contact, which was a clear signal in the bonding that took place
between mother and neonate, and which in those accounts which
described the meeting-through-touch of mother and baby obvi
ously initiated a rush of feeling. A mother who had had a
cesarian section woke up to find the baby waiting to be put in
her arms, and holding her baby, "washed him in tears of joy.*'
Another woman said, "I didn't feel any emotion when I first saw
Catherine lifted out and heard her cry, but as soon as they gave
her to me to hold a few seconds later I thought she was fantas
tic." The mothers themselves often wanted touch most of all: "I

1 10 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

did so want to cuddle and touch her before she was wrapped."
Denial of the opportunity for this seemed not only the greatest
hardship, but was interpreted as an aggressive act on the part of
authority. Women described how they tried to put the baby to
the breast, for example, but how it was "grabbed" or "snatched
away," or how the midwife "did not believe in it" or "was
shocked," or took the baby away because she must not do it as
it would "make the baby sick," or took the baby away because
she said it was necessary to weigh, bathe, Apgar-rate, clothe it,
put it under a heater, or give it to the paediatrician. Other
mothers said they were not permitted to hold their babies im
mediately because "they were too busy with the placenta. " These
mothers clearly surrendered their babies reluctantly, and some
experienced helpless anger.

As a result of the drugs administered, especially analgesics
which are injected into the epidural space in the lower back, the
mother frequently does not feel the cutaneous contact between
herself and the baby as it is being born. The child is "delivered,"
born, and experienced in an unfeeling way, so that it is not to
be wondered at that the mother fails to develop any feeling for
the child. As more than one woman has remarked under such
conditions, "If the baby hadn't been brought back to me, I
wouldn't have missed him." A quite frequent remark heard
from such mothers when the baby is first returned to them, after
an absence of twenty-four hours in the "nursery," is, "Hello,
little stranger."

Klaus and Kennell have observed that when the newborn is
separated from its mother, the mother frequently tends to be
noticeably hesitant and clumsy when she begins to take on the
infant's care. It takes her several visits to learn the simple
mothering tasks of feeding and diapering that most mothers
pick up rapidly. "When the separation is prolonged," they
write, "mothers report that they sometimes forget momentarily
that they even have a baby. After a premature baby has gone
home it is striking to hear how often the mother reports
that, although she is fond of her baby, she still thinks of
him as belonging to someone else the head nurse in the nur-

Tender, Loving Care 111

sery or the physician rather than to herself."

The maternal sensitive period, as Klaus and Kennell have
termed the period immediately after birth, is crucial for that
bonding which locks not only mother and child together, but
also would lock mother, father, child, and other children to
gether, if they were but given the opportunity to participate in
welcoming the new member into the bosom of the family. As
things only too often are in hospital deliveries, the baby is
separated from the mother, the father does not participate in
the birth of his child, and such emotions as the mother is left
with she all too frequently projects upon the obstetrician or
whatever other helpful figure may have been present ... or else
is left grievously frustrated, a candidate for the development of
postpartum blues. It is reported that well over 80 percent of
women delivered of babies in hospital suffer from postpartum
blues. The position of helplessness in which the mother is put
when the baby is separated from her is exceedingly depressing,
especially when all her drives are readied to make her the most
active participant in the continuing sustenance of the child
outside the womb that she was to it inside the womb. When she
is denied this, the mothering of her infant, she may come to look
upon him as a foreign body, or even, as Dr. E. Furman has
stated, to maltreat him because his demands interfere with the
fulfillment of her own needs.

Dr. Marjorie J. Seashore and her colleagues investigated the
effects of denial of early mother-infant interaction on maternal
confidence in the context of the premature birth situation. One
group of twenty-one mothers of prematures were denied physi
cal interaction with their infants in the first two weeks following
birth, and a contact group of twenty-two mothers were allowed
to care for their premature infants in the hospital nursery dur
ing this period. Separation resulted in lower self-confidence for
primiparous mothers, but not for multiparous mothers; how
ever, even in their case separation had a negative effect on those
who were initially low in self-confidence.

A year later it was found that mothers who had not been
separated touched their infants more than separated mothers

112 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

touched theirs. Mothers of nonseparated male infants laughed
with, smiled, and talked to their infants more than mothers in
other corresponding groups. Mothers of separated female in
fants behaved like the mothers of nonseparated male infants.
Primiparous mothers spent much more time with their infants
in nonspecific play and distal attachment behaviors such as
looking, talking, smiling, and laughing. Proximal attachment
behaviors such as touching and holding were primarily affected
by the sex of the infant. Mothers touched their male infants
more, but female infants were held a greater amount of the
time.

Klaus and Kennell have summarized the findings of eight
studies on the amount of contact between mothers and their
newborn infants, and of seven other studies of a similar sort, as
well as a number of others. The significant conclusion to be
drawn from all these studies is that the groups with early con
tact, usually within the first thirty minutes, showed significantly
more attachment behaviors. Typically, De Chateau in Umea,
Sweden, found that in the early contact group three months
later mothers fed their babies twice as long as did the controls
(after thirty minutes); they also spent more time looking face
to face at their infants, whereas the control mothers were more
often involved in cleaning them. As Klaus and Kennell remark,
"The two groups appear to focus on different ends of the baby.
One group was busy cleaning up whereas the other was giving
love." Early contact infants cried less and smiled and laughed
more than control group infants. Breastfeeding in the early
contacts was 175 days, in the later contacts 108 days.

In an endeavor to understand how the normal mother-infant
relationship works, Dr. Myron A. Hofer of the Department of
Psychiatry, Montefiore Hospital, and Albert Einstein College
of Medicine, Bronx, New York, studied the effects of maternal
separation in two-week-old rats, when survival without the
mother is possible. After one day those that have been separated
show clear differences from those that have been normally
mothered. The separated infants show less locomotor and self-
grooming behavior and are generally less active, and their body

Tender, Loving Care 113

temperatures have fallen 1-2 C below normal levels. When heat
is supplied they become more active; indeed, they show more
locomotor, exploratory, self-grooming, defecation, and urina
tion, and are slower to fall asleep than normally mothered
littermates. It would seem that the separation experience in an
unfamiliar environment leads to a state of increased excitability
which normal mothering tends to regulate.

Over the first twelve to eighteen hours cardiac and respira
tory rates led to 40 percent reductions in the separated rats.
These rates could be returned to normal levels by strong tactile
stimulation, a tail pinch, for example. The rates could also be
maintained at normal levels in the absence of the mother for
some twenty-four hours if enough milk was given to produce
normal weight gain. Subsequent work supports the view that at
this developmental age the central nervous system is "in
formed" of the amount of nutrient in the gut and regulates
cardiac rate accordingly.

"What," asks Dr. Hofer, "does this tell us about the transfer
of information within the mother-infant relationship?" And he
answers, "Apparently the mother functions as an external
physiological regulatory agent for the infant, through the milk
she supplies." The mother maintains a certain level of respon
siveness in the tone of the heart by the milk she supplies, of
behavioral responsiveness by her thermal input, and also tends
to reduce longterm levels of excitability by tactile and olfactory
stimulation. Dr. Hofer concludes that the effects of early sepa
ration from the mother are the effects of sudden loss of informa
tion. From these studies it is clear that functional organization
depends on certain kinds of specific sensory stimulation early
in life, the chief of these being tactile and olfactory.

Finally, in a most important statement, Dr. Hofer empha
sizes that insofar as the longterm effects of early experience are
concerned we would do well to recognize the coexistence of
several discrete behavioral and physiological processes set in
motion by the early experience, each of which interacts with
subsequent developmental processes. Because of the different
developmental schedules followed by individual behavioral and

114 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

physiological subsystems, the resulting pattern responses may
be very different at different ages.

Much research remains to be done on the nature of the
physiological changes that occur in mother and infant during
the various periods, the sensitive periods, of their reciprocal
development. But whether premature or full term it is clear that
the mother needs her baby immediately after birth quite as
much as the baby needs her. Each is primed to develop their
own potentialities the maternal role in the one case, that of
developing human in the other. The crucial timing within this
sensitive period is the first thirty minutes after birth. Any inter
ruption in the physical contact between mother and infant at
this time detrimentally affects both. Physiologically, the physi
cal interaction between mother and child activates and en
hances those essential hormonal and other changes in each
which contribute to their optimum functioning. Psychologi
cally, the involvement in each other is profoundly deepened.
The presence of each to 'the other constitutes a continuous
reenforcement of their mutual strengths, their reciprocal in
volvement.

Nonetheless, a large proportion of obstetricians, the hospitals
with which they are associated, and pediatricians, seem to be
unaware of these facts. During a round-table discussion held in
1974 on maternal attachment, one of the women participants
(Ms. Suzanne Arms) "expressed exasperation with the general
reluctance to accept the importance and benefits of early moth
er-infant contact. Dr. Klaus agreed that obstetricians had not
accepted it, and Dr. Quilligan added that pediatricians have, in
fact, enhanced separation, 'the first thing the pediatrician does
is to put the baby in an isolette and get it out of the delivery
room/ "

There is clearly urgently important work to be done in re
forming the attitudes of obstetricians and pediatricians towards
the care of mother and child.

Among the things we need to understand more fully than we
have yet done is that the baby takes its cues from the mother's
behavior towards it. Bateson and Mead, writing of Bali, state:

Tender, Loving Care 115

The Balinese child is carried either loosely on the hip, as in most
of the plains villages, or in a sling, as in Bajoeng Gede, but even
where the hand of the mother is substituted for the sling, the
child's adaptation is the same, passive, adjusting itself by com
plete limpness to the movements of the mother's body. It may
even sleep with head wobbling to the timing of the mother's rice
pestle. The baby receives its cues as to whether the outside world
is to be trusted or feared directly from contact with the mother's
body, and though the mother may have schooled herself to smile
and utter courtesy phrases to the stranger and the high-caste,
and may display no timorousness in her artificially grimacing
face, the screaming baby in her arms betrays the inward panic.

The kinesic means which enable the child to respond to its
mother's inward states, no matter what her outward ones may
appear to be, have already been discussed. The observation is
universally confirmed that the child is able to do so in response
to the messages he receives from his mother's muscle-joint
behavior.

GRASPING AND LEARNING. It is evident from the child's explor
atory movements with its hands that they play an important
role in discovering the lineaments and boundaries of the world
in which it lives. Also fascinating to observe is the way young
infants will clap the palms of their hands together, at first very
much as a reflex, later in obvious enjoyment. It is possible that
this constitutes the origin of later clapping in pleasure or ap
proval.*

During the first two or three months the infant's grasping is
largely reflex. It is not until about twenty weeks of age that it
is voluntarily able to grasp an object, and even that grasping has
to develop through several stages, from the ulnar grasp (on the
little-finger side) in the early months to the radial grasp (on the
thumb side), and then to the finger-thumb grasp at about nine
months of age. At six months the infant transfers objects from

*For a discussion of the problem thus raised see M. Mead and F. C.
Macgregor, Growth and Culture (New York: G. P. Putnam's Sons, 1951), pp.
24-25.

116 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

hand to hand. It plays with its toes and, as it were by way of
validation, everything goes to its mouth, an activity which it
abandons at about the end of its first year. After that the child's
progress is one of increase in manipulatory precision so that by
the time it is three years old it can fully dress and undress itself.

These are skills achieved principally by means of the learning
that has gone on through the skin and joint-muscle senses in the
feedback interaction between mother and child and the as
sociated experiences she provides. Learning is defined as the
increase in the strength of any act through repetition, the child
being constantly reinforced by the pleasurable rewards it re
ceives in relation to its mother; the greater the satisfaction, the
greater the strengthening of the bond between the stimulus and
the response. The opposite is also true, namely, the greater the
discomfort, the greater the weakening of the bond.

The manner of learning through these senses is illuminat-
ingly described by Margaret Mead in her account of the Bali-
nese child. In Bali the child spends most of its first two years
first within the arms and then on the hip of another human
being who is lightly conscious of its presence. The baby is
carried very loosely wrapped in a cloth that is sometimes laid
over its face when it is carried indoors, and suspended in a sling
around the shoulder of mother or father or of a young adoles
cent. Sleeping and waking occur without the baby moving out
of the arms of its mother. At about two months of age, still in
the sling, the infant is set astride the hip, now securely fastened
to the carrier's body. The mother feels free to pound her rice
without further attention to the infant, and the latter learns to
adjust to her every movement. If it falls asleep it may be laid
down on a bed-platform inside the house, but when it awakens
it is immediately picked up. Practically the only occasion when
a child under five or six months is out of someone's arms is
when it is bathed. Since the child is almost invariably carried
on the left hip its right arm is pinioned under the carrier's arm
or extended around the carrier's back, so that when it reaches
out with the left hand for something offered it, the carrier pulls
the left hand back for it is forbidden to receive things in the

Tender, Loving Care 111

left hand and pulls the right hand out. In this manner the
child's reaching behavior occurs in a supervised, culturally pat
terned situation. In the course of its first year the child is carried
by all sorts of people, male and female, young and old, skilled
and unskilled. The child enjoys a rather varied experience of the
human world, of different skin surfaces, different odors, differ
ent tempos, different ways of being held, and a correspondingly
narrow experience of objects. The only objects that it habitually
touches are its own ornaments: a beaded necklace with a little
silver box attached, on which it teethes, and its own silver
bracelets and anklets.

"So the child learns life within human arms. It learns to eat,
with the exception of the experience of being fed in its bath, to
laugh, to play, to listen, to watch, to dance, to feel frightened
or relaxed, in human arms." The child urinates in the arms of
its carrier, and feels the urination disregarded. It defecates, and
feels the low concern with which a dog is called to tidy up the
scene, the baby, the sling, and the body of the carrier. The child
is relaxed and the carrier habitually inattentive. Since the infant
spends many hours on the mother's hip while she is pounding
rice, it is of great interest to learn that Colin McPhee, the
leading authority on Balinese music, found that the basic tempo
of Balinese music is the same as the tempo of the women's rice
pounding. Ethnomusicologists do not appear to have concerned
themselves with the possible relation between childhood experi
ences and the character of a particular culture's music. But
clearly this would appear to be a promising field of inquiry.

The early conditioning the Balinese child receives in relation
to its mother's body is apparently connected with the ease with
which older children fall asleep leaning against other people.
Some people fall asleep while standing in the midst of a tightly
packed audience at a theatrical performance, relaxed and
slightly swaying. The expected environment for sleep is the
close proximity of other bodies. During ceremonies of various
sorts people may be crowded together in a space no larger than
a double bed, sitting, sleeping, dozing.

Clothing for the child means something that binds the child

118 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

and its mother together. This is quite different from the mean
ing clothing has in the Western world, where it is used to
separate child and mother. In Bali the mother's shawl serves as
a sling, a wrapper for the infant, a diaper, and a pillow folded
under its head. When it is frightened the mother draws the cloth
over the child's face; she may also do this when it sleeps. The
child is attached to its carrier by a cloth that is neither distinc
tively its own nor the carrier's, and since children are neither
dressed nor undressed at routine times each day, neither clothes
nor sleeping habits differentiate night from day for the Balinese.
They develop no internalized time pattern, waking and sleeping
at any hour, as impulse or interest dictates.

During infancy the child is fed in the bath, and mother and
father often splash and manipulate the genitals of the male
baby; thus the bath becomes a situation of heightened bodily
pleasure. It is, however, a mixed kind of pleasure during which
the child is manipulated as if it were a puppet capable of ob
structive but not of human movement, an attitude which con
trasts strongly with the closer contactual relationship with the
carrier in suckling and eating snacks in the arms. When, signifi
cantly enough, the child is old enough to walk to the spring, he
bathes himself, and bathing becomes from then on a solitary
pleasure, performed in company but in a withdrawn manner.
In this account of the early cutaneous experiences of the
Balinese child we may see, as it were in high relief, the effects
of certain kinds of experiences, for which the skin represents a
most important sensory receptor, upon the later behavior of the
individual, even to the act of sleeping in bodily contact with
another. In this connection the question may here be raised
whether the increasing modern practice of husband and wife
occupying separate beds may not be related to the decreasing
tactile relationships between the modern mother and her child.
Separating mother and baby, dressing the baby in clothes,
and similar dissociative practices certainly serve to reduce the
amount of intercutaneous contact and communication between
mother and infant. Instead of sleeping in another human
being's arms, as the Balinese infant does, the infant of the

Tender, Loving Care 119

Western world spends the greater part of its waking hours and
all of its sleeping hours alone and apart from others. One will
spend the whole of one's sleeping life before marriage in a bed
by oneself, and when married may find it impossible to adjust
to sleeping in the same bed with another, except for the pur
poses of making love. Hence, the popularity of twin beds may
be positively correlated with child-rearing habits in which from
an early age the child is conditioned to "go" to sleep alone. It
"goes" to sleep. Its separation contributes to a later feeling of
separateness, and to the separateness of each of the members of
the family.*

To be tender, loving, and caring, human beings must be
tenderly loved and cared for in their earliest years, from the
moment they are born. Held in the arms of their mothers,
caressed, cuddled, and comforted, the familiar human environ
ment, to which Balinese children can always return, is found in
"the known arms of parents and siblings, where fright and
comfort, interest and sleep, have already been experienced.
Bodies are always there, other people's bodies to lean against,
to huddle together with, to sleep beside."

The close contacts and the rhythmic tactual stimulation ac
companying the carrier's bodily movements, the patting, strok
ing, and caressing the child receives in this way or from the
hands or other parts of the body of the carrier, are soothing,
assuring, and comforting. The rhythm of this kind of tactual
stimulation that the mother conveys to the child in her arms is
almost universally reproduced in the lullabies sung or hummed
to lull children to sleep. Children who are unhappy, frightened,
or otherwise disturbed may usually be soothed and restored to
a sense of security when taken up in the arms of a comforter.
To put one's arms around another is to communicate love to
the other, for which another word is security. To rhythmically
rock the body when emotionally disturbed is comforting.

The cradle was an admirable invention, many thousands of

*For an early discussion of this subject see A. Montagu, "Some Factors
in Family Cohesion," Psychiatry, vol. 7 (1944), pp. 349-352.

120 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

years old, which sophisticated societies have discarded. Why?
The answer to this question constitutes a case history in itself.
It serves to illustrate how our ignorance of the most elementary
facts concerning the needs of infants permits us, in the name of
progress, to abandon the most valuable of practices and substi
tute the worst for them. The answer will also serve to shed some
additional light on the functional activities of the skin in main
taining physical and mental health.

THE NATURAL HISTORY OF THE CRADLE AND THE SKIN. The

story of the decline and fall of the cradle is a typical one of fads,
fashions, fallacies, and of ill-informed and misguided au
thoritarianism. During the 1880's the view developed among
physicians and nurses that there was danger in overindulging
the child. It was thought that many of the complaints from
which babies suffered were due to the well-meant interference
of fond parents. It soon came to be "authoritatively" held that
the clearest and first evidence of this spoiling of the baby was
the cradle. Hence the cradle had to go. Dr. John Zahovsky of
St. Louis, recalling this period, writes,

I had the opportunity to follow this attack on the cradle during
my early professional career. It seemed to me then that the
greatest influence emanated from the babies' hospitals in New
York, Philadelphia, and Chicago, since many of the writers in
the prominent women's magazines had received their training
there. In the nineties all these magazines published numerous
articles on the care of the baby. Many of these contained vicious
attacks on the use of the cradle.

The well-known educator of nurses, Lisbeth D. Price, in her
textbook on nursing published in 1892, emphasized (in italics)
that the baby "should never be rocked nor hushed on the nurse's
neck. " And this, of course, meant that mothers should desist
from such practices also.

In America during the 1890's the attack on the cradle was
widely extended through articles on child care, for the most
part published in the leading women's magazines of the day.

Tender, Loving Care 121

The greatest influence in the campaign against the cradle was
exercised by the pediatrician to whom reference has already
been made in a similar connection, namely Dr. Luther Emmett
Holt (p. 78). For more than a generation Dr. Holt kept up his
attack on the cradle. In the first edition of his widely used
textbook on pediatrics (1897), Holt wrote, "To induce sleep,
rocking and all other habits of this sort are useless and may be
harmful. I have known of an instance where the habit of rock
ing during sleep was continued until the child was two years
old; the moment the rocking stopped the infant would awake."

It was Holt who was responsible for writing what became the
most popular guide to the rearing of children for almost fifty
years. This was entitled The Care and Feeding of Children: A
Catechism for the Use of Mothers and Children's Nurses and
was first issued in 1894. This booklet was read by millions of
mothers and mothers-to-be. In it, replying to the question, "Is
rocking necessary?", Holt wrote, "By no means. It is a habit
easily acquired, but hard to break and a very useless and some
times injurious one." Again, writing in 1916, Holt advised that
the crib should be one that does not rock in order that "the
unnecessary and vicious practice may not be carried on." One
does not have to imagine the effect that that word vicious had
upon so many mothers.*

This sustained attack on the cradle, led by one of the most

*The reader who may wish to know what manner of man could have
entertained such ideas may be referred to a profile written by one of his last
assistants together with another pediatrician: Edwards A. Park, and Howard
H. Mason, "Luther Emmett Holt (1855-1924)," in B.S. Veeder (ed.), Pediat-
ric Profiles (St. Louis, Missouri: C. V. Mosby Co., 1957). A few excerpts may
be quoted. "His manner was more than serious, it was earnest. There was
nothing about him which could be called impressive, due perhaps to the
absence of any outstanding feature; rather he appeared a highly efficient,
perfectly coordinated human machine. He seemed to us austere and unap
proachable." He is not known to have said "good morning" to his secretary
in the many years she worked for him, nor is he known ever to have praised
anyone or anything (p. 58). Finally, of The Care and Feeding of Children, the
writers remark, "It is only fair to point out that in recent years some pediatri
cians have felt that through its rigid philosophy of upbringing the booklet had
had a harmful influence" (p. 53).

122 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

influential pediatricians of his day, eventually succeeded in
rendering the cradle obsolete, and the outmoded model was
turned in for the new one: the stationary prison-like crib. The
very fact that, from the earliest days of human history, mothers
had rocked their babies to sleep in their arms was taken to mean
that the practice was archaic, and that rocking babies in cradles
was equally antiquated, certainly not "modern." Alas, in the
headlong rush to be "modern" worthwhile institutions and
ancient virtues may be abandoned and lost. With so many
authoritative voices raised against the cradle as "habit-form
ing," "unnecessary and vicious," "spoiling," and even ruinous
of the child's health, no mother who genuinely loved her child
could conscientiously disregard the injunction to discontinue so
"detrimental" a practice.

All this was made easier for the mother to accomplish be
cause it was during this period (from 1916 to the 1930's) that
the newest and most influential psychology of the day was
beginning to make itself felt. This was the "Behaviorism" of
John Broadus Watson, Professor of Psychology at Johns Hop
kins University. "Behaviorism" held that the only sound ap
proach to the study of the child was through its behavior. The
basic contention was that only the objectively observable can
constitute the data of science. What could not be observed the
child's wishes, needs, and feelings was excluded from the
behaviorisms interest and was therefore treated as if it did not
exist. The behaviorists insisted on treating children as if they
were mechanical objects that could be wound up any which way
one pleased; children were at the mercy of their environment,
and parents could by their own behavior make them into any
thing they wished. Sentimentality was to be avoided, because
any show of love or close physical contact made the child too
dependent upon its parents. What one should aim for, urged the
behaviorists, was the encouragement of independence, self-reli
ance, and the avoidance of any dependence upon the affections
of others. One must not spoil children with affection.

It was through his book Psychological Care of Infant and
Child, published in 1928, that Watson and his disciples were

Tender, Loving Care 123

able to compound the errors of Luther Emmett Holt. Mothers
were enjoined to keep their emotional distance from the child,
to desist from kissing, coddling, or fondling it. They were not
to respond too readily to their children's cries for food or
attention. Their capacities, Watson said, should be trained to
wards conquering the world. In order to do so, children must
be taught to master their feeding schedules, toilet training, and
other tasks, according to a strict regimen. It is the problem-
solving techniques and boundless absorption in activity with
which the child must be prepared that will enable him to cope
with the demands of American society. Such a child will be "as
free as possible of sensitivities to people and one who, almost
from birth, is relatively independent of the family situation."

It is perhaps not altogether surprising that with such beliefs
it was not long before Watson was persuaded to leave the
academic world to spend the greater part of his remaining life
as an executive in a large advertising agency.

This unsentimental, mechanistic approach to child rearing
greatly influenced psychology for a time and exercised a pro
found effect upon pediatric thinking and practice. Pediatricians
advised parents to maintain a sophisticated aloofness from their
children, keeping them at arm's length, and managing them on
a schedule characterized by both objectivity and regularity.
They were to be fed by the clock, not on demand, and only at
definite and regular times. If they cried during the intervals of
three or four hours between feedings, they were to be allowed
to do so until the clock announced the next feeding time. Dur
ing such intervals of crying they were not to be picked up, since
if one yielded to such weak impulses the child would be spoiled,
and thereafter every time he desired something he would cry.
And so millions of mothers sat and cried along with their
babies, but, as genuinely loving mothers obedient to the best
thinking on the subject, bravely resisted the "animal impulse"
to pick them up and comfort them in their arms. Most mothers
felt that this could not be right, but who were they to argue with
the authorities? No one ever told them that an "authority" is
one who should know.

124 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

Giving the child too much attention, it was repeatedly em
phasized, was calculated to spoil it, while the practice of rock
ing the baby to sleep, either in a cradle or in one's arms, was
considered to belong to the Dark Ages of child rearing. And so
the cradle was finally banished to the attic or lumber room and
the baby consigned to a crib. In this way, it was felt, at one
stroke was eliminated an old-fashioned way of caring for babies
and an "archaic" piece of furniture. Mothers were resolved to
be modern and unsentimental It is sad to have to record that
wherever other nations have "gone modern" they, too, have
discarded the cradle.

In India and in Pakistan, for example, where the most "en
lightened" people have begun to introduce Western ways, the
cradle is also beginning to be considered "old-fashioned," and
is being threatened with a fate similar to that which it suffered
in the Western world. Dr. Brock Chisholm, the distinguished
psychiatrist and former director of the World Health Organiza
tion, tells of an occasion when he was being shown over a large
general hospital in Pakistan. He writes:

As we were going along a corridor which was a sort of balcony
on the side of the building, we passed the screened door of a
ward. Suddenly someone pointed out to me, with great enthusi
asm, something away off on the horizon in the opposite direc
tion. Now, to any old Army inspecting officer, the situation was
perfectly clear; there was something nearby they didn't want me
to see. Therefore I was quite sure that whatever was hidden
behind this screened door I should see. If you see only what
people want you to see you will never find out anything.

So I insisted, at some risk of offense, on seeing this ward, and
when I insisted, my guides began apologizing, saying that I
really wouldn't like to see it at all. It was of a very old pattern;
they were ashamed of it; they hoped to get it changed; they
hoped that the World Health Organization might help them get
the money to adopt modern and new patterns for this particular
ward, because it was very bad indeed. It was a pattern hundreds
of years old.

However, I still insisted that even as an antiquity I would like

Tender, Loving Care 125

to see it. I went in to see this ward, with the reluctant accompani
ment of the train of people with me, and I saw the best maternity
ward I have ever seen in any country, far better than I have ever
seen in North America. Here was a big maternity ward with beds
down both sides. The foot posts of each bed were extended up
about three feet or so, and slung between the foot posts was a
cradle. The baby was in the cradle, and I noticed as I looked
down the ward that one squeak out of the baby and up would
come the mother's foot, and with her toe she would rock the
cradle. On the second squeak, which showed that the baby was
really awake, she would reach into the cradle and take the baby
into her arms, where a baby is supposed to be most of the time.

Dr. Chisholm adds:

They wanted to get rid of that perfectly beautiful arrangement,
to put their babies under glass the way we do, and to keep them
in inspection wards where they can be seen at a distance by their
loving fathers whenever they visit, and taken to their mother if
she is good and does as the nurse tells her! They wanted to do
all that because we Westerners had given them the impression
that all our methods are superior to theirs.

This is a sad story, for in their idolizing drive towards the
achievement of Western "progress" and "advancement" the
peoples of the East and other technologically developing coun
tries, who until recently had preserved many of their ancient
virtues, are slavishly bent on catching up with us, even to the
extent of imitating our worst errors.

Among ourselves the cradle went out of existence when the
notion became fashionable that to fondle a child, to caress or
to rock it was to endanger its development as an unspoiled
independent person. To rock it in a cradle came to be regarded
as especially backward and reprehensible.

Unsound as this kind of thinking is, and damaging as it has
been to millions of children, many of whom later grew up into
disturbed persons, the behavioristic, mechanistic approach to
child rearing is still largely with us. Hospital "deliveries," the
technologization of obstetrics, the removal of babies from their
mothers at birth, the failure to feed them soon after they are

126 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

born, the elimination of breastfeeding and the substitution and
encouragement of bottlefeeding, the demotion of the pacifier,
and so on, constitute some of the melancholy evidences of the
dehumanizing approach to the making of people, as opposed to
human beings.

Having spent the whole of its preceding life snugly ensconced
in its mother's womb, the baby would certainly feel more com
fortable cosily tucked into a cradle than abandoned to a large
crib in which it lies, either on its front or on its back, exposed
to the dull and uninteresting flat white surface of either the
sheet or the ceiling, with only the prison bars at the side of its
crib to break the monotony of this bleak, one-dimensional land
scape. As Sylvester has said,

Small infants raised in oversized cribs are frequently very fright
ened infants because they are too far removed from sheltering
surfaces. They often appear inhibited in their courage to experi
ment and explore. Infants disturbed by new situations or by the
prodrome [a premonitory symptom] of physical illness often
draw closer to protective shelter (the mother's arms, the sides of
the crib), giving spatial expression to their need to constrict the
boundaries of their pre-ego protectively.

One cannot help wondering whether the unexplained occur
rence of "crib death," or "the sudden infant death syndrome,"
that is, the finding dead in its cot of a baby who has been
perfectly healthy and for whose death no cause can be found,
may not, at least in part, be due to inadequate sensory stimula
tion, particularly tactile stimulation. Inadequate sensory stimu
lation may not be the only factor involved in crib deaths, but
it may well be a predisposing factor. It is rare for a child over
one year to be found dead unexpectedly. Most crib deaths occur
in infants between one and six months. It would be interesting
to know what the incidence of sudden infant death would be in
cradle-raised as compared with cot-raised babies.*

*A reader of this paragraph sent me an account from her local newspaper
of a nurse who, recognizing the symptoms of sudden infant death in her own
seven-month-old girl, wired her to an alarm that monitors her heartbeat.

Tender, Loving Care 127

In a crib the baby is weighed down by a set of coverings
tucked in at the sides and foot of the crib, and thus left partially
surrounded by air; this is not quite what it wants or needs. What
it does want and need is the supporting contact of a snugly
comforting environment, as reassurance and security that it is
still in contact with the world and not airily suspended in it. The
baby assures itself that all is well largely through the messages
it receives from the skin. The supports it receives in the envelop
ing environment of the cradle are very reassuring to it, for the
cradle affords it something of a replication, a continuation, of
the life it led so long in the womb, and this is good and comfort
ing. When the baby feels uncomfortable or insecure it may
whimper, and if its mother or anyone else rocks the cradle this
will have a soothing effect. Rocking reassures the baby, for in
its mother's womb it was naturally rocked by the normal mo
tions of her body. To be comfortable means to be comforted,
and for the infant this comfort is largely derived from the
signals it receives from its skin. The greatest of all comforts is
to be cradled in the mother's arms or lap or supported on her
back. There is, as Peiper has remarked, "no better sedative." As
he says, "It is necessary to rock a healthy young infant in his
cradle or in the arms or baby carriage only once when he is on
the verge of crying: He immediately quiets down and starts to
cry again as soon as the movement stops momentarily. He will
surely not cry if it is done right."

It is absurd to suggest that the cradle is harmful because the
infant will develop the habit of having to be rocked before it will
be able to fall asleep. If cradle rocking is habit-forming, so is
breastfeeding or bottlefeeding. Yet children are weaned from
breast or bottle, unless it is done too suddenly, without any
serious difficulty or after effects. Millions of babies who had
been rocked to sleep in cradles grew up to be adults who were
able to fall asleep without needing to be rocked. Children out-

When her heart stops the alarm goes off, and the mother simply by touching
the little girl starts her breathing again "About People," The Sacramento
Bee, 15 January 1974.

128 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

grow the cradle as well as they do their baby clothes.

Rocking chairs are still popular among older folks, especially
in unsophisticated rural areas, where "modernity" has not
made such complete inroads as it has in the more worldly-wise
urban areas. It is strange that no one has ever suggested that
the rocking chair is "unnecessary and vicious" in adults, or that
adults will be unable to relax unless they can do so with the
assistance of a rocking chair. Rocking chairs, in fact, for adults,
and especially the aging, are to be highly recommended for
reasons similar to those which make the cradle so highly recom-
mendable for babies. Rocking, in both babies and adults, in
creases cardiac output and is helpful to the circulation; it pro
motes respiration and discourages lung congestion; it stimulates
muscle tone; and not least important, it maintains the feeling
of relatedness. A baby, especially, that is rocked, knows that it
is not alone. A general cellular and visceral stimulation results
from the rocking. Again, especially in babies, the rocking mo
tion helps to develop the efficient functioning of the baby's
gastrointestinal tract. The intestine is loosely attached by folds
of peritoneum to the back wall of the abdominal cavity. The
rocking assists the movements of the intestine like a pendulum
and thus serves to improve its tone. The intestine always con
tains liquid chyle and gas. The rocking movement causes the
chyle to move backward and forward over the intestinal
mucosa. The general distribution of chyle over the whole of the
intestine undoubtedly aids digestion and probably absorption.
Writing in 1934, Zahovsky stated that "young infants who are
rocked after nursing as a rule have less colic, less enterospasm
[intestinal spasm] and become happier babies than those who
are laid in the crib without rocking. In fact, I have several times
availed myself of this physical therapy even in recent years to
relieve the dyspeptic young baby. ... I firmly believe that the
cradle assists maternal nursing." Dr. Zahovsky concludes with
the words, "Someday, I believe, it will be no disgrace to rear
the young baby in a cradle and even sing him to sleep by a
lullaby."

More than a generation has had to elapse before anyone

Tender, Loving Care 129

could be found to echo Dr. Zahovsky's words. The cradle
should be restored to the infant. It should never have been
discarded in the first place. The reasons that were given for its
banishment were completely unsound and wholly unjustified,
based as they were on misconceptions concerning the nature
and needs of the child and the ludicrous notion that cradle
rocking is detrimental to the child.

The benefits of rocking are considerable. When the infant is
too warm the rocking has a cooling effect, hastening evapora
tion from the skin. When the infant is too cold the rocking helps
to warm him. The warming has a hypnotic effect on the infant,
and it is soothing to his nervous system. Above all, the rocking
motion produces a gentle stimulation of almost every area of his
skin, with consequential beneficial physiological effects of every
kind.

As a first step in the ultimately possible, and much to be
desired restoration of the cradle to its rightful place,* rocking
chairs have been introduced into some hospitals. For example,
at Riverside Hospital, Toledo, Ohio, rocking chairs have been
in use as a regular part of the infant-care program. In 1957 a
mahogany rocking chair was introduced as a Christmas gift
from Riverside nurse aides, who pooled money to buy what
they voted as "most needed new equipment" at the hospital. In
each of the three nurseries a rocking chair is available, includ
ing one for premature infants. Mrs. Herbert Mercuric, obstetri
cal supervisor, states that the old rocking chairs are always used
by nurses and aides at infant feeding time. "It's the best way
to feed a baby and put him to sleep at the same time. It's
relaxing for the nurse, too.'* The rocking chairs are used to
pacify crying babies. Mrs. Mercurio feels strongly that rocking
chairs are useful and practical and encourages their use at
home. "A rocking chair," she remarked, "won't spoil a child.
This is something they enjoy, but outgrow rapidly."

Quite possibly the rocking chair used in this manner has

*For those who are handy with simple tools cradle patterns may be or
dered for $1.00 each from Craft Patterns, Dept. L, Elmhurst, Illinois, 60126.

130 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

some advantages over the cradle. I think both might well be
come standard equipment in the home with a small infant in
this manner at once satisfying the need for rocking of both
infant and adult.*

Studies on the effects of rocking on human infants indicate
their considerable benefits. Neal studied the effects of rocking
on two-to-three-month prematures. These were rocked for the
number of days they were premature, and it was found that the
rocked prematures were significantly superior to the nonrocked
prematures in the development of tracking behavior to visual
and auditory stimulation, head lifting, crawling, muscle tone,
strength of grasping, and weight gain. In addition no edema
ever developed in the rocked prematures, whereas it did in some
of the nonrocked ones. Ms. Neal suggests that rocking stimula
tion provided by the mother during pregnancy constitutes an
important sensory input for normal development, and that
prematures are unduly handicapped, following deprivation
stimulation, by their premature birth.

Woodcock observed the effects of rocking newborn female
babies in a mechanical bassinet for one hour a day for six days.
On the sixth day they were tested for heart-rate response to a
buzzer as a measure of reactivity. It was found that the rocked
babies had significantly fewer responses and took a shorter time
to finish their acceleration response than the unrocked new-
borns. The decreased heart-rate and acceleration responses in
the rocked infants suggest an increased maturational develop
ment.

A fascinating account of the serendipitous discovery of the
benefits of rocking for seriously disturbed mental patients is
reported by Dr. Joseph C. Solomon. Dr. Solomon observed that
patients taken from their rooms in hospital for transfer to an
other town by train, though they had earlier needed to be

*On the advantages of the rocking chair see R. C. Swan, "The Therapeutic
Value of the Rocking Chair," The Lancet, vol. 2 (1960), p. 1441; J. Yahuda,
"The Rocking Chair," The Lancet, vol. 1 (1961), p. 109. For an amusing
account of a club devoted to the cultivation of the rocking chair see T. E. Saxe,
Jr., Sittin 9 Starin* V Rockin' (New York: Hawthorn Books, 1969).

Tender, Loving Care 131

restrained in straitjackets and muffs, became very quiet and
calm as soon as the train was in motion. Solomon reasoned that,
since in the womb the child is subjected to considerable passive
motion, part of the human contact these patients may have
missed as children was the active rocking in the mother's arms
which would, among other things, stimulate the vestibular ap
paratus. Purposive active motions, Solomon suggests, develop
with facility and pleasure when the passive motion imparted by
the mother has been satisfactorily internalized as an integrated
inner function.

Conversely, when there is little chance for the internalization of
the passive movements derived from the mother, the active rock
ing becomes a habitual device for self-containment. It is a
method of defending the formative ego against the feeling of
being abandoned. This follows the principle of Newton's Second
Law. If you actively push against something, it is as though
something is pushing against you. In this way the infant accom
plishes the goal of not feeling completely alone. It is as though
somebody is always there. As such it is another self-containment
device similar to thumbsucking, the security-blanket, nail-biting,
or masturbation.

Dr. William Greene, Jr., in the course of studying a group
of patients suffering diseases of the lymphatic and blood vessels,
found that a large proportion of them had developed their
illness following a loss, usually of the mother or mother substi
tute. The association of vascular ills with the loss of maternal
support suggested to Dr. Greene that the fetus, far from being
a passive recipient of nourishment, was really a working mem
ber of a going partnership. Within the uterus, Greene suggests,
the fetus may feel and respond to "vibrations, pressures and
sounds provided by the mother's vascular pulses, and emanat
ing chiefly from the aorta, and perhaps other abdominal blood
vessels." The growing fetus, stimulated by the mother's internal
functions, may be aware of the presence or absence of these,
their constancy and change. Intra-uterine activity, for the fetus,
may constitute the "outside environment," just as, somewhat

132 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

later, the functioning of its own digestive system will constitute,
for the newborn, its outside environment. Within the womb the
fetus may perceive the mother's internal functions as a kind of
outside object, and become aware of itself as a being separate
from such stimuli. Dr. Greene suggests that the infant, sepa
rated from the mother at birth, is "exposed to new stimuli
. . . different, less persistent, exotic, and, most important, rela
tively random." The change, however, need not be total. The
rocking and patting a mother gives her newborn may provide
it with "a kind of object perception which bridges birth and
... is the model for all those perceptions to come later."
Rocking "tends towards synchrony with the mother's and/or
baby's respiratory rate," while patting "approximates the
mother's and/or baby's cardiac rate." The mother, in other
words, who rocks and pats her baby may in some measure
recreate the stimuli of her breathing and pulse rhythms,
rhythms that were significant to it before birth, and thus give
the baby the reassurance of a familiar environment that it so
much needs.

In this connection, the findings on premature babies, that is,
on babies of low birth weight, are extremely interesting. For
example, Freedman, Boverman, and Freedman in a study of
five co-twin control cases found that the rocked twin, after an
upward weight trend was established some seven to ten days
after birth, gained weight at a greater rate per day than the
unrocked control twin in every instance, although the advan
tage of the rocked group was only a temporary one. The experi
mental twin was rocked for thirty minutes twice daily.

A variety of deficits is likely to be exhibited by many prema
turely born infants in later life. However, one factor that has
received insufficient attention in previous research is the possi
bility that sensory deprivation may contribute to such impair
ments. The possible adverse effects of life in the controlled,
monotonous environment of an isolette where the premature
infant remains, receiving minimal emotional and tactile stimu
lation for several weeks, have been the subject of a pilot study
by Sokoloff, Yaffe, Weintraub, and Blase. These investigators

Tender, Loving Care 133

studied four boys and one girl of low birth weight and com
pared them with a similar group. The experimental group were
stroked five minutes every hour of the day for ten days, while
the control group were provided with routine nursery care. The
handled infants were found to be more active, regained their
initial birth weight faster, appeared to cry less, and after seven
to eight months were found to be more active and healthier as
measured by growth and motor development. Though the sam
ple is very small these findings agree with those of Hasselmeyer,
who found that premature infants who received increased sen
sory, tactile, and kinesthetic stimulation were significantly
more quiescent, especially before feedings, than unstimulated
controls.

Klaus and Kennell on the basis of their own studies and a
thoroughgoing examination of the work of others have con
cluded that early contact between mother and premature is
vitally important for both of them. Mothers who early touched
and explored the bodies of their infants showed increased com
mitment to the infant, greater confidence in their mothering
abilities, and greater stimulating and caretaking skills, as com
pared with the mothers who did not have early contact with
their infants. In fact the studies had to be discontinued because
the nurses found them too painful, observing as they did how
unfavorable the outcome was for the later contact couples as
compared with the early contact ones.

When the children reached age three and a half, mothers who
had had early contact with their prematures spent more time
looking at them during feeding, and the children had signifi
cantly higher I f Q.s, 99 as compared with 85 for late contact
children.

The studies revealed that if a small premature is either
touched, rocked, fondled, or cuddled daily during his stay in the
nursery, he has fewer nonbreathing (apneic) periods, enjoys an
increased weight gain, as well as advances in central nervous
system functioning.

Over many years of observation Klaus and Kennell gained
the distinct impression that the earlier the mother comes to the

134 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

premature unit and touches her baby, the more rapid is her
recovery from the pregnancy and birth. Their survey of the
subject confirms that impression impressively. The importance
of the father's participation in these close contacts with the
premature should be given greater attention than it has yet
received, for it is at this time that a profound bonding is initi
ated between infant and father, the value of which cannot be
overestimated.

What is most needed, indeed, in all our hospitals, as Dr. A.
J. Solnit has put it, is "a warm, receptive, flexible environment
that is people centered rather than technique centered/'

The self-rocking commonly seen among patients in mental
hospitals has often been remarked, and is frequently observed
as an act of self-comfort in grief among individuals who do not
otherwise rock. Among many Semitic-language-speaking peo
ples, including orthodox Jews, body-rocking often accompanies
prayer, grief, and study. It is quite clearly a comforting form
of behavior.

The behavior and motivations of all mammalian infants are
directed towards maintaining contact with the mother. Contact
seeking is the foundation upon which all subsequent behavior
develops. When such contact seeking is frustrated, the infant
resorts to such behaviors as self-clasping, finger-sucking, rock
ing, or swaying. These behaviors constitute a regression to the
passive movement-stimulation experienced in the womb, the
swaying, rocking motions, and the sucking of fingers with fore
arms pressed against the body. Self-rocking and similar repeti
tive activities represent substitutes for passive movement-
stimulation, just as self-clasping and finger-sucking substitute
self-stimulation for social stimulation. Dr. William A. Mason
and his colleague Dr. Gershon Berkson, then at the Delta Re
gional Primate Research Center of Tulane University, New
Orleans, tested the presumed relationship between self-rocking
and the quality of maternal stimulation. They compared two
groups of rhesus monkeys, both separated from their mothers
at birth. One group was reared with a cloth-covered social
substitute that moved freely about the cage on an irregular

Tender, Loving Care 135

schedule; the other group was reared with a device identical to
the moving dummy, except that it was stationary. The three
monkeys reared with stationary dummies all developed stereo
typed rocking as a persistent pattern, whereas those reared with
the moving robots showed no evidence of such behavior.

Thus it would seem probable that self-rocking represents a
form of substitute satisfaction of the need for passive move
ment-stimulation which would normally be obtained from a
mother to whom one could cling or who carried one in contact
with her body.

Solomon's view that the rocking motion stimulates the ves-
tibular apparatus is undoubtedly sound, but misses the point
that, in rocking, the skin itself undergoes a complex series of
motions, not to mention the motions of proprioceptors and
interoceptors, and the motions of internal organs. All of this is
eroticizing. Rocking or swaying represents a kind of self-caress
ing, a self-comforting, and as such it is often observed in grief
and mourning. It is significant that the region of America in
which the rocking chair remains most popular should be New
England the land of the cod and the cold fish.

ROCKING, MUSIC, AND THE DANCE.

But O for the touch of a vanished hand
And the sound of a voice that is still!

Was Tennyson, when he wrote those poignant words, uncon
sciously or consciously recalling his early experiences of his
mother? It has been said that music utters the things that
cannot be spoken. In much music there is a very pervasive
tactile quality. Wagner's Liebestod is said to represent a musical
version of coitus leading to orgasm and postcoital subsidence.
Debussy's UApres-Midi d 9 un Faune conveys the most tactile of
sexual nuances. In the "rock" music of our day, so aptly named,
for the first time in the history of the dance in the Western
world the participating couples no longer touch each other at
any time but remain separated throughout the dance, dancing
most of the time to deafeningly loud music of which the lyrics,

136 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

usually addressed to one's parents, or generally to the older
generation, only too often say, "You do not understand,"
"Where were you when I needed you?" or words to that effect.

As Lawrence H. Fuchs has noted, these songs are sharply
critical of the older generation, they stress the hypocrisy of
society, the loneliness of the good in an unloving world, and the
evils of its social injustice. "They constituted not just a mani
festo of rebellion but an admission of loneliness and confusion,
as in Dylan's words when he tells us that his existence is tied
to 'confusion boats/ "

Sounds of various sorts may be experienced and appreciated
for their tactile qualities, as, for example, when one says of
someone's voice that it is "smooth," like "velvet," or "caress
ing." Music may be similarly experienced. Sally Carrighar, in
her autobiography, tells us that when at the age of six she heard
a distinguished violinist play, she "seemed to receive this mag
nificent sound through not my ears alone but through the skin
all over my body."

"Singers," Edmund Carpenter tells us, "determine pitch by
feel. The experience is not unlike rock music which one feels,
often through the entire body."

Lawrence K. Frank, in a brilliant paper on tactile communi
cation, writes, "The potency of music, with its rhythmical pat
terning and varying intensities of sounds, depends in large mea
sure upon the provision of an auditory surrogate for the
primary tactile experiences in which . . . rhythmic patting, is
peculiarly effective in soothing the baby."

Can it be that dances like the Twist and later ones of the same
rock variety, together with rock music, represent, at least in
part, reactions to a lack of early tactile stimulation, to a depri
vation suffered in the antiseptic, dehumanized environments
created by obstetricians and hospitals? Where but in such a
setting should we enact this most important of all dramatic
events: the birth and welcoming of a new member into "the
bosom of the family"?

The most involved and the larger part of the constituency of
the rock groups are adolescents. This is not surprising. For it

Tender, Loving Care 137

is they who remain closest to the conditions they are protesting
through their music, their dances, and their other forms of
expression. Under the circumstances it is highly desirable that
the young should protest in these ways against the conditions
they find so intolerable. But unfortunately the young are not
always clear as to the nature of all the things that need to be
changed. This would be too much to expect. However, in the
areas in which they are most perceptive, child rearing, educa
tion, and human relations, they often see far beyond their el
ders. Love is a word which has come to be meaningful to them,
to signify a great deal more than it does to most adults, and if
they will demonstratively act it out, they may yet succeed in
remaking the world.

It is interesting that, in February 1974, George Thiess, presi
dent of Arthur Murray, Inc., commenting on the 20 to 35
percent increase enrollment in his dance studios, said that men
were no longer embarrassed about dancing. Couples were doing
things together. Hostile dancing his term for rock dancing
"doesn't work anymore, because couples are relating to each
other differently than in the sixties." He referred to his dance
groups as "touch-go-theques."

The tactual sensitivity with which the baby is born has al
ready undergone much preparatory development in the womb.
We know that the fetus is capable of responding both to pres
sure and to sound, and that the beating of its own heart at about
140 beats per minute and the beating of its mother's heart, with
a frequency of 70, provides it with something of a syncopated
world of sound. Given the knowledge that the baby is laved by
the amniotic fluid to the symphonic beat of two hearts, it is not
surprising to learn that the soothing effect of rhythmical sounds
has been connected, in the hypotheses of some researchers, with
the feeling of well-being assumed to exist in utero in relation to
the mother's heartbeat.

Dr. Lee Salk has shown that, both in monkeys and in the
human species, the mother has a marked preference for holding
her infant on the left side. Because the apex of the heart is more
exposed on the left side, it is reasoned that the preference which

138 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

these primate mothers show for holding the baby's head against
that side is related to the need of the baby to continue to hear
the solacing rhythm of its mother's heartbeat. Since, however,
most mothers are right-handed, they are most likely to hold the
infant in the left arm, thus leaving the right hand free and
putting the infant's head opposite the apex of the heart. This
may be the real explanation for the manner in which most
mothers hold the infant on the left side.

On the assumption that exposure to a normal heartbeat
sound immediately following birth would tend to buffer the
trauma of birth by providing the infant with the continuity of
a familiar security-giving stimulus, Dr. Salk exposed a number
of babies in a hospital nursery to the tape recording of normal
authentic heartbeat sounds at 72 paired beats per minute. The
results were most interesting. A significantly larger number,
69.6 percent of babies who were exposed to the heartbeat
sounds, gained weight after the first twenty-four hours of age,
whereas only 33.0 percent of the unexposed group gained
weight. One or more babies were crying 38.4 percent of the time
during the heartbeat phase of the experiment, but 59.8 percent
of the time when the sound was not present. Breathing was
deeper and more regular among the heartbeat babies than
among the controls. Respiratory and gastrointestinal difficulties
decreased during the heartbeat period.

Dr. Salk concluded that the sound of a normal heartbeat
during the early days and weeks of its postnatal life may well
contribute to the infant's better emotional adjustment later in
life. Because of its deep-rooted biological significance as the first
sound, the constant security-giving sound, the sound ex
perienced when closest to the mother, the heartbeat sound or
its equivalent later succeeds in allaying fear where all else might
fail.

What connection, if any, does the mother's heartbeat and
that of the fetus have to the beat and rhythms of music? Zwei
Herzen in Dreiviertel Takt Tvvo Hearts in Three-quarter Time,
was a highly successful film in the early thirties. Its theme song,
from which the film took its title, was a waltz written, as are

Tender, Loving Care 139

all waltzes, in three-quarter time, 1. 2. 3 the baby's heart
having beaten, most of its time in utero, twice for every one beat
of the mother's heart. Is it possible that such a juxtaposition of
meanings represents a reverberation of uterine or infantine ex
periences? Dr. Joost Meerloo thinks it likely.

Every mother [he writes] intuitively knows that in order to put
her baby to sleep she has to rock it, thereby repeating the nir-
vanic dance [of the fetus in the womb]. The lullabye "Rock-a-bye
Baby" unobtrusively takes the child's memory back to the world
it has just left. Rock 'n' Roll does the same for older children.
It is just as simple as that! Rhythm and whirling around take
each of us back to reminiscences of nirvanic equanimity.

But listen well. This does not imply that the dance means no
more than a regressive reminiscing, even though in many of us
syncopated rhythms, music and counterpoint at regular inter
vals cause a deep oceanic yearning and a longing for maternal
protection, which once was the happy world we lived in.

Dr. Meerloo also draws attention to what he calls "The Milk
Dance," the rhythmic interaction between mother and child
during the baby's suckling at the mother's breast. The kind of
experience the infant has had at the breast, Dr. Meerloo be
lieves, will influence the individual's later rhythmic interests
and moods. Nursing deprivations, being brought too late to the
breast or getting no breastfeeding at all, may cause the re
pressed rhythms to come to the fore inappropriately. "As a
result of this so-called early oral frustration these children may
withdraw desolately in a corner, spontaneously showing the
milk dance, while rocking and rolling in a void. These are the
children whom doctors give the sophisticated label of being
early schizophrenics. Indeed, some of these children can remain
such dancing zombies for the rest of their lives, always search
ing, in a frozen rhythm and unrest, for the lost Nirvana."

Dr. Meerloo considers it important to describe these early
biological roots of the dance, because in his clinical practice he
has met "many a dance student who used her or his dance
aspirations not only to create beauty of gesture and movement,

140 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

but also as a means to return unobtrusively to frustrated, des
perate moods carried over from childhood."

"The charm," he adds, "and the seduction imposed on us by
these vibrant reminiscences can drag us into the despair of
continuous repetition of sad memories just as easily as they can
lead us into the highest triumph of freely creating a new coun
ter-gesture: the dance. From then on our movements become
lighter than air, ethereal gestures into space, away from all
heaviness."

In the dance, Dr. Meerloo thinks, man's earliest existence is
revealed. "Whenever rhythm, cadence, syncopation reach ear
and eye man is unobtrusively dragged back into the very begin
ning of his existence; together with others he undergoes a com
mon regression. The clue of mental contagion is the inadvertent
common regression all people undergo when special sounds
and rhythms reach their ears. That is the reason why tapping,
rhythmic calling, musical shouting, jazz, etc., are so infec
tious."

There is no genetically determined predisposition to tap, or
for rhythmical calling or music or the dance. The manner in
which all these things are developed is culturally determined,
learned. For example, keeping time to music by tapping with
the foot is a culturally learned activity, mostly as a result of
unconscious imitation. Most of us are unaware that we are
beating time in this way to the music. Apropos of this point I
remember, many years ago, reading the autobiography of the
great Hungarian philologist Arminius Vambery. Vambery was
an extraordinarily gifted linguist. His Arabic was perfect. This
enabled him, in disguise as an Arab, to make the pilgrimage to
Mecca when that was still a forbidden city to infidels like him.
In Mecca he was honored with a feast by one of the local
chieftains, as a visiting Arab dignitary from distant parts. While
music was being played the chieftain approached Vambery, and
good-humoredly said to him, "You are a European." Vambery
was astonished. "How did you find out?" he inquired. "I ob
served," the chieftain replied, "that during the playing of the

Tender, Loving Care 141

music you beat time with your foot. No Arab ever does that."*
There does appear to be a natural predisposition for rhythmi
cal movement in man. The manner of that movement is, how
ever, culturally conditioned. The body contact characteristic of
ballroom dancing represented a formalized closeness in rhythm
which would not in other situations be permitted except be
tween husband and wife or parents and children. Then in the
twenties in America, cheek leaning was added to body contact
in dancing. Again, this was a formalized act which would not
otherwise have been allowed except between relatives. Did this
cheek leaning represent an attempt to achieve the cutaneous
contact that had been denied the cheek leaners earlier in life?
May it not also be that rock 'n* roll and other popular contem
porary varieties of music and the dance represent a like re
sponse? At least in part, but in a very fundamental way, may
not these forms derive from a periphrastic response to an early
insufficient experience of comforting, rocking, rolling, and cu
taneous stimulation?

In the cradle-rockingless, lullabyless, strife-torn world of the
twentieth century, rock *n 5 roll music and plaintive lullabies,
often very beautiful, sometimes stridently percussive, possibly
represent compensatory effects for the lack of solicitude which
parents have in the past exhibited for their children's cutaneous
needs. Ignorance concerning the experience of such needs is
widespread. But this does not mean that it is uncorrectable. The
music of a segment of the population and of a period may
sometimes bear a direct relation to the kind of early condition
ing experiences, or lack of them, the individual has undergone
in his early life. Whether or not this is true in the present
instance, in relation to the skin, cannot be decided until a great
deal more research has been done on this engaging subject. It
is an interesting conjecture, and it is worth pursuing if only for
the light it might throw on the micro-mechanics of human

*I quote the story from memory. It will be found in Anninius Vambery,
The Story of My Struggles (London: Fisher Unwin, 1904).

142 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

development, which is to say the light it might throw on human
nature.

CLOTHES AND THE SKIN. Our discussion has considered the
possible relation of the kinds of experiences of early cutaneous
stimulation and the kinds of music and dance that may develop,
especially in response to the lack of adequate rocking and cu
taneous stimulation. This brings us to another interesting ques
tion, namely, the relationships of clothes, skin, and behavior.

Irwin and Weiss have found that activity was significantly
less in infants when they were clothed than when they were
unclothed. This raised the question whether the reduced activ
ity was due to mechanical restraint by the clothes or possibly
the elimination of self-stimulation, or perhaps the alleviation of
hunger contractions, or finally, whether the clothing perhaps
reduced or offered insulation against incoming stimuli.

The correct answer to these questions is probably that all
four factors are operative, but that the last is the most impor
tant the insulation that clothing produces against incoming
stimuli.

It is difficult to say whether or not the habit of dressing the
infant in clothes early in his life bears any relation to the devel
opment of behavioral differences, distinguishing those behav
iors from behaviors found in cultures in which neither children
nor adults wear clothes. Clothes, and different kinds of clothes,
probably affect the skin differently enough to result in behavior
directly traceable to the effects exercised through the skin. It
may be conjectured that the remarkable innovations in dress
worn by young people, and such phenomena as long hair,
beards, and other hispid facial embellishments in the male, have
some connection with early kinds of tactile or lack of tactile
experiences. Hair is an important appendage of the skin, and
indeed constitutes the avenue through which much of its stimu
lation is initiated. Possibly the hair that young men began to
sport on their heads and faces in the late 1960's in some mea
sure represents an expression of the need for love which was
earlier denied them because of the stroking and patting and

Tender, Loving Care 143

caressing they failed to receive in infancy. The highly successful
musical play Hair was emphatically, among other things, de
voted to long hair and, for a bit, to nudity. Perhaps it would
not be putting too great a strain on the imagination to offer the
exegesis that what the play was pleading for is more love, for
being stroked the right way rather than being rubbed the
wrong.

During World War I, when women began to bob their hair
and shorten their skirts, Eric Gill, the distinguished English
type designer, typographer, and sculptor, penned the following
quatrain:

If skirts should get much shorter
Said the flapper with a sob,
There'll be two more cheeks to powder
And one more place to bob.

One wonders what he would have thought of miniskirts, topless
waitresses, see-through blouses, and bikinis.

Allowing for the demise of Anthony Comstock, Mrs.
Grundy, and the Censor, as well as for the increasing amplitude
of our enlarging freedoms, it is possible that the exposure of the
skin and its integumentary specializations may be related to the
needs for cutaneous satisfaction of those who in their earlier
lives failed to receive such satisfactions.

The increasing popularity of "skinny dipping" and "nude
beaches" may not be altogether unrelated to this. The waterbed,
which in recent years has enjoyed some popularity, appeals,
presumably, because of its "cuddly" sensual qualities. Instead
of the statically "indifferent" qualities of the ordinary bed, it
provides a constantly stimulating series of hugs and caresses as
one moves in its embrace, and an encompassing support when
one sleeps in it reminiscent of that time we fell asleep on our
mother's body. Many young couples with an infant or two have
spoken enthusiastically of the virtues of the waterbed. In addi
tion to making a fine bed it also makes a good rocker-cradle.
The waterbed has to be filled nearly to capacity and set within
a frame, in order to save stress on the seams. Because the infant

144 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

may manage to find his way between the bed and the frame, he
should never be left unattended on the waterbed. Padding and
bedclothes help to protect the bed from puncture. Parents can
sleep together with their infants on the bed in comfort, and with
much less interruption than when the infant is in a crib. Infants
and their siblings love to run and jump about on a waterbed,
and one never has to worry about spills ruining the mattress.
Failing a waterbed, a regular bed can be lowered to a safe level
or the mattress placed on the floor as a safety precaution to keep
young ones from tumbling out.

Clothes largely cut off the experience of pleasurable sensa
tions from the skin, hence, the actual or symbolic shedding of
clothes may represent attempts to enjoy experiences that had
been earlier denied. Natural skin stimulation, the play of air,
sun, and wind upon the body, can be very pleasurable. Fliigel,
who conducted an inquiry into the matter, found that such
natural skin stimulation was often described in "glowing"
terms, as "heavenly," "perfectly delightful," "like breathing in
happiness," and in similar expressions of pleasure. The growth
of the nudist movement almost certainly reflects the desire for
more freedom of communication through the skin.*

This, interestingly enough, takes the form of visual commu
nication through the inspection of the nude body. All nudists
agree that this greatly reduces sexual tension, and is of general
therapeutic value. Touching, even between husband and wife,
was strictly forbidden in all nudist camps, but that rule is today
tending to be somewhat relaxed. Hartman, who has made a
serious study of nudists, expresses his pleasure in seeing "nu
dists engaged in various games involving physical contact but
not involving any suggestive activities. I had heard so much
about the no-touch rule but had been warmly embraced by both
males and females during the period of the research and found

*One of the earliest serious discussions of nudism and the disadvantages
of clothes is to be found in Maurice Parmalee The New Gymnosophy (New
York: Hitchcock, 1927). See also the book that introduced nudism to Amer
ica, by F. Merrill and M. Merrill, Among the Nudists (New York: Garden
City Publishing Co., 1931).

Tender, Loving Care 145

that such cordiality had nothing to do with sexual arousal. This
contact was one of the more pleasurable experiences of the
research." Hartman points out that American culture has been
regarded as a no-touch one. His observations on nudists lead
him to believe that nudists may unwittingly have aggravated
the situation. "I believe," he writes, "that much more personal
growth would take place among individuals where there is some
kind of affectionate touch contact, especially with closely
related individuals and generally between all persons. It was my
observation that the no-touch rule is on its way out."

The association of nudity with sex is, of course, so strong that
where touching of the clothed body is permissible, the same
part of the body is taboo to touch when it is unclothed. This
rule, however, does not apply to parents and their small chil
dren. As the children grow older, physical contact becomes
more restrained, and by adolescence is completely terminated,
so that adolescents who touch each other while clothed cease
to do so when in the nude in camps.

One of the consequences of the habit of wearing clothes from
early infancy is that the skin fails to develop the sensitivity it
would have done had clothes not been habitually worn. It has
been observed, for example, that among nonliterate peoples the
skin is very much more responsive to stimuli than it is among
Europeans. Kilton Stewart, in his book Pygmies and Dream
Giants, reports of the Philippine Negritos that they "are very
sensitive to creeping things, and were amazed that an ant could
crawl up my leg without my being aware of it."

The differences between individuals in skin sensitivity are
quite remarkable. There are some who when they touch an
other feel "a sort of electrical current" passing between them,
whereas others experience nothing of the sort. It is also of
interest to note that while some individuals retain this sensitiv
ity into old age, others tend to lose it in middle age. Quite
possibly in these latter cases hormonal changes may be in
volved.

The "electricity" that is often, metaphorically speaking, said
to pass between people when touching one another may be

146 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

something more than a mere metaphor. The skin is an espe
cially good electrical conductor. Electrical changes may be
measured at the skin surface in a variety of ways, one of the best
known of these being the psychogalvanometer or, as it is com
monly miscalled, "the lie detector." Emotional changes acting
through the autonomic nervous system usually produce an in
crease in the electrical conductance of the skin (a decrease in
resistance) across the palms of the hands or feet. There can be
little doubt that in tactile stimulation electrical changes are
transmitted from one individual to the other.

Finally, it is worth noting that the skin usually contains little
moisture, and that cold dry skin is a good insulator and consti
tutes the principal protection against electric shock.

"DERMO-OPTICAL PERCEPTION." Some persons claim to pos
sess skins so sensitive that they are able to "see" with them.
Since the skin is derived from the same embryological ectoder-
mal layer as the eyes, several investigators have maintained that
in such individuals the skin has retained some primitive optical
properties, and it is this that enables them to see with the skin.
This view was forcibly argued by the French novelist Jules
Romains in 1919 in his book, Vision Extra-Retinienne. At regu
lar intervals the idea makes its appearance in the press, when
some individual is reported with "eyeless sight," or as being
able to see from the socket from which his eye was removed,
or through his fingers, or through the skin of the face following
a thorough sealing of the eyes.

There is, in fact, no evidence whatever th$t will withstand a
moment's critical examination that anyone has ever been able
to see with the skin. What appear to be impressive perfor
mances are usually due to trickery. Martin Gardner has dis
cussed these alleged cases of dermo-optical perception, and
thoroughly disposed of them. The sensory capacities of the skin
are remarkable enough to render the making of exaggerated
claims for it quite unnecessary. The ability of blind persons like
Laura Bridgman and Helen Keller, and Madame de Stael, who
used to pass her hands over the faces of her visitors in order to

Tender, Loving Care 147

gain some idea of what they looked like, are a matter of record.
But no one ever claimed that these ladies were seeing through
their skin. We all have stereognostic ability that is, the ability
to perceive objects or forms by touch and in a metaphoric
sense most human beings can almost "see" the form of the
object they have touched. The tips of the fingers are the parts
of the body that are characterized by the greatest sensitivity in
"reading," that is in stereognizing, the form of objects by touch.
The Braille Alphabet, three dots high and three dots wide,
makes it possible for blind people to read the most complex
works in any language. In Braille the reader does not "see,'* but
interprets the dots in the brain as read through the fingertips.
This code was the invention of a blind boy of fifteen, Louis
Braille (1809-1852).

If any evidence were required to demonstrate the mind of the
skin it could rest on the sensory capacities of the fingertips
alone. Those capacities, in the form of sensory receptors that
pick up the stimuli, in turn transmit them to the brain in the
form of complex nervous impulses. Through repetition, that is
by learning, capacities become abilities enabling the individual
to make the fine discriminations that endow the particular sen
sations with particular meanings. An ability is a trained capac
ity, and every human being has to learn how to make such fine
discriminations. Just as he has to learn the ability of stereogno-
sis so, too, he learns to develop the sensitivities inherent in his
skin, or he does not. That particular variety of learning is
almost entirely determined by the cutaneous and related experi
ences he has undergone during infancy and childhood.

DERMOGRAPHIA. Dermographia or dermatographia is skin
writing or the raising of wheals by pressure, usually upon the
broad expanse of the back. One may write on the skin with a
blunt instrument. When the wheals show up red, hyperreac-
tivity of the vagus nerve (vagotonia) is involved; when the
wheals are predominantly white the sympathetic nervous sys
tem is involved. The wheals themselves are produced by oozing
of fluid from capillaries into the surrounding tissue, the oozing

148 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

in turn, apparently, resulting from local dilation of the blood
vessels. Everyone's skin will wheal if stroked sufficiently often
or struck sufficiently hard, but in the abnormal cases mild
stroking is sufficient to produce dermographia. Whether or not
dermographia has any relation whatever to early childhood
cutaneous experience is at present quite unknown.

Children have for generations played at tracing letters on
each other's backs, competing with each other for the highest
number of correct identifications. Adults can play this game
with varying degrees of competence. The brain, clearly, is capa
ble of translating patterns of stimulated touch receptors into
letters and simple images. No one, so far as I know, has ever
studied the variability in translating such dermatographic mes
sages in different individuals. It would not, I think, be too rash
to predict that significant correlations would be found between
such dermatographic skills and early cutaneous experience.

Drs. Paul Bach-y-Rita and Carter C. Collins of the Smith-
Kettlewell Institute of Visual Sciences of the University of the
Pacific Graduate School of Medical Sciences in San Francisco,
basing themselves on the knowledge of the ability of the brain
to translate dermal messages, have found that such translation
also occurs when the stimuli come from arrays of electrodes or
vibrating points connected to a camera. After a few hours of
training, blind subjects can recognize geometric figures and
objects like chairs and telephones. Additional training produces
the ability to judge distance and even to recognize faces.

The skin and the retina of the eye are unique in that their
sensory receptors are laid out in a pattern. This enables both the
retina and the skin to pick up regularities and patterns of
stimuli and to convert them readily into images in the brain.
Using an array of electrodes mounted in an elastic matrix,
which can be worn on the back or abdomen, under regular
clothes, a camera is mounted on the blind person's head like a
miner's lamp. This camera can transmit to the electrodes the
information it picks up, which the electrodes in turn transmit
to the skin. The information is then translated in the brain for
what it is. During the course of this research it was found that

Tender, Loving Care 149

the abdominal skin "sees" better than that of the back or fore
arms.

The spatio-temporal perceptive capacities of the skin are
quite remarkable. Time is handled almost as well by the skin
as by the ear. The skin can pick up a break of about 10 thou
sandths of a second in a steady mechanical pressure or tactile
buzz. Eye discriminations are about 25-35 thousandths of a
second. The skin picks up the location of distances on its surface
very much more efficiently than the ear is able to locate sounds
at a distance. Utilizing this information Dr. Frank A. Geldard
of the Cutaneous Communication Laboratory at Princeton
University has worked out an opthohapt alphabet which can be
flashed to the skin rapidly and vividly. The symbols are easy to
learn and read, in a language that may be called "body En
glish." Geldard has shown that Rousseau's envisionment, in
1762, in his treatise on education, fimile, of the possibility of
communicating through the skin was, indeed, a remarkable
piece of prescience. The skin, Geldard has demonstrated, is
capable of receiving and reading rapid and sophisticated mes
sages. "There is every likelihood," he says, "that skin languages
of great subtlety and speed can be devised and used."

Dermo-optical perception is a myth, but perception through
the skin by means of its other properties is a reality. The skin
possesses the ability to respond to a large variety of modalities.
Already electronic devices are available which vibrate in an
outline identical to the letters of the alphabet, enabling a blind
person, after a little practice, to see. In addition to vibrotactile
communication, research is proceeding on coding alphabets
through electropulses. B. von Haller Gilmer and Lee W. Gregg
of the Carnegie Institute of Technology have been pursuing this
approach. They point out that the skin is rarely if ever "busy,"
a fact which enables it to learn, to become habituated to codes
that cannot be interfered with under any conditions. The vi
brotactile or electrotactile signal cannot be shut out. Nor can
the skin close its eyes; it cannot even hold its ears in this
respect it more closely resembles the ear than the eye. Von
Haller Gilmer and Gregg postulate that by its very nature the

150 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

skin is not handicapped with excess verbiage, as is the written
and spoken word. Perhaps the skin has possibilities of codes,
they suggest, even superior to other channels because of its
"simplicity." The skin may be unique in combining the spatio-
temporal dimensions of hearing and vision, the ear being best
in the temporal, and the eye in the spatial dimension.

With an apparatus designed by J. F. Hahn to deliver and
measure square wave pulses to the skin and its resistance, von
Haller Gilmer and Gregg have made exploratory studies on
both normal and blind subjects. Given areas of the skin may be
stimulated at the rate of one pulse per second with a duration
of one milli-second, for up to two hours without report of pain.
A pulse language, therefore, becomes possible once the pulses
for the code have been worked out. Such an artificial language,
the elements of which are defined by cutaneous sensations, has
remarkable possibilities. Placing the cutaneous sensations in
one-to-one correspondence with the elemental sounds of speech
(phonemes), these investigators will be using a programmed
computer (the code interpreter) as an analog to the human
communications receptor. With the aid of this computer they
hope to construct a system that may yield the necessary infor
mation upon which a good code can be based.

Touch as interval has never been properly investigated. By an
interval in music is meant the difference in pitch between any
two notes. The great variety of intervals experienced in touch
carries the signals to the brain, which gives them meaning. As
in music, so also in tactile experience, intervals can be either
concordant or discordant. The psychophysics of the subject has
yet to be explored.

ITCHING AND SCRATCHING. Itching is an irritating cutaneous
sensation which provokes the desire to scratch or rub the skin.
Scratching, the usual means of relieving itching, is done by
scraping with the fingernails. The psychosomatics of itching
and scratching are well known. That distinguished polymath
William Shakespeare put it this way in Coriolanus (I. i. 162),
where he makes Caius Marcius say,

Tender, Loving Care 151

What's the matter, you dissentious rogues,
That, rubbing the poor itch of your opinion,
Make yourselves scabs?

An "itch" in the mind, as it were, will often express itself as
an itch in the skin. Musaph, who has written a fascinating
monograph on the subject of itching and scratching, describes
these as derived activities, that is to say, as activities which are
derived from the "sparking over" or transduction into a skin
response of experiences related to and prepared by the individ
ual's early life. For example, in frustrating situations angry
emotions may be converted infra-symbolically into itching and
scratching. The various forms of psychosomatic pruritis that
is, functionally induced itching of the skin often represent the
unconscious striving to obtain the attention that was denied in
early life, especially the attention that was denied to the skin.
Unexpressed feelings of frustration, rage, and guilt, as well as
the strong repressed need for love may find symptomatic ex
pression in the form of scratching even in the absence of itching.

Seitz has drawn attention to the clandestine scratching of
many persons who feel ashamed because the practice causes
them to experience pleasurable sensations of an erotic quality.
For example, Martin Berezin has described the case of a woman
of forty-eight who suffered from a severe pruritis ani, so severe
that she induced excoriations of the perineum by scratching.
During the course of psychotherapy it was discovered that the
scratching of her anus represented a masturbatory equivalent,
a discovery confirmed when she shifted her scratching to her
external genitalia. With the resolution of her conflict the pruri
tis disappeared altogether.

The erotic quality of much scratching is fairly obvious. An
old proverb has it, " Tis better than riches to scratch where it
itches." Montaigne, in his essay "Of Experience," writes,
"Scratching is one of nature's sweetest gratifications, and near
est at hand." While no less a person than James I of England
declared that "No one but kings and princes should have the
itch, for the sensation of scratching is so delightful." And that

152 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

choleric character Thomas Carlyle went so far as to say, "The
height of human happiness is to scratch the part that itches."
The relief from emotional tension offered by scratching has
been portrayed by Samuel Butler (1612-1680) in Hudibras,

He could raise scruples dark and nice,

And after solve 'em in a trice:

As if Divinity had catch'd

The itch, on purpose to be scratched. [/. /. 163]

Ogden Nash sums it all up succinctly in his quatrain, "Taboo
to Boot,"

One bliss for which
There is no match
Is when you itch
To up and scratch.

Brian Russell points out that deprivation of love often results
in itching, an itch to be loved. "The patient with widespread
eczema whose skin relapses on the very suggestion of discharge
from the hospital, regresses to an infantile stage of dependency
with the mute appeal, 1 am helpless; you must care for me.' "

Scratching may be simultaneously a source of pleasure and
of displeasure, expressing guilt and a tendency towards self-
punishment. Disturbances in sexuality and hostility are almost
always present in patients with pruritis.

The reciprocal benefits implied in the old saying, "You
scratch my back, and I'll scratch yours," convey something
more than a metaphor.

In August 1971 closed circuit TV was installed in the Trib
une Tower in Chicago in order to protect the offices against
would-be thieves. But before word got around of the existence
of the TV monitors they revealed, writes Clarence Petersen,
"something very significant about human nature. The nature of
the human is, more than anything else, to itch. It is simply
astonishing how many people itch and, of course, that is count
ing only those who are uninhibited enough to scratch." Indeed,
itching and scratching are forms of behavior so often indulged

Tender, Loving Care 153

that almost all of us would be astonished were we to become
aware of the frequency with which we resort to them.

The pleasures of back scratching are phylogentically very
old; even invertebrates are soothed by gentle back rubbing, and
it is well known that all mammals enjoy it. Also, like man, other
mammals enjoy back scratching in the absence of itching even
more than they do in its presence. The instrument known as a
back scratcher or scratch-back is a very ancient device; the
latest electric models are advertised as being "better than a
friend, with a hand that jiggles up and down like the real thing."
Thus, the sheer pleasure-giving qualities of the appropriately
stimulated skin testify to its need for pleasurable stimulation.
In this sense almost every kind of cutaneous stimulation that
is not intended to be injurious is characterized by an erotic
component. Under the appropriate circumstances even a touch
on the hand can be sexually exciting. It is highly probable that
the differences in the degree of cutaneous sensitivity that differ
ent individuals exhibit to the pleasures derivable from stimula
tion of the skin in all states and conditions of being are largely
influenced by early experiences of cutaneous stimulation. Cer
tainly the experiments of the Harlows and others abundantly
testify to that fact in monkeys, apes, and other mammals, while
psychiatric research fully supports the relationship in humans.

BATHING AND THE SKIN. The delight that infants take in a
warm bath, their joyful splashing and gurgling, and their great
reluctance to leave the water testify to the pleasure they derive
from this hydrous stimulation of the skin. It is perhaps not
surprising, therefore, that the bathroom has become the temple
of the American household, and the daily bath a ritual celebra
tion of the hymn to self-laving. Women find the bath relaxing;
men find the shower stimulating. And both men and women
often spend considerably more time in the bath than one would
think necessary for the mere purposes of cleanliness. Can it be
that in addition to enjoying the pleasures derived from the
cutaneous stimulation which each sex obtains in its own way,
these pleasures in part represent a ritual revival of pleasures

154 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

originally enjoyed in the aquatic environment of the mother's
womb, and in the early experiences of bathing during infancy?

It is of great interest that men, and sometimes women, who
seldom otherwise sing will break out into song in the bathtub
or under the shower. What can be the explanation of this? Also,
a high proportion of masturbatory activities take place in the
bath or shower. Why? Clearly the stimulation of the skin by the
water is very different in the shower from what it is in the tub.
The sudden and continuing stimulation of the skin by the
shower water induces active respiratory changes which in the
appropriate subject are likely to result in song. This is much less
likely to happen under the more gentle stimulation of the water
in the tub. In both cases, however, the rubbing of the skin is
likely to induce erotic sensations leading to masturbatory ac
tivities.

The heightened pleasure derived from tactile stimulation in
water is a serendipitous discovery that many a couple of lovers
has made. In water the skin appears to assume new properties,
it becomes excitingly smooth, much more pleasant to the touch,
and greatly enhances the pleasures of sexual communication.

The enormous increase in the number of private swimming
pools, and the rush to the beaches in summer, with bathing
incidental to exposure to sun and gentle breezes, further serves
to testify to the great pleasure taken in the sensory excitements
provided by shedding one's clothes and exposing one's skin to
the elements. Years ago Dr. C. W. Saleeby in his book entitled
Sunlight and Health made eloquent comment on this. Refer
ring to the skin, he wrote,

This admirable organ, the natural clothing of the body, which
grows continually throughout life, which has at least four dis
tinct sets of sensory nerves distributed to it, which is essential in
the regulation of the temperature, which is waterproof from
without inwards, but allows the excretory sweat to escape freely,
which, when unbroken, is microbe-proof, and which can readily
absorb sunlight this most beautiful, versatile, and wonderful
organ is, for the most part, smothered, blanched, and blinded in
clothes and can only gradually be restored to the air and light

Tender, Loving Care 155

which are its natural surroundings. Then and only then we learn
what it is capable of.

Virtually everyone, from the time of Plato to the present day,
who has ever written on the subject has sung the praises of
nudity over the clothed body; but contemporary man, and espe
cially woman, quite fail to understand the needs of the skin, and
from this ignorance often do themselves great and irreparable
damage. The sun-worship in which increasing numbers of peo
ple indulge today not only results in drying, wrinkling, and
other damage to the skin, but in many cases initiates the devel
opment of skin cancer. Most visible signs of skin damage at
tributed to aging, as Dr. John M. Knox has pointed out, are
actually a result of sunlight exposure. Moderate exposure to
sunlight is not only desirable but necessary. Immoderate expo
sure to sunlight is not only unnecessary but dangerous. It is a
rather sad reflection on human folly when one thinks of the
billions of dollars women spend on the cosmetic care of their
skin in the form of lotions, balms, creams, and the like, while
at the same time overexposing their skins to the very worst of
possible damaging influences, namely, excessive sunlight.
Twenty minutes of exposure to the midday summer sun can
result in sunburned redness of the skin. Most people will spend
hours on a beach exposed to the sun, an exposure which may
result in painful blistering sunburn. It is interesting that the
notion of tanning as a sign of health came into being in the
1920's. This corresponds to the period when the heavy-handed
teachings of the behaviorists were causing parents to approach
their children as if they were automata, and caressing and other
forms of cutaneous stimulation of the child were being reduced
to a minimum. Possibly, here, too, there is a connection. The
tanning may symbolically mean, "You see, the sun has con
tinued to smile upon me, and I have basked freely and uninhib-
itedly in its embracing rays. I have been well and warmly
loved."

156 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

SKIN AND SLEEP. The skin remains the most alert of the senses
in sleep, and is the first to recover on awakening. Sense organs
in the skin and the deeper interoceptive sense organs appear to
be involved in bringing about the movements of sleep. Skin that
is lain on for too long becomes overheated through lack of
ventilation, and as a result messages which result in a change
of position are communicated to the appropriate centers. Anal
ysis of heartbeat records in normal sleep have shown that some
six minutes before the sleeper stirs his heart begins to beat
faster. With the change in sleeping position the heartbeat slowly
returns to its normal rate.

Anna Freud has commented on the close interrelation be
tween the needs for sleep and for cutaneous contact, "falling
asleep being rendered more difficult for the infant who is kept
strictly separated from the mother's body warmth." Miss Freud
also draws attention to interrelation between sleep and passive
body movement, that is, rocking. The relaxed child sleeps, the
troubled child suffers from disturbed sleep. Normal sleep is a
stimulus barrier. Disturbed sleep is a condition of vulnerability
to internally originating excitements. Children who have been
briefly separated from their mothers will, during the period of
separation, suffer from disturbed sleep. As Heinicke and West-
heimer state in their book on the subject, "We find that not only
is the most intense fretting for the parents concomitant with the
maximum sleep disturbance, but . . . disturbances in sleep are
directly connected with longing for the parents." After the
third day there would be a pronounced decline in the sleep
disturbances of these children, but difficulties in falling asleep
and fear of being left alone were noticeably frequent. Further
more, "more of the children had persistent sleeping difficulties
during the period following reunion (or its equivalent) than did
those who had not been separated." The separations of these
two-year-old children lasted from two weeks to twenty weeks.
At some point during the first twenty weeks after reunion, seven
of the ten children who had experienced separation had notice
able difficulty in falling asleep or remaining asleep, or both. The
duration of the sleeping difficulties persisted from one to

Tender, Loving Care 157

twenty-one weeks with the median at four weeks.

Such findings strongly suggest that early interference with
the normal mothering process, not only after the infant has
made strong identifications with the mother, but even before,
may seriously affect the individual's ability to fall asleep or
remain asleep. And that, in early infancy especially, the
mother's holding, carrying, cuddling, and rocking of the infant
constitute acts which play a significant role in the development
of later sleep patterns that may persist throughout life.

Deprivation of the tactile need, like deprivation of any other
need, causes the infant distress. It will therefore sound the
distress signal designed to compel attention to its need, by
crying. Aldrich and his co-workers found that among the less
generally recognized causes of crying in infants is the need for
fondling and rhythmic motion. These investigators found a
constant relationship between the amount and frequency of
crying and the amount and frequency of nursing care: the more
care, the less crying. Infants will continue to cry even when they
see that they are being approached or when the mother calls to
them. Such infants, however, will cease crying immediately
when picked up and fondled. Affectionate tactile stimulation is
clearly, then, a primary need, a need which must be satisfied if
the infant is to develop as a healthy human being.

And what is a healthy human being? One who is able to love,
to work, to play, and to think critically and unprejudicedly.

FIVE
SKIN AND SEX

For touch,

Touch, by the holy powers of the Gods!
Is the sense of the body; whether it be
When something from without makes its way in,
Or when a thing, which in the body had birth,
Hurts it, or gives it pleasure issuing forth
To perform the generative deeds of Venus.

LUCRETIUS (c. 96 B.C.-C. 53 B.C.), De Rerum

Natura, II, 434.

The true language of sex is primarily nonverbal. Our words and
images are poor imitations of the deep and complicated feelings
within us. Unsure of touching as a way of sharing with others,
we have allowed our fears and discomforts to limit the rich
possibilities for nonverbal communication. Sexual expression
has a power most of us are still beginning to explore.

The French wit (quoted in an earlier chapter) who defined
sexual intercourse as the harmony of two souls and the contact
of two epidermes, elegantly emphasized a basic truth: the mas
sive involvement of the skin in sexual congress. The truth is that
in no other relationship is the skin so totally involved as in
sexual intercourse. Sex, indeed, has been called the highest form
of touch. In the profoundest sense touch is the true language
of sex. It is principally through stimulation of the skin that both
male and female are brought to orgasm in coitus, in the case of

Skin and Sex 159

the male largely through the sensory receptors in the penis, and
in the female through the sensory receptors in the vagina and
circumvaginal areas of the skin. Both in the male and in the
female the pubic and suprapubic areas, which are covered with
hair, are highly sensitive, the mons veneris, however, being
much more sensitive in the female than the corresponding area
in the male. In correlation with this it is interesting to note that
in the female the hair of the suprapubic region tends to be
crinkly, forming a pad, in contrast to the male in whom the hair
tends to be longish and uncurled. Also the mons veneris is more
abundantly padded with fatty tissue than the suprapubic region
in the male. These differences are probably adaptive in response
to the >male's assumption of the prone horizontal position atop
the female in intercourse in relation to the latter's supine hori
zontal position.

Several functions are served by these anatomical arrange
ments. In both sexes chafing or bruising of the skin is thus
avoided as well as excessive pressure on the bony pubis, while
sexual excitement is enhanced. The suprapubic hairs at their
bases, when stimulated, serve to produce those chemo-conduc-
tor changes in the nerve endings which, together with the nerve
endings directly supplying the skin, induce a heightening of
sexual excitement. The perineal region, that is the region ex
tending from the base of the external genitalia to and including
the anus, is also supplied with hair and sensory nerves that are
highly erotogenic. Indeed, the anogenital region in both sexes
is supplied with the most highly innervated tactile sensitive hair
follicles of almost any part of the body. The nipples in both
sexes are similarly highly sensitive, as are the lips. Stimulation
of the nipples is sexually exciting. Both in nonpregnant and in
pregnant women, as also in men, stimulation produces a signifi
cant increase in secretion of the pituitary hormone prolactin,
the hormone that maintains lactation and inhibits ovulation.
The lips and the external genitalia are especially well supplied
with concave, disclike branched sensory nerve endings, each in
contact with a single enlarged epithelial cell. Such nerve end
ings are scarce in hairy skin. In the female, orgasm may be

160 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

produced by rubbing the mons veneris. A similar effect is sel
dom achievable in the male by rubbing the suprapubic region.
Thus, the female may masturbate without stimulating the va
gina directly, whereas the male masturbates by direct stimula
tion of the penis.

For both sexes the most urgently sexually arousing stimuli
are tactile. In sexual foreplay, as well as during intercourse,
manual and oral stimulation of erogenic zones greatly inten
sifies the sexual experience. A little reflection will suggest that
there may be some relation between such sexual experiences
and those we spent or did not spend at our mother's breast.
This is especially true of the exploration of the body which the
infant makes through its fingers. Interestingly enough the
fingertips themselves are erogenous. Reciprocal stimulation of
the fingertips between two mutually sexually interested persons
can be sexually quite arousing. During coitus breathing is deep
ened, and this has the effect of washing the CO 2 from the blood;
this, in turn, changes the ionic balance of the body fluids, with
a resulting increase in nerve excitability, expressed in a tingling
of the skin especially at the fingertips.

The question we have to ask is: Do individuals who are
maternally adequately cared for differ from those who are not,
in the manner in which they respond to cutaneous stimulation
in sex relations, in petting, and coitus? Cardinal Newman once
said that any fool can ask unanswerable questions. The question
we have asked is not unanswerable, but unfortunately not much
scientific research has been done that would enable us to answer
it. We have seen that the Harlows, in their studies of rhesus
monkeys, have got as near that research as anyone. It will be
recalled that none of the Harlows' motherless mother-animals
ever showed normal female sex posturing and responding.
"They were impregnated, not through their own effort, but
because of the patience, persistence, and perspicacity of our
breeding males." Apparently adequate mothering is necessary
for the development of healthy sexual behavior. And what, in
our present connection, "adequate mothering" means is the
complex of cutaneous stimulations, among other things, which

Skin and Sex 161

activates the tactile response systems of the infant, and thus
early in its life experience prepares it for later adequate func
tioning in all situations involving tactility. This appears to be
especially true of sexual behavior. Just as the individual learns
his or her gender role, so, too, each learns or fails to learn the
behavioral responses one makes as a result of conditioning
originally initiated through the skin.

Rene Spitz, in a film he made of the nursing couple, showed
how the nursing mother communicates a kind of vital sex edu
cation to the infant as it feeds at the breast. This is seen best
in the way in which she gives the breast to the infant, the quality
and amount of direct intimate contact she encourages between
herself and the child, the presence or absence of restless, frigid,
or irritated behavior during the feeding or other care of the
child, all of which constitute the first preverbal lessons in sex
education. Nursing mothers will frequently describe the breast
feeding experience as "sexy/' and the quality of this "sexiness"
it may be conjectured is not without its lasting influence upon
the erotic development of the adolescent of such breastfed in
fants.

"At the beginning of life," writes Anna Freud,

being stroked, cuddled, and soothed by touch libidinizes the
various parts of the child's body, helps to build up a healthy body
image and body ego, increases its cathexis with narcissistic li
bido, and simultaneously promotes the development of object
love by cementing the bond between child and mother. There is
no doubt that, at this period, the surface of the skin in its role
as erotogenic zone fulfills a multiple function in the child's
growth.

The mother's holding and cuddling of the child plays a very
eifective and important part in its subsequent sexual develop
ment. A mother who loves her child enfolds it. She draws the
child to her in a close embrace and, male or female, this is what
as adults they will later want and be able to do to anyone they
love. Children who have been inadequately held and fondled
will suffer, as adolescents and adults, from an affect-hunger for

162 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

such attention. Dr. Marc H. Hollander of the Department of
Psychiatry of the Vanderbilt School of Medicine, Nashville,
Tennessee, has reported, as part of a larger study on the need
for body contact, on thirty-nine women with relatively acute
psychiatric disorders, the most common of which was neurotic
depression. In the larger study, Dr. Hollender and his col
laborators found that the need to be held and cuddled, like
other needs, varies in intensity from person to person and in the
same person from time to time. For most women, it was found,
body contact is pleasant but not indispensable. However, at one
extreme they found women who considered body contact disa
greeable and even repugnant, while at the other extreme were
women who experienced it as a desire so compelling that it
resembled an addiction.

The need for body contact, like oral needs, may become
intensified during periods of stress. But while oral longings may
be readily satisfied alone, with food, tobacco, alcohol, or the
like, body-contact longings can scarcely be satisfied without the
participation of another person.

Of the group of thirty-nine women patients, twenty-one, or
slightly more than one-half, had used sex to entice a male to
hold them. Twenty-six of the women had made direct requests
to be held. Nine women who had made a direct request had not
.used sex, and four women who had used sex had not made a
direct request.

Clearly, then, such women may offer men sex when their real
desire is to be held or cuddled. As one of these women put it,
in describing her desire to be held, "It's a kind of an ache.
. . . It's not like an emotional longing for some person who isn't
there; it's a physical feeling."

Hollender quotes a former call girl who said, "In a way, I
used sex to be held." The resort to sexual intercourse as a means
of obtaining body contact has been referred to by Blinder in a
discussion of depressive disorders. "At best," he writes, "the
sexual experiences of these intensely unhappy people seem
more an attempt to make some sort of human contact, however
incomplete, than to achieve physical satisfaction." Malmquist

Skin and Sex 163

and his co-workers, in reporting on twenty women who had
three or more illegitimate pregnancies, state, "Eight of the 20
reported that they were consciously aware that sexual activity
for them was a price to be paid for being cuddled and held.
Pregenital activity was described by these eight as more plea
surable than intercourse itself, which was merely something to
be tolerated." Similar observations have been made by other
investigators.

Hollender and his co-workers comment, "The desire to be
cuddled and held is acceptable to most people as long as it is
regarded as a component part of adult sexuality. The wish to
be cuddled and held in a maternal manner is felt to be too
childish; to avoid embarrassment or shame, women convert it
into the longing to be held by a man as part of an adult activity,
sexual intercourse" (p. 190).

If one asks why being held by women would not be even more
desirable for these patients, the answer is that they do often use
various devices to persuade women friends to hold them, but
when this is achieved they quickly become uncomfortable and
draw away, a withdrawal reaction that never occurs with men.
Most of these women linked their desire for being held with
"adult" sexuality, as unequivocally unrelated to anything sug
gesting homosexuality. Overtly, at any rate, they do not want
to be taken for lesbians. One woman stated that when she was
held by a woman her face reddened and she became afraid that
whoever might see her would think she was a homosexual. A
third woman said, "I don't want any woman to touch me. I
think of lesbians."

Hollender and his co-workers believe that for some women
the need to be held or cuddled is a major determinant of promis
cuity.

It may well be that such women often have a strong uncon
scious drive to be held by women, who represent the mother,
a need which has been repressed and causes them to seek body
contact with men and women on a heterosexual basis, paying
the men with their disinterested sexuality, and withdrawing
from too close contact with the women for fear that their true

164 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

motives may be discovered even to themselves. The face-red
dening of the one woman is perhaps significant in this connec
tion. Some of the patients in this study were so averse to sexual
intercourse with their husbands or anyone else that they would
forego the strong desire to be held rather than submit to inter
course.

What is being observed in the great longing of these women
to be held and cuddled is a response to a need which was largely
left unsatisfied in infancy and childhood. This is made evident
in cases in which women as young girls had turned to their
fathers in the hope of receiving the warmth and love they failed
to receive from their mother. They turned to their father not
as a father but as a mother-substitute. As women they used sex
as a means of obtaining maternal gratifications. In many of
these women the nonverbal message is: being held is being
loved. It is Hollender's view that the more intense the wish to
be held, the more likely it is to stem from the seeking of security,
a response conditioned in infancy.

In a further study, in which the original group of 39 women
participating in the first project was enlarged to 1 12, all between
the ages of eighteen and fifty-nine, information was gathered on
the correlations between the wish to be held and various behav
ioral patterns and subjective reactions. It was found that a
strong desire to be held or cuddled correlated with a general
leaning towards openness in emotional expression. Such women
were interested in and derived much pleasure from orality, they
were comfortable with or accepting of sexuality, felt free to feel
and express hostility, responded in a friendly or affectionate
manner after imbibing alcohol, responded positively to another
form of body contact, ballroom dancing, and found pleasure in
tactile behavior of other kinds.

In a study of the wish to be held during pregnancy Hollender
and McGhee found the variability rather interesting. In many
cases there was a distinct increase in the need to be held; this
was associated with a need for reassurance and security. In
some women, who felt themselves physically unattractive, there
was a decrease in the need to be held. Such women, the inves-

Skin and Sex 165

tigators suggest, may be expressing an actual diminution of that
need, or they may be reacting against an underlying wish that
they either cannot accept or cannot expect to have gratified.
The latter might be the case in women who have no regular
partners or who regard themselves as very unattractive. The
wish may then be blocked before reaching awareness or it may
be denied.

How do the sexes compare in the desire to be held and the
wish to hold? Hollender and Mercer investigated this question.
The subjects were thirty men and forty-five women ranging in
age from eighteen to fifty-four. They were patients in two small
psychiatric units or were seen as outpatients in the same institu
tional settings. It was found that quite a significant number of
men long to be held, and some don't even have sex in mind;
while others feel that it is more masculine to hold than to be
held. Apparently, while men can acknowledge their longing to
be held, its intensity either does not reach the height it achieves
in some women or, if it does, is not reported.

In order to discover what role, if any, cultural differences
might play in influencing the desire to be held among women,
Drs. L. T. Huang, R. Phares, and M. H. Hollender investigated
the matter among five groups of Asian women living in Kuala
Lumpur, Malaysia. Altogether 190 women were investigated:

24 Chinese-educated Chinese
65 English-educated Chinese

25 Malay-educated Malays
34 English-educated Malays
42 English-educated Indians.

All subjects were married, most in their twenties and thirties.
The findings are striking. The Chinese-educated Chinese
showed the least desire to be held, and regarded the wish as
something to be kept secret. At the opposite extreme were the
liberated English-educated Chinese, who preferred to be held
and were not inclined to keep their wish secret. English educa
tion does not have a similar effect on the Malay women among
whom, if anything, the effect is opposite, for the Malay-

166 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

educated women express the need to be held and are less in
clined than the English-educated Malay women to deny the
wish. These findings appear to be consistent with the greater
relative freedom to express sensual feelings and to enjoy sex
among the Malay-educated. The authors conclude that their
study demonstrates that cultural factors as well as psychologi
cal ones exert a profound influence on the wish to be held. The
influence, they add, is similar to that of culture on sexual re
sponsiveness.

Lowen has published a number of case histories of women
who suffered a lack of tactile stimulation in infancy, and who
in later life engaged in sexual activities in a desperate attempt
to gain some contact with their own bodies. "This compulsive
activity," writes Lowen, "may give the impression that these
persons are oversexed. They are, if anything, undersexed, for
the activity stems from a need for erotic stimulation rather than
from a feeling of sexual charge or excitement. Sexual activity
of this kind never leads to orgastic satisfaction or fulfillment,
but leaves the person empty and disappointed."

These are important points, for they draw attention to the
fact that in the Western world it is highly probable that sexual
activity, indeed the frenetic preoccupation with sex that charac
terizes Western culture, is in many cases not the expression of
a sexual interest at all, but rather a search for the satisfaction
of the need for contact. As Lowen remarks, "An ego that is not
grounded in the reality of body feeling becomes desperate."

It is significant that almost universally there is a close iden
tification between touch and sex. In the special case of members
of the English-speaking world, as Bruce Maliver has said of
most Americans (unable to feel comfortable about touch as a
friendly or affectionate statement) they see physical contact
between adults almost exclusively as a prelude to sex, and
hence, subject to the usual range of sexual taboos. Intimations
of sexual interest are readily communicated by a touch of the
hand or a limb, by a gentle squeeze of hand, arm, or shoulder.
And without intercourse each may bring the other to orgasm
by the gentle touching, caressing, or stroking, of loving hands.

Skin and Sex 167

Intercourse should mean what the word once implied: commu
nication between two people in which coitus plays a part, and
does not constitute the whole of the experience of making love.
Without tactile communication what the body feels and says
nonverbally the experience of sex can only be at most incom
plete.

Strictly speaking, as Freud pointed out, the whole body is an
erotogenic zone, and as Fenichel has stated, touch erotism is
comparable to the sexual pleasure derivable from looking
(scopophilia). Both are brought about by sensory stimuli of a
specific kind in particular situations. In the development from
pregenital oral and anal satisfactions to genital primacy, in
which sexual excitations become genitally oriented and domi
nant over the extragenital erogenous zones, the sensory stimu
lations normally "function as instigators of excitement and play
a corresponding part in forepleasure. If they have been warded
off during childhood they remain isolated, demanding full gra
tification on their own account and thus disturbing sexual inte
gration."

The authors of the chapter on "Sexuality" in that admirable
book Our Bodies, Our Selves quote a woman in a group discus
sion who remarked that although she didn't want intercourse,
she did want to be physically close to someone and be held and
touched, and she felt "they all go together."

While the need to held may be experienced as something
quite apart from intercourse, nevertheless it is almost always a
major component of the need for sex, and in many cases, as we
have seen, may be even more compelling. As the authors re
ferred to above say, "From the moment we were born we all
began making ourselves feel good by touching and playing with
our bodies. Some of these experiences were explicitly sexual."
It is these early tactile experiences and the pleasure they have
given that we seek to experience, to reexperience, with a chosen
other, throughout life.

A tragic example of the search for physical contact through
sex as a reassurance of love and alleviation of anxiety is the case

168 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

of the late popular singer Janis Joplin. Myra Friedman, in her
biography of the singer, tells it all.

Janis breathed, thought, felt, acted at a primitive level that was
nearly absolute. Even in her twenties, she was still like a hurt and
pleading child who wants exactly that very love complete in the
physical embrace, and sex, in a way, was a valid synonym for
what she was in search of. It wasn't love as an adult knows it:
no sharing, no interest, no commitment, no giving, none of those
things at all. But it really was love to her. In her hunger for
affection, she was nearly amok. Her constant pursuit of physical
contact resonated with echoes of infant longing, and frustration
of such a need could not help but produce an unbearable anxiety.
In that sense, sex was a palliative, an escape from tension that
could not be endured, thus making sexual relief of inordinate,
overbearing importance.

In Hollender's and in Lowen's women the need for being held
was almost certainly warded off, and has therefore remained
isolated and pressing and quite separated from their disturbed
and unintegrated need for sexual relations. The only real need
they know is the pregenital one of being held and cuddled, and
principally loved in this manner. The high intercorrelation be
tween maternal behavior and later child behavior in other vari
ables renders a causal connection between early parental failure
and the later longing to be held highly probable.

As Jurgen Ruesch has written,

We know that to secure healthy development any person has to
be supplied with the right kind of stimulus at the right time and
in the right amount. This is particularly true of children. Quan
titatively inappropriate responses of the parents to the infants'
primitive messages, such as "I am cold," "I am wet," "I am
tired," or "I have had enough" establish deviant feedback cir
cuits. . . . Qualitatively inappropriate responses can produce
disturbances which are in no way different from those produced
by the quantitatively inappropriate responses. To offer food
when thirst is prominent, to offer fluids when excessive cold has
to be managed, are self-explanatory examples.

Skin and Sex 169

The warding off or separation between the need to be held
and the need for sexual satisfaction in Hollender's women may
be accounted for by the recognition (made as long ago as 1898
by Albert Moll) of the sexual impulse as divisible into two
components, the one limited to bodily and mental approxima
tion to another individual, the contrectation impulse (from con-
trectare, "to touch," "to think about"), and the other insofar
as it was confined to the peripheral organs, as the detumescence
impulse (from detumescere, "to stop swelling," "to subside").
Moll makes it quite clear that each impulse at first operates
quite independently of the other, as we may observe in children
who are highly tactile but who have no accompanying sexual
interest in others until further development has occurred.
Should failure to develop contrectation occur as a consequence
of inadequate tactile experience, the individual may become
fixated on the satisfaction of this need, with consequent exclu
sion of the development of the need for detumescence.

TOUCH AND COMMUNICATION. It has been remarked that in
the final analysis every tragedy is a failure of communication.
And what the child receiving inadequate cutaneous stimulation
suffers from is a failure of integrative development as a human
being, a failure in the communication of the experience of love.
By being stroked, and caressed, and carried, and cuddled, com
forted, and cooed to, by being loved, the child learns to stroke
and caress and cuddle, comfort and coo, and to love others. In
this sense love is sexual in the healthiest sense of that word. It
implies involvement, concern, responsibility, tenderness, and
awareness of the needs, sensibilities, and vulnerabilities of the
other. All this is communicated to the infant through the skin
in the early months of his life, and gradually reinforced by
feeding, sound, and visual cues as the infant develops. The
primacy of the infant's first perceptions of reality through the
skin can no longer be doubted. The messages he receives
through that organ must be security-giving, assuring, and plea
surable if the infant is to thrive. Even in food intake, as Brody
has shown in her excellent study of mothering, "save under

170 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

conditions of body security and comfort no infant, however
hungry, appeared to enjoy his feeding."

Such evidence as we possess strongly suggests that inade
quate communication with the baby through its skin is likely
to result in inadequate development of later sexual functions.

Freud's view of the skin as an erotogenic zone differentiated
into sense organs and special erogenic zones such as the anal,
oral, and genital really refers to erogenized tactile zones, and
what he calls infantile sexuality appears to be, as Lawrence
Frank has observed, largely tactuality. As growth and develop
ment proceed, this tactile sensitivity is gradually transformed
into interpersonal relations, autoerotic activities, and eventu
ally into sexual activities. It is to be regretted that in Freud's
emphasis, some would say overemphasis, on the erotogenic
character of the skin it should have come to be seen principally
and almost exclusively as significant for sexual development
alone. This erotogenic view of the skin has somewhat hindered
the recognition of its role in the development of other behav
ioral traits.

In this area it would be foolish to pretend to more knowledge
than we possess, for while thousands of researches, mono
graphs, books, and articles have been written on virtually every
aspect of sex, the role of early cutaneous experience in the
mothering situation has been largely neglected. Brody raises the
question of "whether earliest skin and muscle erotism has re
ceived less than due recognition for the part it plays in gratifica
tions derived from oral erotism and feeling in the first months
of life" (p. 338). The answer is that it has, indeed. Hence we are
dependent here to a large extent upon conjecture and inference
rather than upon the solid ground of research.

The fact that males have projecting external genitalia, penis
and scrotum and gonads, makes their handling by the mother,
the infant itself, and others, a great deal more inviting and
easier than is the case in the female. It is, therefore, likely that
male infants in all cultures undergo considerably more genital
stimulation than females. This difference in sexual anatomy
may also, at least in part, explain the greater frequency of

Skin and Sex 171

masturbation self-gratification through skin stimulation in
boys than in girls. The early stimulation of the external genitalia
in boys by the mother, or other persons, or both, may have all
sorts of later developmental behavioral effects.
"It is notable," wrote Lawrence Frank,

that in our discussions of personality development in children
and of sexuality, so little attention has been given to the tactual
cutaneous experiences of the infant. Like all young mammals
who are licked, nuzzled, cuddled and kept close to the mother,
the human infant likewise has apparently a similar need for close
bodily contacts, for patting and caressing, for tactual soothing
which calms him and restores his equilibrium when hurt, fright
ened, or angry.

This tactual sensitivity is especially acute in the genitals.

This infantile tactuality, like his other organic needs, is gradu
ally transformed as the child learns to accept mother's voice as
a surrogate, her reassuring words and tones of voice giving him
an equivalent for his close physical contacts, or her angry scold
ing voice serving as punishment and making him cry as if hit.
Caressing becomes the chief form of intimacy and expression of
affection, with appropriate words and tones of voice. All physi
cal contacts become meaningful and colored by emotion.

Frank then goes on to point out that during the so-called
latency period the period from about four or five years to
about twelve during which interest in sex is sublimated girls
and especially boys are less likely to seek and receive tactual
contacts from parents. Tactual sensitivity, however, reappears
more strongly than ever at puberty or shortly thereafter, and
becomes a major need-objective, to touch and to be touched,
not merely as an impersonal sensory stimulation, but as a sym
bolic fulfillment of the search for intimacy, acceptance, reassur
ance, and comforting or, in some who have been failed, a con
tinual avoidance of such contacts.

With further development, the need for tactuality

172 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

becomes one of the chief components in sexual approaches and
intercourse, where the individual's early infantile experiences of
adequate tactuality or deprivation may govern his or her capac
ity for response. The tactual-cutaneous sensitivity of the genitals
at puberty becomes more acute and in the male becomes the
major focus of his sexuality, while the female seems to retain
more of the larger overall tactuality of infancy while exhibiting
especial sensitivity in breasts, labiae and clitoris. Auto-erotic
practices may serve as both vicarious fulfillments and/or prepa
ration for coitus, [pp. 134135]

The enormous variety of meanings which sex may have for
different individuals, a language which has the kinds of things
to say to the other that can be said in no other way, an exchange
of love, a means of hurting or exploiting others, a mode of
defense, a bargaining point, a way of self-denial or self-asser
tion, an affirmation or a rejection of masculinity or femininity,
and so on, not to mention the abnormal or pathological expres
sions which sex may take, all, more or less, are influenced by
early tactile experience.

As Lowen points out,

The quality of the physical intimacy between mother and child
reflects the mother's feelings about the intimacy of sex. If the act
of sex is viewed with disgust, all intimate body contact is tainted
with this feeling. If a woman is ashamed of her body, she cannot
offer it graciously to the nursing infant. If she is repelled by the
lower half of her body, she will feel some revulsion in handling
this part of the child's body. Each contact with the child is an
opportunity for the child to experience the pleasure of intimacy
or to be repulsed by the shame and fear of it. When a mother
is afraid of intimacy, the child will sense the fear and interpret
it as a rejection. The child of a woman who is afraid of intimacy
will develop a feeling of shame about its own body.

Dr. Andrew Barclay of Michigan State University has drawn
attention to the fact that at birth among the ways in which boys
and girls differ from each other are: (1) Boys keep their eyes
open more than girls; (2) boys move more; and (3) girls stop
crying when picked up. As a consequence boys are held more

Skin and Sex 173

during the first six months, and since they do not stop crying
when picked up they are walked and rocked for longer periods.
After six months the girls are held more since they are not so
active and are receptive to holding and cuddling when boys are
more likely to resist this in favor of moving about on their own.
These differences may serve to explain why males are more
easily aroused by visual stimuli and females by tactile ones.
Barclay concludes that the changeover from being held to not
being held in boys, and from not being held to being held in
girls, leads to differences in gender roles.

During the first six months, as Erikson has pointed out, the
child is learning about trust and mistrust, and changes in the
sequence in patterns of holding male and female infants may
influence trust-mistrust in ways which influence and shape gen
der roles. Since boys are relatively deprived in passing from
being held to being less held, males should tend to be more
mistrustful of others. Since girls are relatively enhanced by
being held more over time, females should be more trusting of
people in general. Everyday experience confirms this.

Among the myths with which parents in the Western world
have endeavored to condition their children are: (1) "Little men
don't cry," and (2) "Nice girls don't do that." By repeating the
first myth often enough males learn that to deny their feelings
is to be "grown up." By subscribing to this myth we have been
producing adults who have denied their feelings for so long that
they no longer know what they are feeling, who they are, and
therefore are not sure how they should behave. These people
require extreme stimulation, such as the explicit sex movies or
the "football frenzy" to really feel anything.

Persuading girls to believe that "Nice girls don't do that," is
to train them to deny their sexuality. "Nice" girls don't touch
themselves, or let boys touch them, and so on. Some females
after years of travail manage to free themselves from such early
conditionings, some, alas, never do.

Any display of physical affection or contact tends to be inter
preted as sexual. This in itself is highly significant because
tactility is in fact closely related to the development of sexual

174 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

behavior and almost always retains something of that charac
ter. However, in the tactile-deprived individual the sexual com
ponent of tactility remains confused and anxiety-ridden. Hence,
such individuals tend to avoid touching others and resent being
touched, except under special conditions.

Early deprivations of tactile experience may lead to behavior
calculated to provide substitutes for such tactile deprivations in
the form of self-manipulation of various kinds, masturbation
and toe-, finger-, or thumb-sucking, pulling or fingering the
ears, nose, or hair. It is an interesting fact that among nonliter-
ate peoples who generally give their children all the tactile
stimulation they require, finger-sucking or thumb-sucking sel
dom occurs. Moloney, for example, writes, "My observations
in Africa, Tahiti, and the islands around Tahiti, the Fiji Islands,
Islands in the Carribean, Japan, Mexico and Okinawa
confirmed for me the fact that most babies in these areas are
breast fed and carried on the person of the mother. In these
areas I noted that thumbsucking was practically non-existent."

Moloney believes that the thumb becomes a substitute for the
mother, just as the pellets of paper do, which schizoid or schizo
phrenic children so often roll between their fingers. As Lowen-
feld has put it, the fingers act like antennae or feelers which
probe the surroundings for ensuing motor activities.

The oft-heard complaint directed by women at the clumsi
ness, crassness, and incompetence of men in their sexual ap
proaches and in sexual intercourse itself, men's lack of skill in
foreplay and their failure to understand its meaning, almost
certainly substantially reflects the lack of tactile experience that
such males have suffered in childhood. The roughness with
which many men will handle women and children constitutes
yet another evidence of their having been failed in early tactile
experience, for it is difficult to conceive of anyone who had been
tenderly loved and caressed in infancy not learning to approach
a woman or a child with especial tenderness. The very word
tenderness implies softness, delicacy of touch, caring for. The
gorilla, that gentle creature, is the most frequently slandered
animal when women wish to describe the sexual approaches of

Skin and Sex 175

the average male. Sex seems to be regarded as a tension releaser
rather than as a profoundly meaningful act of communication
in a deeply involving human relationship. In many of its ele
ments the sexual relationship reproduces the loving-mother-
child relationship. As Lawrence Frank has put it,

Tactile communication in adult mating, both as foreplay and in
intercourse, has been elaborated and refined by some cultures
into the most amazing array of erotic patterns which through a
variety of tactual stimulation of various parts of the body serve
to arouse, prolong, intensify, and evoke communication. Here
we see tactile communication, reinforced and elaborated by
motor activities and language, by concomitant stimulation, vi
sual, auditory, olfactory, gustatory, and the deeper muscle
senses, combined to provide an organic-personality relationship
which may be one of the most intense human experiences. It is,
or can be, considered an esthetic experience in that there may
be little or no instrumental, purposive, or cognitive elements,
with greater or less loss of space-time orientation. But the ele
mentary sexual processes of the human organism may be trans
formed and focused into an interpersonal love relationship with
an identified person to whom each is seeking to communicate,
using sex not for procreation, as in the mating of a female in heat
ready to be fertilized, but as "another language," for interper
sonal communication. Here we see how the primary tactile mode
of communication, which has been largely overlaid and super
seded by auditory and visual signs and symbols, is reinstated to
function with elementary organic intensity, provided the in
dividuals have not lost the capacity for communication with the
self through tactile experiences.

It may well be asked, If men are affected in this manner by
lack of early tactual experience, how are women affected? The
answer to that question is: Much in the same manner as the
women discussed earlier in this chapter, who longed to be held
and cuddled. These women were affected by more or less frigid
ity, a condition which they could easily conceal by pretending
to excitements they did not feel, or by a nymphomania which
abnormally craves tactual satisfactions. Once again it must be

176 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

emphasized that it is not being suggested that such conditions
are entirely the results of tactual deprivations in early life, but
only that they may, in part, be so.

Women have always in great numbers complained of the
male's lack of tenderness sexually and in general. May not this
deficiency have become rather more epidemic in the recent
period as a consequence, again at least in part, of the abandon
ment of breastfeeding and the reduction in the tactual experi
ences of the child?

Many mothers early begin to reject demonstrations of love by
their sons in the mistaken belief that unless they do so they will
cause their sons to become too deeply attached to them. There
are many fathers who reject their sons' embraces because, as
one such father, a physician, remarked to me, "I don't want him
to become one of those" (meaning a homosexual). The appall
ing ignorance revealed in such attitudes is very damaging, and
the effects would serve to reinforce the male's inability to relate
himself tactually to another human being.

TACTILE DEPRIVATION AND VIOLENCE. The Harlows, in a
well-known experiment, reported on the adult behavior of a
group of five rhesus female monkeys who had never known a
real mother of their own. As mothers these monkeys were
utterly hopeless two were essentially indifferent to their
young, and three were so violently abusive to their infants they
had frequently to be separated. Normally appropriate cues of
fered by the infants for eliciting maternal behavior resulted in
repulsion and rejection, and otherwise brutal behavior. The
Harlows suggest that "failure of normal gratification of contact-
clinging in infancy may make it impossible for the adult female
to show normal contact relationships with her own infant,"
would be an oversimplified explanation for such behavior, and
we agree. They believe, on the contrary, that "maternal affec
tion in the monkey is a highly integrated, global system, not a
series of isolated components that vary independently ... de
pending more upon general social experience than upon specific
experiences." Tactile experience is fundamental, but it is not the

Skin and Sex 111

only experience necessary for the adequate social development
of animals and humans. Be that as it may, there is a striking
parallel between the motherless monkey's behavior toward her
young, and that of the human mother who has been massively
failed in mothering experience during her own infancy. As Drs.
Brandt F. Steele and C. B. Pollock of the University of
Colorado found when they studied the parents of abused chil
dren in three generations of families, such parents were invari
ably deprived of physical affection themselves during their
childhood. In addition their adult sex life was extremely poor.
The women never experienced orgasm, and the men's sex life
was unsatisfying.

The parallel between the motherless monkey's adult behavior
and that of the parental disasters suffered by the adult child-
batterers as children, is deadly. Dr. James H. Prescott, a devel
opmental neuropsychologist at the National Institute of Child
Health and Human Development, at Bethesda, Maryland, be
lieves that a principal cause of human violence stems from a
lack of bodily pleasure during the formative periods of life.
"Recent research," he writes, "supports the view that the depri
vation of physical pleasure is a major ingredient in the expres
sion of physical violence. The common association of sex with
violence provides a clue to understanding physical violence in
terms of deprivation of physical pleasure." He goes on to point
out that unlike violence, people cannot seem to get enough of
pleasure, for which they are constantly in search of new forms
that ultimately seem to be substitutes for the natural sensory
pleasures of touching. Laboratory experiments have convinced
Dr. Prescott that deprivation of sensory pleasure is the princi
pal root cause of violence. There is a reciprocal relationship
between them; the presence of one inhibits the other. Rage is not
possible in the presence of pleasure. A raging, violent animal
will calm down when electrodes stimulate the pleasure centers
of its brain. Dr. Prescott suggests that during development
certain sensory experiences will create a neuropsychological
disposition for either violence-seeking or pleasure-seeking be
havior later in life. Writes Dr. Prescott:

178 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

I am convinced that various abnormal social and emotional
behaviors resulting from what psychologists call "maternal-
social" deprivation, that is, a lack of tender, loving care, are
caused by a unique type of sensory deprivation, somatosensory
deprivation. Derived from the Greek word for "body," the term
refers to the sensations of touch and body movement which
differ from the senses of sight, hearing, smell, and taste. I believe
that the deprivation of body touch, contact, and movement are
the basic causes of a number of emotional disturbances which
include depressive and autistic behaviors, hyperactivity, sexual
aberration, drug abuse, violence, and aggression.

Dr. Prescott may be claiming a bit too much for the effects
of somatosensory deprivation, but if his claims are in the least
excessive they are in the right direction and for the most part,
as the evidence abundantly testifies, worthy of more attention
than they have thus far received. As Prescott has said, numer
ous studies of juvenile delinquents and criminals have revealed
a background of broken homes, neglectful or abusive parents.
Take almost any violent individual and inquire into his history
as a child, and it can be predicted with confidence that he will
be discovered to have had a lacklove childhood, to have suffered
a failure of tender, loving care.* It should, however, be made
quite clear that there are a number of cases on record of persons
who suffered a lacklove infancy and who somehow emerged
mentally quite healthy. |

To be roughly handled has been considered by many women,
especially women of the working classes, an incontestable token
of love. There is, for example, the well-known feminine Cock
ney supplication to her man: "If yer loves us, chuck us abaht."

*For a detailed discussion of this see A. Montagu, The Direction of Human
Development. (Revised edition, New York: Hawthorn Books, 1970).

fFor the most striking case on record see A. Montagu, The Elephant Man
(New York: Ballantine Books, 1973). See also D. Beres and S. J. Obers, "The
Effects of Extreme Deprivation in Infancy on Psychic Structure in Adoles
cence: A Study in Ego Development," The Psychoanalytic Study of the Child,
vol. 5 (New York: International Universities Press, 1950), pp. 212-235; A.
M. Clarke and A. D. B. Clarke, Early Experience: Myth and Evidence (New
York: Free Press, 1976).

Skin and Sex 179

The sexual element was very evident in the flagellation epidem
ics of medieval times, as a penance which the church at first
approved and then forbade, when it realized the sensuality
involved. That the participants in such flagellation episodes
were more than anxious to receive the caresses of the whip
suggests that a great many infants in medieval times received
an inadequate amount and quality of tactile stimulation.

Slapping children, with whatever intention, as a form of
discipline or for any other reason, turns the skin into an organ
of pain rather than pleasure. For reasons which are not too
difficult to discern, the buttocks have constituted a preferred
locus for spanking the child. This region is closely related to the
sexual organs, and supplied by sensory nerves which form part
of the nervous plexus associated with the sexual functions.
Hence spanking on the buttocks may produce distinctively
erotic sensations in children, including sexual orgasm. Children
have been known to misbehave deliberately in order to receive
such desired "punishment," pretending to be distressed while
experiencing it.

Rousseau relates that when he was eight (he was actually ten)
he learned to know sexual pleasure from the spankings adminis
tered by his governess, who used to lay him over her knees in
order to attend to him a posteriori. Far from being distressed
by these assaults upon his integrity, he tells how he welcomed
them, and how finally his bed was removed from his governess's
room when she became aware of the effects her punishments
were having upon her charge.

Whether or not some element of perverted sadism is present
in the personality of a particular discipliner, the early condi
tioning of the association between pain and sexual pleasure
produced by spanking may result in a permanent pathology,*
the disorder known as algolagnia. Algolagnia is a condition in
which pain and cruelty provoke voluptuous sexual pleasure. It

*For a good discussion of the pathological effects of spanking see J. F.
Oliver, Sexual Hygiene and Pathology (Philadelphia: Lippincott, 1965), pp.
63-67.

180 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

may be either active or passive. Masochistic algolagnia renders
the experience of pain, disgust, or humiliation one which pro
duces sexual excitement. Sadistic algolagnia is the opposite,
making the infliction of pain, discomfort, fear, or humiliation
upon others the source of sexual pleasure in oneself.

Spanking and slapping with the open hand in order to punish
children is still too often indulged. Inflicting pain upon them in
this manner deprives children of the comfort the skin usually
communicates to them; as a result, they may come to associate
their own skin and that of others with fear of contact and pain,
and thus may avoid skin contacts in later life.

Quite often biting, pinching, scratching, and gripping ca
resses, even to the point of pain, are intermixed with normal
sexuality and are enjoyed by one or both partners. In pathologi
cal sexuality such behavior is often intensified, and the skin
becomes a dominant factor in the experience of sexual pleasure.
Flagellation, generally on the buttocks and thighs, has been a
most frequent form of sexual perversion, with every kind of
whip imaginable used for this purpose. Establishments have
long existed on the continent of Europe especially, and doubt
less have existed or continue to exist in North and South Amer
ica, in which the clients for a consideration are all but flayed
alive in the search for sexual satisfaction.

The pinching of women's bottoms by "dirty old men" consti
tutes an example of a sexual perversion which society has
clearly understood and found not unamusing. Interestingly
enough there are some women who similarly exhibit their inter
est in males by pinching them with such passion that they leave
them black and blue. In sexual arousal the whole sensory char
acter of the skin is heightened. Sensations that under ordinary
circumstances would be painful, often become intensely plea
surable. Some women in the midst of orgasm will cry out to be
hurt and will enjoy the pain inflicted upon them a pain always
directed at and experienced through the skin. Others will in
dulge in "love-bites." As Van de Velde says, "Women are con
spicuously more addicted to love-bites than are men. It is not
at all unusual for a woman of passionate nature to leave a

Skin and Sex 181

memento of sexual union on the man's shoulder in the shape
of a little slanting oval outline of tooth-marks. The bite occurs
almost without exception during coitus or immediately after
wards, while the generally gentler, slighter, or at least less
noticeable love-bites given by the man to his partner, are part
of the erotic play before, or the final stage after, coitus." In the
case of the male, "many blue marks or bruises on women's arms
are witnesses of the man's tourbillon. " Van de Velde believes
that the feminine inclination to bite during the sexual act arises
mainly from the wish to give a kiss more intense than is hu
manly possible. It is a wish, as it were, to make a permanent
integumentary impression, the intensification of the tactile sen
sation. "Indeed," writes Van de Velde, "both the active and
passive partner feel a peculiarly keen, erotic pleasure in the tiny,
delicate, gentle or sharp but never really painful nips man and
woman exchange as the love-play quickens, especially when
such caresses are applied in rapid succession and in adjacent
places" (p. 155). The line between the normal and the abnormal
is a thin one here, a subject which has been admirably discussed
by Havelock Ellis and others.

The extraordinary frequency with which individuals with
abnormalities of sexuality suffer from pathologies of the skin
suggests not merely a centrifugal psychosomatic effect, but a
centripetally originating one. This is evidenced by the fre
quency with which such individuals strive to solve their sexual
conflicts by securing a close; dependable, and passive relation
ship to the mother or a mother surrogate. It may be postulated
that failure of adequate mothering, and especially adequate
communication through the skin, almost certainly occurred in
the early lives of such individuals.

Scopophilia, to which reference has already been made, the
pleasure in looking, may become a perversion, which is then
known as voyeurism. The voyeurism may be restricted exclu
sively to the genitals, or be connected with the overriding of
disgust, as in looking on excretory functions. Or instead of
being preparatory to the sexual aim, it may supplant it, as in
exhibitionism.

182 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

During the first year of life the association between looking
at objects, touching them, and taking them into the mouth is
a closely linked one. The association between looking and
touching is especially closely connected. The experiences of
urination and defecation are pleasantly relieving ones and
warming. If, however, the oral needs are unsatisfactorily sa
tisfied, and come to be characterized by greed, hunger, insa-
tiety, with fears of the ensuing hostile aspects of these processes,
the visual functions may come to have a similar compulsive,
devouring quality, and later tend to be defended by complex
inhibitory systems of various sorts. Instead of libidinal oral,
anal, tactile, and visual functions being harmoniously inte
grated, these functions become anarchically and dysfunction-
ally associated. Thus, looking comes to replace normal sexual
outlets as in scopophilia, as does touching, often in abnormal
ways such as pinching, scratching, or biting, with or without
the accompanying desire to inflict pain, or the various forms of
exhibitionism. Women do not usually expose the genital region
in exhibitionism, but they will expose breasts or buttocks. This,
of course, they have done, with the vagaries of fashion, quite
normally for millennia. Exposure of the breasts in ancient Crete
was customary, and at various periods in the Western world,
devices drawing attention to the breasts as well as to the but
tocks have been the vogue. But what appears to be the boldest
attempt of all, the attempt to draw attention to the external
genitalia, namely, the miniskirt, is a development of the 1960's.
Topless dresses have not become the fashion, and see-through
blouses have gained a limited popularity.

These phenomena, however, are not in any sense pathologi
cal evidences of sexual disturbance. What they are evidence of
is the expression of the need for love; and since love and sex
have come to be identified in the Western world, sexual attrac
tiveness becomes a means of achieving "love." In this manner
love establishes itself as "skin-deep." The more skin she exposes
the more lovable the female becomes. This kind of scopophilia
has become normal for most males in the Western world who,
upon the perception of a female possessing the proper curvilin-

Skin and Sex 183

ear properties will phototropically migrate in her direction.
Hence the emphasis upon nudity. In such cases it is not so much
skin as sex that is involved. The true exhibitionist, however,
may be an extreme prude insofar as nudity is concerned, and
may never allow either himself or his wife to see the other in
the nude. Puritanical attitudes of this kind are well known to
be characteristic of the families of exhibitionists. In such fami
lies cutaneous as well as related deprivations are common
throughout childhood.

The motivations of strippers appear to confirm our views.
Skipper and McCaghy studied thirty-five strippers, and found
that some 60 percent came from broken or unstable homes in
which the father was in some way inadequate. Lacking the
strong response from a father, these girls had to settle for
substitutes. In baring their bodies strippers may be merely ask
ing for the attention and affection denied them by their fathers.
The girls in this study estimated that between 50 and 75 percent
of strippers are lesbians. This fact further tends to confirm the
view that the stripper still nurses the feeling of paternal rejec
tion she suffered in childhood.

SEX DIFFERENCES IN TACTUALITY. Sex differences in tactile
sensibility become apparent very soon after birth, girls having
lower touch and pain thresholds than boys, a difference which
remains throughout life. At all ages the female is very much
more responsive to tactile stimuli than the male, and more
dependent upon touch for erotic arousal than the male, who
depends more upon visual stimuli. The difference seems to be,
at least in part, genetic, but cultural differences undoubtedly
also play a role in the development of tactual responsiveness as
between the sexes.

Boys respond less to talking and to touch than girls, so
parents may find it more rewarding to talk to and touch girls
than boys. Beverly Fagot at the University of Oregon studied
sex differences in toddlers' play and related these to parental
behavior. She found that parents both join in play more with
boys than with girls, but paradoxically they also leave boys to

184 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

play alone more often. Boys being left alone more often may as
a result become more independent than girls.

Tactile stimulation is much more meaningful to females than
it is to males. As Fritz Kahn says, bodily contact is to a woman
an act of great intimacy and a far-reaching concession. Hence,
a woman who refuses intimate connection with a man is roused
to indignation if he touches her against her will, and repulses
him with the withering words, "How dare you touch me!"

The unique quality of female tactuality has long been recog
nized in such a demotically meaningful phrase as "the feminine
touch."

Another of the differences between the sexes of tactual inter
est lies in the greater frequency with which the paraphilias
obsessive responses to unacceptable stimuli in order to achieve
orgasm occur in males as compared with females. Examples
are necrophilia (attraction to corpses), exhibitionism (genital
exposure), coprophilia (arousal by feces), masochism (pleasure
in pain), urophilia or uridinism (arousal by being urinated
upon), narratophilia (need to be told erotic stories), pictophilia
(arousal through pictures), scatophilia (dirty talk), zoophilia
(arousal by animals), voyeurism (Peeping Tomism), sadism
(arousal by infliction of pain or discipline), and frottage (the act
of rubbing against another person in order to achieve orgasm,
usually in crowded places). Such paraphilias are largely mascu
line abnormalities. Paraphilias are not only infrequent in
women, but are almost exclusively limited to touch, the feel and
touch of another woman in homosexuality or the feeling and
touch of a pet in zoophilia. Stealing love or pregnancy substi
tutes as in kleptomania may serve as a sexually arousing stimu
lus in women. While feel and contact are essential to a woman's
arousal, the male is erotically attracted from a distance.

SEX DIFFERENCES IN TACTILE EXPERIENCES. With the excep
tion of the United States, there is little information available
relating to the differences between civilized societies in the
tactile experience to which each of the sexes is exposed. Marga
ret Mead has drawn attention to the fact that American moth-

Skin and Sex 185

ers tend to be closer to their daughters than to their sons, an
observation that has been many times confirmed. Goldberg and
Lewis, for example, found that at one year of age girls show
more attachment behavior towards their mothers than do boys.
Moreover, they found that for both sexes the amount of touch
ing the mother provides is correlated with the amount of attach
ment at this age. By attachment behavior Goldberg and Lewis
mean desire for proximity of the mother, touching her, and
response to the mother's departure.

Erikson draws a picture, based on his clinical experience, of
the American mother as one who in her son's "early childhood
. . . deliberately understimulated him sexually and emotion
ally," with "a certain determined lack of maternalism." Sears
and Maccoby, in their retrospective study of child-rearing pat
terns in the United States, found that baby girls received more
demonstrations of affection than boys, and that mothers seemed
to be happier about having girl babies than they were about
having boy babies. It was also found, as in the Fischers' study
of a New England town, that girls were weaned later than boys,
suggesting that the later weaning indicated a more indulgent
attitude towards girls. Clay, in her study of American mother-
infant tactile interactions, also found that female children re
ceived more tactile stimulation than male children. Reva
Rubin, Associate Professor of Nursing at the University of
Pittsburgh, states that it is her impression that "boys are han
dled less, caressed less often, and held for shorter periods than
girls."

Perhaps this difference in tactile experience, at least in part,
accounts for the American female being so much less uptight
about tactuality than the American male.

SIX

GROWTH
AND DEVELOPMENT

Man is a growing animal, and his birthright is devel
opment. ANON

Growth is increase in dimension. Development is increase in
complexity. What role, if any, does tactile experience play in the
growth and development of the organism? The evidence, both
for animals in general and humans in particular, is unequivo
cally clear: tactile experience plays a fundamentally important
role in the growth and development of all mammals thus far
studied, and probably also in nonmammals.

Lawrence Casler has drawn attention to the fact that the
ill-effects of maternal deprivation so ably discussed by Bowlby
and others are probably the result of perceptual deprivations,
principally tactile, visual, and probably vestibular. The vesti
bule is the central part of the inner ear connecting in front with
the cochlea, the essential organ of hearing, and above and be
hind with the semicircular canals, which give us our sense of
balance. Perceptual deprivations are undoubtedly involved, but
this is only another way of speaking of social deprivation and
the elements comprising that are complex. When we have
learned appreciably more than we know at present concerning
the components of maternal love, we shall undoubtedly be able
to describe it as a function of biochemical, physiological,
kinesic, tactile, visual, auditory, olfactory, and other factors.

Growth and Development 187

From observations made on nonhuman animals we may gain
some insight into the manner in which tactile experience, with
which we are here mainly concerned, may affect the growth and
development of humans. So we will begin with a discussion of
the findings on nonhuman animals, and then proceed to the
evidence for the effects of tactile experience upon our own
species.

THE EVIDENCE FROM NONHUMAN ANIMALS. In a Series of

experiments carried out by Dr. John D. Benjamin of the Uni
versity of Colorado Medical School, Denver, Colorado, one
group of twenty laboratory rats, supplied with exactly the same
kinds and amounts of food and living conditions, were caressed
and cuddled by the investigator, while the other group was
treated coldly. "It sounds silly," one investigator is reported to
have remarked, "but the petted rats learned faster and grew
faster."

Far from sounding silly, this is exactly what we would ex
pect. The living organism depends to a very large extent upon
the stimulation of the external world for its growth and devel
opment. Those stimuli must for the most part be pleasurable
ones, just as they must be in learning. Hence, as we would
expect, animals that have been handled in infancy later tend to
be less emotional in open-field tests, defecating and urinating
less, and showing more willingness to explore a strange environ
ment, than those animals who have not been handled in the
pre-weaning period. Also they are better able to learn a condi
tioned avoidance response. Handling before weaning also re
sults in a heavier weight of the brain, and in greater develop
ment of the cortex and subcortex. More cholesterol and the
enzyme cholinesterase have been found in the brains of gentled
rats than ungentled ones, thus indicating a more advanced stage
of neural development, especially in the formation of fatty
sheaths that surround nerve fibers, the myelin sheaths.

Gentled rats show greater liveliness, curiosity, and problem-
solving ability than ungentled rats. They also tend to be more
dominant than ungentled rats.

188 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

Skeletal and body growth are more advanced in gentled than
in ungentled control rats, food is better utilized, and the evi
dence has been cited earlier, showing that gentled experimental
animals show less emotionality in stressful situations. (See pp.
23-25.) Attention has also already been drawn to the fact that
gentled animals show, as adults, a more efficiently developed
immunological system than rats that have been ungentled in
infancy. This is a really quite remarkable finding. How this
works is at present unknown, but it has been suggested that
environmentally responsive hormones may aflFect the develop
ment of thymic function, which plays a significant role in the
establishment of immunologic competency. The hypothalamus,
which is known to play a role in the regulation of immunity,
may also play a role here.

Gentling leads to more rapid maturation of the pituitary-
adrenal axis, that is to say, the alarm-reaction system of the
body. Rats so gentled in infancy recover from electroconvulsive
shock to a degree that is highly significant compared to ungen
tled rats.

We would expect that early tactile stimulation would in most
respects be more important than later tactile stimulation in the
development of the organism, and this, indeed, is experimen
tally found to be the case. Thus, Levine found that handled rats
exhibited greater emotional stability, as measured by excretory
activity, general activity, and so forth, than nonhandled rats.
Furthermore, extra-handled rats, those receiving more than
ordinary handling, are better at learning and retention than
ordinarily handled or unhandled rats.

Larsson found that repeated handling of male maturing rats
made them sexually more responsive to the female. In this way
the onset of puberty was seemingly advanced by several days.
Rats that were handled twice a minute for a few seconds and
then dropped to the female showed shorter intercopulatory
intervals and increased ejaculations, from 3.7 to 5.3 per hour.
Thus, sexual activity was greatly increased as a result of han
dling.

While there can be little doubt that genetic factors enter into

Growth and Development 189

the structure of the behavior with which animals respond to
handling or gentling, the evidence is unequivocally clear that all
animals respond favorably to handling or gentling, and respond
more effectively to whatever tests or trials they are put to than
animals which have not undergone such tactile experience. Urie
Bronfenbrenner has summed up the findings very well.

First, the effects are generally salutary for the organism both
physiologically and psychologically. Thus, handling has been
shown to enhance the organism's later capacity to withstand
stress, its general activity level, and its learning ability. Second,
the presence or absence of handling has its maximal impact
during the first ten days of life, although significant effects have
been reported for animals handled as late as fifty days of age.

On the organismic level, growth and development are con
trolled by endocrine and neural factors. It is well known that
emotional factors are capable of influencing the growth and
development of the organism, principally through the differen
tial action of hormones. Animals that have enjoyed adequate
tactile experiences will respond very differently from those who
have been failed in such experiences. The differences will be
measurable, emotionally, in neural, glandular, biochemical,
muscular, and cutaneous changes. Such differences have been
measured in handled and nonhandled animals, and the findings
have been in the expected direction, namely that in all these
respects the handled animals are more advanced than the non-
handled animals.

The inadequately gentled animal, we may, I believe, safely
assume, is an emotionally unsatisfied creature. The satisfaction
of tactile needs has not hitherto been considered a basic need,
a basic need being defined as one which must be satisfied if the
organism is to survive. But the fact is that the need for tactuality
is a basic need, since it must be satisfied if the organism is to
survive. With complete cessation of skin stimulation the orga
nism would die. An organism deprived of its skin cannot live.
What we are, of course, generally concerned with is quality,
quantity, frequency, and critical periods when the organism

190 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

must receive certain amounts and qualities of tactile stimula
tion, rather than with all-or-none considerations. And what the
evidence abundantly indicates is that there are critical periods
in the development of every organism possessing a skin during
which that outer integument must receive sufficient stimulation
if the organism is to develop in a healthy manner.

The pre-weaning period, whenever that may occur, is criti
cally important here, for the new complexities of existence
introduced into the life of the newborn and neonate confront it
with the kind of insecurities that the beetle placed on its back
experiences when its feet lose contact with the earth. The infant
wants tangible evidence of security, the experience of reassuring
contacts with another body.

THE EVIDENCE IN INFANTS. The early development of the ner
vous system of the infant is to a major extent dependent upon
the kind of cutaneous stimulation it receives. There can be no
doubt that tactile stimulation is necessary for its healthy devel
opment. As Clay says:

The need for peripheral skin stimulation and contact exists
throughout life, but it appears to be most intense and crucial in
the early phase of reflex attachment. Ribble goes so far as to say
that the nervous system of the infant requires some sort of
stimulus feeding at this early period. Certainly the young child
needs an optimum period for the gratification of his sensual
needs, which are both oral and tactile. This is why the preverbal
years are considered a critical period for tactile learning. From
this time on the needs for tactile contact decline, but tactile
stimulation must still be age-graded according to the develop
mental needs of the human organism.

The evidence indicates clearly that the skin is the primary
sense organ of the human infant, and that during its reflex
attachment period it is its tactile experience that is critical for
continued growth and development. This may be seen in a
variety of ways, but most particularly in the growth and devel
opment of tactile sensitivity in the infant receiving an adequate

Growth and Development 191

amount of tactile stimulation as compared with the infant who
has received an inadequate amount.

There is every reason to believe that, just as the salamander's
brain and nervous system develops more fully in response to
peripheral stimulation, so does the brain and nervous system of
the human being.

Yarrow, in an investigation of the effects of early maternal
care on babies, states that perhaps the most striking finding was
the extent to which developmental progress during the first six
months appeared to be influenced by maternal stimulation. The
amount of stimulation and the quality of stimulation were
highly correlated with maternal I.Q. "These data suggest,"
writes Yarrow, "that mothers who give much and intense stim
ulation and encouragement to practice developmental skills
tend to be successful in producing infants who make rapid
developmental progress." The conclusion is reinforced, sug
gests Yarrow, that in institutions it is stimulus deprivation in
early infancy that is a causative factor in developmental retar
dation.

Yarrow also reports on several children who, as a conse
quence of contact failures in infancy, reacted with disturbances
in tactility to any difficulty in the mother-child relationship.

Province and Lipton, comparing seventy-five institutional
ized infants with seventy-five infants reared in families, found
that institutionalized infants reacted peculiarly to being held,
engaged in much rocking behavior, and were usually quiet and
slept excessively. "They did not adapt their bodies well to the
arms of the adults, they were not cuddly, and one noted a lack
in pliability. . . . They felt something like sawdust dolls; they
moved, they bent easily at the proper joints, but they felt stiff
or wooden." By the age of five to six months rocking appeared
in most infants and by eight months was present in all of them.
Province and Lipton distinguish four types of rocking: (1) a
transient rocking as a normal reaction to frustration; (2) rock
ing as an autoerotic activity in children who have suffered some
degree of maternal deprivation; (3) rocking as withdrawal of
attention and extreme preoccupation in children suffering from

192 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

infantile psychoses; and (4) rocking which serves the purpose
of discharge or self-stimulation.

Shevrin and Toussieng of the Menninger Clinic, observing
the disturbed tactile behavior of their juvenile patients, post
ulated the existence of a need for optimum tactile stimulation
in early infancy, which had somehow been denied them. "Such
major disturbances were found," they write, "in the history of
all the children we have studied thus far." When infants receive
too little or too much tactile stimulation, according to these
investigators, conflicts are generated which interfere seriously
with psychic development. The course of these conflicts can be
traced in the thoughts and actions of severely disturbed chil
dren of all ages. The main way these children cope with tactile
conflicts is not by repression or other psychic defenses. It is
either by a defensive raising of thresholds for all stimuli emanat
ing from the environment or from inside the body, or through
protective fluctuations in the physical distance between them
selves and other people. The fantasy productions of these chil
dren yield strong evidence of the conflict, which usually as
sumes the form of an elaborate denial of the need for closeness.
But in spite of this the need for tactile stimulation persists.
Shevrin and Toussieng hypothesize that certain rhythmic be
havior, such as rocking, is used to prevent a total loss of tactile
stimulation resulting from excessive raising of thresholds.

The infant's need for body contact is compelling. If that need
is not adequately satisfied, even though all other needs are
adequately met, it will suffer. Because the consequences of the
lack of satisfaction of such basic needs as hunger, thirst, rest,
sleep, bowel and bladder elimination, and avoidance of danger
ous and painful stimuli are fairly obvious, we are conscious of
the importance of satisfying them. In the case of the tactile
needs the consequences of failing to satisfy them are far from
obvious, and so these needs have been mostly overlooked. It is
important that we begin to understand how necessary it is for
the healthy growth and development of the child that its tactile
needs be adequately satisfied.

We do not have much evidence of a direct kind that tactile

Growth and Development 193

stimulation or its absence affects the growth and development,
physical or psychological, of the human infant. Such direct
evidence is largely lacking for the simple reason that it has
never been sought in humans. We do, however, as we have seen,
have plenty of direct evidence of this sort for nonhuman ani
mals. Also, we have a great deal of direct evidence in human
infants which thoroughly supports the view that tactile stimula
tion is at least as important in the physical and psychological
growth of the human infant as it is in the nonhuman infant.

The failure to satisfy tactile needs in the human infant shows
how damaging such deprivations can be, and how important
such early satisfactions are.

The maternal deprivation syndrome, consisting of the effects
of a minimum amount of mothering, unquestionably involves
substantial tactile deprivations, among others. It is an interest
ing fact that almost invariably the skin of such children, instead
of exhibiting the roseate firm character of the healthy infant,
shows instead a deep pallor and loss of tone, as well as various
other disorders.

Patton and Gardner have published detailed records of chil
dren who had been maternally deprived and shown how
severely their physical as well as their mental growth had been
disturbed, a three-year-old child's bone growth in such a mater
nally deprived situation being just half that of the bone growth
of a normal child. Emotionally deprived children everywhere
suffer serious retardations in growth, both physical and behav
ioral. The literature on this subject is now extensive.

It has been demonstrated that children who are emotionally
disturbed as a result of an unfavorable home environment tend
to suffer from hypopituitarism, with deficiencies in ACTH and
growth hormone the commonest defects, associated with short
stature. When such children are removed to favorable environ
ments they show a spectacular increase in growth and the devel
opment of normal growth hormone secretion.

The physiological mechanisms involved in tactile deprivation
appear to be clearly related to those involved in maternal depri
vation and emotional disturbances in whatever way induced.

194 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

All these mechanisms add up to the one complex series of
processes expressed in the word shock.

The process of birth represents a prolonged series of shocks
which every infant experiences, and nothing exists more power
fully calculated to assuage the effect of those shocks than the
fondling and nursing the mother is designed to give the child
virtually immediately after its birth. When afforded such reas
surance through the skin, the effects of the shock of birth are
gradually mitigated. But if the infant is not afforded such an
alleviation of his shock, the effects of that experience will con
tinue, and will more or less affect his subsequent growth and
development.

Today we know a great deal more about the nature of shock
and its effects than was the case only a few years ago. Indeed,
we are today in a position to discuss the nature of shock at a
cellular level.

Essentially shock is a molecular disorder producing meta
bolic derangements revolving around aerobic glucose metabo
lism, resulting in increased amounts of lactic acid which greatly
contribute to anxiety, and the production of amino acids, fatty
acids, and phosphoric acids. The deficient metabolism of acids
produces disruption in the membranes of the sacs of digestive
and lytic enzymes known as lysosomes, with resulting death of
the cell. The energy upon which the cell is dependent, ATP
(adenosine triphosphate) is decreased, with a consequent de
rangement of protein synthesis and cell membrane pump func
tion. The derangement in protein synthesis interferes with
growth and the ability to withstand shock, and the derange
ment in cell pump function results in swelling. The circulation
tends to slow down, blood pressure falls, red blood cells tend
to agglutinate, oxygen supply to the tissues of the body is re
duced, there is a general wasting away, until the heart stops and
the brain is no longer excited. This is, of course, the extreme
end effect of unrelieved shock; it is, however, very likely that
all these processes occur to some extent in varying degrees in
infants receiving inadequate cutaneous stimulation. And, just
as in shock, the process is usually reversible by the use of blood

Growth and Development 195

volume, antacids, oxygen, corticosteroids, vasodilators, and en
ergy production solutions like glucose, potassium, and insulin,
so the consequences of inadequate cutaneous stimulation in the
infant can be reversed by giving him all the tender, loving care
he needs, principally in the form of what he best and most
immediately understands: warm, fondling, embracing tactual-
ity. The effects upon the infant of such satisfactions of his tactile
needs are remarkable.

Temerlin and co-workers, in a study of thirty-two nonverbal
retarded males of a median age of nine years, found that the
children who received active mothering and maximum skin
contact made significantly higher weight gains during the pe
riod of the experiment than the subjects in the control groups.

WHAT THE INFANT FEELS. In fullterm infants pain and touch
are not well differentiated. McGraw remarks,

When only a few hours or days old some infants exhibit no overt
response to cutaneous irritation such as pinprick. It is impossible
to know whether such absence of response should be attributed
to an undeveloped sensory mechanism or to lack of connection
between sensory and somatic centers, or between receptor cen
ters and those mechanisms governing crying. Such infants usu
ally do respond to deep pressure stimulation. In any event, this
period of hypaesthesia is brief; by the end of the first week or ten
days most infants respond to cutaneous irritation.

The relative insensibility of the newborn to cutaneous stimu
lation has been noted by many investigators.

With growth the number of sensory receptors increase in the
skin over a wider area and in close proximity. Part of the
newborn's reduced sensibility may be due, as Greenacre sug
gests, to sensory birth fatigue.

At first the infant's tactile sense is very generalized; it acts as
a mass effect rather than as a sharply discriminating critical
point effect. Touch and pain are not well differentiated, and the
development of critical discrimination of tactile stimuli follows
much the same course as the development of returning sensa-

196 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

tion after a nerve has been cut. The physiology of this Henry
Head, the distinguished English neurologist, described in some
detail. As sensation begins to return, it is experienced in a very
generalized way; this Head termed protopathic sensation. The
touch which at first is only distinguishable for the area in gen
eral, in time becomes more localized, more critical, so that one
can locate it exactly; this Head termed epicritic. At first the
newborn's tactile sense is largely protopathic; only gradually
does it develop the epicritic ability which enables it to localize
the point of the stimulus precisely.

It is approximately between seven and nine months of age
that specific localization really begins to develop, and becomes
well established by between twelve and sixteen months.

Infants probably differ in skin sensitivity. As Escalona has
said, "There can be no doubt that something like skin aware
ness, or sensations of the kind generated by the skin, are sharp
and frequent throughout the day for some babies and less in
tense for others." And she goes on to point out that just such
skin-sensitive babies will receive an inordinate amount of atten
tion and handling. Such babies tend to receive a considerable
amount of tactile stimulation for the greater part of their wak
ing and half-waking hours. In the Western world it is perhaps
a great advantage for an infant to have a sensitive skin or diaper
rashes or some other dermatological disorder, for then, at least,
it can be assured of receiving something resembling an adequate
amount of cutaneous stimulation. Kibble believes that diaper
ing, at least in America, is "invariably overdone." She considers
that the desire to keep the baby dry in the first months is
misplaced, "except for the comfort of the adults handling the
child." And she adds that the frequent diaper-changing may
focus the child's attention on this area, "and thus foster later
emotional reactions which become deeply involved with the
function of elimination." In many cases this may well be so.
Escalona points out that there are extraordinary differences in
the amount and kind of tactile stimulation to which babies are
exposed, and that "the baby's life is largely a succession of
sharply felt touches, sounds, sights, movements, temperatures,
and the like" (p. 19).

Growth and Development 197

Escalona's reference to "sharply felt touches" almost cer
tainly does not accurately describe what the newborn and
young infant feels. The evidence, on the other hand, indicates
that the baby tends to feel rather more protopathically than
epicritically, and only gradually learns to discriminate discrete
point sensations. It would seem to be an admirably adaptive
provision that the baby should not at first feel "sharply," but
for the most part only in a generalized way, for it is such a
general rather than a "sharp" or specific sensing of assurance
that he requires in his early days. Not that the infant is incapa
ble of discriminating and localizing discrete point sensations.
This he is undoubtedly able to do, but almost certainly in most
cases not "sharply." It is on the foundation of his generalized
tactile experience that he subsequently learns and refines the
sharply felt touches, sounds, sights, movements, temperatures,
and the like, into specific, recognizably distinctive and mean
ingful modalities.

Some babies are born with tactile hypersensitivity, experienc
ing being touched as painful. This apparently provides a hazard
to being comfortable with closeness and to seeing oneself as part
of another person. Lourie points out that if such a baby remains
unrelated this can result in a long-lasting expectation that de
pendency involves pain, and in this way masochism may de
velop, pain in some of these individuals becoming not only a
need but also a pleasure. Usually such a developmental abnor
mality is overcome by the end of the first year, but if it is not,
a fear of being touched together with a mistrust of any depen
dency may result.

More than three hundred years ago Thomas Hobbes wrote,
"For there is no conception in man's mind, which hath not first
been begotten upon the organs of Sense." The shape and form
and space of the outer world of reality, its figures and the
background from which they emerge, are gradually built by the
infant out of the building blocks of its experience, entering
through all its senses, always contingent, correlated, measured,
and evaluated by the criterion of touch. If this object that holds
me so pleasurably does so long and consistently enough I come
to identify her face and eventually all its tangibly visible parts

198 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

with pleasure. It is, however, my skin which primarily tells me
that this face is pleasure-giving, since, as a baby, it is principally
through the skin that I can make that judgment. And so it is
with all the other sensations I experience.

How does this sensation, whatever it is, "feel"? Since the
various senses are really skin receptors of different sorts, the
eyes and ears and nose and certainly the tongue, at first "feel"
rather than see, hear, smell, and taste. As soon as he is able, the
baby will put to the test whatever he can, by putting it into his
mouth, and what he there feels with hand and mouth will tell
him what he desires to know. Gradually he will come to in
crease the distance between what he tactually feels and what he
experiences through the other senses, until he is eventually able
to recognize each experience or object as separate and distinct
from others, and by its own attributes rather than by reference
to the verdict of the skin.

As Sylvester has stated, "The mother's sensitivity and selec
tivity of response facilitates the transition from prevalent orien
tation by close receptors to orientation by distance receptors. In
the earliest stages, the infant's security is a matter of skin con
tact and kinesthetic sensations of being held and supported.
Later, security is derived also from orientation by sight and
sound and from the infant's ability to maintain contact with his
mother through these perceptive modalities." Sometimes, Syl
vester goes on to say, the infant continues to depend upon skin
contact, and fails to develop the ability to use sight and sound
for orientation and communication. This can occur because of
"primary maternal attitudes," or as the result of conditions
leading to increased skin sensitization (such as infantile eczema,
or the loss or absence of other sensory organs). Often, according
to Sylvester, the beginnings of "habitual defects in orientation
or body image" can be traced to such early difficulties.

The mother mutually adapted to her child will respond in
rhythm to her child's needs. Her flexibility will reflect itself in
the child's perceptual development. The mother, as the main
source of the infant's ebb and flow of incoming stimuli, is
thereby also the main source of his comfort and the performer

Growth and Development 199

of the tasks that will later be assumed by his ego. According to
Sylvester, "if a mother prevents her child from regulating ap
proach and retreat autonomously, he may react to threats by
drawing closer to or by taking flight from inanimate objects. It
is possible that such enforced substitution of gadgets for people
is one of the roots of human mechanization."

During the earliest postnatal days the baby spends recovering
from the shock of birth, and in the months that follow, it is
occupied with the organization of its perceptions, tactile, visual,
auditory, taste, and so on. From a base in such experiences the
infant begins to differentiate itself from the world which is not
self. Objects which at first appeared to have no permanence now
become the first conceptual invariants in its mental furniture.
The differentiation of its self from the world of objects is a major
achievement, and it is one in which touch plays a dominant
role. The three principal developments that emerge from this
differentiation are the self (the agent of action), objects (the
objects of action), and the action relation between them. With
the growing differentiation of the self from other persons the
need for communication increases, a need which, as Sinclair has
pointed out, is made even more pressing as the increasing mo
bility of the child reduces direct physical contact with others.
The earliest forms of vocalization are designed to communicate
the emotional and need states of the infant. From such vocaliza
tions his later language abilities will develop.

"From his first day onward," writes Escalona, "the baby is
reacted to and himself reacts to other persons. The nature of
these contacts, more frequent, varied, and complex the older he
gets, is perhaps the single most important determinant of how
he shall experience his world and of the kind of human relation
ships which he will be able to have as he grows up" (p. 33).

The infant will develop a sense of trust or mistrust depending
upon his sensory impressions, received mainly through the skin,
whether gratifying or not. The infant's sense of space, time, and
reality are all of a piece, being experienced first as whatever is
durably gratifying, then as what is perceptually meaningful,
and later as events which can be anticipated. Chronologic time

200 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

remains meaningless until much later in the infant's develop
ment. The earliest steps in the development of mastery of time
and space have been imagined by Escalona to be something like
this:

At first, the world is a succession of different sensations and
feeling states. What varies is the quality and distribution and
intensity of sensations. Except for the difference in the nature of
the sensations involved, hunger, which we say originates from
within, and a sharp sound or cold breeze, which we cannot
imagine except as something that reaches us from outside, are
indistinguishable. There is no awareness of such things as ap
proach, withdrawal, or direction of any sort. Even if the baby
turns his head toward the nipple and grasps it, his sensation is
that the nipple comes or is; no other state with which to contrast
this exists. Light and darkness; harshness and softness; cold and
warmth; sleep and waking; the contours of mother's face as seen
from below, vis-a-vis, or even from above; being grasped and
released; being moved and moving; the sight of moving people,
curtains, blankets, toys; all these recede and approach and com
prise the totality of experience in whatever constellation they
occur at each split second in time. With recurrence, there de
velop islands of consistency. For instance, a certain way of being
grasped, certain kinesthetic sensations, and the change in visual
environment afforded by the vertical position combine into an
awareness of being lifted, being moved, as an entity.

The importance of recurring experiences of the same kind is
of the essence of this developmental process, and Escalona
believes that such "islands of consistency," with a definite
rhythm and sameness to them, in respect to such important
experiences as feeding and bathing, may enable infants to ac
quire a sense of themselves as entities to whom things happen
and who can make things happen. "The one who is not held,
moved about, and rocked is less likely to become aware of
himself through the sensation of passive motion and less likely
to recognize his mother's characteristic touch and tempo" (p.
26).

The infant is at first not only lacking in psychic structure but

Growth and Development 201

also in psychic and somatic boundaries. He is unable to distin
guish between inside and outside, between "I" and "not-I"; in
brief, he is in a state of psychic nondifFerentiation. In this stage
the primary identifications he makes are with his need gratifica
tions as part of his own body. And, as Spitz points out, primary
identification is made difficult by mothers who withhold from
their children the need gratification inherent in being touched:

They extensively restrict the occasions for primary identification
through withholding tactile experiences. Yet, if the infant is to
differentiate himself from his mother, these primary identifica
tions, tactile and otherwise, have to be dealt with, severed and
overcome. Action-directed motility first, and locomotion later,
are the child's devices for dealing with primary identification
and achieving differentiation. When differentiation from the
mother has been accomplished, the infant can form those sec
ondary identifications which pave the way to autonomy and
independence.

Tennyson, in his magnificent elegiac poem, In Memoriam,
refers to the process of individuation, which he clearly fully
understood. Though published in 1 850, many parts of the poem
were written much earlier.

The baby new to earth and sky
What time his tender palm is prest
Against the circle of the breast,
Has never thought that "this is L "

But as he grows he gathers much,
And learns the use of "I" and "me, "
And finds "I am not what I see,
And other than the things I touch. "

So rounds he to a separate mind
From whence clear memory may begin,
As thro 9 the frame that binds him in
As isolation grows defined.

This use may lie in blood and breath,
Which else were fruitless of their due,

202 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

Had man to learn himself anew
Beyond the second birth of Death. \XLV\

The process of what Mahler has called individuation-separa-
tion leads to individuation through secondary identifications.
By taking over the mother's techniques of caring for him
through identification with them the infant makes the first steps
towards ego-formation, the stage of secondary identification,
beginning in the second half of the first year. In this stage the
infant acquires the techniques and devices by means of which
he achieves independence from his mother. In these first six
months tactile experiences are fundamental in the development
of the stage of primary identification and the mechanism of
secondary identification.

Erasmus Darwin, in his Zoonomia, published in 1794, had
arrived at much the same conclusion. He wrote:

The first ideas we become acquainted with, are those of the sense
of touch; for the foetus must experience some varieties of agita
tion, and exert some muscular action, in the womb; and may
with great probability be supposed thus to gain some ideas of its
own figure, of that of the uterus, and of the tenacity of the fluid,
that surrounds it. ...

Many of the organs of sense are confined to a small part of the
body, as the nostrils, ear, or eye, whilst the sense of touch is
diffused over the whole skin, but exists with a more exquisite
degree of delicacy at the extremities of the fingers and thumbs,
and in the lips. The sense of touch is thus very commodiously
disposed for the purpose of encompassing smaller bodies, and for
adapting itself to the inequalities of larger ones. The figure of
small bodies seem to be learnt by children by their lips as much
as by their fingers; on which account they put every new object
to their mouths, when they are satiated with food, as well as
when they are hungry. And puppies seem to learn their ideas of
figure principally by the lips in their mode of play.

We acquire our tangible ideas of objects either by the simple
pressure of this organ of touch against a solid body, or by moving
our organ of touch along the surface of it. In the former case we
learn the length and breadth of the objects by the continuance
of this pressure on our moving organ of touch.

It is hence, that we are very slow in acquiring our tangible

Growth and Development 203

ideas, and very slow in recollecting them; for if I now think of
the tangible idea of a cube, that is, if I think of its figure, and
the solidity of every part of that figure, I must conceive myself
as passing my fingers over it, and seem in some measure to feel
the idea, as I formerly did the impression at the ends of them,
and thus am very slow in distinctly recollecting.

The modalities of space, time, and reality, shape, form,
depth, quality, texture, the three-dimensionality of our vision,
and the like, are almost certainly developed in large part on the
basis of the infant's tactile experiences. As Escalona has put it,

Awareness of the body in space, and of space surrounding the
self must come about in a thousand ways. As the baby's legs kick
and stretch, the pressure of the diaper increases, his feet contact
the blanket, gown, or end of the crib. As he flails his arms, he
encounters the side of the crib, nothing, the surface on which he
lies, or portions of his own body. As he is lifted, he temporarily
feels the absence of contact with anything firm except the part
of the body where his mother is grasping him. Simultaneously,
kinesthetic sensations are quite different from before, the con
tours and range of his visual field change strangely as he is
brought to the vertical position. It is at about the time when
visual coordination and focusing occur more easily that purpos
ive body movement begins to emerge.

As we shall see in the next chapter, the differences in the
kinds of cutaneous experiences to which children are exposed,
within one culture and cross-culturally, make very significant
differences in the rates at which they mature and the ways in
which they relate to their fellows.

Landauer and Whiting have produced some interesting evi
dence suggesting that the handling which results in increase in
size in rodents, as a consequence, they assume, of stress effects,
is similarly operative in the human species. In order to throw
some light on this matter they studied cross-culturally the rela
tion between apparently stressful infant care practices and the
stature of adult males in some eighty different societies for
which appropriate information was available. The stresses they
studied were:

204 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

L Piercing: Nose, lips, circumcision, infibulation, etc.

2. Molding: Stretching arms, legs, shaping head, etc.

3. External: Heat, hot baths, fire, intense sunlight, etc.

4. Extreme cold: Baths, exposure to snow, cold, etc.

5. Internal stressors: Emotions, irritants, enemas

6. Abrasions: Rubbing with sand, etc.

7. Intense sensory stimulation

8. Binding: Swaddling

Upon analysis it was found that "In societies in which the
heads or limbs of infants were repeatedly molded or stretched,
or where their ears, noses, or lips were pierced, where they were
circumcised, vaccinated, inoculated, or had tribal marks cut or
burned in their skin, the mean adult male stature was over two
inches greater than in societies where these customs were not
practiced."

Here the question may well be raised as to the difference
between "handling" and "gentling." Most investigators have
interpreted "handling" to signify the equivalent of a stressful
experience, while "gentling" has been regarded as a comforting,
reassuring experience for the animal exposed to it. The prac
tices used as criteria by Landauer and Whiting were undoubt
edly largely stressful. There remains, however, the very real
question whether they were not in part also pleasurable. The
practices which these investigators found most significantly
correlated with increased growth are for the most part as
sociated with elevations in status, the passage from one grade
into another, greater attractiveness, and therefore greater self-
esteem. Thus, whether as a direct or an indirect result of the
stressful tactile experience, the subsequent pleasurable rewards
of these operations are very considerable. In numberless soci
eties the decoration of the skin by incision, puncture, the rub
bing of dirt in the wounds, tattooing, and the like, though
painful, has nevertheless been voluntarily sought for its reward
ing end effects. Even in rodents who have been handled, reward
is not missing, for the release unharmed from the handling to
the freedom of the cage must be considered to constitute a
reward. In human beings the combination of the stressful cu-

Growth and Development 205

taneous experience with the highly rewarding experiences
which follow probably constitutes a factor in the observed in
crease in growth.

Physiologically, the involvement of the sympathetico-adre-
nal axis, with added secretion of pituitary growth hormone, in
the colligation of conditions described, would be sufficient to
explain the results observed.

Developmental abnormalities which are thought to be the
direct result of lack of adequate contacts with the maternal
figure often express themselves in reactive skin disorders. As
Flanders Dunbar put it, in summarizing the evidence, "It may
well be said that the skin, like other sense organs, is likely to
become sick when contact of the sufferer with his parents and
with the outside world has been disturbed at an early age, and
it appears that many skin disorders are relieved when emotional
contact with the outer world is improved." Many skin sufferers
have experienced early prohibitions of tactile expression and
experience. D. W. Winnicott says, "The smallest skin lesion, if
it concerns the feelings, concerns the whole body. Prohibitions
relative to tactile experience are those in the area of: 'No, no;
don't touch!" and, by way of corollary, 'Don't let yourself be
touched.' " Noli me tangere. Because the skin is the organ of
embrace and contact, many skin disorders can be understood
as the expression of ambivalence relating to such intimate tac
tual experience.

Since tactile communication is essentially an interactional
process, from the first contact with the hands of the person who
has delivered the baby to the contact with the mother's body,
any significant failure in the experience of such contacts may
lead to a profound failure or disorder in later interactional
relationships, which may sometimes express itself in schizo
phrenia, as well as in a variety of other behavioral disorders, not
to mention such respiratory disorders as asthma and the like.

Alexander Lowen has written the best account of the failure
of early tactile experience and its relationship to schizophrenia
in his book The Betrayal of the Body. Based on the clinical
study of many schizophrenics, Lowen shows that the feeling of

206 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

identity arises from a feeling of contact with the body* To know
who one is, the person must be aware of what he feels. This is
precisely what is wanting in the schizophrenic. There is a com
plete loss of body contact to such an extent that, broadly speak
ing, the schizophrenic doesn't know who he is. He is out of
touch with reality. He is aware that he has a body, and is
therefore oriented in time and space. "But since his ego is not
identified with his body and does not perceive it in an alive way,
he feels unrelated to the world and to people. Similarly, his
conscious sense of identity is unrelated to the way he feels about
himself." There is a dissociation between image and reality in
the schizoid state. The healthy person has an image of himself
which agrees with the way he feels and looks, for normally
images derive their reality from association with feeling and
sensation. Loss of touch with the body results in loss of touch
with reality. Personal identity has substance and structure only
insofar as it is based on the reality of bodily feeling.

The fundamental trauma of the schizoid personality, Lowen
states, is the absence of pleasurable physical intimacy between
mother and child. "The lack of erotic body contact is ex
perienced by the child as abandonment. If the child's demands
for this contact are not met with a warm response, it will grow
up with the feeling that no one cares" (pp. 105-106). In order
to cut off unpleasant feelings and sensations, the child will hold
his breath, suck in his belly, and immobilize his diaphragm. He
will lie very still to avoid being afraid. In short, he will
"deaden" his body in order not to feel pain, and by these means
abandon reality. By such dissociation, especially when fear of
the body becomes unendurably terrifying, the ego dissociates
from the body, completely splitting the personality into two
contradictory identities. One of these identities is based on the
body, the other is based on the ego image.

As Otto Fenichel has pointed out, "A lack of emotions which
is due not to mere repression but to real loss of contact with the
objective world gives the observer a specific impression of
'queerness.' " Sometimes these individuals "seem normal be
cause they have succeeded in substituting 'pseudo contacts' of

Growth and Development 207

manifold kinds for a real feeling contact with other people; they
behave 'as if' they had feeling relations with people." And as
Lowen adds, pseudo contacts often take the form of words,
which serve as substitutes for touch. Such people are among the
innumerable casualties who find it difficult to be closer to others
than words. Another form of pseudo contact is role playing,
which serves as a stand-in for emotional involvement. The main
complaint of the schizoid personality is that, as Herbert Weiner
puts it, he is unable to feel any emotions; he is estranged from
others, withdrawn, and detached.

Involvement and identity become established by involvement
and identification between mother and infant, and this mainly
through touch. Tactile failure in infancy results only too often
in estrangement, uninvolvement, lack of identity, detachment,
emotional shallowness, and indifference all marks of the
schizoid or schizophrenic personality.

The body-feeling image we have of ourselves as sensitive or
insensitive, sensuous or unfeeling, relaxed or tense, warm or
cold, is largely based on our tactual experiences in infancy, and
subsequently reenforced by our experiences in childhood. The
skin of those who have been tactually deprived is "turned off"
to those experiences which the tactually satisfied enjoy. The
turned-off individual may be so cutaneously uptight that he
actually recoils from the slightest touch. It is interesting to learn
that George Washington was such a person. He hated to be
touched. There is a feeling of tenseness about their skin in such
individuals, as if they were wearing an ill-fitting garment or are
encased in a suit of armor from which, even if they wished, they
are unable to extricate themselves. The "armored" feeling often
gives such individuals a sense of invulnerability to the at
tempted incursions of the external world upon their ego. Such
unreachableness begins at the skin, but it is not really an un-
reachableness that cannot be breached. It does, however, pre
sent an appearance to the world that often takes the form of a
complete indifference to its overtures of love or warmth. The
"cold fish" really feels like a cold fish. In some cases he really
would like to "feel more alive," if he only knew how. Indeed,

208 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

in every failed individual there is a potentially warm, loving
creature struggling to get out. The trick is so to interact with
the individual who has been tactually failed as to release that
potentiality for something resembling the kind of humanizing
experiences he should have enjoyed in infancy and childhood.

Body awareness is produced through stimulation of the body,
chiefly through the skin, and this commences at birth, if not
before.

Persons who are callously unresponsive to human need, who
have become so "hardened" that they are no longer in touch
with the human condition, are not merely metaphorically so,
but clearly physiologically so. The evidence suggests that those
who have been inadequately touched during their early years
have simply not experienced as full a development of the neuro-
tactile elements in the skin as those who have been adequately
touched. These neurotactile elements grow and develop
throughout the growing period of the individual, up to about
twenty-five years or more. The greater plasticity of the nervous
system of children enables them to make far better recoveries,
for example, from nerve section than adults. Furthermore, chil
dren have to learn tactual-kinesthetic localization, and until
they have done so they are relatively poor at localizing stimuli.
From the eighth to the twelfth year tactual-kinesthetic localiza
tion is superior to visual localization. The dominance of vision
as a source of information leading to tactile localization does
not appear until after the age of twelve.

The kind of tactuality experienced during infancy and child
hood not only produces the appropriate changes in the brain,
but also affects the growth and development of the end-organs
in the skin. The tactually deprived individual will suffer from
a feedback deficiency between skin and brain that may seriously
affect his development as a human being.

Bodily connectedness is the basis of that interconnectedness
with others that we call sociality, and this is brought about by
the closeness of mother and child in infancy. Such a close bodily
relationship is the basis of good feelings about oneself, and the
feeling of bodily connectedness leads to a feeling of self-esteem.

Growth and Development 209

Fundamentally the source of self-esteem is love. The infant uses
its body to express its love, its emotions.

In a study of the relationship between self-esteem and tactu-
ality Drs. Alan F. Silverman, Mark E. Pressman, and Helmut
W. Bartel, utilizing eighty male and female students, found that
the higher the subject's self-esteem, the more intimate he or she
was in communicating through touch, especially when com
municating with a female.

Lack of touch is experienced as a separation anxiety lack
of contact, of connection. "Only connect," as E. M. Forster
enjoined his characters in his novel Howard's End. Something
of the nature of this anxiety becomes evident in adults who have
been deprived of physical contact and who are able to put into
words what it feels like. Dr. Jimmie Holland and her colleagues
at the University of Buffalo School of Medicine have reported
on leukemic patients who as part of their treatment were iso
lated in "germ-free" rooms, which consisted of a large transpar
ent bubble with two-way visibility and verbal communication
facilities, but prevention of all skin contact between the patient
and others. It was found that the chief drawback of the unit was
human touch deprivation. Three-fourths of the patients ex
perienced an acute sense of isolation, chiefly related to the
inability to touch or be touched directly. The staff, too, was
sometimes troubled by their inability to touch and comfort the
patient. One woman patient put it very graphically:

"About a week ago, it started to get on my nerves . . . not
being able to feel other people and hoping I could soon come
out. I felt like everything was closing in on me and I couldn't
stand it anymore. I just had to feel other people, I wanted to
feel somebody, touch another human being. If I could have
done this, I could have stuck it out longer. . . . But since I
couldn't there was no way I could touch anyone or in any way
express my feelings toward somebody just by touching their
hand or squeezing it. This is very difficult to explain It leaves
you at a loss for words. You just feel you are all alone in the
world and everything is cold. There is no warmth. The warmth
is all gone and you just feel like there isn't anything."

210 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

In her book Lonely in America Suzanne Gordon defines
loneliness "as a feeling of deprivation caused by the lack of
certain kinds of human contact." Loneliness is very much in the
same class and of much the same kind as the separation anxiety
that infants and children experience when they are deprived for
any length of time from contact with their mothers. It is a
separation anxiety which causes us, as adolescents and adults,
to become restless when alone for any durable period of time,
and at any cost to seek out the company of others. It is this
deprivation of contact with others that makes solitary confine
ment among the most cruel of punishments . . . even when it
is in the confines of the home. Studies on the communication
of affection between cancer patients and their spouses, carried
out at the Roswell Memorial Institute at the University of
Buffalo Medical School and Hospital by Dr. Lillian Leiber and
her colleagues, showed that while the desire for sexual inter
course decreased among these patients, the desire for physical
closeness increased.

It is sad to have to reflect that in the Western world the only
time that many married couples will exhibit nonsexual physical
closeness or genuine intimacy is when a serious illness befalls
the one or the other. Women are usually far more ready to
display such affection than men, but men often have an inhibit
ing effect upon their wives by actively discouraging any display
of physical affection. Such men literally act as if they feared to
be touched, and become quite anxious, often confused, and not
infrequently hostile, when they are touched. Their love is unex
pressed and often unexpressible. The care they lavish on things
becomes a quite straightforward token for the affection they
have no confidence in placing elsewhere.

How scared he is of human contact,
The clumsy touch of other men.

So writes the Russian poet Yevgeny Vinokurov. How cut off" we
are from each other by outmoded traditional conditionings.
This is underscored by the results of an experiment conducted
by Kenneth and Mary Gergen and William H. Barton of the

Growth and Development 211

Department of Psychology at Swarthmore College, who found
that when persons, mostly students, between the ages of eigh
teen and twenty-five were introduced into a pitch-black room
in which there were half a dozen strangers, persons they knew
they would never meet again, more than 90 percent touched
each other on purpose, while almost none of the subjects in a
similar lighted room did. Almost 50 percent of the dark-room
participants hugged each other. Almost 80 percent of the dark
room subjects said they felt sexual excitement, while only 30
percent of the light-room subjects said they did.

The experimenters were struck by the desire for intimate
alliance among their dark-room subjects, that with the simple
subtraction of light a group of perfect strangers moved within
about thirty minutes to a stage of intimacy seldom attained in
years of normal acquaintanceship. The experimenters con
cluded that people share strong yearnings to be close to each
other, but that our social norms make it too costly to express
these feelings and tend rather to keep us at a distance. Perhaps,
they add, these traditional norms have outlived their usefulness.

It is, however, questionable whether these norms ever had
any usefulness. As one boy wrote, "Felt joy over the possibility
of not having to look at people in cliched ways. Enjoyed feeling
of self-awareness surrounded by a rich environment. . . . En
joyed the wantonness of just crawling around and over other
people to get from one place to another."

Similar observations were made by D.A., a student, relating
to a group of Psychology I students who were individually
blindfolded and led downstairs to a pitch-black room, in which
strange sounds were emanating from a record player. Then they
heard a woman sobbing, who then burst into hysterical laugh
ter. While the students listened, unblindfolded individuals went
around to massage the backs of each blindfolded student, and
smeared a sweet-smelling cream over their hands and faces.
They were then led to the middle of the room where there was
a huge pile of plastic bags. The students played in this pile. They
used their sense of touch to feel their way around and "see"
things. They held hands; touched each others* faces. Some of

212 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

them even began kissing each other. Small groups sat in circles
in the plastic and held hands. Soon the students rose and began
to dance. Groups of four or five blindfolded and unblindfolded
students were all huddled together dancing. Almost all of the
students felt happy and free. In the middle of the music the
blindfolds were removed. Most of the psychology students were
embarrassed by their behavior. They used only their sense of
touch to "see" around them. Now that they were "caught"
hugging and dancing with strangers without their blindfolds
they were embarrassed. "What a strange turn of events," re
marks D.A., "in a group of people who were so happy just
moments before."

These observations throw a much needed light on the value
systems, as it were, of vision as compared with touch. Vision,
in its social aspect, is the censor of the senses. It is, of course,
the brain that does the actual censoring, but vision is the me
dium through which what is seen is conveyed to the brain,
where it is judged. But, then, so is what is touched, with this
difference: that touch has no censorship qualities. Touch is free
and open. Vision acts, as it were, as an arbiter of behavior, an
inhibitor or stimulus thereto; touch is free of censorship, cen-
soriousness, or inhibition. Vision is the medium of perceptual
prejudice, and as Dr. August F. Coppola has said, it is so much
taken for granted that few realize the extent to which most of
our prejudices are bound up with the way we view things. "It
almost seems blasphemous to mention it, but the culprit here
is sight, which dictates most of our values and dominates practi
cally every aspect of our society. Skin color, conspicuous dis
play of wealth, classification of people by dress and appearance,
are all based on distinctions made available to us through vi
sion. To be accepted we must fit into the sighted world, even
if we are blind." As Dr. Coppola goes on to say, the importance
of sight is beyond question, nevertheless it can be overestimated
in the sense that it can blind us to those things that are not
meant to be seen but to be felt. Blindness and deafness, hand
icapping as they are, are not incompatible with an adequate
adjustment to the situation. With a loss of touch or bodily

Growth and Development 213

feeling there would, however, be little sense of life. And for the
feeling of being alive and the potentials of interpersonal rela
tions touch has a fundamental value and significance not in
cluded in the world of sight.

We will happily relate to strangers by touch when we cannot
see them, but the moment we do see them we become "appro
priately" distant. The student who wrote that he felt joy over
the possibility of not having to look at people in cliched ways
in the dark put it in a nutshell. The cliches and stereotypes in
which he had been conditioned visually by his culture, when
rendered nonfunctional, allowed the enjoyment of tactile ex
periences and the complete overriding of the "Don't touch"
taboo, without inhibition or conventional constraint. This was
clearly understood by that extraordinary spirit, William Blake,
when in his poem The Everlasting Gospel he wrote,

This life's five windows of the soul
Distorts the Heavens from pole to pole,
And leads you to believe a lie
When you see with, not thro\ the eye.

Cheek patting, hair patting, and chucking under the chin are,
in the Western world, forms of behavior indicating affection,
and all are tactile.

The "laying on of Hands," "the King's touch," for the cure
of specific diseases like scrofula, known as "the King's evil,"
was at one time widely practiced, and often very effective.
Healing rites have everywhere involved a "laying on of hands."
The royal touch dates back to the Capetians in France and the
Normans in England. The sacred and miraculous character of
kings was considered to give them divine powers of healing,
especially in such a disease as scrofula, that is, tuberculosis of
the lymphatic glands. During the Middle Ages almost all the
kings of France and England exercised the royal touch, and the
practice continued into modern times. In England in the eigh
teenth century, with the advent of the House of Hanover, the
custom was discontinued. In France the practice is recorded as
late as 31 May 1825, when Charles X touched between 120 and

214 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

130 persons. . . . The Sisters at the Hospice Corbeny-St-Mar-
coul, where the rite took place, fourteen weeks after the cere
mony were able to find only five persons cured. As Marc Bloch
remarks in his splendid book The Royal Touch, "During the
ages of real faith, it was a very wise rule to exercise patience in
this matter/'

From the frequent association of the laying on of the royal
hands with scrofula it came to be known as "the King's evil."
Samuel Johnson, who had contracted scrofula from his wet-
nurse, was taken by his mother to London at the age of two
and a half on 30 March 1712, where he was among the 200
persons touched by Queen Anne, alas, at least in his case,
without effecting a cure. The healing gesture was performed
for the last time in England by the queen some three years
later on 27 April 1714, three months before her death. But
even though royalty ceased to practice the rite, the belief lin
gered on into the twentieth century in the form of medallions
bearing the royal image to which the power of the royal touch
had been transferred.

In children affected by any skin disease or disorder the touch
of the human hand is especially important; hence some der
matologists recommend that when a mother applies medication
it should be done with the hand, so that the child feels the caress
rather than the impersonal application of a cotton swab or
tongue depressor. Since very few skin diseases or disorders are
infectious the mother need usually have no fear of contracting
the condition.

The belief in the curative power of the laying on of hands is
still widespread throughout the "civilized" world. For example,
in Ireland it is believed that the seventh son of a seventh son
invariably has the "gif" Finbarr Nolan is said to be such a one.
By 1974, at the age of twenty-one, he was said to have already
earned half a million pounds in "contributions" from those who
have sought his healing touch. In February 1974 he extended
his activities to England, with great success as measured by the
more than six thousand contributions he received within a few
days in London.

Growth and Development 215

In the matter of allergic disorders, Dr. Maurice J. Rosenthal
made a direct test of the thesis "that eczema arises in certain
predisposed infants because they fail to obtain from their
mother or mother-substitute adequate physical soothing con
tact (caressing and cuddling)." Towards this end he investi
gated twenty-five mothers with children under two years of age
suffering from eczema, and found that, indeed, the hypothesis
he set out to test was abundantly confirmed. The majority of
these infants had mothers who had failed to give them an
adequate amount of cutaneous contact.

In discussing a case of infantile eczema, Spitz raises an inter
esting question. "We might ask ourselves/' he writes, "whether
this cutaneous reaction represents an adaptive effort, or alterna
tively, a defense. The child's reaction could be in the nature of
a demand addressed to the mother to incite her to touch him
more frequently. It could also be a form of narcissistic with
drawal, in the sense that through the eczema the child would
be giving himself the stimuli in the somatic sphere which his
mother denies him. We do not know."

It has, however, been pointed out that the demands the ec-
zematous child makes upon its mother, the constant daily skin
care, the inhibition of scratching, the exhausting attention to
medical details, can play havoc with mother-child relation
ships.

A review of the evidence leads Lipton, Steinschneider, and
Richmond to conclude that in eczema itching may in some
instances be primary and not secondary to the diseased skin.
Through the autonomic nervous system, which has some con
trol over the structures and functions of the skin, it is possible
that a significant influence may be exerted by psychosocial and
cultural factors on disordered skin function.

The use of the skin as a tension-reliever assumes many forms,
perhaps the most familiar in Western cultures being head
scratching in men. Women do not usually behave in this man
ner; indeed, the sexual differences in the use of the skin are
marked. In states of perplexity men will rub their chins with
their hand, or tug at the lobes of their ears, or rub their forehead

216 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

or cheeks or back of the neck. Women have very different
gestures in such states. They will either put a finger on their
lower front teeth with the mouth slightly open or pose a finger
under the chin. Other masculine gestures in states of perplexity
are: rubbing one's nose, placing the flexed fingers over the
mouth, rubbing the side of the neck, rubbing the infraorbital
part of the face, rubbing the closed eyes, and picking the nose.
These are all masculine gestures; so is rubbing the back of the
hand or the front of the thigh, and pursing of the lips.

These all appear to be self-comforting gestures, designed to
relieve or reduce tension. Similarly, in states of alarm or grief
the wringing of hands, the holding on to oneself by clasping or
grasping one's hands is comforting. In ancient Greece it was
customary, and is still so in much of Asia, to carry a smooth-
surfaced stone, or amber, or jade, sometimes called a "finger
ing-piece." Such a "worrybead," as it is also named, by its
pleasant feel, serves to produce a calming effect. The telling of
beads by religious Catholics seems to produce a similar result.
"Worrybeads" in the United States have, in recent years, en
joyed increasing sales. Quite recently "executive tranquilizers"
have been introduced in the form of small pieces of polished
wood called "Feelies." Apropos of "worrybeads," it is of more
than passing interest to note here that during World War II Dr.
Jenny Rudinesco, who provided sanctuary for orphaned schiz
oid children, observed that many of them rolled a small pellet
of paper between thumb and index finger. And J. C. Moloney,
in his interpretation of these rolled pellets of paper as "stand-
ins" for the absent mothers, points out that "they are 'mothers'
that can be controlled by the emotionally disturbed child be
cause they are 'mothers' created by the child."

Rubbing of thumb and index finger together is often observed
in persons under tension. This may also be extended to rubbing
all the fingers simultaneously against the palm of the same
hand.

In the matter of skin disorders, Dr. S. Hammerman of the
Department of Psychiatry of Temple University Medical
School, Philadelphia, has reported to me the case of a girl who

Growth and Development 217

suffered very badly from acne, and who was cured by treatment
involving tactile stimulation in a beauty parlor to which she was
sent by a perceptive physician when every other form of ortho
dox medical treatment had failed. As Dr. J. A. M. Meerloo has
stated, many skin disorders unconsciously express the need for
continual skin contact and skin protection, as well as the need
for attention and affection. Acne may sometimes represent the
expression of repressed sexual feelings. Other dermatoses are
sometimes an expression of defense against incestuous skin con
tact.

For those who have not been lovingly and securely held in
infancy the fear of falling is a not unexpected development in
later life. Lowen points out that the fear of falling, whether
from high places or falling asleep, is related to the fear of falling
in love. Indeed, the patient who presents any one of these
anxieties is usually found to be susceptible to the others, the
common factor in all three being an anxiety about the loss of
full control of the body and its sensations. Such patients experi
ence these fears as a "sinking" sensation, and they can be
terrifying and utterly immobilizing. Such sensations "are the
delight of little children, who seek these sensations on their
swings, slides, and similar amusements. The healthy child loves
to be thrown into the air and to be caught by the waiting arms
of a parent."

In the matter of distance, it is of interest that in the theatre
certain directors tell their actors not to touch each other when
playing comedy, but certainly not to refrain from doing so when
playing tragedy. It is like the difference between extraversion
and introversion. In comedy distance is required, noninvolve-
ment, hence one refrains from touching. In tragedy it is the very
reverse, involvement is what must be communicated, hence
touching is encouraged. Again, gestures may be vertical in
comedy, but they should be horizontal in tragedy. In comedy
such vertical gestures are or tend to be manic, in tragedy hori
zontal gestures tend to suggest sympathy, embrace. Thus,
Helen Hayes has said, "In comedy I have found that I must
keep myself up, arms must be held higher, gestures must be of

218 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

an upward nature. In tragedy just the reverse."

Sexual differences in cutaneous behavior are very marked in
probably all cultures. Females are very much more apt to in
dulge in every sort of delicate tactile behavior than males. Also
females appear to be much more sensitive to the tactile proper
ties of objects, as for example, when they will pass their hands
over a fabric in order to appreciate its texture or quality, some
thing males seldom do. Fondling and caressing are largely femi
nine activities, as is gentleness of approach on every level. Back-
slapping and handshake crushing are specifically masculine
forms of behavior. Cultural differences in these respects are also
marked. As Hall points out, the Japanese are very conscious of
the significance of texture. "A bowl that is smooth and pleasing
to the touch communicates not only that the artisan, cared
about the bowl and the person who was going to use it but about
himself as well." Hall goes on to add that the rubbed finishes
of their works in wood reflected the medieval craftsman's feel
ing he had about the importance of touch. "Touch," he writes,
"is the most personally experienced of all sensations. For many
people, life's most intimate moments are associated with the
changing textures of the skin. The hardened, armorlike resist
ance to the unwanted touch, or the exciting, ever-changing
textures of the skin during love-making, and the velvet quality
of satisfaction afterward are messages of one body to another
that have universal meanings."

Bowlby has postulated certain responses in the infant that
function to tie mother and child reciprocally to one another.
These responses are sucking, clinging, following, crying, and
smiling. The baby initiates the first three responses: the second
two are signals to the mother to respond to him. Bowlby found
that in his experience the mother's acceptance of clinging and
following is consistent with favorable development, even in the
absence of breastfeeding, while rejection of clinging and follow
ing by the mother, even in the presence of breastfeeding, is apt
to lead to emotional distance. Furthermore, it was Bowlby's
impression that fully as many psychological disturbances, in
cluding the most severe, could be initiated in the second year

Growth and Development 219

when clinging and following are at their peak, as in the early
months when they are rudimentary.

The psychoanalyst Michael Balint has found that in his pa
tients the need to cling represents a reaction to a trauma, "an
expression of, and a defense against, the fear of being dropped
or abandoned ... its aim being the restoration of proximity and
touch of the original subject-object identity." This identity,
expressed by identity of wishes and interests between subject
and object, Balint calls primary object relation or primary love.

Balint divides these patients into two types, the philobatic,
that is, those who enjoy swings, thrills, trapezes, and the like,
and the oncophilic, those who cannot stand swings, high places,
and similar "perils." The philobatic tends to be a loner, relying
on his own resources, while the oncophilic constantly struggles
with the fear that the object might fail.

The suggestion is that the child who has enjoyed a satisfying
primary object relationship, that is, the child who has been
satisfyingly tactually stimulated, will not need to cling, and will
enjoy high places, thrills, and being swung about. By contrast
the child who has been failed in his clinging needs, especially
during his preverbal reflex period of development, will react to
this traumatic experience with an excessive need to hold on, to
cling, with fear of the unsteady and of the support that may fail.

Two different perceptual worlds are involved here; one is
sight oriented, the other is touch oriented. The touch-oriented
world is more immediate and friendly than the sight-oriented
world. In the sight-oriented world space may be friendly, but
also often horribly empty or filled with dangerous and unpre
dictable, unsteadying objects. Georges Braque, the French
painter, has remarked that tactile space separates the viewer
from objects, while visual space separates objects from each
other.

As Drs. Arthur Burton and Robert K Kantor have pointed
out, humans are creatures of the earth, bound in continuous
tactual contact to terra firmcu When, by flying or diving, we
surrender that contact, anxiety is created because we lose
"touch" with that upon which we depend.

220 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

The extraordinary frequency with which one comes upon
accounts of breakthroughs brought about by body contact in
reaching schizophrenics who had for years been inaccessible to
other therapeutic approaches is striking. In May 1955 the suc
cesses with catatonic schizophrenics of Paul Roland, a physical
therapist at Veterans Administration Mental Hospital, Chil-
licothe, Ohio, were reported in the press. Roland began by
sitting with the patient and then after a time touching his arm.
Before long Roland was able to give the patient a rubdown.
Once that occurred, rehabilitation proceeded rapidly. Gertrude
Schwing has reported how she was able to break through to
schizophrenic children by embracing them. Waal has given an
excellent description of massage therapy with an apparently
autistic boy, in which "the therapist gives the patient a general
soft and maternal massage, with the stimuli of rhythmical pet
ting and very gentle tickling and touching." The solar plexus,
the neck, and the whole length of the spine, are massaged while
the chest, chin, hands, and palms are tickled very sensitively
and cautiously. After this the therapist proceeds to the eyes,
and to a second stage in which there is a provocative massage
of jaws, chest, shoulders, and eyes again. In this second stage
the pressure of the therapists' hands are no longer soft. The
patient reacts by screaming and crying and kicking, and is told
that these are the reactions of a disappointed baby, and that
they are all right. After these outbursts the patient receives
soothing and mothering in an uninvolved, objective manner
from the therapist. The effect of the therapy, according to Waal,
seems to be a bodily maturation and a break .in autistic with
drawal, and it seems to have a quicker effect than any other
technique thus far attempted.

Similarly, a great deal of cuddling and stroking is involved
in the highly successful approach to the treatment of schizo
phrenics developed by Mr. and Mrs. Morris Schiff of Freder-
icksburg, Virginia.

TOUCH IN PSYCHOTHERAPY. There has long been a taboo on
touching the client or patient in psychotherapy. This originated

Growth and Development 221

with Freud. It was his view that the therapist should not inter
vene between himself and the patient but remain completely
objective, neither stimulating nor adding anything of himself to
the patient. The therapist was to remain invisible to the patient,
hence, he was enjoined to sit behind the patient's couch. Many
psychoanalysts still observe these practices. But as Dr. Bertram
R. Forer has put it, "Verbal contact alone leaves one in a limbo
of isolation from one's own body and from other persons." As
a psychotherapist who believes that the inescapable need for
skin contact is psychologically more crucial than hunger for
food, Forer strongly urges the use of touching, in informed and
skillful hands, in the psychotherapeutic situation. Forer points
out that personal integrity represents a continual search for and
intake of social nourishment through close relationships, in
cluding tactual experience and its reverberations throughout
the body. "Most clients and many therapists/' he writes, "are
struggling with internalized parents in the form of an oppres
sive conscience which they needed originally to give them psy
chological structure. One potential function of the therapist is
to become more appetizing or precious to the client than the
internal parents have been."

The appropriate contact tells the client a good deal more
about the therapist's emotional relationship to him, and what
he may expect, than purely verbal comments. The therapist's
touching is reassuring and at the same time serves to produce
a dissolution of the client's fears and unhappy expectations, and
thus demonstrates the client's own resistance to human rela
tionships.

His emotional response may surprise him into a recognition of
deep longings. He can then be helped to recognize that his
oppressive conscience and the roles that he has played to get
along with it has limited his freedom to give and obtain from
others. Thus, taking the therapist inside is an antidote to the
destructive residuals of early relationships and opens the closed
system of the person to new interpersonal experiences.

The primitive reaction to being touched gently at critical peri
ods is a feeling of body relaxation and reassurance that one is not

222 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

alone, that old feelings of unworthiness are not justified. If he is
still caught in an unresolved fusion with a destructive parent,
contact may at first be rebuffed as a threat of annihilation to the
self. Such persons may be literally out of contact and have an
enormous need for contact.

"Touching/* Dr. Forer concludes, "makes for mutuality and is
part of the process of testing whether one dares to become or
will be permitted to become an equal." The touching involved
is that in which the patient or client touches the therapist, as
well as the therapist's touching of the person who has sought
his help. Nevertheless, to this day psychoanalysts in the Eng
lish-speaking world at least desist from so much as shaking
hands at the beginning and end of each hour. The reason given
for this prohibition is that it would be introducing into the
analytic situation an unnecessary and hence unwelcome psy
chic stimulus, a stimulus which might be disadvantageous to
the course of the analysis. The analyst's interests must be in the
determinants of the patient's thoughts and behavior. Whatever
the analyst says or does, it is held, should be subordinated to
that attitude.

Why touching between patient and therapist should consti
tute a barrier to an understanding of the patient's thoughts and
behavior it is difficult to understand. Freud felt that such behav
ior might easily lead to eroticism of some sort and in this way
to complete collapse of the analytic therapy. There have been
some abuses of this kind, but the responsible therapist will
remain responsible. Both client and therapist are presented with
problems throughout the therapeutic experience. One of the
most important of these is the experience of soothing reassur
ance which is integrative, passing into an excited erotic or
sensual experience which may at first appear to be disintegra-
tive. Shame and guilt resolved by self-alienation and turning off
of body-acceptance probably followed developmentally upon
this transition from reassurance to sensual or erotic feelings.
Forer puts its significance for both therapist and client very
well:

Growth and Development 223

This erotic psychosomatic arousal and the fantasies associated
with it are crucial therapeutic raw material, but they are a major
source of the disrepute into which contact has fallen. Such feel
ings have fostered ethical controls lest the therapist lose his
perspective about his responsibilities. Some therapists them
selves may experience erotic feelings and become upset out of
their own unresolved shame and guilt. If they need to defend
themselves against such awareness, they are likely to be rejecting
and confirm their patients' own convictions that words are good
and touch is always erotic or destructive and bad. Both therapist
and client need to learn tolerance for their own excitement and
realize that fantasies need not lead to action. Thus the therapist's
nonerotic touch may break through the client's defenses and
help him to separate and tolerate the two kinds of experiences.

Drs. Arthur Burton and Robert E. Kantor, while agreeing
with the general psychoanalytic viewpoint that with rare excep
tions the patient need not be touched, also conclude that it is
a probably valid generalization that most psychotherapists at
the unconscious level dislike their own bodies. This, together
with legalistic definitions of touching behavior, they feel, make
it extremely difficult to be free and spontaneous in this area of
treatment.

The answer to such a view may perhaps be that such psycho
therapists are not the proper people to treat those who are
psychologically troubled, that nonswimmers should not act as
lifeguards.

While we are on this subject it should be added that in every
branch of the practice of medicine touching should be consid
ered an indispensable part of the doctor's art. As a member of
a family the doctor should know what the human touch is
capable of achieving in soothing ruffled feelings, in assuaging
pain, in relieving distress, in giving reassurance, in making, in
short, all the difference in the world. The world of humanity is
the family writ large, and on a smaller scale the relationship
seen in the family holds true between patient and doctor.

What the patient expects from the doctor is a human touch
and healing effect. Touch always enhances the doctor's thera-

224 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

peutic abilities and the patient's recuperative capabilities. The
laying on of hands has for centuries been well understood in
religious communion. It would be well if it were similarly un
derstood within the healing community.

Interestingly enough the one branch of the healing commu
nity which has recognized the importance of touch is the nurs
ing profession. In the nursing periodicals many valuable articles
have appeared on the therapeutic benefits of touch. First, as
women, and second, being so much closer to the patient than
the doctor, nurses have been in a far better position to appreci
ate the importance of touching in the care of the patient, in
understanding that the care of the patient begins with caring for
the patient.

TOUCH AND ASTHMA. In 1953 1 reported the case of Mrs. C ,

a thirty-year-old Englishwoman, of upper-class background,
divorced and childless, height 5 feet 4 inches, weight 90 pounds,

seen in July 1948, in London. Mrs. C was one of identical

twins. Both had suffered approximately fortnightly episodes of
asthma since they could remember. For the six years prior to

1948 Mrs. C had been in and out of sanitaria for treatment.

Her doctor had then informed her that if she suffered another
attack it might be her last. It was this shocking prognosis that
brought me into the case. In calling upon her at her home in

London, Mrs. C , a pretty young woman, seemed rather

tense but otherwise appeared quite healthy. She greeted her
caller with a cold limp hand, and then folded her forearms over
her chest. She then sat down on a davenport against the back
of which she soon, in a quiet and unobtrusive manner, began
nibbing her back. To the question whether her mother had died
early, she replied that her mother had died at her birth, and in
some astonishment inquired why I had asked that particular
question. I explained that the possibility had occurred to me on
the basis of the following observations: (1) the way she had
limply shaken hands; (2) her folding of her forearms across her
chest; and (3) her rubbing herself against the back of the daven
port. All this had suggested that she might have failed to receive

Growth and Development 225

adequate cutaneous stimulation as an infant; and since this
frequently came about as a result of the early death of the
mother, I had thought of this as one possibility.

The theory of the relationship between tactile stimulation
and the development of the respiratory system was explained,
particular pains being taken to emphasize the fact that this was
merely a theory, and that there was nothing about it that had
yet been proven, but that there existed a certain amount of
evidence which suggested such a relationship, and that if she
desired she might try testing it. It was suggested that she might
attend a physiotherapy clinic in London where, according to
instructions, she would be expertly massaged. To this she read
ily agreed, and several days later, following her first massage,
she was overflowing with enthusiasm. She was then told that
the probabilities were high that if she continued with the mas
sage for some time, she would never experience another asth
matic attack unless, possibly, she underwent some serious emo
tional disturbance. She continued with the treatment for several
months, and during the many years which have since elapsed
she has not suffered a single serious asthmatic episode.

Mrs. C 's sister had experienced identical attacks of

asthma until she married a famous author, whereupon her
attacks declined in frequency although they did not altogether
cease. Subsequently there was a divorce, soon after which she

died during an asthmatic seizure. In the case of Mrs. C her

attacks, for all practical purposes, ceased altogether. She subse
quently remarried and has lived happily ever after.

There may, of course, be little or no relation in this case
between the cessation of the asthma and the cutaneous stimula
tion Mrs. C received. On the other hand, the relation may

be a very direct one. In my original paper I wrote, "This case
has been cited for its suggestive value. It is to be hoped that
those having the adequate opportunities may carry out the
observations necessary to show whether or not persons suffer
ing from asthma and other disorders that may be related to
inadequate cutaneous stimulation in infancy may be relieved by

226 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

a course of cutaneous stimulation given them on the theory
outlined in this paper."

While that paper aroused a certain amount of interest, it does
not appear to have stimulated much research, at least in rela
tion to asthma.

In connection with asthma, it has been noted on an earlier
page that putting one's arm around the shoulders of the sufferer
during an asthmatic attack is likely to alleviate or bring the
attack to a halt.

Sir William Osier once remarked that "Taking a lady's hand
gives her confidence in her physician." And, indeed, taking
almost anyone's hand under conditions of stress is likely to
exert a soothing effect, and by reducing anxiety give both the
taken and the taker a feeling of greater security.

How is it, we may ask, that tactile stimulation, in the form
of caressing, fondling, cuddling, embracing, stroking, and the
like, is capable of working such remarkable effects upon emo
tionally disturbed individuals?

The explanation is quite simple: Tactile stimulation appears
to be a fundamentally necessary experience for the healthy
behavioral development of the individual. Failure to receive
tactile stimulation in infancy results in a critical failure to estab
lish contact relations with others. Supplying that need, even in
adults, may serve to give them the reassurance they need, the
conviction that they are wanted and valued, and thus involved
and included in a connected network of values with others. The
individual who is awkward in his contact relations with others,
is clumsy in his body relations with others, in shaking hands,
in embracing, in kissing, in any, and often all, of his tactile
demonstrations of affection, is so principally because he has
been failed in his interactive body-contact relations with his
mother. His mother has failed him in motherliness, which Gar
ner and Wenar define as maternal gratification of the infant's
needs for body care and pleasurable stimulation in ways that
also provide the mother herself with satisfaction. Not only does
the motherly woman provide her child with gratifications, but
she also derives gratification from doing so, as she provides her

Growth and Development 227

infant with the close physical contact and protection he needs
for growth and development. These investigators show that
psychosomatic disorder tends to develop in individuals who
have lacked the experience of motherliness a hypothesis that
has been many times confirmed. A basic ingredient of "mother
liness" is close physical contact, the hugging, cuddling, caress
ing, embracing, rocking, kissing, and other tactile stimulations
that a motherly mother gives her child.

Restriction or deprivation of the opportunity for tactile and
manipulative experience early in life of the infant is likely to
derange its later tactile and affective behavior. In a rather horri
ble experiment Professor Henry W. Nissen and his colleagues
at the Yerkes Laboratory at Yale University encased the limbs
of a male infant chimpanzee, from the age of four months to
thirty-one months, in cardboard cylinders. When freed, no de
fects in the perception of size, form, and depth were found, but
what was found was that this young chimp, unlike others of its
age, did not cling to the attendant, nor did it groom; further
more "the lip movements and sounds which are part of this
presumably instinctive pattern were completely absent." Such
extreme treatment is never meted out to human infants; never
theless, the findings on this deprived chimpanzee are consonant
with the general finding that any prolonged deprivation of tac
tile experience in infancy is likely to produce inadequacies in
the child's later tactile and affective behavior.

Body contact is a basic mammalian need which must be
satisfied if the individual is to develop those movements, ges
tures, and body-relatednesses which will be normally developed
during the growth of one's experience in relation to one's
mother's body. Deprivation of this experience has been experi
mentally shown to produce the most atypical movements and
postures. On an earlier page we saw how this affects sexual
behavior, contributing to the awkwardness of the socially de
prived male in copulatory behavior. As Mason and others have
shown, in such socially deprived individuals, deficiencies in
social communication are the rule. While the need is there, one
learns to nuzzle, root, cuddle, embrace, kiss, and tenderly and

228 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

lovingly care for others as a consequence of experiencing such
behavior from one's mother. In the absence of such maternal
behaviors the need remains but the performance of the behav
iors associated with it is left more or less crudely unrealized.
Indeed, to a very significant extent, a measure of the individ
ual's development as a healthy human being is the extent to
which he or she is freely able to embrace another and enjoy the
embraces of others ... to get, in a very real sense, into touch
with others.

The tactually failed child grows into an individual who is not
only physically awkward in his relations with others, but who
is also psychologically, behaviorally, awkward with them. Such
persons are likely to be wanting in that tact which the Oxford
English Dictionary defines as the "Ready and delicate sense of
what is fitting and proper in dealing with others, so as to avoid
giving offence, or win good will; skill or judgement in dealing
with men or negotiating difficult or delicate situations; the fac
ulty of saying or doing the right thing at the right time."

In 1793 we find Dugald Stewart, the Scottish philosopher,
writing in his Outlines of Moral Philosophy of "The use made
in the French tongue of the word Tact, to denote that delicate
sense of propriety which enables a man to feel his way in the
difficult intercourse of polished society." Here the word feel
feeling one's way, nicely reflects the initial tactile explorations
with which we begin our first communications with another
human being. On that ground we either develop as tactful
beings or, if we have been failed in the experience of tactuality,
we do not, becoming instead awkward and insensitive to the
needs of others. It is no accident that the awkward and the
insensitive are usually those who have been failed in the need
for love, the earliest and most basic component of which is
touch.

There appears to be a very distinct carryover from tactile
experience in infancy to tactful behavior in later life. It is inter
esting that the word tact, derived from the Latin tactus mean
ing "touch," was not infrequently used in England in place of
the word touch, down to the middle of the nineteenth century.

Growth and Development 229

Tact, in its modern sense, was adopted from the French early
in the nineteenth century. What the word really means is
clearly "to delicately touch" the other. Both the etymological
and the psychological relationship of tact, in its contemporary
meaning, "to touch," have not altogether escaped attention, for
we will say of a tactless man that he has a heavy touch. What
is so interestingly inherent in the use of the word tact in its
modern sense is the uncannily clear understanding of the im
portance of early tactile experience in the development of that
delicate sense of fitting and proper behavior implied by the
word.

ADAPTIVITY AND REACTIVITY OF THE SKIN. Among the re
markable capacities of the skin is its ability to develop increased
acuity and to compensate for deficiencies in other sensory sys
tems. Thus, Zubek, Flye, and Aftenas found that in sixteen
hooded students confined to a room in complete darkness for
one week there was a marked increase in cutaneous sensitivity
as well as in sensitivity to pain. In the blind there is considerable
variability in the development of cutaneous sensitivity, some
individuals showing increases, others showing decreases. It is a
matter worthy of further investigation.

Not only will the skin react to every kind of stimulus with
the most appropriate physical changes, but it will also do so
behaviorally, for the skin is capable of behaving in very percep
tible ways. The reference here is to stimuli originating at the
skin surface. The skin is not merely a complex cellular struc
ture, it is an equally complex chemical one; moreover, the
substances present on its surface play an important role in the
defense system of the body. For example, contact of human
plasma or whole blood with the skin accelerates clotting time.
If the skin is washed with alcohol the clotting time is prolonged.

Reactivity of the skin to stimuli originating at the skin sur
face can only occur after mediation of the originating sensory
stimuli through the nervous system. It begins to appear that
whatever changes are capable of being produced in the skin by
stimuli originating in the mind, are also capable of being pro-

230 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

duced in the skin by changes originating at the level of the skin.
Such, for example, are the skin disorders resulting from inade
quate tactile stimulation. Clearly, sensory stimuli at the skin
level have to be interpreted at the cortical level and the appro
priate motor reactions initiated. The skin itself does not think,
but its sensitivity is so great, combined with its ability to pick
up and transmit so extraordinarily wide a variety of signals, and
make so wide a range of responses, exceeding that of all other
sense organs, that for versatility it must be ranked second only
to the brain itself. This should not be surprising, for as we have
seen (pp. 2-3), the skin in fact represents the external nervous
system of the organism. The sensitivity of the skin can, how
ever, be considerably impaired by the failure to receive the
tactile stimuli necessary for its proper development. In this
respect, such influences as family, class, and culture play a
fundamental role.

SEVEN

CULTURE AND CONTACT

Each culture fosters or specifically trains its young
as children and as adolescents to develop different
kinds of thresholds to tactile contacts and stimula
tion so that their organic, constitutional, tempera
mental characteristics are accentuated or reduced.

LAWRENCE K. FRANK, "Tactile

Communication," Genetic Psychology Monographs,

vol. 56 (1957), p. 241.

The existence of a wide range of class and cultural differences
in attitudes and practices relating to tactile behavior affords a
fertile field for the investigation of the relation of such social
differences in tactile experience to the development of personal
ity, and to some extent to cultural and national traits. In gen
eral, while the culture prescribes the customary socializing ex
periences to which the infant and child shall be exposed,
idiosyncratic differences within particular families may sub
stantially depart from the prescribed modes of behavior, with
more or less significant consequences for the individuals in
volved.

There are families in which a great deal of tactile contact
occurs, not only between mother and child but also between all
the members of the family. There are other families, within the
same culture, in which there is a minimal amount of tactile

232 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

contact between mother and child and all the other members
of the family. There are whole cultures that are characterized
by a "Noli me tangere, " a "Do not touch me," way of life. There
are other cultures in which tactility is so much a part of life,
in which there is so much embracing and fondling and kissing
it appears strange and embarrassing to the nontactile peoples.
And there are cultures that play every possible variation upon
the theme of tactility. In this chapter the attempt will be made
to inquire into cultural and individual (familial) differences in
attitudes towards tactile contact, the practices to which these
attitudes lead and the manner in which they express themselves
both in the individual and in his culture.

EXTEROGESTATION AND TACTILITY. Exterogestation consti-
tutes the continuation of the uterogestative process in the envi
ronment outside the womb. The exterogestative process is de
signed to continue the feedback relationships between infant
and mother, to continue the development of both, but especially
of the infant for its increasingly complicated postnatal function
ing in an atmospheric world bounded and unbounded by all
sorts of experiences of space. The latter is an important aspect
of the organism's experience which has received insufficient
recognition.

Within the womb the fetus is enclosed and intimately
bounded by the supporting embracing walls of the uterus. This
is a comforting and reassuring experience. But with birth the
infant experiences a more or less open-ended environment; he
must learn to grow accustomed to the very least variations of
his environment. To the last day of his postnatal life the most
fearful and emotionally most disturbing experience that can
befall the individual is the sudden withdrawal of support. The
only instinct-like reaction remaining in humans, other than the
reaction to a sudden loud noise, is the reaction to a sudden
withdrawal of support. The uterogestate fetus, embraced, sup
ported, and rocked within his amniotic environment, as an
exterogestate requires the continued support of his mother, to
be held and rocked in her arms, and in close contact with her
body, swallowing colostrum and milk in place of amniotic fluid.

Culture and Contact 233

He needs to be enclosed in his mother's arms, embraced, in
contact with her warm skin, for among other things the new
born is most sensitive to temperature changes, and one of the
dangers to which he is often exposed in hospitals is a chilling
ambient room temperature, especially in air-conditioned deliv
ery rooms. The professional mode of dealing with this is to
place the baby in a heated bassinet a most inadequate substi
tute for the warm ambience of the mother's embracing, sup
portive body.

The boundaries of the uterogestate's world are the walls of
the uterus. It is necessary to understand that the neonate is
most comfortable when the conditions within the womb are
reproduced as closely as possible in the exterogestational state,
that is, when the baby is enfolded in his mother's arms at her
bosom. The infant needs to learn, on the firm foundation of
closeness, what closeness, proximity, distance, and openness
mean. In short, he has to learn the meaning, and the manner,
of accommodating himself to a great variety and complexity of
spatial relationships all of which are closely bound up with his
experiences of tactility, principally in relation to his mother's
body.

To remove the newborn baby from its mother and place it on
its back or its front on a flat surface, often uncovered, is to fail
to understand the newborn's great need for enfoldment, to be
supported, rocked, and covered from all sides, and that the
infant may only gradually be introduced to the world of more
open spaces. From the supporting, continuous, tangible pres
ence of his mother the infant will gradually come to move some
distance toward the outside world. One sees this particularly
vividly in older infant mammals, and especially in juvenile
monkeys and apes, who from tentative proximate separation
from the mother gradually increase the distance until they can
achieve an independence more or less complete physically, and
to some extent emotionally.

TRAUMAS AT SKIN LEVEL. We must ask ourselves here
whether, in removing the newborn from his mother, as is cus
tomary in hospitals, and placing him in the open space of a

234 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

bassinet or crib, we are not visiting a seriously disturbing
trauma upon the baby, a trauma from which, perhaps, he never
completely recovers? A trauma, moreover, which in the civi
lized world of the West, and those cultures that have been
affected by the West's childbirth practices, is repeatedly in
flicted upon the infant during the early years of his life. It may
be that fear of open spaces (agoraphobia) or of heights (acro
phobia), or of sudden drops, may have some connection with
such early experiences. It may also be that a preference for
having one's bedclothes about one's body rather than tucked in
at the foot and sides of the bed reflects a desire to recreate the
conditions enjoyed in the womb, in reaction to the lack of body
support experienced in infancy. There are those who like to
sleep with their bedroom doors closed; there are others who
cannot abide a closed bedroom door. As one might expect,
those who like their bedclothes snugly embracing them also
tend to prefer their bedroom doors closed, whereas the more
loosely tucked-in-around-the-edges-of-the-bed types prefer
their bedroom doors open. What the range of variability is in
these matters I do not know. There is a suggestion here for some
interesting inquiries in which a good many other variables, such
as breastfeeding, maternal affection, deprivations of various
sorts, hospital deliveries or home births, and the like are consid
ered.

It is during the exterogestative period that the infant is first
and continuously exposed to the culturalizing effects of his
society. And from the moment of birth every society has
evolved its own unique ways of dealing with the child. It is on
the basis of repeated sensory experiences of the culturally pre
scribed stimulations that the child learns how to behave accord
ing to the requirements of his culture. And it is because of the
differences in the kinds and modalities of the individual's tactile
experiences within the family, especially in relation to his or her
mother, as determined for the most part by particular cultures
or segments thereof, that individuals and peoples will differ
behaviorally in many fundamental ways from one another.

It should be evident why, during the exterogestative period,

Culture and Contact 235

the kind of tactile experience the infant undergoes will exert so
fundamental an effect upon his development. The explanation
is very simple: It is because a fundamental part of his learning
is done during this period through his experiences at the level
of the skin. The exterogestative period constitutes a develop
mental period during which the quality of communication ex
perienced through the skin is critical. It is critical because upon
the quality of the tactile communication experienced during
that period will depend the kind of psychomotor, the sort of
emotional response, the infant learns to make to others. This
sort of emotional response will become a fixed and permanent
part of his personality, upon which he will subsequently build
many learned secondary responses. In view of the fact that the
exterogestative tactile learning period has not been adequately
recognized as a critical period in the development of every
organism, and especially in the human species, we shall have to
consider giving children more tactile attention than they have
hitherto received.

CULTURE AND TACTILITY. The differences in the quality, fre
quency, and timing of the tactile experience that the newborn,
infant, child, adolescent, and adult undergoes in different cul
tures run the whole gamut of possible variations. We have
.already touched upon such differences in several cultures in
Chapter Four (pp. 116-119). Here we shall discuss cultural
differences in early tactile experience and their relation to per
sonality and to behavior. We can commence with the evidence
from nonliterate societies, and then proceed to the discussion
of the technologically more advanced societies.

THE NETSILIK ESKIMO. The Netsilik Eskimo live on the
Boothia Peninsula in the Canadian Arctic of the Northwest
Territories. There they have been studied with particular in
sight by Richard James de Boer, who lived in a snowhouse
among them during the winter of 1966-1967. Maternal-infant
caretaking relationships were the focus of Mr. de Boer's inter
est. The Netsilik mother, even though she lives under the most

236 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

difficult of conditions, is an unruffled personality who bestows
warmth and loving care upon her children. She never chides her
infant or interferes with it in any way, except to respond to its
needs. De Boer writes:

At parturition and the onset of exterogestation, the Netsilik
infant is placed in the back of its mother's attiggi (fur parka) in
such a position that its ventral torso is pressed firmly against its
mother's back just below the shoulder blades. The infant as
sumes a sitting posture with its tiny legs around its mother's
waist or slightly above and with its head flexed right or left
which usually elicits the tonic neck reflex that facilitates the
straddling placement of the legs as extensor tonus decreases in
either of these limbs. When the infant is in the proper position,
the mother ties a sash around the attiggi exterior, across her
chest above the breasts and down under the axillae, and where
it passes across her back it forms a sling that supports her infant
under its buttocks and prevents it from slipping down and out
of the garment. The infant wears tiny diapers fashioned from
caribou skins, but otherwise it snuggles naked against its
mother's skin. Most of the infant's ventral anatomy is in a close
tactile and cutaneous contact with its mother and its dorsal body
is completely encased in fur, protecting it from the fierce Arctic
cold. From outward appearances, the Netsilik mother bearing
her infant in this traditional manner presents the appearance of
a congenital hunchback, but her awkward appearance is more
apparent than real, since her infant's weight is distributed in
close proximity to her intrinsic center of gravity. The Netsilik
infant is carried about in this fashion until it achieves locomotor
ability and thence intermittently until it acquires what the Net
silik Eskimo calls "ihuma" or cognitive sense.

Netsilik mother and child communicate with each other
through their skins. When hungry the Netsilik infant roots and
sucks on the skin of its mother's back, alerting her to its need.
Then it is brought round to the breast and suckled. Activity
needs are satisfied by the various motions to which the infant
is subjected in the postural and locomotory and other move
ments of the mother as she pursues her daily tasks. The rocking
movements and contact with the mother's skin promote the

Culture and Contact 237

sleep the infant so much enjoys. Bowel and bladder elimination
occur on the mother's back. The mother's removal of these
eliminations serves to prevent any continuing discomfort to the
infant. Since the mother anticipates most of the infant's needs
with all those sustaining nurturance responses designed to meet
his needs, the Netsilik infant seldom cries. The infant's needs
are anticipated by the mother tactually.

The Netsilik mother's care of her infant beautifully meets the
requirements of its phylogenetically programed needs; the in
fant's responses are invariably pleasant. This invariability of
pleasurable response, de Boer suggests, is the key to the Netsilik
Eskimo's stress-coping ability.

The Netsilik Eskimo [writes de Boer] is seldom if ever assaulted
by aversive and stress-producing interpersonal stimuli, but he is
constantly threatened with the uncertainties of his eco-system.
Ecologically stressful situations never upset his emotional ho-
meostasis and he confronts a raging polar bear with the same
coolness and equanimity that he exhibits when faced with the
threat of food deprivation. The invariability of the homeostatic
emotional response does not imply that these responses are
stereotypic; on the contrary, homeostasis implies a dynamic life
force, but a force that functions below the threshold of disorgani
zation. Evolutionarily, this homeostatic equilibrium has offered
the greatest selective advantages to the individual and his group
in the struggle for survival.

By the time he or she is three years of age the Netsilik child
has acquired "the only two motivational characteristics neces
sary to his functioning as a self-regulated human being,"
namely, pleasant or altruistic responses to interpersonal rela
tionships, and the power of symbolic manipulative ability. Be
cause dominance-subservience relationships are absent in par
ental and especially maternal-infant relations a harmonic
balance is achieved between the Netsilik individual and his
society, with the individual in this manner gratifying his needs
for mutually altruistic interpersonal relationships.

It is, of course, not possible to say with certainty that the
altruistic behavior of the Netsilik individual is largely the prod-

238 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

uct of his experiences in infancy, and especially of those he
undergoes in relation to his mother's body; these experiences
are later reinforced by the behavior of almost everyone else in
his small world. The evidence, however, is strongly suggestive
that it is the early experiences that are the most influential.

The Netsilik infant may defecate and urinate upon his
mother's back without causing any disturbance other than the
mother's cleaning of both the infant and herself. Such relaxed
behavior undoubtedly exerts significantly relaxing effects upon
the child's responses to its excretory activities. Such a child
would never become an anal-erotic who hoards his feces or
grow to become a niggardly adult. The openness and generosity
of the Eskimo character is, no doubt, in part at least, due to the
unuptightness of his early toilet experiences.

The motions of his mother during her daily activities give the
Eskimo child a view of the world from virtually every possible
angle, a view from which its spatial skills will grow and be
reinforced by its subsequent experiences. The extraordinary
spatial faculties of the Eskimo, and probably also their remark
able mechanical abilities, may be closely related to these early
experiences upon the mother's back. Edmund Carpenter has
provided a fascinating account of the remarkable spatial and
mechanical abilities of the Aivilik Eskimo of Southampton Is
land in the northwest boundary of Hudson Bay.

"Aivilik men are first-class mechanics," writes Carpenter.
"They delight in stripping down and reassembling engines,
watches, all machinery. I have watched them repair instru
ments which American mechanics, flown into the Arctic for
this purpose, have abandoned in despair. Working with the
simplest tools, often handmade, they make replacements of
metal and ivory. Towtoongie [an Eskimo friend] made a hinge
for me. I had to hold it directly before my eyes to see how it
worked." And so on.

Carpenter thinks that the explanation for this phenomenal
ability lies in the over-all picture of Aivilik time-space orienta
tion, in that the Aivilik do not conceptually separate space and
time, but see a situation as a dynamic process; furthermore,

Culture and Contact 239

they are acutely observant of details. Moreover, they view space
not as a static enclosure but as a direction in operation. For
example, when handed a copy of an illustrated magazine they
will not turn it right side up, indeed they are highly amused
when the white man does so, but will look at the pictures
whether they are upside down or horizontal, and see them as
if they were right side up!

Whether or not these abilities are related to the tactile, spa
tial-visual experiences on the maternal back, must, again of
course, remain a matter for further research specifically aimed
in that direction. It would seem not unlikely. The infant's eye-
view from all positions as the mother moves about would sug
gest the development of a rather special kind of spatial ability.
As Carpenter puts it, "Space fluctuates in continuous activity.
. . . The visual experience becomes a dynamic experience. Thus
Aivilik artists do not confine themselves to the reproduction of
what can actually be seen in a given moment from a single
vantage point, but they twist and tilt the various possible visual
aspects until they fully explain the object they wish to repre
sent." The twisting and tilting may very well reflect something
of the twistings and turnings the infant experienced while being
carried on the mother's back.

"In most myths," writes Carpenter, "there is an alternative
shrinking and growing of men and spirits in their mutual rela
tions. Nothing has a static, invariable shape or size. Men, spir
its, animals, have unstable, ever-changing dimensions." Again,
a view of the world very reminiscent of the kinds of visual
experiences the infant undergoes from his dorsal elevated view
point, experiences of adults whom he can see face to face, as
well as children, animals, and other things that, from his high
perch in his parka, are small and difficult to see, but suddenly
change in size when mother bends, or kneels, or assumes a
horizontal position.

From his early orientations to the spatial dimensions of the
world the child relies virtually entirely upon his sense of touch,
and by this most primitive of all sensory agencies, by thigmotro-
pism (from the Greek thigma, "touch," and trope, "turn," that

240 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

is, by responding to contact or touch), it learns to find its way
about in the world of the environment its mother provides for.
The child's first space is tactile. Initially it is passively tactile,
experiencing tactile sensations that are gradually converted into
perceptions, that is, sensations endowed with meanings. With
these meanings the child then actively begins to scan the world
for itself. James Gibson, who has made these distinctions be
tween passive and active touch, in an experiment designed to
judge the accuracy of the information received by each form of
touch, found that active touch enabled subjects to reproduce
abstract objects that were screened from view with 95 percent
accuracy. Only a 49 percent accuracy was achieved with passive
touch.

Active touch is stereognostic, that is, it enables one to under
stand the form and nature of objects. This ability is gradually
developed in relation to the mother's body, the taking of the
nipple into the mouth, and the pressure of the lips and jaws on
the areola,* the hand resting on the breast, the infant's own lips,
nose, eyes, genitals, hands, feet, and other parts of its body.
Each of these has its own special characteristics and gradually
comes to be recognized through active touch. In its mother's
parka the Eskimo child, in addition to receiving communica
tions from her body and body motions, will at first receive also
a great many signals from her of an auditory nature, and it will
come to associate these with each other. Hence vocal sounds
will come to have a soothing tactile quality about them, a
repetitive lulling character. One perceives this reflected very
clearly in much of the poetry of the Eskimo. Consider such a
poem as the following: a dance song, typical of those composed
by Eskimos generally, but in this case the creation of a Copper
Eskimo of Victoria Island, south of the North Magnetic Pole.

*In breastfeeding milk is obtained not by sucking the nipple, but by pres
sure on the areola and suction through the nipple created by the "oral pump"
that the infant's lips, suctorial pads, tongue, and other structures within the
mouth constitute. "Sucking'* is to be distinguished from "suckling." Babies
"suck" at rubber tires at the end of bottles, but "suckle" at the breast.

Culture and Contact 241

DANCE SONG

/ am quite unable

To capture seals as they do, I am quite unable.

Animals with blubber since I do not know how to capture,

To capture seals as they do I am quite unable.

I am quite unable

To shoot as they do, I am quite unable.

I am quite unable,

A fine kayak such as they have I am quite unable to obtain.

Animals that have fawns since I cannot obtain them,

A fine kayak such as they have I am quite unable to obtain.

I am quite unable

To capture fish as they do, I am quite unable.

I am quite unable

To dance as they do, I am quite unable.

Dance songs since I do not know them at all,

To dance as they do I am quite unable.

I am quite unable to be swift-footed as they are,

I am quite unable . . .

This song in its rhythm and metre, as well as its phrasing,
repeats something similar to what a child would experience
while being carried in a sling on its mother's back. It remains
a fascinating and unexplained fact that in many parts of the
world children who were probably never carried in this way
compose chants or songs in similar metres and rhythms and
phrases. Nevertheless, as we have seen in relation to music, it
is a speculation worthy of further inquiry whether there may
be a connection between the rhythms and metres of the Es
kimos' songs and poetry and their experiences of motion on
their mothers' backs.

Song-making is highly valued among all Eskimos, and it is
the custom to improvise songs for almost every occasion. What
can be more humanly beautiful than this song, improvised by
Takomaq, an old Iglulik Eskimo woman living on the Melville
Peninsula, east of the Netsilik Eskimo? The old lady was about
to serve a meal she had prepared for Knud Rasmussen and his
companion, when Rasmussen presented her with some tea. This

242 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

touched her so deeply that she at once joyfully improvised the
following song:

Ajaja aja -jaja. All is more beautiful

The lands around my dwelling All is more beautiful,

Are more beautiful And life is thankfulness.

From the day These guests of mine

When it is given me to see Make my house grand,

Faces I have never seen before. Ajaja aja jaja.

These likable people show their friendliness towards those
they have never seen before not strangers, but visitors or
guests by touching and stroking them. Stefansson tells how he
and his party were welcomed by the Copper Eskimo in 1913.
"Our welcome was as warm and friendly as it could possibly
be, and nearly that noisy. Little children jumped up so as to be
able to touch our shoulders and men and women stroked and
handled us in a very friendly way."

In their snowhouses, where the temperature is often in the
vicinity of 100 degrees, and only slightly less at night, Eskimos
usually sleep in the nude in close body contact with one an
other. A man will customarily lend his wife for the night, as an
act of courtesy, to the male visitor. The mixture of body odors,
burning blubber-oil, and other odors, which white men some
times find unendurable, is far from unappealing to the Eskimo,
whose acute sense of smell has been remarked upon by more
than one observer. This trait, too, is perhaps not unrelated to
the experiences of the infant in his mother's parka.

Following and in relation to tactility, the sense which is next
elaborated is not vision but hearing. The mother hums and
sings to the child, while she pats and hugs him, and holds him
close to her body in her parka, and in time he learns to identify
and respond to her voice as a surrogate for her touch. It is a
reflexive form of conditioning, in which the sign of the original
stimulus, the voice, replaces the touch, but the voice always
retains its tactile quality, soothing, caressing, reassuring. It
stands for the presence of the loving mother, whose love the
infant initially knows primarily through the warmth and sup-

Culture and Contact 243

port, and yieldingness, and softness of her skin, and who at
tends to the infant's needs by actively as well as passively stimu
lating its skin, in carrying, cleaning, and washing it.

Eskimos are not given overmuch to washing, since water is
scarce and ice is melted into water only at the great expense of
burning the difficult-to-come-by blubber. Urine will sometimes
be used as a substitute. Among the far northern Ingalik, who
are a Northern Athapaskan group who speak both Ingalik and
Eskimo, following the initial bath which a baby receives soon
after birth, the mother licks the face and hands of the baby with
her tongue every morning to clean them, until the baby is old
enough to sit upon the bench. Though I have found no reference
to this practice among Eskimos proper it is possible that it
occurs.

Visual perception almost certainly follows upon the develop
ment of auditory perception among the Eskimo. Carpenter
confirms this in observing of the Aivilik Eskimo that

they define space more by sound than by sight. Where we might
say, "Let's see what we can hear," they would say, "Let's hear
what we can see." ... To them, the ocularly visible apparition
is not nearly as important as the purely auditory one. The essen
tial feature of sound is not its location, but that it be, that it fill
space. We say "the night shall be filled with music," just as the
air is filled with fragrance; locality is irrelevant. The concert-goer
closes his eyes.

I know of no example of an Aivilik describing space primarily
in visual terms. They don't regard space as static, and therefore
measurable; hence they have no formal units of spatial measure
ment, just as they have no uniform divisions of time. The carver
is indifferent to the demands of the optical eye; he lets each piece
fill its own space, create its own world, without reference to
background or anything external to it. Each carving lives in
spatial independence. Size and shape, proportions and selection,
these are set by the object itself, not forced from without. Like
sound, each carving creates its own space, its own identity; it
imposes its own assumptions.

244 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

It is perhaps not unreasonable to suppose that this auditory
view of reality is related to the Aivilik child's much earlier and
longer continued conditioning in vocal than in visual experi
ence. This conditioning is, of course, perpetuated through its
oral traditional training.

THE KAINGANG OF BRAZIL. The Kaingang tribe of the high
lands of Brazil are a splendidly tactile people. Jules Henry, who
has written the classical account of them, speaks of the children
who "lie like cats absorbing the delicious stroking of adults."
Children receive an enormous amount of attention from adults,
and can always depend upon someone to caress and cuddle
them. When the children grow up, young men love to sleep
together, not as homosexuals, but simply for the sheer pleasure
of tactile contact. "Married and unmarried young men lie cheek
by jowl, arms around one another, legs slung across bodies, for
all the world like lovers in our own society. Sometimes they lie
caressing that way in little knots of three and four. Women
never do these things." Never do the men make an overt sexual
gesture at one another. "The basis," writes Henry, "for man's
loyalty to man has roots in the many warm bodily contacts
between them. . . . The relationships built on these hours of
lying together with anyone at all bear fruit in the softening of
conflicts that are so characteristic of the Kaingang." Violent
conflict occurs only between men who have never shared such
caresses.

Little boys and girls play together in rough and tumble.
Brothers and sisters, brothers- and sisters-in-law, and cousins,
sleep side by side, cross legs, or embrace. The corollaries to this
are that marriages and love affairs may take place among all
classes of relatives, with the exception of parents and full broth
ers and sisters. There is also a complete lack of emphasis on
temperamental differences between the sexes, with consequent
lack of inhibition on the part of women.

THE TASADAY OF MINDANAO. In July 1971 the world was
startled by the announcement of the discovery of a people so

Culture and Contact 245

primitive, that up to their encounter with a member of another
tribe who taught them to trap, they were exclusively foodgath-
erers. This people, consisting of fourteen children and thirteen
adults, are the Tasaday of Southern Mindanao in the Philip
pines. Everyone who meets them is immediately impressed by
their sensitivity, gentleness, and loving nature. Peggy Durdin,
who spent some days with them, writes of them with enthusi
asm: "Babies are in constant bodily contact with their parents."
And she adds,

Among the most quickly discernible and attractive Tasaday
traits are their capacity for affection (and relaxed expression of
it) and their sense of humor. Adults and children do not seem
afraid of being openly loving. Twelve or 15 onlookers did not
prevent Balayem from hugging Sindi [his wife] close to him.
Lobo, a strikingly beautiful and intelligent boy of 10 or 12, and
Balayem, whose extrovert manner contrasts with a mobile, sensi
tive face, unaffectedly throw their arms around Manda [an
thropologist Manuel Elizalde], nuzzle up to him, rub their
cheeks against his and sit very quietly next to him for extended
periods with an arm around his shoulders. . . . The Tasaday live
this partly communal life in very close quarters year after year,
as their ancestors told them to do, with remarkable harmony. I
found no one who had heard them exchange harsh words or even
speak sharply to the young. In the face of something displeas
ing, they seem to use the tactic of evasion: They simply walk
away.

In some societies, as among the Mundurucu Indians of Bra
zil, men and women do not touch except as a tentative invita
tion to sex.

Tactile qualities are frequently recognized in traits or modali
ties not directly associated with touch. The tactile quality of
sound of certain kinds, for example, is described as "silky,"
"smooth," "soft," "abrasive," "coarse," and the like. Some
writers pride themselves on an almost tactile knowledge of their
craft, as if they were more artisans than writers Flaubert and
Kipling were such. Painting is a medium in which tactility has
almost constituted an essential part of the artist's communica-

246 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

tion. One thinks especially of the works of Van Gogh, Segon-
zac, the Impressionists generally, and many others.

TOUCH AND SOUND. It has sometimes been remarked, perhaps
more as a metaphor than anything else, that sound has a tactile
quality. There exists, however, a far deeper relationship be
tween touch and sound than most of us are aware. The versatil
ity of the skin is such that it is capable of responding to sound
waves just as it is to those of pressure. A. S. Mirkin, of the
Pavlov Institute of Physiology at Leningrad, has shown that the
sensory receptors for pressure (deep touch), which are present
around muscles, joints, ligaments, and tendons, the Pacinian
corpuscles, possess very definite resonance properties. Mirkin
subjected Pacinian corpuscles, in mesenteric tissue adjacent to
the intestines, to acoustic stimulation in a uniform acoustic
field, and found that these receptors possess resonance proper
ties, and that a conditioned connection is obtainable between an
optimal frequency of stimulation and periods of bioelectric ac
tivity, thus strongly suggesting a biomechanical resonance in
Pacinian corpuscles.

Madsen and Mears, using deaf subjects, found that sound
vibrations have a significant effect upon the tactile threshold,
that a 50 cycles per second tone at both high and low pressure
desensitizes the skin and raises the threshold, while a 5,000
cycles per second tone at both high and low pressure levels
sensitized the skin.

Gescheider has shown that the skin is able to localize sound
waves of different intensities with remarkable accuracy.

Which suggests all sorts of possibilities.

TOUCH AND PAINTING. In the 1890's Bernard Berenson, im
proving upon a notion of Goethe's that a work of art must be
"life-enhancing," suggested that one way of achieving this is by
the artist making us imagine that we are enjoying genuine
physical feelings when we look at a painting or sculpture. Such
feelings Berenson called ideated sensations. Ideated sensations
exist only in the imagination and are produced by the work of
art by making us realize its being and live its life. The most

Culture and Contact 247

important of the ideated sensations Berenson called tactile val
ues. The work of genuine art stimulates our ideated sensations
of touch, and such stimulation is life-enhancing. Form, not to
be confused with shape, represents that radiance from within
when it realizes itself completely. Form is the life-enhancing
aspect of visible things, and form is but another word for tactile
values. "Through all the ages," writes Berenson, "and in every
place, whenever a visual representation is recognized as a work
of art and not as a mere artifact, no matter how elaborate,
smart, and startling, it has tactile values. It may have much
besides, which is of more or less importance or none at all, but
to be accepted as a work of art these other attractions must rest
on a basis of tactile values, or be in close connection with
them."

The artist, in creating a work of art unconsciously for the
most part, sometimes consciously imagines all the sensations
felt or which he supposes to be felt by whatever he is attempting
to organize and harmonize into an equivalent of what he feels
it to be intrinsically, and what at the same time it says and
means to us. I can think of no better illustration and corrobora-
tion of Berenson's view than Van Gogh's painting of a straw-
seated kitchen chair. The tactile values of that painting make
that chair so real that the chair itself would look almost unreal
by comparison. The writer, as Berenson points out, will do the
same thing with words, as will the artist in virtually every other
medium.

In some painters tactility is so prominent it almost reaches
out and touches one. John Constable is an outstanding example
of such a painter. As Robert Hughes has written of him, "His
childhood was substance rather than fantasy: tactile memories
of mold, mud, woodgrain and brick became some of the most
"painterly" painting in the history of art. The foreground of
The Leaping Horse is all matter, and the things in it squidgy
earth, tangled weeds and wild flowers, prickle of light on the
dark skin of water sliding over a hidden ledge are troweled
and spattered on with ecstatic gusto. This is the landscape of
touch."

248 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

Marshall McLuhan speaks of TV as essentially tactile, and
he and Parker very cogently remark that "the social, the politi
cal and the artistic implications of tactility could only have been
lost to human awareness in a visual or civilized culture which
is now dissolving under the impact of electric circuitry." These
notions have a very real foundation, well understood by the
eminent anthropologist, Alfred Kroeber. In a letter to Meyer
Schapiro, the art critic, Kroeber wrote with reference to Beren-
son's "tactile values" in painting, that

these can appeal only through the eye, and never actually to the
sense of touch, nevertheless they refer to something that under
lies the vision which is at the center of visual art: namely, that
feeling by touching precedes sight, phylogenetically and on-
togenetically in every human baby. We all touch first, learn to
see later, and in learning erect a nearby visual world on a tactile
base, giving a double quality to all perceptions of objects, first
within immediate reach, and later within ultimate or potential
reach. All children, and many adults, want to handle a new
sight. The two senses of course are disparate: they operate
through different sense receptors. But what is seen and touched
is always made part of ourselves more intensely and more mean
ingfully than what is only seen. And so in art representation the
representative picture we only see but cannot, in imagination,
touch, does not carry the same attraction and concentration of
interest as the one we can, imaginatively, handle and touch as
well as see clearly.

To this Kroeber added orally, "that perhaps abstractionism of
whatever era has a more intellectual, a lesser appeal, the sub
conscious tactile aspects having been withdrawn and aban
doned."

The tactile quality of vision is apparent in the touching of
another with the eyes. Hence one avoids looking or staring at
strangers, except in certain conventionally accepted situations.
It is of great interest to observe here that under natural condi
tions gorillas avoid looking directly at a stranger, and especially
regard a direct look, until friendly relations have been estab
lished, with suspicion. This is also true of baboons, and of many
other monkeys.

Culture and Contact 249

As Ernest Schachtel has pointed out, the distance senses,
sight and hearing, both phylogenetically and ontogenetically
attain their full development later than the proximity senses,
touch, taste, and smell. And, as he rightly states, the proximity
senses are neglected and to a considerable extent even tabooed
by Western civilization. He adds, "Both pleasure and disgust
are more intimately linked with the proximity senses than with
the distance senses. The pleasure which a perfume, a taste, or
a texture can give is much more of a bodily, physical one, hence
more akin to sexual pleasure, than is the more sublime pleasure
aroused by sound and the least bodily of all pleasures, the
beautiful."

In the daily lives of animals the proximity senses play an
important role. In man, if they are not repressed in sexual
relations, then they are otherwise tabooed in interpersonal rela
tions, "the more a culture or a group tends to isolate people,
to put distance between them, and to prevent spontaneous rela
tionships and the 'natural' animal-like expressions of such rela
tions."

Marcuse remarks that civilization demands the repression of
the pleasures to be derived from the proximity senses in order
to ensure the desexualization "of the organism required by its
social utilization as an instrument of labor."

Perhaps it would be more accurate to say that the taboos on
interpersonal tactuality grew out of a fear closely associated
with the Christian tradition in its various denominations, the
fear of bodily pleasures. Two of the great negative achievements
of Christianity have been to make a sin of tactual pleasures, and
by the repression of sex to make it an obsession.

ORDER OF SENSORY DEVELOPMENT. The senses of Homo sapi
ens develop in a definite sequence, as (1) tactile, (2) auditory,
and (3) visual. As the child approaches adolescence the order
of precedence becomes reversed, as (1) visual, (2) auditory, and
(3) tactile. It is much more important to experience tactile and
auditory stimulations in the early developing years than it is to
experience visual ones. As soon, however, as one has developed
through one's tactile and auditory senses the know-how of

250 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

being human, vision becomes by far the most important of the
senses. Yet a vision can only become meaningful on the basis
of what it has felt and what it has heard.

It has long been believed that touch educates vision, that as
Bishop Berkeley suggested in the eighteenth century, the infant
discovers size, shape, location, and distinctiveness, by touching.
Experiments conducted in recent years require some modifica
tion of this view. It has been found, for example, that children
have far more difficulty discriminating objects they have
touched but not seen, than they do objects that they have seen
but not touched. It is now quite clear that vision is well devel
oped at birth, and that the human infant has good depth percep
tion before he has had any opportunity to learn it in any way.

Bower, by an ingenious series of experiments, has shown that
by the end of the second week of life an infant expects a seen
object to have tactile properties. He concludes from his experi
ments that in humans there is a primitive unity of the senses,
with visual experience specifying tactile qualities, and that this
primitive unity is built into the structure of the human nervous
system.

As one would expect, younger infants protest tactual separa
tion from the mother more than do older infants. The older
infant tends to make more frequent contact and to manipulate
more objects than the younger. It is this tactual-manipulative
character of his perceptual exploration that sets the more ac
tively adept older child apart from the younger infant.

Older children inspect objects manually more thoroughly
than do younger ones. The three- or four-year-old explores an
object with fixed static movements, in contrast to the older
child's active exploration of the object and its contour.

Zaporozhets, in a study of preschool children, had one group
of children manipulate several irregular geometric forms by
inserting them into a formboard. Children in a second group
inspected the forms visually but never touched them, while
those in a third group only manipulated them tactually. When
the children were required to discriminate geometric from a
group of unfamiliar forms, it was found that those who had

Culture and Contact 251

both visually and tactually manipulated the original forms
made less than half the errors made by the two other groups.
The children in the first group, as they grew older, appeared not
to need to manipulate the forms to do well on the task, whereas
the children who only touched the forms continued to do
poorly; the children, however, who only saw the forms became
progressively more accurate with age. For older children, it
would seem, physical contact with an object is unnecessary for
making a perceptual discrimination; seeing it is sufficient.

Dr. Irvin Rock and Charles S. Harris found, in adult sub
jects, that when the sense of touch conveyed information that
disagreed with what they were seeing, the visual sense predomi
nated and determined the meaning they gave to their sensa
tions.

In adults how dependent our knowledge of the external
world is upon the sense of touch is dramatically illustrated by
the case of the young Englishwoman Sheila Hocken. Sheila
lived nearly thirty years from birth as a blind person. After she
recovered her sight, she had to learn what everything was. As
she explained, "The eye picks up a visual picture, but translates
it and sends impulses to the brain. And I am afraid that my
brain did not know what to do with them. So everything I saw
I had to touch." Information about things that could not be
obtained by touch she would either smell or taste. Individuals
who have become blind after having led a sighted life also
become, as is well known, dependent upon touch for the recog
nition of objects in the external world.

THE GANDA OF EAST AFRICA. Dr. Mary Ainsworth has made
a detailed study of rearing practices in infancy among the
Ganda of East Africa. Her field study was carried out in a single
village some fifteen miles from Kampala. The effects of white
contact have long been operative upon the Ganda, but never
theless the majority of mothers still carried their infants on their
backs and enjoyably breastfed them for a year or more. Ganda
babies spend most of their waking hours being held by someone.
While holding the baby the mother gently patted or stroked

252 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

him. The total care of this kind given by the mother was very
considerable. From her comparative observations, Dr. Ains-
worth concludes: "It is better for a baby to be held a lot, to be
picked up when he cries, to be given what he wants when he
wants it, and to be given much opportunity and freedom to
interact than it is for a baby to be kept for long periods in his
crib apart from other people, where his signals cannot be per
ceived and consequently where he cannot experience a sense of
predictable consequence and control." The rate of sensorimotor
development was accelerated in most babies. They sat, stood,
crawled, and walked much earlier than the average baby in
Western societies. Ainsworth attributes this to the kind of in
fant care the Ganda give, "with much physical contact, much
interaction between the infant and his mother, much social
stimulation, prompt gratification of creature-comfort needs,
lack of confinement, and freedom to explore the world."

Unfortunately, Ainsworth's study deals only with the first
fifteen months of the Ganda child's development, and tells us
nothing at all of the later personality traits of the Ganda adult.
The anthropological literature on the Ganda is not much more
helpful in this connection, and such other information as is
available on this score is largely anecdotal. Audrey Richards
emphasizes the fact that there was a remarkable unanimity in
the early European visitors' accounts of the Ganda, emphasiz
ing their good manners, politeness, and charm, their cleanli
ness, neatness, modesty, orderliness, dignity, and intelligence.
But it was also observed that they were touchy, competitive,
legalistic, capable of cruel behavior, reticent, and difficult to
know well. There seem to be many contradictions here, but they
may not really be so. It may well be that the congenial qualities
of Ganda adults owe much to the motherliness they received
during their first year or so, and that their less desirable quali
ties were engendered by later conditionings. This would appear
so from the findings of Dr. Marcelle Geber who studied 308
children in Kampala. Here, also, the newborns and infants up
to two years showed remarkable advances both in physical and
intellectual development, as well as in personal-social relations,
over comparably aged European children. Children examined

Culture and Contact 253

before and after weaning showed marked differences in their
behavior. The attitudes of the mothers towards the children
seemed to be largely responsible for the differences. Before the
child is weaned the mother's whole interest is centered on him.
She never leaves him, carries him on her back often in skin-to-
skin contact wherever she goes, sleeps with him, feeds him on
demand at all hours of the day and night, forbids him nothing,
and never chides him. He lives in complete satisfaction and
security, always under her protection. The child is, moreover,
continually being stimulated by seeing her at her various occu
pations and hearing her interminable conversations, and be
cause he is always with her, his world is relatively extensive. He
is also the center of interest for neighbors, and visitors, to whom
he is off erred, as a matter of course, as soon as the usual greet
ings have been exchanged. If, however, he shows the slightest
sign of displeasure, he is at once taken back by his mother.
While the Gesell tests were being administered to the children,
the loving and warm behavior of the mothers, always ready to
help if help were needed, showed very clearly how the children
were surrounded by affection. The mothers' interest in the tests
and the detailed answers they gave to the questioning were
further evidence of this solicitude.

Dr. Geber's follow-up studies showed that there were some
other aspects to child rearing in this society that did not encour
age and accelerate the growth of the children. For when the
child reaches eighteen months to two years of age it is taken
away from its mother and given to another woman in another
village to be disciplined and "socialized." The natural mother
had been required to love her child, fondle and feed it, and
generally stimulate its development, but not to "train" it. This
was the task of the foster mother. Dr. Geber found that the
children underwent a remarkable deceleration in their develop
mental progress, some children showing even less ability than
before, presumably because they had lost skills acquired earlier.

BUSHMEN OF THE KALAHARI. Dr. Patricia Draper, who lived
among the IKung Bushmen, on the edges of the Kalahari Des
ert in Botswana, Southwest Africa, found that they lived in

254 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

bands of thirty people, and that they very much liked being
close together and touching. In camp, resting, talking, doing
chores, they prefer to gather in knots or clumps, leaning against
each other, their arms brushing, their crossed legs overlapping,
physical contact reaching its highest expression in children,
with girls showing more physical contact than boys.

Lorna Marshall, who has spent much time living among the
IKung over a period extending from 1950 to 1961, writes,

IKung babies are carried most of the time by their mothers, tied
in soft leather slings against their mother's side, where they can
easily reach their mother's breast. They nurse at will. IKung
women have excellent lactation. All the babies are plump. The
babies wear no clothes and are in skin-to-skin contact with their
mothers. They sleep in their mother's arms at night. When they
are not in their mother's arms or tied to their sides, they are in
someone else's arms, or if they are set down to play they clamber
over their elders as they lie chatting and resting, or play within
arm's reach. The babies are constantly in the presence of people
who are gentle and affectionate with them and who are watchful.
The babies have no special toys, but are allowed to play with any
of the adults' possessions that come to their hands and mouths,
except knives and hunting equipment. These items are hung
carefully in the bushes, out of reach of the children.

The IKung never seem to tire of their babies. They dandle
them, kiss them, dance with them, and sing to them. The older
children make playthings of the babies. The girls carry them
around, not as a task set them by their parents (though they
might carry babies around for that reason also), but because they
play "mother." The boys also carry babies around, give them
rides, and drag them on karosses (a favorite game). If the babies
utter a whimper they are carried back to their mothers to nurse.
Altogether the babies appear to be as serene and contented as
well-fed young puppies.

When people are sitting at leisure, they spend time teaching
the babies. They help them to stand or to take their first steps
between outstretched arms of the adults and they play little
games with them.

Culture and Contact 255

Dr. M. J. Konner was much impressed by the amount and
quality of tactile stimulation that IKung children received from
their mothers. Compared to these Bushmen, he remarks, the
American child can be considered to be "deprived" of physical
stimulation. He notes that the experiences of children in each
culture are, of course, related to the nature of the culture. The
Bushman infant grows up in a world in which survival arises
from mutual economic dependence, is dependent upon cooper
ation, whereas the world of the American infant favors compe
tition and mobility.

From the first weeks the Bushman infant is carried on the hip
or side in a sling contoured to support the back, buttocks, and
thighs. In connection with this posture Konner quotes the re
mark of Gesell and Amatruda concerning the six-month-old
sitting up, "His eyes widen, pulse strengthens, breathing quick
ens and he smiles when he is translated from the supine hori
zontal to the seated perpendicular. This ... is more than a
postural triumph. It is a widening of horizon, a new social
orientation."

From their position on the mother's hip [these children have]
available to them her entire social world, the world of objects
(particularly work in the mother's hands) and the breast, and the
mother has immediate easy access to the infant. When the
mother is standing, the infant's face is just at the eye level of
desperately maternal 10- to 12-year-old girls, who frequently
approach and initiate brief, intense, face-to-face interactions,
including mutual smiling and vocalization. When not in the sling
they are passed hand to hand around a fire for similar interac
tions with one adult or child after another. They are kissed on
their faces, bellies, genitals, sung to, bounced, entertained, en
couraged, even addressed at length in conversational tones long
before they can understand words. Throughout the first year
there is rarely any dearth of such attention and love.

Breastfeeding may continue as long as six or eight years, the
child feeding on demand. Such early experiences in interaction
with the mother's body and her nurturing support undoubtedly
exert a powerful influence upon the Bushman personality, a

256 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

personality which has charmed so many different writers. One
of the outstanding traits, almost certainly related to this regi
men, Dr. Konner remarks, is the continual giving and receiving
of food among adults.

Throughout a great part of Black Africa similar variations
are played on much the same theme.

NEW GUINEA. From New Guinea we have some excellent ac
counts of the relationship of early childhood experience to the
development of adult personality, in which tactile experience
clearly played a significant role. These accounts, by Margaret
Mead, are principally of the Arapesh and Mundugumor soci
eties.

Among the Arapesh children are always being held by some
one. The infant is carried by the mother in a small net bag
suspended from her forehead. A child's crying is a thing to be
avoided, the breast being immediately given to comfort it.
Breastfeeding is continued for three or four years. The children
usually sleep in close contact with the mother's body, either
hung in a thick net bag against her back, crooked in her arm,
or curled on her lap as she sits cooking or plaiting. The child
thus enjoys a continuous warm sense of security. Later, when
the mother is away for a whole day working in the garden, she
will compensatorily make up for her absence by a full day of
nursing, when the infant, held in her lap, may suckle at will,
play about, suckle again, play with her breasts, and gradually
regain any sense of security it may have lost. This is an experi
ence the mother enjoys as much as the child. The mother takes
an active part in the suckling process. She holds the breast in
her hand and gently vibrates the nipple inside the child's lips.
She blows into its ear, or tickles its ears, or playfully slaps its
genitals, or tickles its toes. The child in turn plays little tattoos
on its mother's or its own body, plays with one breast while
suckling the other, teases the breast with its hands, plays with
its own genitals, laughs and coos, and makes a long pleasant
game of suckling. "Thus," Mead remarks, "the whole matter
of nourishment is made into an occasion of high affectivity and

Culture and Contact 257

becomes a means by which the child develops and maintains a
sensitivity to caresses in every part of its body." Interestingly
enough, no Arapesh child sucks its thumb or a finger, but there
is a great deal of playing with one's lips during the increasingly
prolonged absences of the mother. The lip playing is continued
for some time after weaning and much later. Boys are encour
aged to stop lip playing after initiation and permitted to chew
betel nut, while girls may continue till they have borne children.

Half an hour's cuddling, and the child will follow anyone
anywhere. The response to demonstrative affection is immedi
ate. As a result of such demonstrations of affection from every
one on every possible occasion the Arapesh child grows up with
a complete sense of emotional security in the care of others. The
result is an easy, gentle, receptive, unaggressive adult personal
ity, and a society in which competitive or aggressive games are
unknown, and in which warfare, in the sense of organized
expeditions to plunder, conquer, kill, or attain glory, is absent.

The Mundugumor, a river people living to the south of the
Arapesh, by contrast with the latter, are an aggressive, hostile
people who live among themselves in a state of mutual distrust
and uncomfortableness. Even before a child is born there is
much discussion as to whether it shall be saved or not, depend
ing on its sex, mothers preferring boys, fathers girls. In Mun
dugumor society the child lives an unloved life. From birth on
the infant is carried in a rough-plaited basket, semicircular in
profile, suspended from the mother's forehead. The basket is
harsh, stiflF, and opaque. No warmth from the mother's body
can penetrate it, and the infant lies cramped within it, seeing
nothing but narrow slits of light at both ends. At home the
infant in its basket is hung up. When it cries, without touching
its body, the mother or other female scratches the outside of the
basket with her fingernail, making a harsh grating sound. Chil
dren generally respond to this sound. If, however, the crying
does not stop the infant is suckled the mother standing up
while doing so. There is no playful fondling between mother
and child. The moment suckling stops, the child is returned to
his prison. Children therefore develop a strong fighting attitude,

258 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

holding on to the nipple as firmly as possible, frequently chok
ing from swallowing too rapidly. The choking angers the
mother and infuriates the child, thus further turning the suck
ling experience into one of anger and frustration, struggle and
hostility, rather than one of affection, reassurance, and content
ment.

Children of one or two years are carried on the mother's
back. A crying, crawling child will be picked up firmly and
placed on the mother's neck, holding on to its mother by her
hair. The breast is given only when it is thought the child is in
need of food, never to comfort it in fright or pain. From the time
he begins walking his mother's hostility toward suckling is
made very evident to the child, who is pushed away, and as
often as not slapped. Thus, weaning is accomplished with hos
tility. A few Mundugumor children suck the back of the hand
or a pair of fingers, with an unmistakable peevish, fretful, anx
ious look on their faces.

It is hardly surprising that with such a socializing experience
in childhood the Mundugumor child becomes the kind of unat
tractive, aggressive, cannibalistic creature he is.*

Dr. James Ritchie of the University of Wakaito, New Zea
land, tells of a delightful experience he enjoyed on a field trip
to New Guinea where he met a psychiatric nurse who had been
given a manual of sensitivity training. As a result of reading it
she had begun letting her Melanesian patients, with whom she
had no language contact, touch each other, and letting herself
touch them. "It took nerve to do it," writes Dr. Ritchie, "to
meet her own reactions and more still to meet their response.
They returned her touch; they stroked her hair, greeted her
with the gentlest of finger caresses, held her hand for hours at
a time. She now moves through her ward, previously filled with
agitated and mute humanity with a new sense of fulfilling her
mission to heal."

This is how the Mundugumor were in 1930; since then they have under
gone considerable change.

Culture and Contact 259

THE ATIMELANG. Among the Atimelang of the Netherlands
East Indies island of Alor, when an individual is dying it is
the custom for one of the grown children or some kinsman
to hold the dying person in his lap, much as parents hold
children. Dr. Cora DuBois, who observed this, suggests that
such behavior constitutes a reversion to infantile nurturing
patterns in the search for which she suspects many men
have spent their lives.

THE DUSUN OF NORTH BORNEO. Williams has made the
only anthropological study known to me of tactuality in a
nonliterate culture. He studied the Dusun of the mountain
highlands of North Borneo, an agricultural-hunting people
whose principal crop is rice. Williams has emphasized the
need for studies devoted to the various ways in which, in
different cultures, individuals are required or expected to re
linquish particular tactile experiences or practices and de
velop compensatory symbolic substitutes at different periods
in life. "The transformation," he writes, "of tactile experi
ence into abstract conceptualizations would seem crucial to
understanding the way some cultural conceptions are ac
quired by the individual in the course of cultural learning
and transmission."

Concern with and recognition of tactile experience in Dusun
life is complex, but can be observed in both overt behavior
and in a variety of linguistic, gesture, and body posture sur
rogates for touch used in many social situations. Contacts
such as "living touch" are distinguished from a "non-living
touch" while "touchy," and "touchable," and "touched,"
each are differentiated from the "act of touching," "tickling,"
and "touching together." Linguistic uses for specific tactile
contacts, including terms denoting limits and acceptability of
such experience, comprise a special lexicon. Other surrogates
for tactile experience commonly used in Dusun life are in the
form of culturally structured gestures meant to be suggestive
of particular touch actions; some 40 gestures are used to note
emotion, while at least 12 have openly sexual meanings de-

260 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

noting acts of intercourse.* Body posture surrogates for tac
tile experiences often involve a complex set of actions, includ
ing inclinations of the head, facial expression, and hand, arm,
and trunk movements. The behavior repertoire of the co
quettish Dusun woman includes a variety of such complex
body posture surrogates for tactile experience. Such body ac
tions are used generally to indicate approval, or dislike, of
displays of body arts, grooming, and decoration as invitations
to direct touch experience.

In greeting another no tactile contact is involved in Dusun
society, while strict boundaries of permitted tactile contacts
exist for various social action situations. It is of interest that the
Dusun newborn is isolated for some eight to ten days from all
tactile contacts, except those of the mother. Among the phrases
used in the several rituals to which the child is exposed during
his first year of life is one saying that "no stranger will be
allowed to touch you to bring you harm."

The way in which the members of a culture learn to deal with
the sense of touch is culturally defined, and this is made explic
itly clear in Williams' excellent study. Williams' plea for further
investigation of this important, but most neglected aspect of
human behavior, can only be echoed here.

OTHER NONLITERATE CULTURES. James Prescott of the Na
tional Institute of Child Health and Development, Bethesda,
Maryland, and Douglas Wallace of the University of California
Medical School, San Francisco, in an interesting cross-cultural
study of the relationship between tactile (somatosensory) expe
rience and the origins of aggressive behavior covering forty-
nine nonliterate cultures, found that there existed a highly sig
nificant correlation between the two in all but one of these
cultures. The Jivaro of Brazil were the one exception. In general
it was found that in those cultures in which tactile experience
was high, adult aggression was low, while in those cultures in

* "Thus, the thumb inserted between the first and second fingers of the
same hand is a symbol of intercourse, while the waving of hands along
side the ears, with fingers up and palms forward denotes fright and deri
sion.*'

Culture and Contact 261

which such experience was low, adult aggression was high. In
thirteen cultures which seemed to be exceptions to the rule it
was found that five of the six that were characterized by high
infant affection and high adult violence were repressive of
premarital sexual behavior, while six of the seven cultures that
exhibited low physical affection towards infants and had low
adult violence were characterized by permissive sexual behav
iors. The somatosensory pleasure hypothesis was thus
confirmed for both the prepubertal and postpubertal stages of
development.

THE TACTILE EXPERIENCE OF THE AMERICAN CHILD. Passing

from nonliterate cultures such as the Dusun, the Ganda, the
Eskimos, or the Bushman to the highly sophisticated culture of
the United States, we find that the differences in tactile experi
ence of infants and young children in each culture are very
revealing. For the United States there is available an excellent
study of the tactile experience of children from infancy to four
and a half years of age in working-class, middle-class, and
upper-class families. This is an unpublished doctoral disserta
tion by Vidal Starr Clay entitled "The Effect of Culture on
Mother-Child Tactile Communication." Forty-five mother-
child pairs were the subjects of this study, with twenty boys and
twenty-five girls. The observations were made on public, coun
try-club, and private beaches. In Table III, the findings are set
out for the average tactile contacts by age and class for one hour
of observation of children in groups designated A, B, C, and
D, according to the age of the children. From this table it will
be seen that tactile contact becomes a diminishing factor in the
mother-child aflfectional system with the increasing age of the
child. When, however, tactile frequency and duration scores are
compared by age and social class, a surprising exception occurs
in the youngest or infant group, where the highest degree of
tactile contact would be expected.

In all three classes, [writes Clay] the tactile frequency scores
were less for the youngest children, the neonates and non-walk
ing ones, than they were for the walking children. The duration

262 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

TABLE III. CONTACTS AND PATTERNS OF PLAY
BY AGE AND SOCIAL CLASS

For one hour of observation at the beach.
Number of children = 45

Mean Number Contacts Mean Time in Contact

Group

Group

Group

W*

M*

U*

Average

W

M

U

Average

A

4.5

4.2

4.0

4.2

0.0

8.0

9.7

7.5

B

3.1

5.5

15.3

6.3

3.0

8.0

22.3

8.2

C

2.6

3.3

6.0

3.7

1.4

1.3

3.4

1.8

D

5.3

4.8

5.0

8.3

2.8

4.9

Average

for

Total 3.1 4.4 7.0 4.9 2.2 5.8 8.2 5.6

*W = Working Class; M = Middle Class; U = Upper Class
SOURCE: Vidal S. Clay, "The Effect of Culture on Mother-Child Tactile
Communication" (Ph.D. dissertation, Teachers College, Columbia Univer
sity, 1966), Table IV, p. 284. By permission.

scores were lower also for the working class and upper class
infants than they were for the children just above them in age.
Only the middle class duration score shows the pattern we would
expect to find: the highest score for the youngest age group. The
middle class mothers* duration score was much higher than the
duration score for the mothers of the other classes: nearly forty
minutes in contact for each child in the hour observed. It was
this figure that skewed the duration score average and made it
appear that the youngest children in the field study sample re
ceived the most time in tactile contact. Therefore the conclusion
about tactile contact and age must be rephrased to say that
overall tactile contact does decline with age but in this culture,
as it was observed in the field study, it is the just walking child
who receives the most frequent tactile contact and the contact
of longest duration, not the infant and non- walking child. From
a high at this time, just walking to two years of age, the amount
of contact declines regularly as the child grows older.

It is a general assumption that the neonate and infant receive
most tactile stimulation, but the truth seems to be that with the

Culture and Contact

263

Mean Time Near

Group

A
B
C
D

Average

for
Total

W

4.0
30.5
22.4

M

3.0
13.5
22.0
15.0

U

31.0
19.0
28.7
25.2

27.4 16.2 25.8

Group
Average

27.2
22.9
23.8
21.1

23.3

Mean Time Away

Group

W

M

U

Average

13.0

20.0

20.0

17.7

19.6

30.0

15.7

20.5

23.0

24.0

20.0

22.6

31.3

29.2

30.0

20.5 27.4 23.2 23.7

advent of hospital deliveries, bottlefeeding, clothes which form
a barrier between the caretaker and the infant's skin, the A-
group child, in the group from two months to fourteen months
of age, the non walkers, receives less tactile experience than the
j?-group child, the just-walkers from fourteen months to two
years. The C group included twelve children between two and
three years, and the D group included ten three- and four-year-
olds. In view of the actual needs of the infant, this is a very
striking and significant finding.

Reva Rubin, who has had many years of experience in obstet
rical nursing, has remarked how struck she has been by the very
small number of American mothers who, even at the end of the
first year, are sufficiently comfortable to hold their babies up
close to their chests in pure enjoyment and pleasure of contact.
Those who are most likely to do so, she found, were the mothers
who really enjoyed breastfeeding, and, of course, she adds,
grandmothers and aunts.

Harlow and his co-workers found that in the rhesus mother-
infant affectional system three phases were clearly evident: (1)
attachment and protection, (2) ambivalence, and (3) separation.
The stage of attachment and protection is characterized by
virtually total positive conduct, cuddling, cradling, nursing,
grooming, restraining, and retrieving. The stage of ambivalence
includes both positive and negative responses, such as mouth
ing or biting, cuffing or slapping, clasp-pulling the fur, and
rejecting attempts to maintain physical contact. The stage of

264 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

separation results in the termination of contact between mother
and infant. There is no doubt that similar stages or phases occur
in the maternal affectional development of the human mother,
and that the behaviors associated with them are of great conse
quence for the development of the infant. This is especially
clearly most significant in the phase of attachment and protec
tion. It is precisely in this most important of these phases that
the American mother seems to fail most. In the rhesus monkey
the mother normally exhibits a high degree of interest in her
infant for the first thirty days, and then begins to display ambiv
alent responses. In the human mother the period of attachment
is normally of much greater duration. But, as Clay says,

Unlike the primate mother, and mothers of many other societies,
the American mother largely omits the phase of close bodily
attachment. In this culture, the separation of the bodies of the
mother and child at birth is the end for the most part of the
mother-child physical symbiosis. Instead of a relationship where
the mother's need for intimate physical contact exceeds that of
the infant, there is a relationship where the mother shows mater
nal attachment behavior only in response to the child's gross
vocal and kinesthetic demands. This difference in the American
maternal pattern in the infant's first four months of life is of
course due to the fact that close mother-infant tactile contact is
not the norm for this culture. The fact that American mothers
did not themselves experience close physical contact with their
own mothers no doubt reinforces this behavior. The lack of
physical proximity between mother and young child, whereby
the mother stimulates the infant and in turn picks up and re
sponds to the cues that the infant gives back to her, also rein
forces the cultural pattern of separation.

In America both mother and infant are clothed even during
breastfeeding, so that the baby, as he is fed, often experiences
little more of her skin than the breast, and perhaps an occa
sional handstroking. In the bottlefeeding situation, which is the
rule in America, the infant experiences the very minimum of
reciprocal tactile stimulation. The deprivation of tactile stimu
lation experienced in this way by both infant and mother ex
plains the institutionalization in American culture of the nonex-

Culture and Contact 265

pression of affection, especially between mother and baby,
through close physical contact. Tactile contact between the
American mother and child expresses caretaking and nurtur-
ance, rather than love and affection. This is clearly evident from
the fact that mothers in this culture touch their walking chil
dren more frequently than they do when their children are
nonwalking.

In keeping with the findings of other investigators, Clay
found that girl babies received more demonstrative acts of affec
tion than boy babies. Mothers seem to be happier about having
girl babies than boy babies, and girl babies tend to be weaned
later than boys. Moss, Robson, and Pedersen, in a detailed
study of maternal stimulation of infants, in Washington, D.C.,
found that mothers talked, kissed, and rocked in a rocking chair
their male infants, at the examining age of one month, more
than they did their female infants at the same age. These inves
tigators suggest that the difference probably reflects a social-
affectionate orientation towards the males, involving behaviors
that tend to soothe and modulate rather than excite or activate
the infant. The mothers significantly more often resorted to the
distance receptors of vision and hearing in dealing with their
female children than with their male infants at one month of
age. Moss and his collaborators suggest that since female in
fants develop earlier than male infants, the more expressive
mothers may have adjusted the type of stimulation they pro
vided for their infants in consonance with the developmental
requirements or status of the child. Thus male infants would
have received more talking to, more kissing, and more rocking,
whereas female infants with their more advanced developmen
tal status would tend to be stimulated through their active
attention and the processing of stimuli (auditory and visual)
ordinarily associated with higher cortical (cognitive) function
ing.

Interestingly enough, the animation of the mother's voice
was found to be highly reliably predictive of the amount and
type of stimulation she provided her infant at one month and
three months of age. The animated mothers were found to give

266 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

their children more stimulation than the soft-spoken mothers.
Less educated mothers tended to provide more physical stimu
lation than more educated mothers. The better-educated
mother tended to spend more time talking to her male infant.
Fear of strangers and gaze-averting behavior at eight to nine
and a half months of age was definitely found to be related to
the type of stimulation the infant received from his mother in
earlier infancy. The more stimulation, particularly of the dis
tance receptors, the infant received, the more comfortable the
infant appeared to be with a stranger at age eight to nine and
a half months. These investigators suggest that children who
are accustomed to experiencing novel visual and auditory stim
ulation may have a better mental organization for coping with
and assimilating "strangeness." Since strange stimuli are less
novel for such children they tend to evoke less of a sense of
subjective uncertainty in them. That is to say, the children
who receive more stimulation through the distance recep
tors become more complex cognitively and therefore have
more resources for dealing with unfamiliar auditory or vis
ual stimuli.

Tactile demonstrations of affection between mother and
daughter are not as inhibited as they are between mother and
son. The very thought of any such demonstration of affection
between father and son is something that still makes many
American fathers squirm. A boy putting his arm around the
shoulders of another boy is cause for real alarm. It is simply not
done. Even women are reluctant to indulge in such open dis
plays of affection towards members of their own sex. One
touches others largely in a sexual context. To touch another out
of such context is open to grave misinterpretation, since touch
ing is to a large extent restricted to and associated with sex.
When intercourse is completed the male ceases to touch his
partner and usually retires to his twin bed to spend the rest of
the time in pleasurable lack of contact with himself.

The replacement of the double bed in which husband and
wife sleep together by twin beds in which husband and wife
sleep apart may well be significantly correlated with the decline
in both breastfeeding and the reduction in maternal-infant tac-

Culture and Contact 267

tile stimulation that prevailed in earlier times. I have elsewhere
suggested that parents who sleep together in the same bed are
likely to develop a quite different relationship to one another
and towards their children than parents who habitually sleep in
separate beds, and that "same-bed" families tend to be more
cohesive. "Keeping in contact" in the same bed comprises a
very different experience from the contactless separateness of
twin-bed sleeping arrangements. In her novel Strange Fruit
Lillian Smith makes Alma, the wife of Dr. Tracy or "Tut,"
reflect as follows:

Sometimes all she could remember of her's and Tuf s nights
together was the lifting of his leg off her body. There was some
thing almost dissipated about the way Tut slept, letting himself
go, so, so uncontrolled, you might say. Alma had thought of
twin beds but had never done anything about it, for she doubted
in her heart that husbands and wives should sleep separately. It
was all a little vague to her, but sleeping together, cold weather
or hot, seemed a necessary thread in the fabric of marriage,
which, once broken, might cause the whole thing to unravel.

Just how she was not certain. She was convinced, however,
that her own mother's custom of sleeping in a room separate
from father's had caused their family life to be not as successful
as it should have been.

Alma was quite right. Such husbands and wives tend to grow
"out of touch" with one another. The subject has been investi
gated by two American anthropologists working in Japan. Drs.
William Caudill and David W. Plath studied the co-sleeping
patterns of parents and children in Japanese families in Tokyo
and Kyoto. They found that in urban Japan an individual can
expect to co-sleep in a two-generation group, first as a child and
then as a parent, over approximately half his life. Commencing
at birth, this goes on till puberty, and then commences again
with the birth of the first child, continuing till about the time
of the menopause in the mother, and recurring for a few years
in old age. In the intervening years the individual generally
sleeps in a one-generation group with a sibling after puberty,
with a spouse for a few years after marriage, and again with a
spouse in late middle age. Sleeping alone is a reluctant alterna-

268 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

tive most commonly occurring in the years between puberty
and marriage. Caudill and Plath offer the broad generalization
that "sleeping arrangements in Japanese families tend to blur
the distinctions between generations and between the sexes, to
emphasize the interdependence more than the separateness of
individuals, and to underplay (or largely ignore) the potential
ity for the growth of conjugal intimacy between husband and
wife in sexual and other matters in favor of a more general
familial cohesion."
The speculation the authors offer

concerns the coincidence of those age periods when sleeping
alone is most likely to occur, with the age periods when suicide
is most likely to occur in Japan. The rates for both types of
behavior are highest in adolescence and young adulthood, and
again in old age. It might be that sleeping alone in these two
periods contributes to a sense of isolation and alienation for an
individual who, throughout the rest of his life cycle, seems to
derive a significant part of his sense of being a meaningful person
from his sleeping physically close by other family members.

Under the conditions of co-sleeping in Japanese families de
scribed by Caudill and Plath the kind of relationships they have
postulated may well exist. But under other conditions the oppo
site effects may be produced. For example, among the working
classes of Europe and elsewhere children are often forced to
occupy the same bed with strangers taken in by the parents as
lodgers. The revulsion caused by such experiences may have
enduring effects, resulting in avoidance of any kind of physical
contact with strangers, as well as in other forms of rejection and
withdrawal.

Hall points out that the Japanese are pulled in two directions.
One is a deeply involved enveloping intimacy that begins in the
home in childhood and extends far beyond. "There is a deep
need to be close, and it is only when they are close that they
are comfortable." The other pole is to keep one's distance. In
public, and in the ceremonial occasions of everyday life, the

Culture and Contact 269

emphasis is on distance, self-control, and the concealment of
feelings. Until very recently there was no public display of
intimacy or touching in Japan. And yet from his interpretation
of the evidence Hall believes that deep down the Japanese feel
quite uncomfortable about the ceremonial, institutionalized
side of life. Their principal drive is to move from the "stand on
ceremony" side towards the homey, comfortable, warm, inti
mate, friendly side. "Their drive to be close and get to know
other people is very strong."

PURITANISM, CLASS DIFFERENCES, AND TACTUALITY. In New

England, one would expect that the effect of Puritanism would
tend to be characterized by child-rearing practices that reduce
reciprocal tactile stimulation between mother and child to a
minimum, and this is indeed the case. The Fischers in their
study of Orchard Town child-rearing practices found that most
babies spent a good part of each day alone in a crib, playpen,
or in the yard. "Such contact as a baby has with other human
beings is not marked by close bodily contact as in many soci
eties."

New Englanders, in what remains of their Puritanism,
closely resemble the English from whom they originated, and,
in common with the English, they suffer from the effects of
residual primness. The upper-class Englishman and espe
cially the upper-class Englishwoman has notoriously been
characterized by an inability to exhibit emotion, and a certain
striking lack of warmth.* Not all members of the upper classes
are characterized by these traits, and certainly many members
of the middle and working classes exhibit them. But such traits
are generally due to a lack of parental love, a failure experienced
in early infancy and throughout childhood which expresses
itself in an inability to relate warmly and affectionately towards
others.

* Derek Monsey speaks of "the frigid voluptuousness of the dedicatedly
unsatisfied English gentlewoman,** in his novel, Its Ugly Head (New York:
Simon & Schuster, 1960), p. 38.

270 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

The custom among the English upper and middle classes
of sending their children away to boarding schools at an
early age, of institutionalizing them, as it were, outside the
warm ambience of the family, deprives these children of the
love and affection so necessary for the development of a
healthy personality. The privation of parental love, and es
pecially love in the form of tactile stimulation, during in
fancy, probably constitutes one of the principal causes of the
apparent coldness, the seemingly unemotional character, of
the upper-class, and often the middle-class, Englishman. On
this aspect of the Englishman's character, E. M. Forster has
some illuminating comments:

People talk of the mysterious East, but the West also is mysteri
ous. It has depths that do not reveal themselves at the first
glance. We know what the sea looks like from a distance; it is
of one color, and level, and obviously cannot contain such crea
tures as fish. But if we look into the open sea over the edge of
a boat, we see a dozen colors, and, depth below depth, the fish
swimming in them. That sea is the English character appar
ently imperturbable and even. The depth and the colors are the
English romanticism and the English sensitiveness we do not
expect to find such things, but they exist. And to continue my
metaphor the fish are the English emotions, which are always
trying to get up to the surface, but don't quite know how. For
the most part we see them moving far below, distorted and
obscure. Now and then they succeed and we exclaim, "Why, the
Englishman has emotions! He actually can feel!" And occasion
ally we see that beautiful creature, the flying fish, which rises out
of the water altogether into the air and sunlight. English litera
ture is a flying fish. It is a sample of the life that goes on day after
day beneath the surface; it is a proof that beauty and emotion
exist in the salt, inhospitable sea.

Jane Austen, in 1816, in her novel Emma, had already com
mented on the seeming indifference of the middle-class English
man towards those for whom he actually cared, when she re
lates the meeting of the Knightley brothers after an absence of
a year. "How d'ye do, George?" and "John, how are you?" The

Culture and Contact 271

author comments, they "succeeded in the true English style,
burying under a calmness that seemed all but indifference the
real attachment which would have led either of them, if requi
site, to do everything for the good of the other/'

Interesting examples of the upper-class and middle-class
types of English cold fish are represented by Sir William Eden,
the father of Anthony Eden, and by Hugh Walpole, the English
novelist. The American counterpart is William Randolph
Hearst, whose frightful life was also tellingly and sensitively
portrayed in Orson Welles' film, Citizen Kane. Yet another
casebook history of the unloved child is provided by the victim
himself, the English newspaperman Cecil King. All of these
individuals, representative of untold thousands like them, were
alike in having suffered a lacklove childhood and an inability
to behave with affection. This is interesting in the light of the
fact that in her study of a group of American mothers Clay
found that upper-class mothers gave their infants somewhat
more tactile affection tactile affection being defined as behav
ior through touch designed to convey love than both working-
class and middle-class mothers.

In the bathing of babies, a situation in which one would
expect to find increased magnitudes of tactile stimulation for
the infant, this is not necessarily the case. Margaret Mead has
pointed out how the attention of the American baby is directed
away from the personal relationship to his mother by toys
which are introduced into his tub. Hence his attention is
focused on things rather than on persons. As Mead says, "The
average American woman may never hold a little baby until she
nurses her own, and even then she often behaves as though she
were still afraid that the infant might break in her hands. In
New Guinea and Bali, on the contrary, they know all about
babies. Small infants are looked after by child nurses as young
as 4 years old, and this familiarity is shown in all their move
ments."

With the passing of the extended family, in which grandpar
ents, aunts and uncles, cousins and other relatives often gave

272 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

children large amounts of tactile stimulation of various sorts,
that kind of experience is now limited to a rather undemonstra
tive mother. Clay remarks that she observed a grandmother
sitting under a tree next to her grandchild strapped in a plastic
carrier. "The grandmother," reports Clay, "told me with a
degree of sadness that she wanted to pick up the baby, he
wanted it, but his mother had told her he had to learn to be by
himself."

Class differences in touching are revealing. The general law
seems to be, the higher the class the less the frequency of
touching, the lower the class the greater the frequency of touch
ing. As between classes the rule is that while members of the
superior class may touch members of the inferior class, mem
bers of the inferior class may not touch members of the superior
class. The same rule holds true for caste and status differences.
One recalls the "Untouchables" of India. In the matter of sta
tus, although one may be a member of the same class as another
who is of superior status, say in occupational hierarchy, rank,
or assigned role, the status difference is usually sufficient to
inhibit touching of the individual of higher status by the indi
vidual of lower status. As Nancy Henley has remarked, touch
may be regarded as the nonverbal equivalent of calling another
by first name. Just as members of higher class or status may call
members of inferior class or status by their first names, so they
may also touch them, while confidently expecting that members
of inferior rank will not do so. Indeed, it is considered a breach
of etiquette of the most serious kind when, occasionally, some
froward individual ventures to break either one or the other
rule.

Touching, like being called by first name, is considered an act
of intimacy, a privilege usually granted only to those of one's
own class or status whom one has allowed to pass across those
social barriers which serve to exclude the unprivileged. Among
members of one's own class or status being called by first name
or a touch may be used to establish an immediate friendly
relationship. The acceptance or rejection of such an advance
will be quickly indicated by the response made to it.

Culture and Contact 273

Touch, however, very much more than first-name-calling,
reduces social distance and often constitutes a declaration of
intimacy: it is for this reason that it is so often regarded as an
incursion upon one's privacy by those who resent such intru
sions. By extension any accidental or unnecessary touching
even from an intimate may be found annoying or unacceptable.

It is evident, then, that in social encounters touch is regarded
as a token of power exercised nonreciprocally at the discretion
of one's betters or reciprocally between equals. Since in the
power structure of Western societies females are regarded as
inferior in status to males, and are treated as if they belonged
to an inferior class or caste, females from their earliest days
receive a good deal more touching than males. In infancy
daughters are touched by both parents more frequently than
sons, and daughters, according to a familial study by Jourard,
touch both parents more than sons do. In another study by
Jourard and Rubin it was found that mothers touch their sons
more than fathers do, and fathers touch their daughters more
than they do their sons; daughters touch their fathers more than
sons do, and sons touch their mothers more than their fathers.
Touching between males is, then, less frequent than it is be
tween females and males within the family. It was also found
that both mothers and fathers touch daughters in more regions
of the body than they do sons, and that daughters do more of
this kind of touching of both parents than do sons. These ob
servers also found that males touch their female best friends in
more regions than females report touching their male friends.

Jourard and Rubin are of the opinion that touching is
equated with sexual intent, either consciously or at a less con
scious level. As a general rule but not as a universal one, this
is probably a sound statement. Nancy Henley reports a piece
of research by a male assistant of hers in which it was found
that under ordinary conditions males touch females more fre
quently than females touch males. However, when females
enjoy greater status advantages than males they are more likely
to initiate touching. Henley concludes that between the sexes it

274 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

is status rather than sex that determines the frequency of touch
ing, and that touching by males is used as one of the means of
keeping women in their place, "another reminder that women's
bodies are free property for everyone to use." Henley feels that
women should refuse to accept such male tactual assertion, and
"remove their hands from the grasp of men who hold them too
long," to reject unsolicited and unwanted touch, and when the
situation is appropriate to begin touching men.

If in the politics of sex and touch men are still for the most
part Tories, women are enjoined to look deeper, to get to the
root of things, and to become more radical.

TACTILE STIMULATION AND SLEEP. Anna Freud has pointed
out that "it is a primitive need of the child to have close and
warm contact with another person's body while falling asleep,
but this runs counter to all the rules of hygiene which demand
that children sleep by themselves and not share the parental
bed." She goes on to say, "The infant's biological need for the
caretaking adult's constant presence is disregarded in our West
ern culture, and children are exposed to long hours of solitude
owing to the misconception that it is healthy for the young to
sleep, rest, and later play alone. Such neglect of natural needs
creates the first breaks in the smooth functioning of the pro
cesses of need and drive fulfillment. As a result, mothers seek
advice for infants who have difficulty in falling asleep or do not
sleep through the night, in spite of being tired."

In Western cultures one constantly encounters the phenome
non of children begging their mothers to lie by their side or at
least to stay with them until they fall asleep, a supplication
which the mother tends to discourage. The endless calls from
the child's bed, the demand for the presence of the mother, for
an open door, a drink of water, a light, a story, to be tucked in,
and so on, are all expressions of the child's need for that pri
mary object, his mother, to whom he can securely relate. A
cuddly toy, a pet one can take to bed, soft materials, a security
blanket, some object to which the child is particularly attached,

Culture and Contact 275

and autoerotic activities such as thumb-sucking, rocking, mas
turbation, are the child's means of facilitating the transition
from wakefulness to sleep. When these objects are given up a
new wave of difficulties in falling asleep may develop.

Among many peoples of the world co-family sleeping, in
which children and parents sleep together, is a regular occur
rence. It is a practice which has many advantages for everyone
involved. Children may sleep either in the same bed with their
parents or with their siblings. It would be a matter for each
family to work out according to its needs. Tine Thevenin has
written a book on the subject, The Family Bed, in which she
makes a strong case for co-family sleeping.

It is in his second year that the child experiences the need for
the close contact that will enable him to fall alseep. It should
be given him. A mother who is involved in the welfare of her
child should not find it insuperably difficult, even in the modern
world, to lie at bedtime by the side of her child. This will usually
be necessary only during the second year. She need stay only
until the child falls asleep. It is quite possible that with further
discoveries in this area the time that should be devoted to this
will be reduced or even eliminated. One possibility has been
pioneered by the members of the New Zealand Christchurch
Parents Centre. These women became interested in the idea
that babies might benefit from lying on the soft, springy fleece
of lambskins and derive the same sort of comfort that adult
patients obtain from invalid-care sheepskins. The lambskins are
specially tanned. At the latest report some twenty-four babies
were being nursed on the lambskin rugs. "With nearly all babies
there was some indication of added comfort from the rug, and
in a number of cases parents reported enthusiastically about the
longer hours of sleep, and contentment of the baby. . . . The
added sleep and contentment and the lessening of strain on the
mother that resulted with many babies, has been most en
couraging."

Mothers of handicapped, and especially cerebral palsied chil
dren, report enthusiastically the extra comfort their babies seem

276 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

to gain from lying on lambskin rugs.*

It is quite possible that when babies are started off on such
a lambskin sleeping rug they may have less difficulty in achiev
ing sleep later on. It is an experiment worth trying.

A further report on lambskins indicates that not all skins are
suitable. The best skins must be of large area, with a fine dense
fleece such as is grown by Corriedale or Merino breeds or the
Southdown Romney cross-lamb. Preliminary tests with the lat
ter type of lambskins indicated that babies were more content
and slept longer on them than on conventional sheets and mat
tresses. When deprived of the skins the babies invariably be
came restless.

Following a lecture I delivered at the University of Ottawa
in January 1976 a psychiatrist informed me that she had had
considerable success in the treatment of patients by getting
them to sleep on lambskin rugs.

Reference to security blankets draws attention once again to
the attachment qualities of cutaneously comforting materials.
The general belief that the blanket provides the child with a
feeling of security, and serves as a mother substitute, is borne
out by experiment and observation. Drs. Richard Passman and
Paul Weisberg found that nondistress, play, and exploration
were facilitated significantly by giving attached children their
security blanket as compared to giving other preschoolers their
favorite hard toy or no familiar object. When the mother was
in the room with the child, her presence had similar facilitative
properties to the blanket. For children who had no attachment

*"Lambskin Comfort for Handicapped Children,'* Parents Centres (Auck
land, N. Z.), Bulletin 41 (November 1969), p. 14. The sterilization of baby-
care lambskin rugs is also discussed on the same page. The lambskin rugs may
be obtained from G. L. Bowron & Co., Ltd., Christchurch, New Zealand; The
Sheepskin Rug Co., 33 Queen St., Auckland, New Zealand (bank reference
Credit Department, Southern Region H.Q., Crocker Citizens National
Bank, Los Angeles, Calif.); and Donald Macdonald (Antartex) Ltd., Lomond
Industrial Estate, Alexandria, Dunbartonshire, Scotland (main U.S.A. ware
house, 120 Greenwich Ave., Greenwich, Conn. 06830 shops in London;
New York; Cambridge, Mass.; Geneva, 111.; and Minneapolis, Minn.). In
Australia the lambskins are obtainable from the Nursing Mothers Association
of Australia, 95A Burwood Road, Hawthorn, Victoria, 3122.

Culture and Contact 277

to blankets, the blanket's presence was no more functional than
the control condition in which no familiar object was present.
Similar results were found with regard to learning.

In a third study Dr. Passman found that there is a limit to
the functional properties of the blanket. In cases of heightened
arousal, the mother is significantly more effective than the blan
ket in increasing play and exploration and in decreasing dis
tress. The relative potency of the maternal attachment bond is
far superior to that attaching to the blanket. Dr. William
Mason's theory that stimuli more suitable for clinging provide
more arousal reduction is supported. That is to say, hard toys
offer fewer opportunities for clinging than blankets, and blan
kets fewer than mothers.

Since almost half of all middle-class children become at
tached to inanimate objects, mostly security blankets, often also
to pets that they can take to bed with them and carry around,
it is highly desirable to recognize the importance of such needs
to children. Among the functions of the security blanket is its
service as a defense against anxiety, and as a helpful means in
making the transition from the world of inner to the world of
outer reality. As is said in one of the most famous of all stories
bearing on this subject,

. . . so wherever I am, there's always Pooh,

There's always Pooh and Me.

"What would I do?" I said to Pooh,

"If it wasn 't for you, " and Pooh said, "True,

It isn't much fun for One but Two

Can stick together, " says Pooh, says he,

"That's how it is, " says Pooh . . .

A. A. Milne, Now We Are Six

As is well known, many individuals hang on to their loved
objects well into adult life, and it has been suggested that many
who do not would perhaps be better off if they did.

In connection with pets it is of interest to note that many
individuals who, for one reason or another, experience difficulty
in touching others, often satisfy their tactile needs with pets.

278 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

The very word itself, pet, and the verb to pet in one of its
meanings is "to stroke or pat gently; fondle; caress," and col
loquially, "to kiss, embrace, fondle intimately, etc. in making
love."

Recognizing the importance of relatedness to animals Dr.
Boris M. Levinson has developed a pet-oriented child psycho
therapy, in which he uses animals, chiefly dogs, in the diagnosis
and treatment of psychologically disturbed children. The thesis
of his book on the subject is that "contact with the inanimate
and particularly the animate world via the pet is most impor
tant to a wholesome emotional development."

There can be little doubt that in many an emotionally re
frigerated home the mental health of a child has been saved by
the presence of a pet with whom it could communicate, in the
physical presence of human beings who could not. In this con
nection Drs. Samuel and Elizabeth Corson and their colleagues
in the Department of Psychiatry at Ohio State University have
conducted some interesting experiments in custodial institu
tions with patients ranging from adolescents to the old and
infirm. The experimenters selected patients who had failed to
respond to the traditional forms of therapy and brought in dogs
of various breeds who were offered as pets to the patients. The
responses were dramatic. Only three of the fifty patients refused
to accept the dogs as pets, but the other forty-seven adopted
them with enthusiasm, and from the outset showed a striking
improvement. One man who had not spoken for twenty-six
years began to speak.

As E.L. Corson, and his collaborators, state, the attachment
humans develop for pet dogs is probably related to the ability
of these animals to offer love and tactile reassurance without
criticism, "and their maintenance of a sort of perpetual infantile
innocent dependence which may stimulate our natural tend
ency to offer support and protection." As they say, the success
of pet-facilitated psychotherapy is based on the assumption that
many patients will accept the love of a dog before they are able
to accept love from or give love to a human being.

Tactual interchange between dog and human is important as

Culture and Contact 279

"an ice-breaker," but it is not the only important exchange
involved in the resocialization of the withdrawn patient. The
sense of responsibility that the patient develops for the welfare
of the dog, his care for it, the sense of reciprocal commitment
he experiences, all minister to the opening up of a view of the
world in which he can find others to whom he can relate, and
interrelate.

Interestingly enough child-battering and abusing parents,
who were themselves neglected and abused as children, rarely
report having had a childhood pet.

THE TACTILE EXPERIENCE OF THE INDIAN CHILD. Throughout

the greater part of India children receive much tactile attention
from their earliest days. Babies from about one month to six
months are regularly bathed and massaged with such mixtures
as tumeric paste and castor oil. As children they run around
naked until six or seven, from their earliest days they are
hugged and kissed by everyone.

Frederick Leboyer has published a detailed photographic
account of this traditional Indian art of baby massage. This is
most illuminating, for there is not a nook or cranny of the
baby's body that is not lovingly massaged by the mother's
hands.

THE TACTILE EXPERIENCE OF THE JAPANESE CHILD. Dr. Wil
liam Caudill and Mrs. Helen Weinstein have made a valuable
comparative study of child-rearing methods in Japan as com
pared with those in the United States. They studied a selected
matched sample of thirty Japanese and thirty American infants,
three to four months old, equally divided by sex, all firstborn,
and all from intact middle-class families in urban settings. On
the basis of previous studies these investigators predicted they
would find Japanese mothers spending more time with their
infants, and that they would emphasize physical contact over
verbal interaction, and would have as a goal a passive and
contented baby. The American mothers, they predicted, would
spend less time with their infants, would emphasize verbal in-

280 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

teraction rather than physical contact, and would have as a goal
an active and self-assertive baby. These hypotheses were gener
ally confirmed by the investigators, and indeed they agree fully
with those of other students of Japanese and American culture.
Caudill and Weinstein found that "largely because of different
patterns of interaction with their mothers in the two countries,
infants have learned to behave in different and culturally appro
priate ways by three to four months of age. Moreover, these
differences in infant behavior are in line with preferred patterns
of social interaction at later ages as the child grows to be an
adult in Japan and America."

It is generally agreed that Japanese are more "group"-ori-
ented and interdependent in their relations with others, while
Americans are more "individuaP'-oriented and independent.
Associated with this is the tendency of Japanese to be more
self-effacing and passive as contrasted with Americans, who
tend to be more self-assertive and aggressive.

In matters requiring a decision, Japanese are more likely to rely
on emotional feeling and intuition, whereas Americans will go
to some pains to emphasize what they believe are the rational
reasons for their action. . . . Japanese are more sensitive to, and
make conscious use of, many forms of nonverbal communication
in human relations through the medium of gestures and physical
proximity, in comparison with Americans, who predominantly
use verbal communication within a context of physical separate-
ness.

We have already touched upon the co-sleeping family habits
of the Japanese in contrast to the separate sleeping habits of
Americans, from the earliest age, and the resulting differences
in tactile experience in the two cultures. In keeping with these
sleeping habits, at least as significant, are the bathing practices
of Japanese and Americans. In Japan, from the earliest possible
age, approximately at the beginning of the infant's second
month, the whole family bathes collectively. The mother or
another adult holds the infant in her arms while they bathe
together in the deep bathtub (furo) at home or in the neighbor-

Culture and Contact 281

hood public bath (sento). This pattern of shared bathing contin
ues for the Japanese child until he or she is about ten years old,
and even later. In contrast with this, the American mother
rarely bathes with an infant, but rather gives him a bath from
outside the tub, and communicates with him verbally and by
positioning his body. Breastfeeding is still more widespread in
Japan than is bottlefeeding, and while babies are started on
semi-solid food at the end of the first month in America, this
is not the case until the end of the fourth month for Japanese
babies. Quite clearly the Japanese infant receives a great deal
more reassuring tactile stimulation than does the American
infant, and of a kind which by the early age of three to four
months has already made a distinctively perceptible behavioral
difference in the infants of these two cultures. Caudill and
Weinstein summarize their findings as follows:

American infants are more happily vocal, more active, and more
exploratory of their bodies and their physical environment, than
are Japanese infants. Directly related to these findings, the
American mother is in greater vocal interaction with her infant,
and stimulates him to greater physical activity and exploration.
The Japanese mother, in contrast, is in greater bodily contact
with her infant, and soothes him toward physical quiescence,
and passivity with regard to his environment. Moreover, these
patterns of behavior are in line with the differing expectations for
later behavior in the two cultures as the child grows to be an
adult.

Caudill and Weinstein predicted that when they were ready
to report their findings on two-year-olds and six-year-olds from
each culture they would probably find that these early patterns
of behavior will jell and persist.

As Douglas Haring says,

One outstanding fact not stressed in the literature but amply
verified involves the almost uninterrupted bodily contact of Jap
anese infants with mother or nursemaid. Practically never is a
baby left to lie alone quietly. Always he rides on someone's back
or sleeps close to someone. When he is restless his bearer sways

282 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

or jiggles from one foot to the other. Some writers deem this
jiggling a fearsome experience for the infant. . . . My own unsys
tematic observations indicate that most Japanese think it soothes
the child. At any rate the infant almost constantly feels the
reassuring touch of human skin. When he cries he is given the
breast, and in lower-class families his sexual organs are manipu
lated until he falls asleep. Many better-educated Japanese repu
diate the latter practice, but they employ nursemaids versed in
the folkways rather than in the niceties of genteel refinement.

Then when the child reaches walking age he is quite drastically
left on his own a great deal of the time, and must learn to
conform to the implicit taboo on touching other people.

As Haring points out, the sudden break in the infant's habit
ual basic dependence on contact with other persons involves
frustration, and frustration will result in emotional behavior
designed to compel attention to the need that has been frus
trated. In the Japanese boy this takes the form of temper tan
trums, the expression of which, either in verbal or physical
abuse, is permitted upon the body of the mother, but not upon
the father. The expression of temper in girls is strictly forbid
den. In the rigidly defined situation of Japanese life no adequate
outlets are provided for the effects of frustration, except in
childhood abuse of animals and of the mother for boys, and also
perhaps through alcoholic intoxication. Girls must repress their
expressions of frustration.

Long postponed revenge for childhood frustration a motiva
tion of which the individual is unconscious may be accom
plished either in suicide or in the sadistic outbursts of war and
torture of the helpless. In males these latter outbursts receive
social approval. Females apparently live with their repressions,
unless the common neurotic malady called hisuteri (derived
from the English hysteria usually nymphomania) may be re
garded as a consequence.

Undoubtedly related to the sudden cessation of tactility, and
especially the relaxing manipulation of the external genitalia of
the small child, is the reactive behavior of adolescent and adult

Culture and Contact 283

males towards their own bodies and those of others. All the
visceral functions that received such lavish attention in infancy,
in the older Japanese male come to symbolize frustration. Sex
ual functions, even though they may provide occasion for boast
ing, are repudiated in disgust: "The unconscious conflict within
the growing boy finds in sex a symbol of frustrated aggression
and longing for dominance. Behavior related to sex is tinged
with sadistic violence; the fierce obscenity of Japanese school
boys, homosexuality, contempt for wives, and sexual mutilation
of helpless enemies all stem perhaps from these unresolved
conflicts."

While these socialization processes and the behavioral re
sponses to them characterize pre- World War II Japan, to vary
ing degrees they remain true of large segments of Japanese
society today.*

Quite clearly the differences in tactile stimulation undergone
by Japanese and American infants play a considerable role in
the development of their behavioral differences. What these
behavioral differences are has already been suggested in the
studies we have cited.

NATIONAL, CULTURAL, AND CLASS DIFFERENCES IN TAC-

TILITY. National and cultural differences in tactility run the full
gamut from absolute nontouchability, as among upper-class
Englishmen, to what amounts to almost full expression among
peoples speaking Latin-derived languages, Russians, and many
nonliterate peoples. Those who speak Anglo-Saxon-derived
languages stand at the opposite pole in the continuum of tac-

*For pre- World War II Japan see Alice Bacon, Japanese Girls and Women
(Boston: Houghton Mifflin Co., 1902); Lafcadio Hearn, Japan: An Attempt
at Interpretation (New York: The Macmillan Co., 1904); R. F. Benedict, The
Chrysanthemum and the Sword (Boston: Houghton Mifflin Co., 1946); B. S.
Silberman (ed.), Japanese Character and Culture (Tucson: University of Ari
zona Press, 1962); G. DeVos and H. Wagatsuma, Japan's Invisible Race:
Caste and Culture in Personality (Berkeley: University of California Press,
1966); R. J. Smith and R. K. Beardsley, Japanese Culture: Its Development
and Characteristics, (New York: Viking Fund Publications in Anthropology,
vol. 34, 1962).

284 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

tility to the Latin peoples. In this continuum Scandinavians
appear to occupy an intermediate position. I do not propose
here a calculus of tactile variations among the peoples of the
world. The necessary information for such a discussion is sim
ply not available. Clay's study on a small sample of the popula
tion of one local region in North America is the only one of its
kind. However, from general observation of the marked differ
ences in tactility observable among different peoples today it is
possible to draw certain obvious conclusions.

There exist not only cultural and national differences in tac
tile behavior but also class differences. As I have earlier already
remarked, in general it seems possible to say that the higher the
class, the less there is of tactility, and the lower the class, the
more there is. As we have seen, this was not found to be the case
by Clay in her American sample, in which the upper-class
mothers seemed to be more at ease with tactility than the lower-
class mothers. It is possible that this finding could be general
ized for the American population as a whole, with exceptions
represented by blacks and other "minority" groups. Whereas in
Europe, for example, and especially in England, the upper
classes are likely to be hereditary and long entrenched in their
ways, in America social mobility is so great that one can move
from lower- to upper-class status in a single generation. Parents
of the second generation move very much more freely than their
own parents did, not only in the class achieved for them by
earlier generations, but in their ideas on such important matters
as child-rearing practices. Hence, in America, new members of
the upper classes will often give their children more rationalized
attention than the members of other classes. Whatever the ex
planation may be for Clay's sample, there does seem to exist a
highly significant correlation between class membership and
tactility, and this appears to be largely due to early condition
ing.

Among the upper classes of England relationships between
parents and children were, and continue to be, distant from
birth till death. At birth the child was usually given over to a
nurse, who either wet-nursed it for a brief period or bottlefed

Culture and Contact 285

it. Children were generally brought up by governesses and then
at an early age sent away to school. They received a minimum
amount of tactile experience. It is, therefore, not difficult to
understand how, under such conditions, nontouchability could
easily become institutionalized as part of the way of life. A
well-bred person never touched another without his consent.
The slightest accidental brushing against another required an
apology, even though the other might be a parent or a sibling.
Too often a lacklove childhood combined with a minimum of
tactile stimulation, compounded by the experience of a public
school (which in England is so called because the public is not
admitted to it), produced a rather emotionally arid human
being who was quite incapable of warm human relationships.
Such individuals made poor husbands, disastrous fathers, and
efficient governors of the British Empire, since they were sel
dom capable of understanding genuine human need.

I do not know of a single book by a member of the upper
classes that reveals the slightest insight into the nature of these
conditions; the few writings produced on the subject were all
by members of the middle classes.* It is not that the members
of the middle classes necessarily required more tactile affection
than members of the upper classes, but that they were simply,
in some cases, more articulate about the losses and the indigni
ties they had suffered.

The English public schools, as is well known, were breeding
grounds for homosexuality, for these were all-boy schools in
which all the teachers were males, and usually the only love a
boy ever received was from another boy or a master. The paren
tal inadequacies from which many of these boys suffered pro
duced a high rate of homosexuality. Among writers such fa
mous figures as Algernon Swinburne, J. A. Symonds, Oscar
Wilde, Lord Alfred Douglas, A. E. Housman, E. M. Forster,
T. E. Lawrence, W. H. Auden, and numerous others, were all
products of such parents, and such schools. It is not to be

*One of the best of these is George Orwell's Such, Such Were the Joys
(New York: Harcourt, Brace, 1953).

286 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

wondered at that parentally abandoned children sought to find
some human relationship in sexual friendship with others in the
same predicament as themselves.

The conditioning in nontactility received by so many Eng
lishmen of the upper classes seems to have produced a virtual
negative sanction on tactility in English culture. This was so
much the case that the sense of touch and the act of touching
have both been culturally defined as vulgar. The public demon
stration of affection is vulgar, touching is vulgar, and only men
who are quite outside the pale, like Latin types, Italians, and
the like, would ever dream of putting their arms around one
another, not to mention committing such effeminacies as kiss
ing one another upon the cheek!

The essentially human is dismissed as "effeminate."

It is of more than passing interest to note that in England the
National Guidance Marriage Council, in one of its publications,
suggested that the rising divorce rate is largely due to a lack of
physical contact in the English family, even to the extent of
admonishing small boys not to embrace their mothers during
some little crisis, but to retain their manhood by maintaining
a "stiff upper lip." The Council advised that the English "need
to touch, stroke, and comfort one another more often."

Even more far gone in nontactility, if such a thing can be
imagined, than the English, are the Germans. The emphasis
upon the warrior virtues, the supremacy of the hardheaded
martinet father, and the complete subordination of the mother
in the German family made for a rigidified, unbending charac
ter which renders the average German, among other things, a
not very tactile creature.

Austrian males, however, unlike Germans, are tactually
more demonstrative, and will embrace close friends. In Ger
many this rarely occurred, except among men of Jewish extrac
tion but that is quite another thing, for among Jews tactility
is highly developed.

The Jews, as a tribe, culture, or people, are characterized by
a high degree of tactility. "The Jewish mother" has become a
byword, for her deep and consuming care for her children. This

Culture and Contact 287

meant that until recent times the children were breastfed on
demand, that there was a great deal of fondling of children by
mother, father, and siblings. Hence, Jews tend to be tactually
very demonstrative, and it is considered perfectly normal for an
adult male to continue to greet his father with a kiss and an
embrace and to do so also on parting. In forty years of close
observation I have only once seen an adult American male (in
this case in his middle twenties) publicly greet his father with
a kiss. Of what cultural origins this American male may have
been I do not know.

Americans of Anglo-Saxon origin are not quite as untactual
as the English or the Germans, but they do not lag far behind.
American boys neither kiss nor embrace their fathers after they
have "grown up" "grown up" in this sense is generally taken
to be about ten years of age. Nor do American males embrace
their friends as Latin Americans do.

There are occasions, however, when American males will
spontaneously drop their inhibitions and joyfully embrace each
other, even kiss each other with complete abandon. This is most
likely to occur when they win an important match or series. The
hugging on such occasions is something to behold, and it is all
the more impressive because of its utter spontaneity.

There are clearly contact peoples and noncontact peoples,
the Anglo-Saxon peoples being among the latter. Curious ways
in which noncontactuality expresses itself are to be seen in the
behavior of members of the noncontact cultures in various
situations. It has, for example, been observed that the way an
Anglo-Saxon shakes hands constitutes a signal to the other to
keep his proper distance. In crowds this is also observable. For
example, in a crowded vehicle like a subway, the Anglo-Saxon
will remain stiff and rigid, with a blank expression on his face
which seems to deny the existence of other passengers. As
Germaine Greer has remarked, "Crushed against his brother in
the Tube the average Englishman pretends desperately that he
is alone." The contrast on the French Metro, for example, is
striking. Here the passengers will lean and press against others,
if not with complete abandon, at least without feeling the neces-

288 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

sity either to ignore or apologize to the person against whom
they may be leaning or pressing. Often the leaning and lurching
will give rise to good-natured laughter and joking, and there
will be no attempt to avoid looking at the other passengers. A
protesting Englishman on such occasions is regarded as a rather
pathetic figure of fun.

While waiting for a bus Americans will space themselves like
sparrows on a telephone wire, in contrast to Mediterranean
peoples who will push and crowd together.

Sydney Smith, "The Smith of Smiths," the great English wit,
writing in 1820, amusingly described the varieties of the hand
shake. "Have you noticed," he wrote,

how people shake your hand? There is the high-official the
body erect, and a rapid, short shake, near the chin. There is the
mortmain the flat hand introduced into your palm, and hardly
conscious of its contiguity. The digital one finger held out,
much used by the higher clergy. There is the shakus msticus,
where your hand is seized in an iron grasp, betokening rude
health, warm heart, and distance from the Metropolis; but pro
ducing a strong sense of relief on your part when you find your
hand released and your fingers unbroken. The next to this is the
retentive shake one which, beginning with vigour, pauses as it
were to take breath, but without relinquishing its prey, and
before you are aware begins again, till you feel anxious as to the
result, and have no shake left in you. Worse, there is the pisces
the damp palm like a dead fish, equally silent, equally
clammy, and leaving its odour in your hand.

Sydney Smith did not quite exhaust the varieties of hand
shaking. Two forms of the handshake observable at the present
day are the following: Shaking hands and at the same time
grasping the elbow or forearm of the shaken arm. Or to grasp
the shakee's hand with both hands. I know a young woman who
does this. When I commented on the fact she surprised me by
saying that she was quite unaware that she shook hands in this
manner.

It is of interest to note that free-living chimpanzees will
stretch out the hand to let it be touched by another as a gesture

Culture and Contact 289

of friendliness. So will the gorilla. It also constitutes a measure
of one's opposite number's intentions. Contact greetings of this
sort take a variety of forms among chimpanzees. For example,
they will place a hand on the thigh, or place the hand on the
other's body in gentle reassurance.

The reference to the handshake brings us to the matter of
tactile salutations in general. These represent a form of tactile
behavior that has received very little attention. The handshake
is clearly an evidence of friendliness. Ortega y Gasset has elabo
rated an anthropologically quite unsound theory of the origin
of the handshake. In this he sees the submission of the van
quished or of the slave to his master. The theory is not by any
means novel, but, as Westermarck points out, handshaking in
many cases seems to have the same origin as other ceremonies
consisting in bodily contact. Salutatory gestures may express
not only absence of evil intentions but positive friendliness.
Whatever its origins the handshake is quite obviously a tactile
communication. So is the placing together of the palms of the
hands, placing the hand on the heart, nose rubbing, embracing,
kissing, and even the backslapping, cheek-tweaking, and hair-
mussing in which some people indulge. Westermarck long ago
recognized that these various forms of salutation by contact
"are obviously direct expressions of affection." He goes on to
add that

we can hardly doubt that the joining of hands serves a similar
object when we find it combined with other tokens of good will.
Among some of the Australian natives, friends, on meeting after
an absence, "will kiss, shake hands, and sometimes cry over one
another."* In Morocco equals salute each other by joining their
hands with a quick motion, separating them immediately, and
kissing each his own hand. The Soolimas, again, place the palms
of the right hands together, carry them to the forehead, and from
thence to the left side of the chest, [p. 151]

*For an account of weeping as a form of salutation see W. G. Sumner, A.
G. Keller, and M. R. Davie, The Science of Society (4 vols., New Haven: Yale
University Press, 1927), vol. 4, pp. 568-70.

290 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

Dr. Sandor S. Feldman points out that in handshaking we
cling to the other person. In his view, the gesture means that
we should trust each other, as a baby has perfect and complete
trust in his mother. There is a right way and a wrong way of
handshaking. In the right way the hands of the two persons are
fused, and both feel a certain pressure. Each expects the same
pressure of the other. When one feels an uneven exchange of
pressure, he feels let down.

The showoffs crush the hand they grasp. The handshake of
the meek and mild is vapid. Feldman thinks that those who
merely extend a finger, do so usually out of a fear of contact,
a social anxiety.

Dr. August Coppola has very rightly drawn attention to the
fact that in the handshake something immediate and direct is
told us about the other person, that however much people may
attempt to "put on" with their handshake, the tactile image is
directly related to the effort involved, the way in which one
person attempts to know the other. As Coppola says, "There
are no poses, no lies, nothing static, for even a hand that is still,
limp, effortless, would be read as withdrawn in relation to the
other, and would in turn provoke a response. . . . Since our only
way of knowing each other is to sense the slightest movements,
it seems impossible for people to mask their reactions, for the
very attempt would be sensed as a hesitation or restraint within
the touch relation." In the world of touch personality consti
tutes the very process of engagement.

It is no accident that in being introduced to another we say
such things as, "Delighted to meet you," "How do you do?"
"I'm glad to know you," and the like, for as Coppola says, in
the handshake the tactile awareness is underscored of the "very
sensitive reciprocity of two persons attempting to know each
other, opening a series of responses that go beyond the abyss at
the edge of the touch world." Coppola very appropriately
quotes from Rilke's poem, "Palm of the Hand," which shows
Rilke's grasp of this idea when he says, "It enters into other
hands, it turns its own kind into landscape: journeys and ends
its journey in them, filling them with arrival"

Culture and Contact 291

So remember, when you next shake hands you may be
whether you are aware of it or not embarking upon a journey
of discovery.

Cheek patting, head patting, chin chucking are all, in the
Western world, forms of behavior indicating affection, and all
are tactile. Such tactile salutations, as evidence of friendliness
or affection, are probably founded on the earliest experiences of
tactile affection received from the mother (and others) as a
child.

Sexual differences in salutations are of interest here. For
example, in the Western world it is customary for men to shake
hands, but not for women to do so. Women kiss or embrace
when they are friends, and shake hands only when meeting for
the first time or as casual acquaintances. Men do not shake
hands with women, but bow, unless the woman extends her
hand, when in the English-speaking world it will be shaken, and
in the Latin-speaking world kissed. In recent years, in their
growing affection for women, after some acquaintance men
have taken to kissing them where formerly they would merely
have bowed or shaken hands. Different times, different mores.
In Elizabethan England kissing as a greeting was extended to
all members of the same class, whether friends or strangers.
Erasmus (14667-1536) in one of his letters comments on this
delightful custom of the English. It would not be too bold an
inference from this that perhaps the English, as children, re
ceived a great deal more tender loving care in Elizabethan days
than they did in a period like that of Victoria and her son
Edward, a period, as Rupert Brooke said of Victorian Sundays,
full of impalpable restraints.

It is of great interest that in the middle 1960's something of
the importance of the skin should have been rediscovered by
so-called Encounter, Marathon, and Sensitivity Training
groups. These groups usually consist of adults or older adoles
cents. A principal emphasis in such groups is on touching. All
diffidence is dropped and one is encouraged to embrace others,
caress them, hold hands with them, bathe in the nude with
them, and even be massaged by them.

292 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

In a most thoroughgoing investigation of encounter and sen
sitivity training groups Dr. Kurt W. Back concludes,

The encounter group is based on little coherent theory, mainly
on the touch-and-go kind of technique, and even the practition
ers do not claim to know particularly what they are doing.
... In fact, most people leading encounter groups would not
claim any lasting beneficial effects on the patients or participants,
and thus the question of the danger involved becomes important.
The question of breakdowns in encounter groups is controversial
and we have to rest here on a few well-established facts: there
have been some breakdowns, suicides, and psychotic episodes in
members of encounter groups.

Of sensitivity training Dr. Back concludes that it may be more
a symptom of what ails society than a cure for its ills.

Rather more favorable judgments concerning such groups
have been expressed by Dr. J. R. Gibb, who examined 106
research studies on such human relations groups, and con
cluded that they were of distinct therapeutic value. Carl Ro
gers, after a broad survey of the evidence, concludes that en
counter groups do bring about much in the way of constructive
change.

Everyone enjoys having his back scratched, and to be mas
saged constitutes one of the supreme pleasures. But these are
physical gratifications. These various groups are concerned
with much more than physical pleasures. What they seek to
achieve is a greater behavioral aliveness to their own and others'
presence, relatedness to the environment; they seek to put peo
ple who have become dissociated back into touch with their
fellow human and the world in which they are living.

The idea is a good one even though it comes late in the day
for many of the participants. It runs counter to the Freudian
notion that touching should comprise no part of therapy. Freud
himself was a bit of a cold fish, and one cannot avoid the
suspicion that he was insufficiently fondled when he was an
infant. However that may be, the rediscovery of the skin as an
organ which, in its own way, requires just as much attention as

Culture and Contact 293

the mind, is long overdue. Allowing for all the failures, the
therapeutic benefits resulting from the experiences in these vari
ous groups in which tactility plays a significant role have been
reported to be appreciable.

Canadians of Anglo-Saxon origins perhaps even outdo the
English in their nontactuality. On the other hand, French
Canadians are as tactually demonstrative as their counterparts
are in their land of origin.

The manner in which Frenchmen will embrace and kiss their
male friends, and the embracing and kissing that takes place on
ceremonial occasions, as when a general conferring a decora
tion upon another officer will embrace and kiss him ceremoni
ally on both cheeks, embarrasses Anglo-Saxons into depreca
tory giggles. Whereas the nontactuality of Anglo-Saxons
signifies to most tactual peoples that they are unemotional and
cold.

The Russians, who are a highly tactual people, receive a great
deal of cutaneous stimulation when they are young, and con
tinue in the habit of tactility all through their lives. The swad
dling which most Russians customarily underwent as infants
ensured them a great deal of tactile stimulation, for they were
usually unswaddled in order to be breastfed, otherwise fed,
bathed, cleaned, and in other ways attended, a fact which seems
to have been overlooked by the proponents of the "swaddling
hypothesis" who claimed that many of the national traits of
Great Russians (Central and Northeastern Russians) could be
explained by the restraints such children suffered as infants as
a consequence of swaddling. The child was kept isolated from
its parents, with only siblings and maids for human contact, and
was only brought out of the nursery or children's quarters in
order to perform in some manner such as the recitation of
poetry, the playing of a musical instrument, or singing. During
infancy, according to the swaddling hypothesis, the swaddling
inhibits muscular activity, while the release from swaddling in
order to be fed and otherwise cared for becomes associated with
an "all or none" feeling toward pleasure which the Russian
adult displays in his emotional life, an emotional life in which

294 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

gratification is experienced as orgiastic.

There has been much misunderstanding concerning the na
ture of swaddling. It takes skill to do it. As Peter Wolff has
written,

Swaddling is a very effective method to quiet a fussy baby,
provided it is done by someone who knows how, and who sees
to it that the baby is immobilized. When the swaddling is done
unskillfully so that the clothing simply restricts the range of
movement without inhibiting it totally, the procedure has a
marked arousal effect and may provoke the "mad cry." The
critical difference is probably that "poor* 9 swaddling generates a
constant background of variable proprioceptive feed-back,
whereas "good" swaddling generates a constant background of
tactile stimulation.

The swaddling hypothesis has been severely criticized and
found wanting on virtually every ground. Under the Soviet
system swaddling has been largely abandoned throughout the
Russias.

In The Study of Culture at a Distance, edited by Mead and
Metraux, there is a valuable account of the sense of touch
among the Russians, written by a sensitive woman informant
in the Research on Contemporary Cultures project. It is well
worth reproducing here in its entirety.

The Dictionary of the Russian Language defines the sense of
touch as follows: "In reality all five senses can be reduced to one
the sense of touch. The tongue and palate sense the food; the
ear, sound waves; the nose, emanations; the eyes, rays of light."
That is why in all textbooks the sense of touch is always men
tioned first. It means to ascertain, to perceive, by body, hand, or
fingers.

There are two words to express the idea "to feel." If one feels
with some outer part of the body, it is ossyazat; but to feel
without touching, without direct contact, is oschuschat physi
cally, morally, or spiritually: "I feel (oschuschat) too cold or
cold," or "I feel (oschuschat) happiness." But when I feel some
thing with my fingers, I ossyazat I don't really feel, I finger,
grope.

Culture and Contact 295

Though there exists an adverb ossyasatelny (tangible), Rus
sians avoid using it. I have never heard anybody using it, nor
have I come across it in literature. Tangible evidence in Russian
will be "material proof." Touch is not considered the right way
of exploration. One does not have to finger a thing when one can
see it with one's eyes. One of my [Russian] college professors
complained that his students were "savages." When he showed
them a bone, drawing their attention to a cavity, the majority of
the students poked their fingers into it. Children were taught not
to touch things. They learned very quickly, and when you
handed a child something you wanted him to feel like a piece
of velvet or a kitten the child picked it up and put it against
his cheek.

The standard joke among lower-class people was for a man to
ask a woman, "Nice calico you are wearing. How much did you
pay a yard?" And under the pretext of feeling the material, he
would pinch the woman.

Russians in general touch each other much less than Ameri
cans do. There is hardly any horseplay, slapping on the back,
patting, fondling of children. The exception is when somebody
is very happy or drunk. Then he hugs somebody. But that is not
touching. He opens his arms wide as if to embrace the whole
world, and then presses you against his breast. The breast is the
dwelling place of the soul, and this gesture means that he has
taken you to his heart.

These are interesting observations, though not entirely inter
nally consistent. For example, if Russians are nontactile why is
it that the students poked their fingers into the cavity of the
bone? In spite of the fact that this informant states that hugging
is not touching, the fact is that it is very much so. Soviet officials
when they meet embrace and often kiss each other, and may
behave in this manner towards nationals of other countries, if
one may depend upon what one sees in TV news reports and
photographs.

Several students have reported the emphasis they believe
Russians place on visual experience. Thus Leites writes of their
"desire to translate all the abstractions visually." Haimson be
lieves that in contrast with the "objective" thinking that charac-

296 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

terizes Western society, and which he believes is largely
founded on motor activity and tactile manipulation of external
objects, the visual thinking of Great Russians is singularly lack
ing in specificity, especially when evaluated by the measure of
manipulation. The suggestion is that tactual manipulation is
important in the development of abstract and conceptual
thought. These students suggest that an element is lacking in
Russian abstract thought, present in the concrete situation, and
which may be approached through tactual or physical manipu
lation. Combined with the supposed effects of swaddling upon
the kinesthetic movements of the child, the lack of the tactual/
manipulative approach to experience is somehow seen to affect
the Russian's ability to grasp the essentials of a given whole, to
break up a given whole in parts, to isolate and synthesize them.
The "whole," on the contrary, is likely to be seen as consisting
of overlapping and contradictory items, all of which being
lumped together, constitute one diffused whole, to which one
responds with "emotion and intensity." Russian thinking is
declared to be deficient in logical simplicity, consistency, and
completeness.

Interesting as these observations are, it would be of value to
have them explored further, and to have the comments of in
formed students of the childhood and development of "Great
Russians."

THE CRADLEBOARD. The cradleboard is used among many
peoples in managing the child. Among the Navaho Indians of
the Southwest, the newborn was placed in a temporary cradle,
and then after three or four weeks transferred to a permanent
tightly laced cradle. Before being placed in the cradle the infant
was tightly wrapped in cloths in such a way, sometimes, that
its legs were separated and firmly encased. The cradle itself
would be lined with some soft material, formerly the soft bark
of the cliff rose. A canopy would be placed at the top and a
footrest at the bottom of the board. The infant, fully wrapped,
would then be strapped to the cradle by a lacing cord, which
in zigzag fashion between cloth or buckskin loops was attached

Culture and Contact 297

to the sides of the board and was finally fastened through a loop
on the footboard. From the canopy a cloth could be lowered to
cover the whole cradle to keep out light, flies, and cold. Babies
were taken out of the cradle only to be breastfed, cleaned, and
bathed. Babies of two months averaged two hours a day out of
the cradle; those of nine months averaged nearly six. In addi
tion to these times of full release from the cradle, the child's
arms might be freed for varying intervals two or three or four
times a day.

An infant's movements are sharply restricted for most of the
day and all of the night by its binding to the cradleboard. Its
position is varied from the vertical to the horizontal, but the
infant cannot move of its own volition. This would suggest a
severe limitation on its tactile experience. There is also a restric
tion upon its response to internal stimuli, such as anger, hunger,
or pain. It cannot kick or wriggle; it can only cry or refuse to
suck or swallow. Leighton and Kluckhohn suggest that the
desire for bodily movement may be lost after repeated frustra
tion. I believe another more physiological explanation is possi
ble. The snugness of the cradleboard continues the snugness of
the womb, and far from feeling frustrated by the restriction of
movement the baby may feel a great deal more secure than he
would be were he abandoned to the insecurity of the open space
of a crib. The mother carries the cradleboarded baby wherever
she goes, on her back, and placed upright when she is spinning
or similarly engaged, so that the child may always see her. In
the cradle he receives a great deal of tactile stimulation from his
mother and everyone else, for his face is continually being
patted and caressed, and the cradled baby joggled by relatives
and others. Furthermore the cradle permits the baby to be
comfortably in an upright position so that he is able to keep in
touch with what is going on around much more effectively than
the baby who is lying down. The fact of interest is that far from
being restricted in the cradle the Indian infant greatly enjoys its
comforts, and will often cry to be returned to it.

When one observes the spasmodic movements of babies dur
ing the first two or three weeks, and especially soon after they

298 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

have been born, one cannot help being struck by their resem
blance to the movements of a person falling through space. May
it not be that with the removal from the snug comfort and
support of the womb to the open space of a crib the baby
experiences something of a similar feeling of insecurity some
thing the cradleboard and swaddling serve to prevent? May it
not be that the complete lack of fear of great heights exhibited
by American Indians, which makes them such popular and
successful construction workers on skyscrapers, is related to
their early cradleboard experience? Leighton and Kluckhohn
comment upon the missionaries, teachers, and others who urge
the Navaho mothers "to give up those savage cradles and use
cribs like civilized folks," that it should never be forgotten that
every people's way of life represents their particular set of solu
tions to the conditions of life with which they have been con
fronted. With the cradleboard they appear to have come a great
deal nearer to providing the baby with a far superior environ
ment than the modern crib.

The experience on the cradleboard in no way retards the
motor development of the child. Hopi infants who have been
kept on the cradleboard walk no later than those who have not
experienced it at all, and show no differences whatever in motor
skills. Indeed, the pediatrician, Margaret Fries, suggests that
the practice of propping the cradled child in an upright position
before he can even crawl may facilitate his motor development.
Balance and vision are then in the same plane as when the child
is walking. His legs are kept constantly extended, with the feet
flexed against the footboard in the position for standing.

A white mother, a teacher living in Arizona, has written of
the great advantages of the cradleboard on which she raised her
own infants. Mrs. Louise Galley points out that the child feels
snug and secure on the cradleboard, as if someone were holding
him tightly and continuously. The child is more comfortable on
the board for any prolonged period than he can possibly be in
someone's arms. In the evening her son would be rocked and
sung to sleep in his own cradle made to fit his growing size,
instead of being plunked into a big cagelike bed. He was always

Culture and Contact 299

sleeping in a familiar bed no matter where his parents might be.
Mrs. Galley states that one of her sons would not go to sleep
unless strapped on the cradleboard for the first eight months of
his life. He always gratefully acquiesced in going back to the
board after his abundant romps, and would voluntarily put his
arms to his sides ready to be strapped in. "Surely," Mrs. Galley
remarks, "the Indians have been ahead of their white brothers
in the art of childrearing."

Far, then, from tight binding and swaddling exerting any
unfavorable effects upon the development of the child, the very
opposite seems to be true. These practices would seem to have
very real psychological advantages, in no way interfering with
the motor development of the child and, if anything, affording
him more tactile satisfactions than many children receive in
noncradleboard cultures.

MOTHER, FATHER, CHILD, AND SKIN. In the symbiotic relation
ship in which the infant is programmed to continue with his
mother, skin contact, as we have seen, plays a fundamental role.
It is a communication which the father is also designed to make
through the skin, if not in quite as massive and continuous a
manner as the mother. But in civilized societies men are even
more enveloped by clothes than women and so this important
cutaneous means of early communication between father and
child tends to be nullified by this artificial barrier. A basic factor
in the development of the ability to love is the growing recipro
cal involvement in the source from which the pleasure-giving
sensory stimulations are received. Between mother and child
there is normally an exchange of pleasure-giving experiences.
The father, in civilized societies, is to a large extent deprived of
the possibility of such direct reciprocal pleasure-giving ex
changes. It is, therefore, not surprising that children in these
societies should develop such close identifications with the
mother.

The male in all societies is at greater risk in this, as in all other
connections. As Ritchie has pointed out, "The female, as she
grows and develops, has before her in more or less continuous

300 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

direct relationship, the model of her mother. The man, as he
goes through life, begins his life also in primary relationship to
a maternal object but he has to give it up, he has to leave off
identification with the mother, he has to take on the full male
role. Males have to switch identification during development,
and all sorts of things can go wrong in this." And, unfortu
nately, they frequently do. The male has a much harder time
than the female does, in growing up and separating himself
from the loving mother, and in identifying himself with a father
with whom he is nowhere nearly as deeply involved as he
remains with the mother; this often puts some strain upon him.
The switch in identification he is called upon to make results
in something of a conflict. This he usually seeks to resolve by,
in part, rejecting the mother and relegating her to a status
inferior to that into which he has, so to speak, been thrust.
Masculine anti-feminism can be regarded as a reaction-forma
tion designed to oppose the strong unconscious trend towards
mother-worship. When the male's defenses are down, when he
is in extremis, when he is dying, his last, like his first word, is
likely to be mother, in a resurgence of his feeling for the mother
he has never really repudiated, but from whom, at the overt
level, he has been forced to disengage himself.

If in our culture we could learn to understand the importance
of fathers as well as mothers giving their infants adequate tactile
satisfactions, we would be taking a considerable step towards
the improvement of human relations. There is nothing to pre
vent a father from bathing his infant child, from drying it,
fondling it, caressing it, cuddling it, changing its diapers and
cleaning it, from holding it, rocking it, carrying it, playing with
it, and continuing to give it a good deal of affectionate tactile
stimulation. The only thing that stands in the way of such
behavior on the part of males is the ancient and outmoded
tradition that such conduct is feminine and therefore unbecom
ing a male. Fortunately, this is a tradition which is rapidly
breaking down; increasingly one sees young fathers involved
with their children very much more deeply and in all sorts of
"feminine" ways which only a generation or so ago were con-

Culture and Contact 301

sidered beneath the dignity of a "real" male. Dignity, as Lau
rence Sterne observed, is usually a mysterious carriage of the
body calculated to conceal the infirmities of the mind.

There is good evidence that a strong bond of attachment is
capable of being formed between father and child within the
first few days of its life, and also of being reenforced by his
subsequent attentions to the infant. Not only this, Dr. Ross D.
Parke of Madison, Wisconsin, in an investigation of the interac
tion between middle-class fathers with their two- to four-day-
old infants found that in the triadic situation mother, father,
and infant together in the mother's hospital room the father
tends to hold the baby nearly twice as much as the mother,
vocalizes more, touches the baby slightly more, and smiles at
the baby significantly less than the mother. The father's pres
ence significantly influenced the mother's emotional state. In
the presence of the father mothers smiled more at their infant
and explored more.

Dr. Parke tentatively concluded that the father is much more
involved in his infant and responsive to it than our culture has
acknowledged; that the practice of excluding the father from
early interaction with his infant merely reflects and reenforces
a cultural stereotype. A critical issue for Dr. Parke is that the
care of infants be acknowledged as natural and appropriate
male behavior.

Winnicott has observed that the physical holding of the child
is a form of loving, that it is, in fact, perhaps the principal way
in which a mother can show the infant her love for it. This is
equally true for the father or, for the matter of that, for anyone
else. And as Winnicott says, "There are those who can love an
infant and there are those who cannot; the latter quickly pro
duce in the infant a sense of insecurity, and distressed crying."

TACTILE STIMULATION AND THE EXPRESSION OF HOSTILITY.

During the nineteenth century, and probably also in earlier
centuries, males in the Western world often indulged in the
peculiar custom of greeting children with noxious manipula
tions of their skin. Such practices lasted well into the twentieth

302 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

century. The victims of these assaults must have been sorely
puzzled by such behavior and in some cases probably developed
strange ideas concerning the relationships between skin, pain,
and the putative demonstration of affection. It is of interest to
note that males exclusively were guilty of such sadistic prac
tices, and then usually only towards male children, although
girls with braids did not entirely escape their attentions. A
favorite trick was to grasp the child's cheek between thumb and
forefinger and give it a thorough tweak, or the ear might be so
treated or pulled or given an even more painful flick with a
finger. Graham Greene in his autobiography, A Sort of Life,
tells how, when he was eight years old, his schoolmaster at
Berkhamsted "indulged his jovial ogrish habit of screwing a fist
in one's cheek till it hurt" Hair-mussing, pinching, a spank on
the bottom or a push were among the other engaging indignities
to which children, all in the guise of affection, were subjected.
A hearty slap on the back was usually reserved for older adoles
cent boys and males up to middle age. Such demonstrations of
affection by painful attacks on the skin could only have been
performed by individuals who had themselves been the victims
of such abnormal treatment.

Just as those who have been inadequately loved, or have been
frustrated in their need for love as infants, will exhibit a great
deal of hostility in their verbal activities, so, too, those who have
been failed in the experience of tactile affection will often be
awkward and crude in their attempts at demonstrations of such
affection. There are men who almost crush the hand they shake
when introduced to another male, who with their familiars
punch them in the chest or abdomen, as a mark of affection.
The same males tend to be rough, awkward, and crude with
"the gentler sex." Since a lacklove infancy and the privation of
tactile affection generally go together, it is not surprising to find
that the unloved child grows up to be not only awkward in his
demonstrations of love but also awkward in his body relation
ships towards others. Such persons rub others the wrong way
because they have been failed in the experience of being stroked
the right way.

Culture and Contact 303

There has been a great change in the earlier forms of hostile
demonstration of "affection" towards boys, but what remains
is the expression of anger towards the child in the form of
aggressive tactilisms, such as slapping, spanking, or shoving.
"Corporal punishment" is still widely practiced throughout the
Western world, and the skin not only made a target and a
vehicle for the experience of pain, but an organ which is directly
associated with anger, punishment, sin, aggression, naughti
ness, and evil. As Lawrence Frank has remarked,

Spanking and slapping are often used to punish a child, utilizing
this tactual sensitivity as the chief mode of making him suffer,
thus depriving him of his usual comforting, and giving instead
painful contacts.

This infantile tactuality, like his other organic needs, is gradu
ally transformed as the child learns to accept mother's voice as
a surrogate, her reassuring tones of voice giving him an equiva
lent for his close physical contacts, her angry scolding voice
serving as a punishment and making him cry as if hit.

An unkind remark "hurts" just as if it were a slap or a painful
blow to the body. A cutting remark causes its target to "bleed"
just as if his skin were slashed. Words may also "sting to the
quick."

Class differences in the use of angry words containing the
threat of tactile punishment were very marked in Clay's study.
The working-class mothers used words harshly, the middle
class used them sparingly, while the upper class "used them
most often in a kind of affectionate play and, more than the
other classes, they combined touch and words."

Some parents, particularly fathers, make it a point to tell
their children before they strap them why they are being pun
ished. One can thus learn to dissociate the infliction of bodily
pain from the display of any emotion at all. The Nazis were
particularly adept at this, and there can be little doubt, as we
have seen, that their affectless inhumanity was in no little part
due to their early conditioning, with tactile experience largely
neglected or else restricted to a punishing kind. This would

304 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

seem to be an especially undesirable form of conditioning.

The canings, usually administered by senior prefects, cus
tomary in English public schools, during which any display of
emotion on the part of either the caner or his victim was strictly
tabooed, undoubtedly served to produce a dissociation between
pain and emotion. Hence, one could not only remain unin-
volved with the pain of others, but inflict it upon them without
in any way feeling that one was being anything but just. Hence,
the great pleasure educated Englishmen have often taken in wit
that was cruel, and their indifference to and lack of understand
ing of the consequences of their conduct.*

TATTOOING. One wonders whether those dermatological
graffiti known as tattoos may not be related to an exhibition-
istic desire to reward oneself and one's skin through a regres-
sively painful experience resulting in a permanent embellish
ment or disfiguration of the abused organ. The tattoo has been
seen as a defense practiced by those who expect to be attacked
and who arm themselves this way by emphasizing appearances.
This explanation would appear to fit the elaborate tattooing to
which the Japanese yakuza or gangsters submit themselves, and
who in the feudal period grew to be a symbol of resistance to
despotism. Florence Rome, who made a special study of the
yakuza, says that "Because it was such a test of strength to
endure the pain of tattooing, it began to take on other aspects
manliness, courage, health, vitality and so on and the
yakuza in adhering to this custom feel themselves to be the
possessors of such attributes."

Similar motivations appear to be at work among young gang
members and delinquents in the Occident as well as in the
Orient, Dr. J. H. Burma in a study of tattooing among male
delinquents in one school found 67 percent to have tattoos. In
a similar school for girls 33 percent were found to be tattooed.

This was strikingly exhibited in the English film If, widely seen in the
United States in 1969.

Culture and Contact 305

There was an average of five to ten different kinds of tattoos
over their bodies, and most were in clearly visible places, a
greater proportion being visible in boys than in girls. The words
and phrases associated with the tattoos frequently revealed
identification with a gang or a significant friend. The delin
quents themselves were not unaware of the fact that their tat
toos advertised their affiliation with power sources. It is a way
of declaring: "I am such and such a kind of a person and you
can expect me to behave in certain brave, strong, forceful
ways."

In the United States about 10 percent of the population is
tattooed. Males are much more commonly tattooed than
females. It is said that tattooing increases in frequency during
periods of crisis.

The motivations for tattooing are probably many. In Egypt
tattooing is believed to confer sexual potency on both male and
female, and, indeed, is considered sexually attractive by each
sex. In Iraq tattooing was used to induce and also to maintain
pregnancy. Since the custom has been virtually worldwide and
practiced for every conceivable reason it would be folly to
attempt to attribute it to a single cause. However, whatever the
cause initiation, religious, sexual, ostentation, prestige the
element of self-gratification can be seen to run like a red thread
through all the ostensible motivations. This is clearly evident in
the tattoos with which so many sailors and soldiers, long de
prived of the society of women, choose to decorate their bodies
usually their arms. The sexual motif is usually quite explicit,
and its presence obviously gratifying. The tattoo legitimizes a
continuous erotic involvement.

CORPORAL PUNISHMENT. It is astonishing to find how widely
the barbarism of spanking children is still defended princi
pally among members of the working classes. A group of such
women whom I met in June 1976 maintained that spanking was
good for children. Two of the most articulate proponents of this
view mentioned that they had divorced their husbands because
they were wife-beaters. When I asked them whether they did

306 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

not think it possible that parent-beaten boys might later become
wife-beaters, they considered the suggestion absurd.

It is becoming increasingly evident that parents who become
child batterers and abusers were in most cases themselves ne
glected and abused as children. In the half dozen studies thus
far reported it was found that 25 percent and more of batterers
had themselves suffered separation from the mother.

Dr. Henry Kempe of the University of Colorado Medical
School has stated that the most important indicator of whether
a child will be abused is the mother's attitude at the time of the
baby's birth. If she does not smile, does not want to see and hold
the baby, and if the father behaves in the same way, they will
need help in raising the child. Since some 2,000 children die of
abuse annually in the United States, the follow-up of such
families is imperative.

Dr. Ray Heifer in a study of about one hundred adolescent
males brought into juvenile court found that more than 85
percent had abusive parents and suffered very negative experi
ences as children. Abusive parents cannot identify one friend
who would help them in time of trouble, and a significant
number tend to have phones with unlisted numbers. The
prematurity rate of abused children is twice that of the general
population, and the cesarean section rate is many times that of
the general population.

Professor Selma Fraiberg, in discussing Dr. Heifer's paper,
stated that although all the battering parents she had studied
remember the actual abuse they had suffered in childhood in
stunning and chilling detail, they did not remember the effect
of the experience, that is, being abused and injured. When her
group could help such parents reach the point of saying, "Oh,
God, how I hated him when he would get that strap and lay
me out and begin to beat me. Oh, how I hated him," only then
could some progress be made. When her group helped the
parents to remember the anxiety and the sense of terror that
had come over them with the abuse of a powerful parent, they
could demonstrate that the parents' behavior towards their own
children changed. Thus, it was with the actual reexperiencing

Culture and Contact 307

of the terrifying feelings involved that changes occurred.

In immediate anticipation of a spanking and during the as
sault the child is often terrified, exhibiting all the accompani
ments of extreme fear, pallor, muscle rigidity, accelerated
heartbeat, and weeping. In later years, under conditions of
emotional upset persons who have undergone such childhood
experiences will frequently exhibit similar reactions. Or in an
effort to defend themselves against the autonomic discharge of
feeling, they will "bite their lips," grow rigid, or clasp one hand
with the other in a firm grip. This is a method, like keeping "a
stiff upper lip," of preventing one's emotions from expressing
themselves, of holding back the tears, of bracing oneself for the
blow by employing muscle tension. Muscle tension as a method
of keeping emotionally disturbing feelings under control has
been remarked by many observers. Or one can dig one's nails
into the palms of one's hands until they bleed, in an effort to
counteract the expression of emotion, or use the skin ambiva
lently as a means of both drawing attention to one's needs and
at the same time rejecting the other. As Clemens Benda has put
it, "Skin diseases vividly demonstrate the difficulties of main
taining contact a sore skin, a running nose, an infected mouth
each area of external or internal contact is a possible spot for
an interference with the even flow of human exchange."

It is here being suggested that behavior of this kind is signifi
cantly related to the tactile experiences of the individual during
infancy and childhood.

The weeping which is usually associated with physical pun
ishment in childhood may, in later years, express itself in weep
ing through the skin. Kepecs and his co-workers in a series of
ingenious experiments have shown that in emotional weeping
the visible expression "is not limited in its effects to the lacrimal
glands, but also finds expression in other parts of the body,
including the skin." Having, under hypnosis, induced an artifi
cial cantharides blister in the skin of their experimental sub
jects, the investigators then induced various emotional states in
them and measured the amount of fluid exudation into the
blister site. Emotional states were associated with a rise in the

308 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

exudation rate, especially in weeping; the heavier the weeping
the higher the exudation rate. Interestingly enough, as would
be expected, inhibition of weeping was associated first with a
fall and then with a great rise in exudation rate. Thus, the male
of the English-speaking world who is everywhere taught that "a
little man" doesn't cry, having repeatedly been caused to re
press his desire to weep until he has become incapable of weep
ing from his lacrimal glands, often begins, in later life, to weep
through his skin or his gastrointestinal tract. It is now well
established that in a large proportion of cases of atopic dermati
tis there is associated a strong but inhibited desire to weep.

INFANT-DIRECTED TACTILE BEHAVIOR TOWARDS THE

MOTHER. Harlow has made it clear, in his studies of rhesus
monkeys, that the most important of the young animal's experi
ences, for its subsequent development, is bodily contact with its
mother, and so it is with the young of Homo sapiens.

The four phases of the child-mother affectional system, in
both human infants and infant monkeys, are: (1) a reflex stage
in which the infant reacts automatically to the stimuli presented
by the mother; (2) a stage of affectionate attachment; (3) a
security stage; and (4) a stage of independence. The reflex stage
lasts only a few weeks in rhesus monkeys and a few months in
human infants. The phase of affectionate attachment begins in
the human infant within the first thirty minutes after birth, but
it is not until between two and three months of age that this
becomes very evident in the infant's behavior. By smiling, cud
dling, gurgling, and the like the baby begins to show active
voluntary affection for its mother. The primary tie to the
mother appears to operate, in the rhesus monkey, through the
two systems of nursing and contacting; these are primarily
operative during the first year. Clinging and following, that is,
visual and auditory responsiveness to the mother, are at their
peak in the second year.

The third stage, the security stage, follows shortly after the
commencement of the attachment phase. The so-called six-
months anxiety is thought to mark the beginning of this phase,

Culture and Contact 309

which is considered to be the period at which the infant begins
to experience visually induced fear reactions. However, in the
human infant visually induced fear reactions may occur as early
as the end of the second week, fear of heights seems to develop
only after the infant has had some experience of locomotion.
Among the maternal responses to the infant at this stage are
acts of comfort, protection, and reassurance in all situations in
which the infant feels fearful and insecure. Under such condi
tions little monkeys run to their mother and attach to her.
"Within minutes or even seconds after attaching, the subject's
hands and body relax and the monkey (or child) will visually
explore the frightening stimulus with little or no sign of anxi
ety." In time, the security responses of the infant, derived from
the security-giving satisfactions his mother has afforded him,
enable the young monkey to leave the mother, and explore the
world tentatively at first, and later, more securely, for himself.

As Clay puts it, "The mother can be thought of as the center
or pivot of the small child's security. As the child becomes able
to move about he no longer wants to remain physically in
contact with the mother; visual contact is sufficient. The con
cept of behavior distance can be used to explain the distance
from the mother that the mobile child is able to experience
comfortably." As a child grows older in the socialization pro
cess behavior distance is increased.

In her study Clay found that it was the nonwalking toddlers
who spent most time in contact with their mothers. It was at
this period that the children's affectionate attachment to their
mothers was at its height. As soon as the child is able to walk
his independent forays away from the mother in the "exhilara
tion of his new mobility and excitement of learning about the
world around him" grow more frequent. His independence,
however, is tentative, for he must maintain visual contact with
his mother or know where she is in order to feel safe.

The child, Clay found, who had not experienced satisfactory
tactile contact with his mother did not make any tactile ap
proaches to her. There were two examples of this behavior, both
of them in children in the crawling stage, who stayed away from

310 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

their mothers during the period when affectionate attachment
is usually at its height. However, it appeared that children who
had experienced a highly satisfactory tactile relationship with
the mother did not come to the mother for more. Finally,
overanxious children tended to have very high tactile needs, a
condition which showed itself in the physical use of the mother
as a haven of security. One of these children had suffered from
inadequate maternal responsiveness, while two others appeared
to be reacting to marital difficulties between their parents.
"Like the infant monkeys, all three children clung to their
mothers and were unable, except for relatively short sallies, to
go out, explore and play in the environment."

In Clay's group middle-class children expressed more tactual
affection towards their mothers than did the children of the
other two classes. Clay suggests that this may have been due to
the greater duration of tactile contact they received in the neo-
nate and just-walking stages of development.

The Harlows remark that "all the mother-infant interactions
relating to nursing, bodily contact, and following-imitation
contribute to security, although there is evidence that sheer
bodily contact-comfort is the dominant variable in the rhesus
monkey." This appears also to be the case in the human infant.

CONTACT AND PLAY. The importance of play in learning is now
recognized by almost everyone, and, as Harlow has pointed out,
all forms of play behavior reduce to expressions of the funda
mental motive of exploration and manipulation. "Social play is
preceded by exploration of the physical environment and play
with inanimate objects, and apparently social exploration and
play take precedence over environmental exploration and play
because of the greater regard and feedback given by animate
rather than inanimate objects."

Among the monkeys observed by the Harlows, object explo
ration preceded social exploration, and each involved three
identifiable components: (1) a visual exploration, in which the
monkey orients closely to, and peers intently at, the object or
other animal; (2) an oral exploration, a gentle mouthing re-

Culture and Contact 311

sponse; and (3) a tactual exploration, limited to a transient
clasp, either of a physical object or of another animal. Here,
once more, we perceive that the tactile sense remains the domi
nant one, and it is important to note that these components are
not separate but interrelated, so that when one speaks of visual
exploration, this is not to be construed as a behavior unrelated
to the tactual-oral explorations, but coordinated with them.

In the rhesus monkey close physical ties between infant and
mother must cease before play can develop with age-mates and
peers. Here, too, three stages may be identified: (1) a reflex
stage; (2) a manipulation stage; and (3) a stage of interactive
play. In the reflex stage during the early weeks of life infants
will fixate each other visually and make approach attempts. If
they contact each other, they cling to one another reflexly as
they do to their mothers. When two infants are involved they
cling in a ventral-to-ventral manner, if more than two are in
volved they will cling in a typical "choo-choo" pattern. In the
manipulation stage, beginning at the end of the first month, the
infants explore each other as they would objects, with eyes,
hands, mouth, and body, alternating manipulation of age-mates
with manipulation of the physical environment. Like the
preceding stage, this is a presocial period in peer relationships,
the exploratory activity characterizing it persisting into the
stage of interactive play. As they come to learn more from their
experiences of each other they gradually begin to respond to
one another as social rather than as physical objects, and social
play emerges from the matrix of manipulatory play. The third
stage, interactive play, marks the development of genuine social
interactions between peers. This occurs at about three months
of age, and overlaps with manipulatory play and sequence of
exploration of the physical environment. Interactive play devel
ops in the human infant during the second year of life.

Clay observed a pattern of development of play behavior in
her subjects consisting of alternating periods of mother-child
interaction, followed by periods of play at a distance from the
mother, with a subsequent return to her for further communi
cation.

3 12 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

As the child grows older and extends his behavior distance, the
time actually in contact with the mother, or next to her, de
creases and the time spent away from her increases. The kinds
of contact and the kinds of feedback that the child requires from
the mother for his emotional well-being change also. Where at
first the small child or toddler might want to sit upon the
mother's lap for several minutes, the actively mobile child may
just run up to his mother and say, "Hi!" This kind of psychologi
cal tagging in at the source of security is a pattern that was
observed for almost all the children. It was especially noticeable
among the older children whose mothers allowed them a larger
circle of play.

The "tagging in" is especially important in making certain
that contact is still maintained, especially when one is beginning
to explore other parts of the world for oneself. As Clay found,
with time the child comes to depend less and less upon his
mother for physical contact, and devotes more and more time
to play away from her. At the younger ages he is still not ready
to play independently at any remove from her for more than
short periods of time. He still needs the reassurance of contact
with her, to keep in touch both physically and visually.

As Clay emphasizes, the young of all mammals must learn
to play. The development of the ability to play in relation to the
mother will depend on whether or not the infant's tentatively
playful approaches are rewarded. Working-class mothers ap
parently do not encourage their young to play with them as
much as middle-class and upper-class mothers do the upper-
class children, in Clay's study, make more tactile play ap
proaches to their mothers than do middle-class children.

Interestingly, Clay found that mothers who did not give their
youngsters much tactile stimulation nevertheless encouraged
their children to play with them. It was almost as though the
direct physical contact and the feelings it arouses were consid
ered uncomfortable, but that physical contact, through games,
mediated often through objects like a ball, a picnic spoon, or a
popsicle stick, were acceptable substitutes.

Clay refers to Williams' study of tactility among the Dusun

Culture and Contact 313

of Borneo, in which he called attention to the need to study
". . . ways in which individuals are required, or expected, to
relinquish particular tactile experiences and develop compensa
tory symbolic substitutes at different periods in enculturation."
This kind of learning of symbolic substitutes for tactility is seen
in the behavior of the children who approached their mothers
with various play objects. And it is important to understand
that a great many other forms of symbolic learning of a similar
kind constitute but an extension of the learning based on the
mind of the skin.

Tsumori has shown how important the prolonged experience
of exploratory play activities is in the development and discov
ery of new adaptive behaviors in Japanese macaques, and Hall
makes it quite clear that much of the later behavior of the
nonhuman primate is learned in social situations and practiced
in play.

These observations hold true with even greater force in the
human species.*

The separation or detachment from the mother in all mam
mals plays an important role in the initiation and extension of
the infant's contacts with the rest of the world. As Rheingold
and Eckerman point out, even when the infant is carried about,
his contacts with the world are necessarily circumscribed. Only
when he leaves his mother's side by himself can many new kinds
of learning occur.

The infant comes in contact with an increasing number and
variety of objects. Through touching them he learns their shapes,
dimensions, slopes, edges, and textures. He also fingers, grasps,

*For several other valuable books on play see J. Huizinga, Homo Ludens
(New York: Roy Publishers, 1950); H. C. Lehman and P. A. Witty, The
Psychology of Play Activities (New York: A. S. Barnes Co., 1927); P. A. Jewell
and C. Loizos (eds.), Play, Exploration and Territory (New York: Academic
Press, 1966); S. Miller, The Psychology of Play (Baltimore: Penguin Books,
1968); J. S. Bruner, A. Jolly, and K. Sylva (eds.), Play: Its Role in Develop
ment and Evolution (New York: Basic Books, 1976); J. N. Lieberman, Play
fulness: Its Relationship to Imagination and Creativity (New York: Academic
Press, 1977).

314 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

pushes, and pulls, and thus learns the material variables of heavi
ness, mass, and rigidity, as well as the changes in visual and
auditory stimuli that some objects provide. He moves from place
to place within a room, and from one room to another. From the
consequent changes in visual experience, coupled with his own
kinesthetic sensations, he learns the position of objects relative
to other objects. He also learns the invariant nature of many
sources of stimulation. In a word, he learns the properties of the
physical world, including the principles of object constancy and
the conservation of matter.

CONTACT, INDIVIDUATION, AND AFFECTION. Awareness of

self is largely a matter of tactile experience. Whether we are
walking, standing, sitting, lying, running, or jumping, whatever
the other messages we receive from muscle, joint, and other
tissue, the first and most extensive of these messages are re
ceived from the skin. Long before body temperature either falls
or rises from external causes, it is the skin that will register the
change and communicate to the cortex the necessary messages
designed to initiate those behaviors which will lead to the ap
propriate response.

In separating himself from the mother the exploratory activi
ties in which the infant engages, though based on what he sees,
fundamentally constitute an extension of learning through tac
tile experience. Vision endows the tactile experience with a
formal meaning, but it is the tactile meanings which largely
endow the objects seen with form and dimension.

In summarizing the results of her study Clay concludes:
"The question that we have been pursuing in this project,
whether the amount and kind of tactile stimulation and contact
that American mothers give their babies and young children is
adequate to their physiological and emotional needs, must
therefore be answered negatively." The mothers observed at the
beach were not so much concerned with holding, cradling,
cuddling, caressing, or expressing love to their babies and
young children, as with controlling their behavior and attend
ing to their nurturance needs. "Comforting, playing and giving

Culture and Contact 315

tactile affection were maternal behaviors of much less impor
tance and frequency." Repeatedly Clay observed that tactile
contact between mothers and preverbal children most often
expressed caretaking and nurturance, rather than love and
affection.

The impersonal child-rearing practices that have long been
the mode in the United States, with the early severance of the
mother-child tie, and the separation of mothers and children by
the interposition of bottles, blankets, clothes, carriages, cribs,
and other physical objects, will produce individuals who are
able to lead lonely, isolated lives in the crowded urban world
with its materialistic values and its addiction to things. Clay
properly feels that perhaps a higher degree of closeness within
the family, commencing with the primary mother-child tactile
tie, would help Americans to feel somewhat more anchored in
the family, while an acceptance of the importance of emotional
tactile needs beyond childhood might help them to withstand
the impersonal pressures of our times and the inevitable vicissi
tudes of life.

This is, perhaps, expecting too much of touch relationships
within the family, but the common adoption of such tactile
practices is certainly a consummation devoutly to be wished.
The contemporary American family constitutes only too often
an institution for the systematic production of mental illness in
each of its members, as a consequence of its concentration on
making each of them a "success." Which, in practice, means
that the individual is gradually converted into a device with a
built-in design for achievement in accordance with the prevail
ing requirements, entailing the suppression of emotion, the
denial of love and friendship, the ability to trade with whatever
serves one for a conscience, while conveying an unvarying ap
pearance of rectitude. Towards this end, parents feel that they
must not give their children "too much" affection, even in the
reflex and affectionate stages when children, so much in need
of it, literally cannot receive too much affection. All sorts of
reasons and pseudological rationalizations are produced: the
child will be spoiled, he will become too dependent upon others,

316 TOUCHING: THE HUMAN SIGNIFICANCE OF THE SKIN

he will develop abnormal interests in his mother, or in other
boys or even girls, he will become feminine, and so on. The
cultural goal is to make "a he-man" of the male, and a success
ful manipulator of her world of the female. Given the emphasis
on such goals, whether consciously or unconsciously followed,
the success-oriented American would still constitute the prob
lem he presents, no matter how adequate the tactile experience
of the young might be. The importance of tactility in the sociali
zation process, therefore, is not likely to be overemphasized,
nor should it be, as it has been, underemphasized.

The importance of tactile experience, especially in the prever-
bal stages of human development, cannot, in fact, be overem
phasized, and it is the burden of this book to convey that
message.

ENVOI

Camerado, this is no book,
Who touches this touches a man.
Walt Whitman, So Long!

In the preceding pages we have seen that the human signifi
cance of touching is considerably more profound than has hith
erto been understood. The skin as the sensory receptor organ
which responds to contact with the sensation of touch, a sensa
tion to which basic human meanings become attached almost
from the moment of birth, is fundamental in the development
of human behavior. The raw sensation of touch as stimulus is
vitally necessary for the physical survival of the organism. In
that sense it may be postulated that the need for tactile stimula
tion must be added to the repertoire of basic needs in all verte
brates, if not in all invertebrates as well.

Basic needs, defined as tensions which must be satisfied if the
organism is to survive, are the needs for oxygen, liquid, food,
rest, activity, sleep, bowel and bladder elimination, escape from
danger, and the avoidance of pain. It should be noted that sex
is not a basic need since the survival of the organism is not
dependent upon its satisfaction. Only a certain number of or
ganisms need satisfy sexual tensions if the species is to survive.*
However that may be, the evidence points unequivocally to the

*For a discussion of the basic needs see A. Montagu, The Direction of
Human Development (Revised edition, New York: Hawthorn Books, 1970).

318 ENVOI

fact that no organism can survive very long without externally
originating cutaneous stimulation.

Cutaneous stimulation may take innumerable forms, such as
those of temperature or radiation, liquid or atmospheric stimu
lation, pressure, and the like. Such cutaneous stimulation is
clearly necessary for the physical survival of the organism. Yet
even this elementary fact does not seem to have been adequately
recognized. Important as such cutaneous stimulation is, the
form with which we have been principally concerned in this
book is tactile stimulation, that is, touching. By touching is
meant the satisfying contact or feeling of another's or one's own
skin. Touching may take the form of caressing, cuddling, hold
ing, stroking or patting with the fingers or whole hand, or vary
from simple body contact to the massive tactile stimulation
involved in sexual intercourse.

As we have seen, in our brief survey, different cultures vary
in both the manner in which they express the need for tactile
stimulation and the manner in which they satisfy it. But the
need is universal and is everywhere the same, though the form
of its satisfaction may vary according to time and place.

The evidence presented in these pages suggests that adequate
tactile satisfaction during infancy and childhood is of funda
mental importance for the subsequent healthy behavioral devel
opment of the individual. The experimental and other research
findings on other animals, as well as those on humans, show
that tactile deprivation in infancy usually results in behavioral
inadequacies in later life. Significant as these theoretic findings
are, it is their practical value that is of principal interest to us.
In short, how may these findings be utilized in the raising of
healthy human beings?

It should be evident that in the development of the person
tactile stimulation should begin with the newborn baby. The
newborn should, whenever possible, be placed in his mother's
arms, and allowed to remain by her side as long as she may
desire. The newborn should be put to nurse at his mother's
breast as soon as possible. The newborn should not be removed
to a "nursery" nor placed in a crib. The cradle should be

Envoi 319

restored to universal usage as the best auxiliary and substitute
for cradling in the mother's arms ever invented. Fondling of the
infant can scarcely be overdone a reasonably sensible human
being is not likely to overstimulate an infant hence, if one is
to err in any direction it were better in the direction of too much
rather than too little fondling. Instead of baby carriages infants
should be carried on their mother's backs, and also on their
fathers' backs, in the equivalent of the Chinese madai or Es
kimo parka.*

Any abrupt cessation of fondling should be avoided, and it
is recommended that in cultures of the Western world, and in
the United States particularly, parents express their affection
for each other and for their children more demonstratively than
they have in the past. It is not words so much as acts com
municating affection and involvement that children, and, in
deed, adults, require. Tactile sensations become tactile percep
tions according to the meanings with which they have been
invested by experience. Inadequate tactile experience will result
in a lack of such associations and a consequent inability to
relate to others in many fundamental human ways. When affec
tion and involvement are conveyed through touch, it is those
meanings, as well as the security-giving satisfactions, with
which touch will become associated. Hence, the human signifi
cance of touching.

*Such a baby-carrier may be obtained from the La Leche League, 9616
Minneapolis Avenue, Franklin Park, Illinois, 60131; from Mrs. Anne Mar
shall, 260 Woodham Road, Linwood, Christchurch 6, New Zealand; and
from Geny Designs Inc., Boulder, Colorado. The Gerry Designs baby-carrier
is obtainable in many retail shops throughout the United States. For a good
evaluation of baby-carriers see Consumers Reports, November 1975, pp. 667-
671.

APPENDIX: TOUCH AND AGE

The wiser mind

Mourns less for what age takes away
Than what it leaves behind.

Wordsworth, The Fountain

Everyone wants to live long, but no one wants to grow old,
for old age, as someone has aptly put it, is a dirty trick. The
answer to that, of course, is to die young as late as possible.
But that is mainly a matter of the spirit. In most cases the body
wears out long before we are ready to vacate the premises. The
skin presents the most visible of the evidences of aging: wrin
kling, spotting, pigmentary changes, dryness, loss of elasticity,
and so wearisomely on. With aging the various tactile nerve
endings undergo significant changes. The structure of nerve
endings within the organized corpuscles of the skin undergoes
neurofibril breakdown. Tactile or Meissner's corpuscles de
crease, exhibiting marked changes in size, shape, and relation
ship to the epidermis. Throughout the nervous system and its
appendages there is evidence of change, mostly in the form of
cell and fiber loss. This is reflected in decreased acuity in the
sense of touch, in the ability to sharply localize stimuli, speed
of reaction to tactile stimuli, and speed of reaction to pain
stimuli. One of the striking changes with age is, in many cases,
the apparent loss of the great sensitivity of the palmar surfaces

Appendix: Touch and Age 321

of the hands. The fingers and palms, in which the greatest
number of neurotactile elements are located, seem as it were to
have become indurated, as if the "callused" skin has undergone
a loss of its ability to transmit and receive its former communi
cations.

However, tactile needs do not seem to change with aging
if anything they seem to increase. Yet, in the Anglo-Saxon
world we are taught that the tactual behavior of childhood is
inappropriate in adolescents and adults. The taboo upon such
behavior is almost complete for the male, for females much less
so. Males as adolescents and adults may embrace their mothers,
but not their fathers; a favored aunt or grandmother may also
be embraced, but not their male counterparts. Males may em
brace girls on certain private occasions, but may not do so
publicly unless a generally accepted mutual understanding ex
ists between them. Compared to the female the male is cultur
ally encouraged, in the Western world, to remain all the days
of his life a virtually nontactile creature hungering for tactual
experience, and seeking it, mainly, through sexual contacts.
When, in old age, the male's sexual capacities are diminished
or completely reduced the tactual hunger is more powerful than
ever, for it is the only sensuous experience that remains to him.
It is at this time, when he has again become so much dependent
upon others for human support, that he is in need of embraces,
of an arm around his shoulder, of being taken by the hand,
caressed, and given the opportunity to respond. Women need
such communications at least as much as men. Yet this is where
we fail the aging quite miserably as we do in so much else.
Because we are unwilling to face the fact of aging, we behave
as if it isn't there. It is this massive evasion that is the principal
reason for our failure to understand the needs of the aging.

The most important and neglected of these needs is the need
for tactile stimulation. One has only to observe the responses
of older people to a caress, an embrace, a handpat or clasp, to
appreciate how vitally necessary such experiences are for their
well-being. On the basis of the kind of evidence cited in this
book it may be conjectured that the course and outcome of

322 APPENDIX: TOUCH AND AGE

many an illness in the aged has been greatly influenced by the
quality of tactile support the individual has received before and
during the illness. Furthermore, in a substantial number of
cases one may suspect that it was the individual's history of
tactile experience prior to his or her illness, and particularly
during it, as well as expectations of its continuation, that made
the difference between life and death.

In the aged especially the need for tactile stimulation is a
hunger which has so often remained unsatisfied that, in their
disappointment, its victims tend to become uncommunicative
concerning their need for it. A perfunctory peck on the cheek
is no substitute for a warm embrace, nor is a conventional
handshake capable of replacing a caressing hand, "the only
touch of love."

REFERENCES

CHAPTER ONE. THE MIND OF THE SKIN

Page and Line

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13:8-9 F. S. HAMMETT, "Studies in the Thyroid Apparatus: I,"

American Journal of Physiology, vol. 56 (1921), pp. 196-
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15:33 to J. A. REYNIERS, "Germ-Free Life Studies," Lobund Reports,
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H. L. Rheingold, "Maternal Behavior in the Dog," ibid.,
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326 References

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20:7 Experiences and Immunity," Nature, vol. 220 (1968),

pp. 821-823.

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21:1 of Sucking Drive in Newborn Lambs," Science, vol. 146

(1964), pp. 665-666.

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Man," in B. Schaffner (ed.), Group Processes (New York:
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22:6-12

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:27-28

:29-32

23:12-20

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D. S. LEHRMAN, "Hormonal Regulation of Parental Behav
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N. E. COLLIAS, "The Analysis of Socialization in Sheep and
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L. HERSHER, A. U. MOORE, and J. B. RICHMOND, "Effect
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L. HERSHER, J. B. RICHMOND, and A. U. MOORE, "Modifia-
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B. M. McKiNNEY, "The Effects upon the Mother of Re
moval of the Infant Immediately after Birth," Child-
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M. H. KLAUS and J. H. KENNELL, Maternal-Infant Bonding
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H. F. HARLOW, M. K. HARLOW, and E. W. HANSEN, "The
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V. H. DENENBERG and A. E. WHIMBEY, "Behavior of Adult
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R. ADER and P. M. CONKLIN, "Handling of Pregnant Rats:
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J. WERBOFF, A. ANDERSON, and B. N. HAGGETT, "Han
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A. SAYLER and M. SALMON, "Communal Nursing in Mice:
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328 References

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24:4-8 R. B. CAIRNS, "Fighting and Punishment from a Develop

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vol. 119(1954), pp. 285-286.

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:25-31 L. HERSHER, J. B. RICHMOND, and U. MOORE, "Maternal
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26:2 Experience upon Later Avoidance Learning" (M. A. the

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of Infantile Experience on Maturation of Stress Response,*'
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Electroconvulsive Shock as a Function of Infantile Stimu
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: 12-14 V. H. DENENBERG and G. G. KARAS, "Effects of Differential
Handling upon Weight Gain and Mortality in the Rat
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V. H. Denenberg and G. G. Karas, "Interactive Ef
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28:2-5 R. A. GILMORE, "The Friendly Whales of Laguna San Ig-

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29:4-6 H. F. HARLOW, "The Nature of Love," The American Psy

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30:35

31:22 to HARLOW, HARLOW, and HANSEN, "The Maternal Affec-
i32:2 tional System . . . ," p. 260.

-.4-7 Ibid., p. 279.

33:23-26 L. L. ROTH, "Effects of Young and of Social Isolation on
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35:1-2 H. HEDIGER, Wild Animals in Captivity (London: Butter-

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330 References

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CHAPTER TWO. THE WOMB OF TIME

38:7-17 MAY SARTON, "An Informal Portrait of George Sarton,"

Texas Quarterly, Autumn 1962, p. 105.

42:22-25 R. W. JoNDORF, R. P. MAICHEL, and B. B. BRODIE, "In
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43:26-36 A. MONTAGU, The Human Revolution (New York: Bantam
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J. BOSTOCK, "Exterior Gestation, Primitive Sleep, Enuresis
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44:13-16 D. B. and E. F. P. JELLIFE, "Human Milk, Nutrition, and
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46:17-30 A. MONTAGU, Prenatal Influences (Springfield, Illinois:
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47:21-25 A. MONTAGU, Prenatal Influences; A. Montagu, Life Before
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51:28-33 C. M. DRILLIEN, "Physical and Mental Handicap in the
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52:24 turely-Born Children," Child Development, vol. 10 (1939),

pp. 115-128.
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53:1 W. B. Saunders, 1965), pp. 45-46.

:2-4 A. P. KIMBALL and R. J. OLIVER, "Extra-Amniotic Caesar-

ean Section hi the Prevention of Fatal Hyaline Membrane
Disease," American Journal of Obstetrics and Gynecology,
vol. 90 (1964), pp. 919-924.

: 10-12 R. J. McKAY, JR., and C. A. SMITH, in W. E ; NELSON (ed.),
Textbook of Pediatrics (7th ed., Philadelphia: W. B. Saun
ders, 1959), p. 286.

: 13-24 G. W. MEIER, "Behavior of Infant Monkeys: Differences
Attributable to Mode of Birth," Science, vol. 143 (1964),
pp. 968-970.

332

References

Page and Line

:30-35 S. SEGAL, in T. K. OLIVER, JR. (ed.), Neonatal Respiratory
Adaptation (Bethesda, Maryland: IL S. Dept. of Health,
Education, and Welfare, National Institutes of Health,
1966), pp. 183-188.

:36 to T. K. OLIVER, JR., A. DEMIS, and G. D. BATES, "Serial
54:2 Blood-Gas Tensions and Acid-Base Balance during the

First Hour of Life in Human Infants," Ada Paediatrica,
vol. 50 (Stockholm, 1961), pp. 346-360.

:3-ll M. CORNBLATH, et al> "Studies of Carbohydrate Metabo

lism in the Newborn Infant," Pediatrics, vol. 27 (1961),
pp. 378-389.

:14-17 L. J. GROTA, V, H. DENENBERG, and M. X. ZARROW,
"Neonatal Versus Caesarean Delivery: Effects upon Sur
vival Probability, Weaning Weight, and Open-Field Activ
ity," Journal of Comparative and Physiological Psychology,
vol. 61 (1966), pp. 159-160.

:37 to W. J. PIEPER, E. E. LESSING, and H. A. GREENBERG, "Per-
55 :20 sonality Traits in Cesarean-Normally Delivered Children,"

Archives of General Psychiatry, vol. 2 (1964), pp. 466-471.
:32-34 M. STRAKER, "Comparative Studies of Effects of Normal and
Caesarean Delivery upon Later Manifestations of Anxi
ety," Comprehensive Psychiatry, vol. 3 (1962), pp. 113-124.
:34-37 W. T. LiBERSON and W. H. FRAZIER, "Evaluation of EEC
Patterns of Newborn Babies," American Journal of Psychi
atry, vol. 118 (1962), pp. 1125-1131.

56:5-17 D. H. BARRON, "Mother-Newborn Relationships in Goats,"

in B. Schaffner (ed.), Group Processes (New York: Josiah
Macy, Jr., Foundation, 1955), p. 225.
: 18-33 Ibid., p. 226.
:34-37 MEIER, "Behavior of Infant Monkeys . . .", Science, vol. 143

(1964), pp. 968-970.

:37 to R. A. MCCANCE and M. OTLEY, "Course of the Blood Urea
57:5 in Newborn Rats, Pigs and Kittens," Journal of Physiology ,

vol. 113 (1951), pp. 18-22.
: 11-12 H. B. PACK, "Mother-Newborn Relationship in Goats," in

Schaffner, Group Processes, p. 228.
: 13-14 Editorial, "The Gut and the Skin," Journal of the American

Medical Association, vol. 196 (1966), pp. 1151-1152.
:14-16 M. E. OBERMAYER, Psychocutaneous Medicine (Springfield,
Illinois: Charles C Thomas, 1955), pp. 376-377; L. Fry,
S. Shuster, and R. M. H. McMinn, "The Small Intes
tine in Skin Disease," Archives of Dermatology, vol. 93

References 333

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(1966), pp. 647-653; M. L. Johnson and H. T. H. Wilson,
"Skin Lesions in Ulcerative Colitis,'* Gut, vol. 10 (1969),
pp. 255-263.

: 17-26 F. REITZENSTEIN, "Aberglauben," in M. Marcuse (ed.),
Handworterbuch der Sexualmssenschaft (2nd ed., Bonn:
Marcus & Weber, 1926), p. 5.

CHAPTER THREE. BREASTFEEDING

59:1-3 O. RANK, The Trauma of Birth (London: Allen & Unwin),

1929.
61:31-33 Personal communication, 2 April 1976.

:35 to Associated Press, May 1975. See also Leaven, La Leche

62:12 League International, Franklin Park, Illinois, July- August

1975, p. 21.
:25-33 Infant Care (Washington, D. C: U. S. Government Printing

Office, 1963), p. 16.
63:30-32 M. H. KLAUS and J. H. KENNELL, Maternal-Infant Bonding

(St. Louis, Missouri: C. V. Mosby Co., 1976).

:34 to M. P. MlDDLEMORE, The Nursing Couple (London: Cassell,

64:1 1941), pp. 18-19.

:24-26 T. SMITH and R. B. LITTLE, "The Significance of Colostrum
to the New-Born Calf," Journal of Experimental Medicine,
vol. 36 (1922), pp. 181-198.

:26-32 J. A. TOOMEY, "Agglutinins in Mother's Blood, Mother's
Milk, and Placental Blood," American Journal of Diseases
of Children, vol. 47 (1934), pp. 521-528; J. A. Toomey,
"Infection and Immunity," Journal of Pediatrics, vol. 4
(1934), pp. 529-539.

66: 15-17 N. BLURTON JONES, "Comparative Aspects of Mother-Child
Contact," in N. Blurton Jones (ed.), Ethological Studies of
Child Behaviour (Cambridge: The University Press, 1972),
pp. 305-328.

: 17-25 D. M. BEN SHAUL, "The Composition of the Milk of Wild
Animals," International Zoo Yearbook vol. 4, 1962,
pp. 333-342.

:31-34 R. C. BOELKINS, "Large-Scale Rearing of Infant Rhesus
Monkeys (M. mulatto) in the Laboratory," International
Zoo Yearbook, ibid., pp. 286-289.

67:1-11 ALBRECHT PEIPER, Cerebral Function in Infancy and

Childhood (New York: Consultants Bureau, 1963),
pp. 570-571.
: 1 3-17 T. J. CRONIN, "Influence of Lactation upon Ovulation," The

334

References

Page and Line

Lancet, vol. 2 (1968), pp. 422^24; R. Gioiosa, "Incidence
of Pregnancy during Lactation in 500 Cases," American
Journal of Obstetrics and Gynecology, vol. 70 (1955),
pp. 162-174; I. C. Udesky, "Ovulation and Lactating
Women," American Journal of Obstetrics and Gynecology,
vol. 59 (1950), pp. 843-851; N. L. Solien de Gonzales,
"Lactation and Pregnancy: A Hypothesis," American An
thropologist, vol. 66 (1964), pp. 873-878.

: 18-20 D. B. and E. F. P. JELLIFE, "Human Milk, Nutrition, and
the World Resource Crisis," Science, vol. 188 (1975),
pp. 557-561.

:21-28 E. R. KIMBALL, "How I Get Mothers to Breastfeed," OB/
GYN'S Supplement in Physician's Management, June 1968.

:29-37 C. HOEFER and M. C. HARDY, "Later Development of

Breast Fed and Artificially Fed Infants," Journal of the

American Medical Association, vol. 96(1929), pp. 615-619.

68:2-20 "Phenotype: Postnatal Development," Science, vol. 159

(1968), pp. 658-659.

:29 to F. M. POTTENGER, JR., and B. KROHN, "Influence of Breast

69:2 Feeding on Facial Development," Archives of Pediatrics,

vol. 67 (1950), pp. 454-461; F. M. Pottenger, Jr., "The
Responsibility of the Pediatrician in the Orthodontic Prob
lem," California Medicine, vol. 65 (1946), pp. 169-170.

: 14-17 PHILIP SLATER, Earthwalk (New York: Doubleday, 1974),
p. 188.

: 1 9-23 MARGARET WRIGHT, "On the Importance of Skin Contact,"
Sounding Board, vol. 3, no. 4 (1969), p. 7.

:27-29 W. PAINTER, The Palace of Pleasure (London: Tottell and
Jones, 1566), I, 43.

:30 to FRANCES E. BROAD, "The Effects of Infant Feeding on
70:12 Speech Quality,*' New Zealand Medical Journal, vol. 76

(1972), pp. 28-31; Frances E. Broad, "Further Studies on
the Effects of Infant Feeding on Speech Quality," New
Zealand Medical Journal, vol. 82 (1975), pp. 373-376;
Frances E. Broad, "Suckling and Speech," Parents Centres
Bulletin 53, November 1972, pp. 4-6.

: 13-14 D. L. RAPHAEL, "The Lactation-Suckling Process within a
Matrix of Supportive Behavior" (Ph. D. diss., Columbia
University, 1966), p. 246.

: 14-17 See Chapter 2 of the above work for a survey of the ethologi-
cal evidence.

: 17-1 9 For further discussion of this subject see F. H. Richardson,

References

335

Page and Line

The Nursing Mother (New York: Prentice-Hall, 1953);
M. P. Middlemore, The Nursing Couple (London: Cas-
sell & Co., 1953); La Leche League International, The
Womanly Art of Breastfeeding (Franklin Park, Illinois,
1963); B. M. Caldwell, "The Effects of Infant Care," in
M. L. Hoffman and L. W. Hoffman (eds.), Review of
Child Development Research (New York: Russell Sage
Foundation, 1964), vol. 1, pp. ii-41.
71:3-25 M. KING, Truby King the Man (London: Allen & Unwin,

1948), pp. 170-178.
72:14-22 Ibid, p. 167.

:27 to H. MOLTZ, R. LEVIN, and M. LEON, "Prolactin in the Post-

73 :4 partum Rat: Synthesis and Release in the Absence of Suck

ling Stimulation," Science, vol. 163 (1969), pp. 1083-1084.
:10-12 S. LORAND and S. ASBOT, "Uber die durch Reiziing der
Brustwarze reflektorischen -Uterus Kontraktionen," Zen-
tralblattfur Gyndkologie, vol. 74 (1952), pp. 345-352.
74:1-15 E. DARWIN, Zoonomia, or the Laws of Organic Life (4 vols.,

3rd ed., London: J. Johnson, 1801), vol. 1, p. 206.
:21-35 Ibid., p. 210.

75:10-22 R. ST. BARBE BAKER, Kabongo (New York: A. S. Barnes &
Co., 1955), p. 18.

CHAPTER FOUR. TENDER, LOVING CARE

76:3 to J. L. HALLIDAY, Psychosocial Medicine: A Study of the Sick

77:12 Society (New York: W. W. Norton, 1948), pp. 244-245.

: 18-21 H. D. CHAPIN, "A Plea for Accurate Statistics in Children's
Institutions," Transactions of the American Pediatric Soci
ety, vol. 27 (1915), p. 180.

78:13-22 F. TALBOT, "Discussion," Transactions of the American Pe
diatric Society, vol. 62 (1941), p. 469.

:26-28 L. E. HOLT, The Care and Feeding of Children (15th ed.,
New York: Appleton-Century, 1935); E. Holt, Jr., Holt's
Care and Feeding of Children (New York: Appleton-Cen
tury, 1948).
79:14-18 J. Brennemann, "The Infant Ward," American Journal of

Diseases of Children, vol. 43 (1932), p. 577.
: 1 8-2 1 H. BAKWIN, "Emotional Deprivation in Infants," Journal of

Pediatrics, vol. 35 (1949), pp. 512-521.

79:37 to M. H. ELLIOTT and F. H. HALL, Laura Bridgman (Boston:

80:16 Little, Brown, 1903); Helen Keller, The Story of My Life

(New York: Doubleday, 1954).

336

References

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: 17-3 6 K. DAVIS, "Extreme Social Isolation of a Child," American
Journal of Sociology, vol. 45 (1940), pp. 554-565; K. Davis,
"Final Note on a Case of Extreme Isolation," Ameri
can Journal of Sociology, vol. 52 (1947), pp. 432-437;
M. K. Mason, "Learning to Speak after Six and One
Half Years," Journal of Speech Disorders, vol. 7 (1942),
pp. 295-304.

81:20-32 The historian Salimbene (13th Century), in J. B. Ross and
M. M. McLaughlin (eds.) A Portable Medieval Reader
(New York: Viking Press, 1949), p. 366.
82:3-10 H. BAKWIN, "Emotional Deprivation in Infants," Journal of

Pediatrics, vol. 35 (1949), pp. 512-521.
: 13-17 "Annotation, Perinatal Body Temperatures," The Lancet,

vol. 1 (1968), p. 964.
:20-21 B. D. BOWER, "Neonatal Cold Injury," The Lancet, vol. 1

(1962), p. 426.

:27 to O. FENICHEL, The Psychoanalytic Theory of Neurosis (New

83:3 York: W. W. Norton, 1945), pp. 69-70.

:4-10 Editorial, "At What Temperature Should You Keep a

Baby?" The Lancet, vol. 2 (1970), p. 556.
: 19-23 L. GLASS, "Wrapping Up Small Babies," The Lancet, vol. 2

(1970), pp. 1039-1040.

83:24-28 J. W. SCOPES, "Control of Body Temperature in Newborn
Babies," in The Scientific Basis of Medicine, Annual Re
views (London: The Athlone Press, 1970), pp. 31-50.
:29 to W. AHERNE and D. HULL, "The Site of Heat Production in
84:3 the Newborn Infant," Proceedings of the Royal Society of

Medicine, vol. 57 (1964), pp. 1172-1173.
:7-8 F. A. GELDARD, The Human Senses (New York: Wiley,

1953), pp. 211-232.

:7-14 T. P. MANN and R. I. K. ELIOT, "Neonatal Cold Injury Due

to Accidental Exposure to Cold," The Lancet, vol. 1
(1957), pp. 229-234; W. A. Silverman, J. W. Fertig, and
A. P. Berger, "The Influence of the Thermal Environment
upon the Survival of Newly Born Premature Infants,"
Pediatrics, vol. 22 (1958), pp. 876-886.

: 18-25 E. N. HEY, S. KOHLINSKY, and B. O'CONNELL, "Heat-
Losses from Babies during Exchange Transfusion," The
Lancet, vol. 1 (1969), pp. 335-338.

:26-27 C. P. BOYAN, "Cold or Wanned Blood for Massive
Transfusions," Annuals of Surgery, vol. 160 (1964),
pp. 282-286.

References 337

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85:11-13 M. S. ELDER, "The Effects of Temperature and Position on
the Sucking Pressure of Newborn Infants," Child Develop
ment, vol. 41 (1970), pp. 94-102.

: 13-1 6 R. E. COOKE, "The Behavioral Response of Infants to Heat
Stress," Yale Journal of Biology and Medicine, vol. 24
(1952), pp. 334-340.

:27-30 T. SCHAEFER, JR., F. S. WEINGARTEN, and J. C. TOWNE,
"Temperature Change: The Basic Variable in the Early
Handling Phenomenon?" Science, vol. 135 (1962),
pp. 41-42.

:30-33 R. ADER, "The Basic Variable in the Early Handling Phe
nomenon," Science, vol. 136 (1962), pp. 580-583; also
G. W. Meier, pp. 583-584, and T. Schaefer, Jr., et al,
"Temperature Change . . .", Science, pp. 584-587.

87:9-1 1 R. G. PATTON and L. I. GARDNER, Growth Failure in Mater

nal Deprivation (Springfield, Illinois: Charles C Thomas,
1963).

:20-23 R. L. BIRDWHISTELL, "Kinesic Analysis of Filmed Behavior
of Children," in B. Schaffner (ed.), Group Processes (New
York: Josiah Macy, Jr., Foundation, 1956), p. 143; R. L.
Birdwhistell, Kinesics and Context (Philadelphia: Univer
sity of Pennsylvania Press, 1970); J. Fast, Body Language
(New York: M. Evans, 1970); see also M. ARGYLE, Bodily
Communication (New York: International Universities
Press, 1975); M. Argyle and M. Cook, Gaze and Mutual
Gaze (London & New York: Cambridge University Press,
1976).

88:1 1-13 P. LACOMBE, "Du Role de la Peau dans 1' Attachment Mere-
Enfant," Revue Francaise du Psychoanalyse, vol. 23 (1959),
pp. 83-101.
:19 to P. F. D. SEITZ, "Psychocutaneous Conditioning during the

89:30 First Two Weeks of Life," Psychosomatic Medicine, vol. 12

(1950), pp. 187-188,

91:20-33 M. A. RIBBLE, "Disorganizing Factors of Infant Personal
ity," American Journal of Psychiatry, vol. 98 (1941),
pp. 459-463.

92:8-9 L. S. KUBIE, "Instincts and Homeostasis," Psychosomatic

Medicine, vol. 10 (1948), pp. 15-30.

:28-30 D. B. DILL, Life, Heat, and Altitude (Cambridge: Harvard
University Press, 1938).

93:12-14 V. V. ROZANOV, Solitaria (London: Wishart, 1927).

94:14-24 M. L HEINSTEIN, "Behavioral Correlates of Breast-Bottle

338

References

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Regimes under Varying Parent- Infant Relationships,"
Monographs of the Society for Child Growth and Develop
ment, Serial No. 88, vol. 28, no. 4 (1963); M. I. Heinstein,
"Influence of Breast Feeding on Children's Behavior,"
Children, vol. 10 (1963), pp. 93-97.

95:25-30 G. STANLEY HALL, "Notes on the Study of Infants," Peda
gogical Seminary, vol. 1 (1891), pp. 127-138.

:33 to S. FREUD, Three Essays on the Theory of Sexuality [1905]

96:11 (London: Imago, 1949), p. 60.

:29-33 S. RADO, "The Psychical Effects of Intoxication," Psy
choanalytic Review, vol. 18 (1931), pp. 69-84.

97:7-22 H. F. HARLOW and M. K. HARLOW, "The Effect of Rearing

Conditions on Behavior," in John Money (ed.), Sex Re
search: New Developments (New York: Holt, Rinehart &
Winston, 1965), pp. 161-175.

:31-33 G. W. HENRY, AH The Sexes (New York: Rinehart, 1955);
R. J. Stoller, Sex and Gender (New York: Science House,
1968); S. Brody, Patterns of Mothering (New York: Inter
national Universities Press, 1956).

97:33 to M. P. MIDDLEMORE, The Nursing Couple (London: Cassell,
98:1 1941).

:6-10 L. J. YARROW, "Maternal Deprivation: Toward an Empiri

cal and Conceptual Re- valuation," Psychological Bulletin,
vol. 58 (1961), pp. 459-490; p. 485. See also John Bowlby,
Attachment and Loss, vol. 1, Attachment (New York:
Basic Books, 1969).

: 18-24 E. GAMPER, "Bau und Leistung eines menschlichen Mittel-
hirnwesens, II," Zeitschrift fur die Gesammte Neurologie
und Psychiatrie, vol. 104 (1926), pp. 48 et seq.

:34 to R. A. SPITZ, No and Yes (New York: International Universi-

99:2 ties Press 1957), pp. 21-22.

:4-ll I. DEVORE, "Mother-Infant Relations in Free-Ranging Ba

boons," in H. L. Rheingold (ed.), Maternal Behavior in
Mammals (New York: Wiley, 1963), p. 312.
: 15-17 Ibid., pp. 314, 317-318.

:33-36 R. LANG, The Birth Book (Palo Alto, California: Science and
Behavior Books, 1972); M. H. Klaus and J. H. Kennell,
Maternal-Infant Bonding (St. Louis, Missouri: 1976),
p. 73.

100:24-26 W. ONG, The Presence of the Word (New Haven: Yale Uni
versity Press, 1967), pp. 169-170.
:26~29 ABRAHAM LEVITSKY, quoted by Richard Register, "In

References 339

Page and Line

Touch with Feeling," Human Behavior, vol. 4 (1975),
pp. 16-23.

101:2-15 JOSE ORTEGA Y GASSET, Man and People (New York:

W. W, Norton, 1957), pp. 72 et seq.

:25-29 M. A. RIBBLE, The Rights of Infants (2nd ed., New York:
Columbia University Press).

:37 to W. HOFFER, "Mouth, Hand, and Ego-Integration," in A.

102:3 Freud, et al (eds.), The Psychoanalytic Study of the Child,

vols. 3/4 (New York: International Universities Press,
1949), pp. 49-56; W. Hoffer, "Development of the Body
Ego," in The Psychoanalytic Study of the Child, vol. 5
(New York: International Universities Press, 1950),
pp. 18-23.

:7-8 J. W. WEIFFENBACH (ed.) Taste and Development (Be-

thesda, Maryland: U. S. Department of Health, Education
and Welfare, Publication N. NIH 77-1068, 1977); G. H.
Nowlis and W. Kessen, "Human Newborns Differentiate
Differing Concentrations of Sucrose and Glucose," Sci
ence, vol. 191 (1976), pp. 865-866.

104:9-17 BRUNO BETTELHEIM, "Where Self Begins," The New York

Times Magazine, 12 February 1967. Reprinted in Child
and Family, vol. 7 (1967), pp. 5-9.

:35 to RAVEN LANG, "Delivery in the Home," in Marshall S.

107:3 Klaus, T. Leger, and Mary Anne Trause (eds.), Maternal

Attachment and Mothering Disorders: A Round Table

(New Brunswick, New Jersey: Johnson & Johnson, 1975),

pp. 45^9.

:5-30 R. RUBIN, "Maternal Touch," Nursing Outlook, vol. 11

(1963), pp. 828-831.

108:15-19 M. PAPOUSEK, "Discussion," in M. A. Hofer (ed.), Parent-
Infant Interaction (New York & Amsterdam: Elsevier,
1975), p. 82.

:22-26 M. H. KLAUS, J. H. KENNELL, N. PLUMB, and S. ZUEHLKE,
"Human Maternal Behavior at the First Contact with Her
Young," Pediatrics, vol. 46 (1970), pp. 187-192.

:32 to C. R. BARNETT, P. H. LEIDERMAN, R. GROBSTEIN, and K.
109:1 MARSHALL, "Neonatal Separation: the Maternal Side of

Interactional Deprivation," Pediatrics, vol. 45 (1970),
pp. 197-205.

:l-2 C. P. S. WILLIAMS and T. K. OLIVER, JR., "Nursery Rou

tines and Staphylococcal Colonization of the Newborn,"
Pediatrics, vol. 44 (1969), pp. 640-646.

340 References

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:4-21 Editorial, "Mothers of Premature Babies," British Medical

Journal 6 June 1970, p. 556.

109:25 to SHEILA KITZINGER, Some Mothers' Experiences of Induced
110:21 Labour (London: The National Childbirth Trust, 1975).

:27 to KLAUS and KENNELL, Maternal-Infant Bonding, p. 51.
111:1

:7-16 Ibid., pp. 93-94.

:22-24 E. FURMAN, In Klaus and Kennell, Maternal-Infant Bond
ing, p. 52.

:25-35 M. J. SEASHORE, A. D. LEIFER, C. R. BARNETT, and P. H,
LEIDERMAN, "The Effects of Denial of Early Mother-
Infant Interaction on Maternal Self-Confidence," Journal
of Personality and Social Psychology, vol. 26 (1973),
pp. 369-378.

:36 to P. H. LEIDERMAN, "Mother-Infant Separation: Delayed
112:11 Consequences," in Klaus, Leger, and Trause, Maternal

Attachment and Mothering Disorders: A Round Table,
pp. 67-70.

: 18-28 P. DE CHATEAU, "Neonatal Care Routines: Influences on
Maternal and Infant Behavior and on Breast Feeding,"
(Doctoral thesis, Umea University Medical Dissertations,
N.S., no. 20) Umea, Sweden, 1976, quoted in Klaus and
Kennell, Maternal Infant-Bonding, pp. 62-65.

113:18-28 M. A. HOFER, "Infant Separation Responses and the Ma
ternal Role," Biological Psychiatry, vol. 10 (1975),
pp. 149-153.

:28-30 M. A. HOFER, "Studies on How Maternal Separation Pro
duces Behavioral Change in Young Rats," Psychosomatic
Medicine, vol. 37 (1975), pp. 245-264; M. A. Hofer,
"Physiological and Behavioural Processes in Early Mater
nal Deprivation," in D. Hill (ed.), Physiology, Emotion and
Psychosomatic Illness (London & Amsterdam: Elsevier,
1972), pp. 175-200; M. A. Hofer, "Maternal Separation
Affects Infant Rats' Behavior," Behavioral Biology, vol. 9
(1973), pp. 629-633.

:31 to HOFER, "Physiological and Behavioural Processes in Early
114:2 Maternal Deprivation," p. 185.

:23-31 KLAUS, LEGER, and TRAUSE, Maternal Attachment and

Mothering Disorders: A Round Table, p. 43.

115:1-12 G. BATESON and M. MEAD, Balinese Character (Special

Publication, New York: New York Academy of Sciences,
1942), p. 30.

References

341

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116:3-5 R. S. ILLINGWORTH, The Development of the Infant and

Young Child (Edinburgh: Livingstone, 1960), pp. 130-132.

116:9-15 E. L. THORNDIKE, Animal Intelligence (New York: The

Macmillan Co., 1911), p. 244. For an account of learning
theory see A. Montagu, The Direction of Human Develop
ment (Revised edition, New York: Hawthorn Books,
1970), pp. 317-345.

117:12-15 M. MEAD and F. C. MACGREGOR, Growth and Culture (New

York: G. P. Putnam's Sons, 1951), pp. 42-43.

: 19-24 C. McPHEE, quoted in Mead and Macgregor, Growth and
Culture, p. 43. See also C. McPhee, Music in Bali (New
Haven: Yale University Press), 1966.
:24-27 B. NETTL, Ethnomusicology (New York: Free Press, 1964).

119:17-20 MEAD and MACGREGOR, Growth and Culture, p. 50.

120:20-27 J. ZAHOVSKY, "Discard of the Cradle," Journal of Pediatrics,
vol. 4 (1934), pp. 660-667.

122:36 to J. B. WATSON, Psychological Care of Infant and Child (New

123:13 York: W. W. Norton, 1928).

124:20 to B. CHISHOLM, Prescription for Survival (New York: Co-

125:20 lumbia University Press, 1957), pp. 37-38.

126:14-21 E. SYLVESTER, "Discussion," in M. J. E. Senn (ed.), Prob
lems of Infancy (New York: Josiah Macy, Jr., Foundation,
1953), p. 29.

:29-31 A. B. BERGMAN, J. B. BECKWITH, and C. G. RAY (eds.),
Sudden Infant Death Syndrome (Seattle: University of
Washington Press, 1970).

127:20-25 A. PEIPER, Cerebral Function in Infancy and Childhood

(New York: Consultants' Bureau, 1963), p. 606.
:29-31 G. R. FORRER, Weaning and Human Development (New
York: Libra Publishers, 1969).

128:27-36 ZAHOVSKY, "Discard of the Cradle," pp. 660-670; see also
Ashley Montagu, "What Ever Happened to the Cradle?"
Family Weekly (New York), 14 May 1967.

129:16-33 M. A. POWELL, "Riverside Is Rockin' Along With Old-
Fashioned Rhythm," Toledo Blade Sun, 2 February 1958,

p. 13.

130:5-14 M. NEAL, "Vestibular Stimulation and Developmental Be

havior of the Small Premature Infant," Nursing Research
Report, vol. 3, nos. 1-4, New York: American Nurses
Foundation, 1968.
: 19-27 J. M. WOODCOCK, "The Effects of Rocking Stimulation on

342

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the Neonatus Reactivity," Purdue University, Lafayette,

Indiana, 1969.

131:11-21 J. C. SOLOMON, "Passive Motion and Infancy," American
Journal of Orthopsychiatry, vol. 29 (1959), pp. 650-651.
:22-33 W. J. GREENE, JR., "Early Object Relations, Somatic, Affec
tive, and Personal," The Journal of Nervous and Mental
Disease, vol. 126 (1958), pp. 225-253.

132:5-14 W. J. GREENE, JR., quoted by A. P. Shasberg, "Of Reading,

Rocking, and Rollicking," New York Times Magazine, 5
January 1969.

:21-28 D. G. FREEDMAN, H. BOVERMAN, and N. FREEDMAN,
"Effects of Kinesthetic Stimulation on Weight Gain and
Smiling in Premature Infants," paper presented at the
meeting of the American Orthopsychiatry Association,
San Francisco, April 1960.

:33 to N. SOKOLOFF, S. YAFFE, D. WEINTRAUB, and B. BLASE,

133:8 "Effects of Handling on the Subsequent Development of

Premature Infants," Developmental Psychology, vol. 1
(1969), pp. 765-768.

:8-13 E. G. HASSELMEYER, "The Premature Neonate's Response

to Handling," Journal of the American Nurses Association,
vol. 2 (1964), pp. 14-15.

133:14 to KLAUS and KENNELL, Maternal-Infant Bonding,

134:8 pp. 99-166.

:9-ll A. J. SOLNIT, "Comment," in ibid., p. 190.

134:30 to W. A. MASON, "Early Deprivation in the Nonhuman Pri-

135:5 mates: Implications for Human Behavior," in D. C. Glass

(ed.), Environmental Influences (New York: The Rockefel
ler University Press, 1968), pp. 70-101.

136:4-10 L. H. FUCHS, Family Matters (New York: Random House,

1972), p. 57.
: 14-1 8 S. CARRIGHAR, Home to the Wilderness (Baltimore: Penguin

Books, 1974), p. 37.

: 19-21 E. CARPENTER, Oh, What a Blow the Phantom Gave
Me (New York: Holt, Rinehart & Winston, 1973),
p. 23.

:22-27 L. K. FRANK, "Tactile Communication," Genetic Psychology
Monographs, vol. 56 (1957), p. 227.

137:14-21 W. DEVLIN, "Touch Dancing Where It's At," Harpers Ba
zaar, February 1974, p, 131.

138:9-28 L. SALK, "The Effects of the Normal Heartbeat Sound on the

References 343

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Behavior of the Newborn Infant: Implications for Mental
Health," World Mental Health, vol. 12 (1960), pp. 1-8.
139:6-17 J. A. M. MEERLOO, The Dance (Philadelphia: Chilton Co.,

1960), pp. 13-14.
:23 to Ibid., pp. 15-16.

140:9

: 10-1 8 Ibid., p. 35.

142:9-15 O. C. IRWIN and L. WEISS, "The Effect of Clothing and

Vocal Activity of the Newborn Infant," in W. Dennis (ed.),
Readings in Child Psychology (New York: Prentice-Hall,
1951).

143:35 to L. WILSON, "Of Babies and Water Beds," Childbirth and
144: 10 Parent Education Association, Miami, Florida, Newsletter,

vol 8, no. 9, September 1973.

:15-19 J. C. FLUGEL, The Psychology of Clothes (London: Hogarth
Press, 1930), p. 87; J. C. FLUGEL, "Clothes Symbolism and
Clothes Ambivalence," International Journal of Psychoa
nalysis, vol. 10 (1929), p. 205.

:27 to W. E. HARTMAN, M. FITHIAN, and D. JOHNSON, Nudist
145:10 Society (New York: Crown, 1970), pp. 289, 293.

:24-27 K. STEWART, Pygmies and Dream Giants (New York: W. W.

Norton, 1954), p. 105.

146: 1 1-1 3 S. R. ARBEIT, B. PARKER, and I. L. RUBIN, "Controlling the
Electrocution Hazard in the Hospital," Journal of the
American Medical Association, vol. 220 (1972), pp. 1581-
1584.

:20-21 JULES ROMAINS, Vision Extra-Retinienne (Paris, 1919;
English translation, Eyeless Sight, New York: Putnam,
1924).
:30-32 M. GARDNER, "Dermo-Optical Perception: A Peek Down

the Nose," Science, vol. 151 (1966), pp. 654-657.

147:35 to M. R. OSTROW, "Dermographia: A Critical Review," Annals

148:2 of Allergy, vol. 25 (1967), pp. 591-597.

:17 to P. BACH-Y-RITA, "System May Let Blind 'See with Their
14 9 :2 Skins,' " Journal of the American Medical Association,

vol. 207 (1967), pp. 2204-2205.

:5-21 F. A. GELDARD, "Body English," Readings in Psychology

Today (Del Mar, California: CRM Associates, 1969),
pp. 237-241; F. A. Geldard, "Some Neglected Possibilities
of Communication," Science, vol. 131 (1960), pp. 1583-
1588. See also J. R. Hennessy, "Cutaneous Sensitivity
Communication," Human Factors, vol. 8 (1966), pp. 463-

344

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469; G. A. Gescheider, "Cutaneous Sound Localization"
(Ph.D. diss., University of Virginia, 1964); G. von Bekesy,
"Similarities between Hearing and Skin Sensation," Psy
chological Reviews, vol. 66 (1959), pp. 1-22.
:25-27 "Replacing Braille?" Time, 19 September 1969.
:27 to B. VON HALLER GILMER and L. W. GREGG, "The Skin as
150:4 a Channel of Communication," Etc., vol. 18 (1961),

pp. 199-209.

:7-8 J. F. HAHN, "Cutaneous Vibratory Thresholds for Square-

Wave Electrical Pulses," Science, vol. 127 (1958),
pp. 879-880.

151:5-12 H. MUSAPH, Itching and Scratching: Psychodynamics in Der

matology (Philadelphia: F. A. Davis Co., 1964).

:12-18 P. F. D. SEITZ, "Psychocutaneous Aspects of Persistent
Pruritis and Excessive Excoriation," Archives of Dermatol
ogy and Syphilology, vol. 64 (1951), pp. 136-141; M. E.
Obermayer, Psychocutaneous Medicine (Springfield; Illi
nois: Charles C Thomas, 1955); S. Ayres, "The Fine Art
of Scratching," Journal of the American Medical Associa
tion, vol. 189 (1964), pp. 1003-1007; J. J. Kopecs and M.
Robin, "Studies on Itching," Psychosomatic Medicine, vol.
17 (1955), pp. 87-95; B. Russell, "Pruritic Skin Condi
tions," in C. Newman (ed.), The Nature of Stress Disorder
(Springfield, Illinois: Charles C Thomas, 1959), pp. 40-51.
151:19-21 SEITZ, "Psychocutaneous Aspects of Persistent Pruritis
. . . ," Archives of Dermatology and Syphilology, vol. 64
(1951), pp. 136-141.

151:22-29 M. A. BEREZIN, "Dynamic Factors in Pruritis Ani: A
Case Report," Psychoanalytic Review, vol. 41 (1954),
pp. 160-172.

152:9-14 O. NASH, Verses from 1919 On (Boston: Little, Brown, 1959).

: 15-19 RUSSELL, "Pruritic Skin Conditions," in Newman, The Na
ture of Stress Disorder, p. 48.
:2Q-23 E. STERN, "Le Prurit," Etude Psychosomatique, Ada Psy-

chotherapeutica, vol. 3 (1955), pp. 107-116.

154:29 to C. W. SALEEBY, Sunlight and Health (London: Nisbet,

155:2 1928), p. 67.

:3-5 PLATO, The Republic, Book 5; G. V. N. Dearborn, "The

Psychology of Clothing," Psychological Monographs,
vol. 26 (1918/19), no. 1 (1928), p. 64; Hilaire Hiler, From
Nudity to Raiment (London: Simpkin Marshall, 1930);
Maurice Parmelee, The New Gymnosophy (New York:
Hitchcock, 1927); Fliigel, The Psychology of Clothes; L. E.

References

345

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Langner, The Importance of Wearing Clothes (New York:
Hastings House, 1959).

:11-13 J. M. KNOX, Symposium on Cosmetics, "The Sunny Side of
the Street Is Not the Place to Be," Journal of the American
Medical Association, vol. 195 (1966), p. 10.

:13-15 A. L. LORINCZ, "Physiological and Pathological Changes in
Skin from Sunburn and Suntan," Journal of the American
Medical Association, vol. 173 (1963), pp. 1227-1231; R. G.
Freeman, "Carcinogenic Effects of Solar Radiation and
Prevention Measured," Cancer, vol. 21 (1968), pp. 1114-
1120; A. M. Kligman, "Early Destructive Effect of Sun
light on Human Skin," Journal of the American Medical
Association, vol. 210 (1969), pp. 2377-2380.

156:7-11 C. PINCHER, Sleep (London: Daily Express, 1954), pp. 18-

19; G. G. Luce and J. Segal, Sleep and Dreams (London:
Heinemann, 1967).

: 12-17 ANNA FREUD, "Psychoanalysis and Education," The Psy
choanalytic Study of the Child, vol. 9 (1954), p. 12.

:22 to C. M. HEINICKE and I. WESTHEIMER, Brief Separations
157:1 (New York: International Universities Press, 1965),

pp. 165, 266.

:2-9 FENICHEL, The Psychoanalytic Theory of Neurosis, pp. 120-

121.

: 13-21 A. ALDRICH, CHIEH SUNG, and C. KNOP, "The Crying of
Newly Born Babies," Journal of Pediatrics, vol. 27 (1945),
p. 95.

CHAPTER FIVE. SKIN AND SEX

158:1-6 Our Bodies Our Selves (2nd ed., New York: Simon &

Schuster, 1976), p. 41.

159:16-19 A. MONTAGU, The Human Revolution (New York: Bantam
Books, 1967), pp. 150-151.

159:30-33 R. C. KOLODNY, L. S. JACOBS, and W. H. DAGHHADAY,
"Mammary Stimulation Causes Prolactin Secretion
in Non-Lactating Women," Nature, vol. 238 (1972),
pp. 284-285.

:34-37 A. BRODAL, Neurological Anatomy in Relation to Clinical
Medicine (New York: Oxford University Press, 1969),
p. 33.

160:13-20 DONALD GOULD, "Spirits, Doctors and Disease," New Sci
entist, 17 May 1976, pp. 474-475.

: 29-34 H. F. HARLOW, M. K. HARLOW, and E. W. HANSEN, "The
Maternal Affectional System of Rhesus Monkeys," in H. L.

346

References

Page and Line

Rheingold (ed.), Maternal Behavior in Mammals (New

York: Wiley, 1963), pp. 277-278.
161:4-5 R. J. STOLLER, Sex and Gender (New York: Science House,

1968).
:21-29 A. FREUD, Normality and Pathology in Childhood (New

York: International Universities Press, 1965), p. 199.

162:1-30 M. H. HOLLENDER, L. LUBORSKY, and T. J. SCARAMELLA,

"Body Contact and Sexual Excitement," Archives of Gen
eral Psychiatry, vol. 20 (1969), pp. 188-191; M. H. Hoi-
lender, "The Wish to Be Held," Archives of General Psychi
atry, vol. 22 (1970), pp. 445-453.

:31-32 M. H. HOLLENDER, "Prostitution, the Body, and Human
Relations," International Journal of Psychoanalysis,
vol. 42 (1961), pp. 404-413.

:32-37 M. G. BLINDER, "Differential Diagnosis and Treatment of
Depressive Disorders," Journal of the American Medical
Association, vol. 195 (1966), pp. 8-12.

:37 to C. P. MALMQUIST, T. J. KIRESUK, and R. M. SPANO, "Per-
163:7 sonality Characteristics of Women with Repeated Illegiti

mate Pregnancies: Descriptive Aspects," American Jour
nal of Orthopsychiatry, vol. 36 (1966), pp. 476-484.

:7-8 A. MOLL, The Sexual Life of the Child (London: Allen &

Unwin, 1912); H. Graff and R. Mallin, "The Syndrome
of the Wrist Cutter," American Journal of Psychiatry,
vol. 124 (1967), pp. 36-42.

164: 16-18 M. H. HOLLENDER, "Women's Wish to Be Held: Sexual and
Nonsexual Aspects," Medical Aspects of Human Sexuality,
October 1971, pp. 12, 17, 19, 21, 25, 26.

: 19-31 M. H. HOLLENDER, L. LUBORSKY, and R. B. HARVEY,
"Correlates of the Desire to Be Held in Women," Journal
of Psychosomatic Research, vol. 14 (1970), pp. 387-390.

:32 to M. H. HOLLENDER and J. B. McGHEE, "The Wish to Be
165:7 Held during Pregnancy," Journal of Psychosomatic Re

search, vol. 18 (1974), pp. 193-197.

:9-18 M. H. HOLLENDER and A. J. MERCER, "Wish to Be Held

and Wish to Hold in Men and Women," Archives of Gen
eral Psychiatry, vol. 33 (1976), pp. 49-51.

:19 to L. T, HUANG, R. PHARES, and M. H. HOLLENDER, "The
166:9 Wish to Be Held," Archives of General Psychiatry, vol. 33

(1976), pp. 41-43.

: 10-19 A. LOWEN, The Betrayal of the Body (New York: Collier
Books, 1969), p. 102.

:25-26 Ibid. p. 24.

References

347

Page and Line

:29-30 B. MALIVER, The Encounter Game (New York: Stein & Day,

1972), p. 130.
167:7-8 S. FREUD, An Outline of Psychoanalysis (New York: W. W.

Norton, 1949), p. 24.
:8-19 O. FENICHEL, The Psychoanalytic Theory of Neurosis (New

York: W. W. Norton, 1945), p. 70
167:20-24 Our Bodies, Our Selves, p. 50.

:28-31 Ibid., p. 47.
168:3-15 M. FRIEDMAN, Buried Alive: The Biography of Janis Joplin

(New York: William Morrow & Co., 1973), p. 16.
:21-23 E. S. SCHAEFER and NANCY BAYLEY, "Maternal Behavior,
Child Behavior, and Their Intercorrelations from Infancy
through Adolescence," Monographs of the Society for
Research in Child Development, vol. 28, no. 3 (1963),
pp. 1-117.
:26-36 J. RUESCH, Disturbed Communication (New York: W. W.

Norton, 1957), pp. 31-32.
169:1-9 MOLL, The Sexual Life of the Child, pp. 29-31.

:35 to S. BRODY, Patterns of Mothering (New York: International

170:2 Universities Press, 1956), p. 340.

:6-10 S. FREUD, Introductory Lectures on Psycho-Analysis (Lon

don: Allen & Unwin, 1922), pp. 269-284.

171:5-13 L. K. FRANK, "Genetic Psychology and Its Prospects,"

American Journal of Orthopsychiatry, vol. 21 (1951),
p. 517.

: 15-22 L. K, FRANK, "The Psychosocial Approach in Sex Re
search," Social Problems, vol. 1 (1954), p. 134.
172:1 1-13 J. S. PLANT, Personality and the Cultural Pattern (New York:

The Commonwealth Fund, 1937), p. 22.
: 13-14 W. A. WEISSKOPF, The Psychology of Economics (Chicago:

University of Chicago Press, 1955), p. 147.

: 16-1 8 FRANK, "The Psychosocial Approach in Sex Research," So
cial Problems, vol. 1 (1954), p. 137.
:21-32 LOWEN, The Betrayal of the Body, p. 105.
173:30-34 ANDREW BARCLAY, "The Effects of Pregnancy and Child
birth on the Sexual Relationship," The CEA Philadelphia
Chronicler, vol. 11, no. 8, December 1975, pp. 6-7, and
personal communications from Dr. Barclay.
174:13-18 J. C. MOLONEY, "Thumbsucking," Child and Family, vol. 6

(1967), pp. 29-30.

:21-23 V. LOWENFELD, Creative and Mental Growth (New York:
The MacmiUan Co., 1947).

348

References

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174:35 to
175:1

:6-29
176:19-36

For the gentle touch of the free-living gorilla see Dian Fossey,
"More Years with Mountain Gorillas," National Geo
graphic, vol. 140 (1971), pp. 574-585.
L. K. FRANK, "Tactile Communication," Genetic Psychology

Monographs, vol. 56 (1957), pp. 209-255; p. 233.
H. HARLOW, M. HARLOW, and E. W. HANSEN, "The Mater
nal AfFectional System of Rhesus Monkeys," in H. L.
Rheingold (ed.), Maternal Behavior in Mammals (New
York: Wiley, 1963), pp. 254-281.

177:5-12 B. F. STEELE and C. B. POLLACK, "A Psychiatric Study of

Parents Who Abuse Infants and Small Children," in R.
Heifer and C. Kempe (eds.), The Battered Child (Chicago:
University of Chicago Press, 1968).

178:1-11 J. H. PRESCOTT, "Body Pleasure and the Origins of Vio

lence," The Futurist, April 1975, pp. 64-65; J. H. Prescott,
"Early Somatosensory Deprivation as an Ontogenetic Pro
cess in the Abnormal Development of the Brain and Be
havior," in E. I. Goldsmith and J. Moor-Jankowski (eds.),
Medical Primatology (Basel & New York: S. Karger,
1971), pp. 1-20.
:29 to R. VON KRAFFT-EBING, Psychopathia Sexualis (New York:

179:4 Putnam, 1965); G. R. Taylor, Sex in History (New York:

Vanguard Press, 1954).
:20-27 J.-J. ROUSSEAU, Confessions, Book 1, 1782.

180:35 to TH. VAN DE VELDE, Ideal Marriage (New York: Simon &

181:8 Schuster, 1932), p. 159.

: 18-20 H. ELLIS, Studies in the Psychology of Sex (New York: Ran
dom House, 1936).

:21-27 M. A. OBERMAYER, Psychocutaneous Medicine (Springfield,
Illinois: Charles C Thomas, 1955), p. 244 et seq.; J. T.
McLaughlin, R. J. Shoemaker, and W. B. Guy, "Personal
ity Factors in Adult Atopic Eczema," Archives of Derma
tology and Syphilology, vol. 68 (1953), p. 506; I. Rosen
(ed.), The Pathology and Treatment of Sexual Deviation
(New York: Oxford University Press), 1964.

:31-37 I. ROSEN, "Exhibitionism, Scopophilia and Voyeurism," in
Rosen, The Pathology and Treatment of Sexual Deviation,
p. 308.

1 82:6-1 1 S. FREUD, "Three Essays on the Theory of Sexuality" [1905],

in Complete Psychological Works ofSigmund Freud (Stan
dard Edition, 24 vols., London: Hogarth Press, 1953),
vol. 7, pp. 120-243.

183:11-13 J. K. SKIPPER, JR., and C. H. McCAGHY, "Stripteasers: The

References

349

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Anatomy and Career Contingencies of a Deviant Occupa
tion," Social Problems, vol. 17 (1970), pp. 391-405.

:21-27 A. C. KINSEY, et al, Sexual Behavior in the Human Female
(Philadelphia: W. B. Saunders, 1953), pp. 570-590, p. 688;
J. Money, "Psychosexual Differentiation," in J. Money
(ed.), Sex Research: New Developments (New York: Holt,
Rinehart & Winston, 1965), p. 20.

183:33 to B. FAGOT, "Sex Differences in Toddlers' Behavior and Paren-

184:2 tal Reaction," Developmental Psychology, vol. 10 (1974),

pp. 554-555.

:4-8 F. KAHN, Our Sex Life (New York: A. A. Knopf, 1939),

p. 70.

: 12-20 J. MONEY and A. A. EHRHARDT, Man & Woman: Boy &
Girl (Baltimore: Johns Hopkins University Press, 1972),
p. 148.

:32 to M. MEAD, Male and Female (New York: William Morrow

185:1 & Co., 1949), Chapter 7.

:l-2 R. R. SEARS, E. E. MACCOBY, and H. LEVIN, Patterns of

Child Rearing (New York: Row, Peterson & Co., 1957),
pp. 56-57, p. 402.

185:2-9 S. GOLDBERG and M. LEWIS, "Play Behavior in the Year-

Old Infant: Early Sex Differences," Child Development,
vol. 40 (1969), pp. 21-33. See also H. A. Moss, "Sex, Age,
and State as Determinants of Mother-Infant Interaction,"
Merrill-Palmer Quarterly, vol. 13 (1967), pp. 1936 et seq.

:10-13 E. H. ERIKSON, Childhood and Society (2nd ed., New York:
W. W. Norton, 1963), p. 309.

:18-21 J. L. and A. FISCHER, "The New Englanders of Orchard
Town, U.S.A.," in B. B. Whiting (ed.), Six Cultures (New
York: Wiley, 1963).

:21-23 V. S. CLAY, "The Effect of Culture on Mother-Child Tactile
Communication," (Ph.D. diss., Teachers College, Co
lumbia University, 1966), pp. 219 et seq.

:23-27 REVA RUBIN, "Basic Maternal Behavior," Nursing Outlook,
vol. 9 (1961), p. 684.

CHAPTER SIX. GROWTH AND DEVELOPMENT

1 86:8-1 1 L. CASLER, "Maternal Deprivation: A Critical Review of the

Literature," Monographs of the Society for Research in
Child Development, vol. 26, no. 2 (1961).

: 9 J. BOWLBY, Maternal Care and Mental Health (Geneva:

World Health Organization, 1961).

187:8-16 Cited in G. W. GRAY, "Human Growth," Scientific Ameri-

350 References

Page and Line

can, vol. 189 (1953), pp. 65-67. The citation is misat-
tributed in this article to Dr. Alfred F. Washburn, when in
fact it belongs to Dr. J. D. Benjamin. See W. R. Ruegamer,
L. Bernstein, and J. D. Benjamin, "Growth, Food Utiliza
tion, and Thyroid Activity in the Albino Rat as a Function
of Extra Handling," Science, vol. 120 (1954), p. 314.

:21-26 V. H. DENENBERG and J. R. C. MORTON, "Effects of Envi
ronmental Complexity and Social Groupings upon Modifi
cation of Emotional Behavior," Journal of Comparative
Psychology, vol. 55 (1962), pp. 242-246.

:27-29 S. LEVINE, "A Further Study of Infantile Handling and
Avoidance Learning," Journal of Personality, vol. 25
(1962), pp. 242-246; V. H. Denenberg and C. G. Karas,
"Interactive Effects of Age and Duration of Infantile Expe
rience on Adult Learning," Psychological Reports, vol. 7
(1960), pp. 313-322.

:27-31 J. T. TAPP and H. MARKOWITZ, "Infant Handling: Effects
on Avoidance Learning, Brain Weight, and Cholinesterase
Activity," Science, vol. 140 (1963), pp. 486-^87.

:34~35 L. BERNSTEIN, "A Note on Christie's 'Experimental Naivete
and Experiential Naivete,' " Psychological Bulletin, vol. 49
(1952), pp. 38-40.

:35~36 J. ROSEN, "Dominance Behavior as a Function of Early Gen
tling Experience in the Albino Rat" (M. A. thesis, Univer
sity of Toronto, 1957).

188:1-2 O. WEININGER, W. J. MCCLELLAND, and K. ARIMA, "Gen

tling and Weight Gain in the Albino Rat," Canadian Jour
nal of Psychology, vol. 8 (1954), pp. 147-151.

:2 RUEGAMER, BERNSTEIN, and BENJAMIN, "Growth, Food

Utilization, and Thyroid Activity in the Albino Rat as a
Function of Extra Handling," pp. 184-185.

:8-14 G. F. SOLOMON, "Early Experience and Immunity," Nature,

vol. 220 (1968), pp. 821-822.

: 1 5-1 7 S. LEVINE, M. ALPERT, and G. W. LEWIS, "Infantile Experi
ence and the Maturation of the Pituitary Adrenal Axis,"
Science, vol. 126 (1957), p. 1347.

:17-19 R. W. BELL, G. REISNER, and T. LINN, "Recovery from
Electroconvulsive Shock as a Function of Infantile Stimu
lation," Science, vol. 133 (1961), p. 1428.

:23-25 S. LEVINE, "Noxious Stimulation in Infant and Adult Rats
and Consummatory Behavior," Journal of Comparative
and Physiological Psychology, vol. 51 (1958), pp. 230-233.

:26-28 L. BERNSTEIN, "The Effects of Variation in Handling upon

References 351

Page and Line

Learning and Retention/* Journal of Comparative and
Physiological Psychology, vol. 50 (1957), pp. 162-167.
188:29-31 K. LARSSON, "Mating Behavior of the Male Rat," in L. R.
Aronson, et al (eds.), Development and Evolution of Be
havior, (San Francisco: W. H. Freeman Co., 1970),
pp. 337-351.

: 3 2-34 K. LARSSON, "Non-Specific Stimulation and Sexual Behaviour
in the Male Rat," Behaviour, vol. 20 (1963), pp. 110-114.

:37 to J. A. KING, "Effects of Early Handling upon Adult Behavior

1 89:5 in Two Subspecies of Deermice, Peromyscus maniculatus, "

Journal of Comparative and Physiological Psychology,
vol. 52 (1959), pp. 82-88.

:7-13 U. BRONFENBRENNER, "Early Deprivation in Mammals: A

Cross-Species Analysis," in G. Newton and S. Levine
(eds.), Early Experience and Behavior (Springfield, Illinois:
Charles C Thomas, 1968), p. 661; L. Bernstein, "A Note
on Christie's 'Experimental Naivete and Experiential Nai
vete,' " Psychological Bulletin, vol. 49 (1952), pp. 38-^W); L.
Bernstein, "The Effects of Variations in Handling upon
Learning and Retention," Journal of Comparative and
Physiological Psychology, vol. 50 (1957), pp. 162-167;
V. H. Denenberg, "A Consideration of the Usefulness of
the Critical Period Hypothesis as Applied to the Stimula
tion of Rodents in Infancy," in Newton and Levine, Early
Experience and Behavior, pp. 42-167.

:22-26 RUEGAMER, BERNSTEIN, and BENJAMIN, "Growth, Food
Utilization, and Thyroid Activity in the Albino Rat,"
pp. 184-185.

190:7-1 1 W. VON BUDDENBROCK, The Senses (Ann Arbor, Michigan:

The University of Michigan Press, 1958), p. 127.

: 19-29 V. S. CLAY, "The Effect of Culture on Mother-Child Tactile
Communication" (Ph.D. diss., Teachers College, Co
lumbia University, 1966), p. 308.

:30 to M. RIBBLE, The Rights of Infants (2nd ed., New York: Co-

191:2 lumbia University Press, 1965), p. 54 et seq.

:3-5 G. E. COGHILL, Anatomy and the Problem of Behavior (New

York & London: Cambridge University Press, 1929; re
printed New York: Hafner Publishing Co., 1964).

:7-22 L. J. YARROW, "Research in Dimension of Early Mater

nal Care," Merrill-Palmer Quarterly, vol. 9 (1963),
pp. 101-122.

:23 to S. PROVINCE and R. C. LIPTON, Infants in Institutions (New

192:2 York: International Universities Press), 1962.

352

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:3-24 H. SHEVRIN and P. W. TOUSSIENG, "Vicissitudes of the Need

for Tactile Stimulation in Instinctual Development," The
Psychoanalytic Study of the Child, vol. 20 (1965), pp. 310-
339; H. Shevrin and P. W. Toussieng, "Conflict over Tac
tile Experiences in Emotionally Disturbed Children,"
Journal of the American Academy of Child Psychiatry,
vol. 1 (1962), pp. 564-590.

193:15-19 R. SPITZ, The First Year of Life (New York: International

Universities Press, 1965); Ribble, The Rights of Infants.
-.20-25 R. G. PATTON and L. I. GARDNER, Growth Failure in Mater-
nal Deprivation (Springfield, Illinois: Charles C Thomas,
1963).

:25-27 E. M. WIDDOWSON, "Mental Contentment and Physical
Growth," The Lancet, vol. 1 (1951), pp. 1316-1318; L. J,
Yarrow, "Maternal Deprivation: Toward an Empirical
and Conceptual Revaluation," Psychological Bulletin,
vol. 58 (1961), pp. 459-490; A. Montagu (ed.), Culture and
Human Development (Englewood Cliffs, New Jersey:
Prentice-Hall, 1974).

:28-34 G. F. POWELL, J. A. BRASEL, and R. M. BLIZZARD, "Emo
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Idiopathic Hypopituitarism," New England Journal of
Medicine, vol. 276 (1967), pp. 1271-1278; G. F. Powell, J.
A. Brasel, S. Raiti, and R. M. Blizzard, "Emotional Depri
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pp. 1279-1283; J. B. Reinhardt and A. L. Drash, "Psy-
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Psychosomatic Medicine, vol. 31 (1969), pp. 165-172. See
also C. Whitten, et al, "Evidence that Growth Failure
from Maternal Deprivation Is Secondary to Undereating,"
Journal of the American Medical Association, vol. 209
(1969), pp. 1675-1682; Montagu, Culture and Human De
velopment

1 94: 1 7-29 For a detailed discussion see W. SCHUMER and R. SPERLING,
"Shock and Its Effect on the Cell," Journal of the American
Medical Association, vol. 205 (1968), pp. 215-219.

195:9-13 M. K. TEMERLIN, et al, "Effects of Increased Mothering and

Skin Contact on Retarded Boys," American Journal of
Mental Deficiency, vol. 71 (1967), pp. 890-893.

: 1 6-24 M. McGRAW, Neuromuscular Maturation of the Human In
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:25-26 P. GREENACRE, Trauma, Growth, and Personality (New
York: W. W. Norton, 1952), pp. 12-14; M. Sherman and
I. C. Sherman, "Sensorimotor Response in Infants," Jour
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Thomas, et aL, Examen Neurologique du Nourrison (Paris:
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Growth and Development of Children (5th ed., Chicago:
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:27-28 E. DEWEY, Behavior Development in Infants (New York:

Columbia University Press, 1935).

:28-30 D. SINCLAIR, Cutaneous Sensation (New York: Oxford Uni
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:31 to H. HEAD, Studies in Neurology (Oxford: Oxford University

196:7 Press, 1922).

:14~18 S. ESCALONA, "Emotional Development in the First Year of
Life," in M. J. E. Senn (ed.), Problems of Infancy and
Childhood (New York: Josiah Macy, Jr., Foundation,
1953), p. 17.
:26-33 RiBBLE, The Rights of Infants, p. 57.

197:3-6 WATSON and LOWREY, Growth and Development of Chil

dren, pp. 220-221.

197:21-28 R. S. LOURIE, "The First Three Years of Life: An Overview
of a New Frontier of Psychiatry," American Journal of
Psychiatry, vol. 127 (1971), pp. 1457-1463.

198:17-32 E. SYLVESTER, "Discussion," in Senn, Problems of Infancy
and Childhood, p. 29.

199:1-6 Ibid.

199:18-25 H. SINCLAIR, "Sensorimotor Action Patterns a Condition for
the Acquisition of Syntax," in R. Huxley and E. Ingram
(eds.), Language Acquisition: Models and Methods (New
York: Academic Press, 1971), pp. 121-135; Harry Beilin,
et aL, Studies in the Cognitive Basis of Language Develop
ment (New York: Academic Press, 1975), p. 340.

200:2-25 ESCALONA, "Emotional Development in the First Year of

Life," in Senn, Problems of Infancy and Childhood, p. 25.

201:3-17 SPITZ, The First Year of Life, pp. 232-233.

202:5-10 M. S. MAHLER, "On Two Crucial Phases of Integration Con

cerning Problems of Identity: Separation-Individuation
and Bisexual Identity," Journal of the American Psy
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: 1 6 to E. DARWIN, Zoonomia, or The Laws of Organic Life (2 vols.,

203:6 London: J, Johnson, vol. 1, 1794), pp. 109-111.

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: 11-23 ESCALONA, "Emotional Development in the First Year of
Life," p. 24.

:29 to T. K. LANDAUER and J. W. M. WHITING, "Infantile Stimu-
204: 1 5 lation and Adult Stature of Human Males," American An

thropologist, vol. 66 (1964), pp. 1007-1028.

205:8-10 D. H. WILLIAMS, "Management of Atopic Dermatitis in

Children, Control of the Maternal Rejection Factor," Ar
chives of Dermatology and Syphilology, vol. 63 (1951),
pp. 545-560.

: 10-16 F. DUNBAR, Emotions and Bodily Changes (4th ed., New
York: Columbia University Press, 1954), p. 647.

: 16-22 D. W. WiNNicOTT, "Pediatrics and Psychiatry," British
Journal of Medical Psychology, vol. 21 (1948), pp. 229-240.

:29-32 R. SPITZ, The First Year of Life (New York: International
Universities Press, 1965); M. E. Allerhand, et al, "Person
ality Factors in Neurodermatitis," Psychosomatic Medi
cine, vol. 12 (1950), pp. 386-390; E. Wittkower and B.
Russell, Emotional Factors in Skin Disease (New York:
Hoeber, 1955).

:32-33 M. E. OBERMAYER, Psychocutaneous Medicine (Springfield,
Illinois: Charles C Thomas, 1955).

:33 H. C. BETHUNE and C. B. KIDD, "Physiological Mechanisms

in Skin Diseases/' The Lancet, vol. 2 (1961), pp. 1419-
1422; J. G. Kepecs> et al., "Atopic Dermatitis," Psychoso
matic Medicine, vol. 13 (1951), pp. 2-9; Dunbar, Emotions
and Bodily Changes, p. 647.

:36 to A. LOWEN, The Betrayal of the Body (New York: Collier
206:11 Books, 1969), pp. 2-3.

:33 to O. FENICHEL, The Psychoanalytic Theory of Neurosis (New
207:2 York: W. W. Norton, 1945), p. 445.

:8-10 H. WEINER, "Diagnosis and Symptomatology," in L. Bellak

(ed.), Schizophrenia (New York: Logos Press, 1958),
p. 120.

208:12-26 R. J. BEHAN, Pain, Its Origin, Conduction, Perception and
Diagnostic Significance (New York: Appleton, 1922); S.
Renshaw and R. J. Wherry, Studies on Cutaneous Local
ization, III. "The Age of Onset of Ocular Dominance,"
Journal of Genetic Psychology, vol., 39 (193 1), pp. 493-496.
209:3-8 A. F. SILVERMAN, M. E. PRESSMAN, and H. W. BARTEL,

"Self-Esteem and Tactile Communication," Journal of Hu
manistic Psychology, vol. 13 (1973), pp. 73-77.

: 14-37 JIMMIE HOLLAND, "Acute Leukemia: Psychological Aspects
of Treatment," in B. Elkerbout, P. Thomas, and A. Zwav-

References 355

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eling (eds.), Cancer Chemotherapy (Leiden, Holland:
Leiden University Press, 1971), pp. 199-300. See also Jim-
mie Holland, et al, "Psychological Response of Patients
with Acute Leukemia to Germ-Free Environments," Can-
cer, Journal of 'the American Cancer Society, vol. 40(1977),
pp. 871-879.
210:1-3 SUZANNE GORDON, Lonely in America (New York: Simon

& Schuster, 1976).

:12-18 LILLIAN LEIBER, et at., "The Communication of Affection
between Cancer Patients and Their Spouses," Psychoso
matic Medicine, vol. 38 (1976), pp. 379-389.
:31-32 YEVGENY VINOKUROV, "Passer-By," trans. Daniel Weiss-

bort, Poetry, July 1974, p. 187.

:35 to KENNETH J. GERGEN, MARY M. GERGEN, and WILLIAM H.
211:25 BARTON, "Deviance in the Dark," Psychology Today, Oc

tober 1973, pp. 129-130.

:26 to D. A., "You're Only Allowed to Touch When . . ." (Paper

212:12 written for anthropology class at a California college,

1971).
:23-32 A. F. COPPOLA, "Reality and the Haptic World," Phi Kappa

Phi Journal, Winter 1970, pp. 14-15.
214:3-6 MARC BLOCK, The Royal Touch (London: Routledge &

Kegan Paul, 1973), p. 240.
:7-19 Ibid., p. 223.

:20-25 I. R. MILBERG, "Pinpointing Emotional Factors in Skin Dis
eases," Practical Psychology, vol. 3 (1976), pp. 49-56.
:29-37 "Seventh Son of a Seventh Son," The Listener (London), 1 1

April 1974, pp. 443-455.

215:1-10 M. J. ROSENTHAL, "Psychosomatic Study of Infantile Ec

zema," Pediatrics, vol. 10 (1952), pp. 581-593.
:11-19 R. SPITZ, The First Year of Life, p. 24.

215:20-24 R. BERGMAN and C. K. ALDRICH, "The Natural History of
Infantile Eczema: A Follow-Up Study," Psychosomatic
Medicine, vol. 25 (1963), p. 495.

:25-31 E. L. LIPTON, A. STEINSCHNEIDER, and J. B. RICHMOND,
"Psychophysiological Disorders in Children," in L. W. and
M. L. Hoddman (eds.), Review of Child Development Re
search, vol. 2 (1966), p. 192.
216:26-30 J. C. MOLONEY, "Thumbsucking," Child and Family, vol. 6

(1967), p. 28.

217:4-10 J. A. M. MEERLOO, "Human Camouflage and Identification

with the Environment," Psychosomatic Medicine, vol. 19
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:13-24 LOWEN, The Betrayal of the Body, pp. 187-188.
:32 to M. EUSTIS (ed.)> Players at Work (New York: Theater Arts,

218:1 1937).

: 12-25 E. T. HALL, The Hidden Dimension (New York: Doubleday,

1966), p. 59.

:26 to J. BOWLBY, "The Nature of the Child's Tie to His Mother,"

219:2 International Journal of Psychoanalysis, vol. 39 (1958),

pp. 364-365; J. Bowlby, Attachment and Loss. vol. 1, At
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:3-15 M. BALINT, "Friendly Expanses Horrid Empty Spaces,"

International Journal of Psychoanalysis, vol. 36 (1955),
pp. 225-241.

219:33-37 A. BURTON and R. E. KANTOR, "The Touching of the

Body," Psychoanalytic Review, vol. 51 (1964), pp. 122-134.

220:4-10 D. SECREST, " 'Catatonics' Cure Is Found," International

News Service, 27 May 1955.
: 10-12 G. SCHWING, A Way to the Souls of the Mentally III (New

York: International Universities Press, 1954).

: 12-30 N. WAAL, "A Special Technique of Psychotherapy with
an Autistic Child," in G. Caplan (ed.), Emotional Prob
lems of Early Childhood (New York: Basic Books, 1955),
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:31-34 N. ICKERINGILL, "An Approach to Schizophrenia that Is
Rooted in Family Love," New York Times, 28 April 1968,
p. 44.

221:6 to B. R. FORER, "The Taboo against Touching in Psychother-

222:8 apy," Psychotherapy, Theory, Research and Practice, vol. 6

(1969), pp. 229-231. See also B. R. Forer, "The Use of

Physical Contact in Group Therapy," in L. N. Solomon

and B. Berson (eds.) New Perspectives on Encounter Groups

(San Francisco: Jossey-Bass, Inc., 1972), pp. 195-210.

:1 1-13 C. BRENNER, Psychoanalytic Technique and Psychic Conflict

(New York: International Universities Press, 1976), p. 30.

:23-25 See Freud's letter to Ferenczi in E. Jones, The Life and Works

ofSigmund Freud (New York: Basic Books, 1955), vol. 3,

p. 163.

223:1-14 FORER, "The Taboo against Touching in Psychotherapy,"

p. 230.

: 15-22 A. BURTON and R. E. KANTOR, "The Touching of the
Body," Psychoanalytic Review, vol. 51 (1964), pp. 122-134.
224:5-7 A. MONTAGU, "On Touching Your Patient," Practical Psy

chology for Physicians, February 1975, pp. 43-47.

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:7-13 A. BURTON and A. G. HELLER, "The Touching of the

Body ," Psychoanalytic Review, vol. 51 (1964), pp. 122-134;
J. De Augustinis, R. S. Isani, and F. R. Kumler, "Ward
Study: The Meaning of Touch in Inter-Personal Communi
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Clinical Approaches to Psychiatric Nursing (New York:
The Macmillan Co., 1963), pp. 271-306; A. Charlton,
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tient Initiated Physical Contact in the Psychiatric Setting"
(Masters thesis, University of Maryland, 1959); L. S. Mer
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ric Care, vol. 4 (1966), pp. 20-25; L. Cashar and B. K.
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"Touch and Psychoanalytic Tradition," Psychoanalytic
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(1971), pp. 112-118; A. L. Clark, Maternal Tenderness-
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pp. 98-123; B. Unger, "Please Touch," Journal of Prac
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peutic Touch': An Ancient But Unorthodox Nursing In
tervention," Lecture, 12 October 1974, Lake Placid,
N.Y.; D. Krieger, "The Relationship of Touch, with
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globin Values: A Study in Personalized Interaction," Pro
ceedings of the American Nurses Association 9th Council
of Nurse Researchers (Kansas City, Missouri: The As
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Touch," Nursing Outlook, vol. 35 (1965), p. 59; M. S.
Saltenis, "Physical Touch and Nursing Support," (Unpub
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tison, "Effects of Touch on Self-Exploration and the
Therapeutic Relationship," Journal of Consulting and
Clinical Psychology, vol. 40 (1973) pp. 170-175.

:14 to A. MONTAGU, "The Sensory Influences of the Skin," Texas
226:2 Reports on Biology and Medicine, vol. 2 (1953),

pp. 291-301.

:32-35 A. M. GARNER and C. WENAR, The Mother-Child Interac
tion in Psychosomatic Disorders (Urbana, Illinois: Univer
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358 References

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227:11-20 H. W. NISSEN, K. L. CHOW, and J. SEMMES, "Effects of
Restricted Opportunity for Tactual, Kinesthetic, and
Manipulative Experience on the Behavior of a Chimpan
zee," American Journal of Psychology, vol. 64 (1951),
pp. 485-507.

:34-36 W. M. MASON, "Early Social Deprivation in the Nonhuman
Primates; Implications for Human Behavior," in D. C
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228:6-9 J. P. ZUBEK, J. FLYE, and M. AFTANAS, "Cutaneous Sen

sitivity after Prolonged Visual Deprivation," Science,
vol. 144(1964), pp. 1591-1593.

:10-12 S. AXELROD, Effects of Early Blindness (New York: Ameri
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: 19-23 D. STEWART, Outlines of Moral Philosophy (Edinburgh:
Creech, 1793), I, X, #87.

229:29-31 D. OcsTON, C. M. OGSTON, and O. D. RATNOFF, "Studies
on Clot-Promoting Effect of the Skin," Journal of Labora
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CHAPTER SEVEN. CULTURE AND CONTACT

235:35 to R. JAMES DE BOER, "The Netsilik Eskimo and the Origin of

236:30 Human Behavior," MS, 1969, p. 8.

237:8-25 Ibid., p. 15.

238:21-33 E. CARPENTER, "Space Concepts of Aivilik Eskimos," Ex
plorations Five, June 1955, pp. 131-145.

240:7-13 J. GIBSON, "Pictures, Perspective and Perception," Daeda

lus, Winter 1961.

241:1-19 H. H. ROBERTS and D. JENNESS, Eskimo Songs, Report of the

Canadian Arctic Expedition, 1913-18 (Ottawa), vol. 14
(1925), pp. 9, 12.
:35 to K. RASMUSSEN, The Intellectual Culture of the Iglulik Es-

242:8 kimos (Copenhagen: Gyldendalske boghandel, 1929),

p. 27.

:1 1-16 V, STEFANSSON, The Friendly Arctic (New York: The Mac-
miilan Co., 1943), p. 418; V. Stefansson, My Life with the
Eskimo (New York: The Macmillan Co., 1915).

243:7-14 C. OSGOOD, "Ingalik Social Culture," Yale University Publi

cations in Anthropology, no. 53 (1958), p. 178.
: 16-36 E. CARPENTER, F. VARLEY, and R. FLAHERTY, Eskimo:
Explorations Nine (Toronto: University of Toronto Press,
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244:7-33 JULES HENRY, Jungle People (New York: Vintage Books,

1964), pp. 18-19.
245:6-26 PEGGY DURDIN, "From the Space Age to the Tasaday AgeJ'

New York Times Magazine, 8 October 1972, p. 14.
:27-29 Y. and R. F. MURPHY, Women of the Forest (New York:

Columbia University Press, 1974), p. 106.

246:8-19 A. S. MiRKiN, "Resonance Phenomena in Isolated Me-

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:20-25 C. K. MADSEN and W. G. MEARS, "The Effect of Sound
upon the Tactile Threshold of Deaf Subjects," Journal of
Music Therapy, vol. 2 (1965), pp. 64-68.

:26-27 G. A. GESCHEIDER, "Cutaneous Sound Localization"
(Ph.D. diss., University of Virginia, 1964; Dissertation Ab
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:29 to B. BERENSON. Aesthetics and History (New York: Pantheon,
247:14 1948), pp. 66-70.

247:29-37 ROBERT HUGHES, "When God Was an Englishman," Time,

1 March 1976, p. 56.
248: 1-5 M. McLuHAN and H. PARKER, Through the Vanishing Point

(New York: Harper & Row, 1969), p. 265.

:5-26 T. KROEBER, Alfred Kroeber: A Personal Configuration

(Berkeley: University of California Press, 1970),
pp. 267-268.

248:34-38 M. ARGYLE and M. COOK, Gaze and Mutual Gaze (Cam
bridge and New York: Cambridge University Press, 1976).
249:1-12 E, G. SCHACHTEL, "On Memory and Childhood Amnesia,"

in P. Mullahy (ed.), A Study of Interpersonal Relations
(New York: Hermitage Press, 1949), pp. 23-24.
: 14-19 Ibid., pp. 25-26.
:20-23 H. MARCUSE, Eros and Civilization (Boston: Beacon Press,

1955), p. 39.

250:7-11 H. L. PICK, A. D. PICK, and R. E. KLEIN, "Perceptual

Integration in Children, in L. P. Lipsitt and C. C. Spiker

(eds.), Advances in Child Behavior and Development,

vol. 3 (New York: Academic Press, 1967), pp. 191-220.

:1 1-13 E. J. GIBSON and R. D. WALK, 'The Visual Cliff," Scientific

American, vol. 202 (1960), pp. 64-71.
: 14-20 T. G. R. BOWER, 'The Object in the World of the Infant,"

Scientific American, vol. 225 (1971), pp. 30-38.
:21-26 H. R. SCHAFFER and P. E. EMERSON, "Patterns of Response
to Physical Contact in Early Human Development," Jour-

360 References

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pp. 1-13.

:3 1 to A. V. ZAPOROZHETS, "The Development of Perception in the

251:9 Preschool Child," in P. H. Mussen (ed.), European Re

search in Cognitive Development, Monographs of the Soci
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vol. 30. ser. no. 100, Chicago: University of Chicago Press,
1965.
: 10-14 IRVIN ROCK and CHARLES S. HARRIS, "Vision and Touch,"

Scientific American, vol. 216 (1967), pp. 96-104.
: 17-24 SHEILA HOCKEN, "Life at First Sight The Surprising
World of Sheila Hocken," The Listener (London), 10 June
1976, pp. 730-731.

252:2-9 M. D. S. AINSWORTH, Infancy in Uganda (Baltimore: Johns

Hopkins Press, 1967), p. 451. See also L. K. Fox (ed.), East
African Childhood (New York: Oxford University Press,
1970).

: 12-16 Ibid., p. 330.

252:20 J. ROSCOE, The Baganda (London: Macmillan, 1911); L. P.

Mair, An African People in the Twentieth Century (Lon
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:22-29 A. I. RICHARDS, "Traditional Values and Current Political
Behavior," in L. A. Fallers (ed.), The King's Men: Leader
ship and Status in Modern Buganda (New York: Oxford
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:33 to M. GEBER, "The Psychomotor Development of African

253:34 Children in the First Year and the Influence of Maternal

Behavior," Journal of Social Psychology, vol. 47 (1958),
pp. 185-195; M. Geber and R. F. A. Dean, "The State
of Development of Newborn African Children," The
Lancet, vol. 272 (1957), pp. 1216-1219; M. Geber,
"Problemes Poses par le Developpement du Jeune Enfant
Africain en Fonction de son Milieu Social," Le Travail
Humain, vol. 23 (1960), pp. 99-111.

:35 to PATRICIA DRAPER, "Crowding Among Hunter-Gather-
254:6 ers: The IKung Bushmen," Science, vol. 182 (1973),

pp. 301-303.

:9-37 L. MARSHALL, The IKung ofNyae Nyae (Cambridge: Har

vard University Press, 1976), pp. 315-318.
255:15-19 A. GESELL and C. AMATRUDA, Developmental Diagnosis

(New York: Harper & Row, 1947), p. 42.

:20-33 M. J. KONNER, "Aspects of the Developmental Ethology of
a Foraging People," in N. Blurton Jones (ed.), Ethological

References 361

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Press, 1972), pp. 285-304; S. R. Tulkin and M. J. Konner,
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256:1 E. M. THOMAS, The Harmless People (New York: A. A.

Knopf, 1959); L. van der Post, The Lost World of the
Kalahari (New York: William Morrow, 1958); L. van der
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Africa (London: Routledge & Sons, 1930); L. Marshall,
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:5-6 See W. D. HAMMOND-TOOKE (ed.), The Bantu-Speaking

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: 1 3-20 M. MEAD, Sex and Temperament In Three Primitive Societies

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:35 to Ibid., pp. 42-43.

257:2

258:27-33 J. RITCHIE, Review of A. Montagu, Touching, Parents Cen
tres Bulletin 52, August 1972, p. 22.

259:1-8 C. DuBois, The People of Alor (Minneapolis: University of

Minnesota Press, 1937), p. 152.

: 13-22 T. R. WILLIAMS, "Cultural Structuring of Tactile Experience
in a Borneo Society," American Anthropologist, vol. 68
(1966), pp. 27-39.
:23 to Ibid., p. 29.

260:9

260:23 to J. W. PRESCOTT and DOUGLAS WALLACE, "Developmental

261:10 Sociobiology and the Origins of Aggressive Behavior,'*

Paper presented at the XXIst International Congress of
Psychology-, July 18-25, 1976, Paris.

: 19-21 V. S. CLAY, "The Effect of Culture on Mother-Child Tactile
Communication" (Ph.D. diss., Teachers College, Co
lumbia University, 1966).
:34 to Ibid., pp. 199-201.

262:17

362

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263:10-17 R. RUBIN, "Maternal Touch," Nursing Outlook, vol. 11

(1963), pp. 828-831.

: 18-20 H. F. HARLOW, M. K. HARLOW, and E. W. HANSEN, "The
Maternal Affectional System of Rhesus Monkeys," in H. L.
Rheingold (ed.), Maternal Behavior in Mammals {New
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264:13-30 CLAY, "The Effect of Culture . . . ," pp. 201-202.
265:8-12 R. E. SEARS, E. E. MACCOBY, and H. LEVIN, Patterns of

Child Rearing (New York: Row, Petersen & Co., 1957),
pp. 56-57, 402; J. L. Fischer and A. Fischer, "The New
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: 12-3 3 H. A. Moss, K. S. ROBSON, and F. PEDERSEN, "Determi
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:34 to R. H. WALTERS and R. D. PARKE, "The Role of the Distance

266:20 Receptors in the Development of Social Responsiveness,"

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:35 to A. MONTAGU, "Some Factors in Family Cohesion," Psychia-

267:6 try, vol. 7 (1944), pp. 349-352.

: 11-23 L. SMITH, Strange Fruit (New York: Reynal, 1944), p. 74.

:26 to W. CAUDILL and D. W. PLATH, "Who Sleeps by Whom?

268:9 Parent-Child Involvement in Urban Japanese Families,"

Psychiatry, vol. 29 (1966), p. 363.
:11-19 Ibid., p. 363.

268:30 to E. T. HALL, Beyond Culture (New York: Anchor Books,

269:9 Doubleday, 1976), pp. 56-58.

:14-19 See FISCHER and FISCHER, "The New Englanders . . . ," in

Whiting, Six Cultures, p. 947.
270:13-32 E. M. FORSTER, Abinger Harvest (New York: Harcourt,

Brace, 1947).

:33 to JANE AUSTEN, Emma (London, 1816), Chapter 12.
271:4

:5-7 TIMOTHY EDEN, The Tribulations of a Baronet (London:

Macmillan, 1933).

:5-8 R. HART-DAVIS, Hugh Walpole: A Biography (New York:

The Macmillan Co., 1952).

References

363

Page and Line

:8-9 W. A. SWANBERG, William Randolph Hearst (New York:

The Macmillan Co., 1961).
:10-12 CECIL KING, Strictly Personal (London: Weidenfeld &

Nicolson), 1969.

:21-34 M. MEAD, "Cultural Differences in the Bathing of Babies,"
in K. Soddy (ed.), Mental Health and Infant Development
(New York: Basic Books, vol. 1, 1956), pp. 170-171.

272:3-8 CLAY, "The Effect of Culture . . . ," p. 273.

272:21-29 NANCY M. HENLEY, "The Politics of Touch," in Phil Brown
(ed.), Radical Psychology (New York: Colophon Books,
1973), pp. 420-433.

273:12-13 S. GOLDBERG and M. LEWIS, "Play Behavior in the Year-
Old Infant: Early Sex Differences," Child Development,
vol. 40 (1966), pp. 21-31; V. S. Clay, "The Effect of Cul
ture on Mother-Child Tactile Communication" (Ph.D.
diss., Teachers College, Columbia University, 1966).
: 1 3-30 S. M. JOURARD, "An Exploratory Study of Body Accessibil
ity," British Journal of Social and Clinical Psychology,
vol. 5 (1966), pp. 221-231; S. M. Jourard and J. E. Rubin,
"Self-Disclosure and Touching: A Study of Two Modes of
Interpersonal Encounter and Their Interaction," Journal
of Humanistic Psychology, vol. 8 (1968), pp. 39-48.
:31 to HENLEY, "The Politics of Touch," p. 431.

274:8

: 12-25 A. FREUD, Normality and Pathology in Childhood (New

York: International Universities Press, 1965), p. 155.
:26-33 Ibid., p. 156.

275:10-12 T. THEVENIN, The Family Bed: An Age Old Concept in Child

Rearing, P. O. Box 16004, Minneapolis, Minn., 55416.
:21-34 Editorial, "Baby-Care Lambskin Rugs," Parents Centres
(Auckland, N.Z.), Bulletin 38, March 1969, p. 8. See also
Bulletin 35, June 1968.

276:5-12 N. F. ROBERTS, "Baby Care Lambskin Rugs," Parents Cen

tres (Auckland, N.Z.), Bulletin 39, June 1969, pp. 12-18.

276:21 to R. H. PASSMAN and P. WEISBERG, "Mothers and Blankets

277:2 as Agents for Promoting Play and Exploration by Young

Children in a Novel Environment: The Effects of Social
and Nonsocial Attachment Objects," Developmental Psy
chology, vol. 11 (1975), pp. 170-177. For earlier studies see
D. W. Winnicott, "Transitional Objects and Transitional
Phenomena," International Journal of Psychoanalysis,
vol. 24 (1953); O. Stevenson, "The First Treasured Pos
session: A Study of the Part Played by Specially Loved

364 References

Page and Line

Objects and Toys in the Lives of Certain Children," in
The Psychoanalytic Study of the Child, vol. 9 (1954),
pp. 199-217.

:3 R. H. PASSMAN, "The Effects of Mothers and 'Security' Blan

kets upon Learning in Children (Should Linus Bring His
Blanket to School?)", Paper presented at the American
Psychological Association Convention, New Orleans, Lou
isiana, September 1974.

: 4_9 R. H. PASSMAN, "Arousal Reducing Properties of Attach

ment Objects: Testing the Functional Limits of the Secu
rity Blanket Relative to the Mother," Developmental Psy
chology, vol. 12 (1976), pp. 468-469.

:9-l 1 W. A. MASON, "Motivational Factors in Psychosocial Devel

opment," in W. A. and M. Page (eds.), Nebraska Sympo
sium on Motivation (Lincoln: University of Nebraska,
1970), pp. 35-67.

: 14-1 5 P. WEISBERG and J. E. RUSSELL, "Proximity and Interac
tional Behavior of Young Children to Their 'Security'
Blanket," Child Development, vol. 42 (1971), pp. 1575-
1579.

278:1-4 Webster's New World Dictionary of the American Language

(New York & Cleveland: World Publishing Co., 1970),
p. 1064.

:5-ll BORIS M. LEVINSON, Pet-Oriented Child Psychotherapy

(Springfield, Illinois: Charles C Thomas, 1969), p. xiv;
B. M. Levinson, Pets and Human Development (Spring
field, Illinois: Charles C Thomas, 1972).

:15 to S. A. CORSON, et al, "The Socializing Role of Pet Animals

279:7 in Nursing Homes: An Experiment in Nonverbal Commu

nication Therapy," in L. Levi (ed.), Society, Stress and
Disease: Aging and Old Age (New York: Oxford University
Press, 1977); S. A. Corson, E. O'L. Corson, and P. H.
Gwynne, "Pet-Facilitated Psychotherapy," in R. S. Ander
son (ed.), Pet Animals and Society (Baltimore: Williams &
Wilkins, 1975), pp. 19-35.

:8-10 R. HELPER, "The Relationship between Lack of Bonding and

Child Abuse and Neglect," in M. H. Klaus, T. Leger, and
M. A. Trause (eds.), Maternal Attachment and Mothering
Disorders: A Round Table (New Brunswick, New Jersey:
Johnson & Johnson, 1975), pp. 21-25.

:11-17 PRAFULLA MOHANTI, My Village, My Life: Portrait of
an Indian Village (New York: Praeger, 1974), pp. 103-
107.

References 365

Page and Line

: 18-22 F. LEBOYER, Loving Hands: The Traditional Indian Art of

Baby Massage (New York: A. A. Knopf, 1976).
:23 to W. A. CAUDILL and H. WEINSTEIN, "Maternal Care and
280: 1 1 Infant Behavior in Japan and America," Psychiatry, vol. 32

(1969), pp. 12-43; p. 13.
: 18-26 Ibid., pp. 14-15.

28 1 : 1-3 E. F. VOGEL, Japan 's New Middle Class: The Salary Man and

His Family in a Tokyo Suburb (Berkeley: University of
California Press, 1963).

: 16-26 CAUDILL and WEINSTEIN, "Maternal Care and Infant Be
havior . . . ," p. 42. See also W. A. Caudill and C. Schooler,
"Child Behavior and Child Rearing in Japan and the
United States: An Interim Report," Journal of Nervous and
Mental Disease, vol. 157 (1973), pp. 323-338.

:32 to D. G. HARING, "Aspects of Personal Character in Japan," in

282:9 D. G. Haring (ed.), Personal Character and Cultural Mi

lieu (Syracuse, New York: Syracuse University Press,
1956), p. 416.
:26-33 Ibid., p. 417.
283:5-11 Ibid.

286:21-22 Quoted in A. F. COPPOLA, "Reality and the Haptic World,"

Phi Kappa Phi Journal Winter 1970, p. 29.

:23-29 B. SCHAFFNER, Father Land (New York: Columbia Univer
sity Press, 1948).
287:32-35 GERMAINE GREER, The Female Eunuch (New York:

McGraw-Hill, 1971), p. 112.
288:10-27 E. A. DUYCKINCK (ed.), Wit and Wisdom of the Rev. Sydney

Smith (New York: Widdleton, 1866) p. 426.

:36 to J. VAN LAWICK-GOODALL, In the Shadow of Man (Boston:
289:5 Houghton Miffiin, 1971), pp. 241 et seq.

289:1 DIAN FOSSEY, "More Years with Mountain Gorillas," Na

tional Geographic, October 1971, pp. 574-585.
:9-12 ORTEGA Y GASSET, Man and People (New York: W. W.

Norton, 1957), pp. 192-221.

: 12-1 5 E. WESTERMARCK, The Origin and Development of the
Moral Ideas. (2 vols., London: Macmillan, 1917), vol. 2,
pp. 150-151.

290:1-8 S. F. FELDMAN, Mannerisms of Speech and Gestures in Ev

eryday Life (New York: International Universities Press,
1959), p. 270.
: 13-25 A. F. COPPOLA, "Reality and the Haptic World," Phi Kappa

Phi Journal Winter 1970, pp. 30-31.
291:24-29 I. PINCHBECK and M. HEWITT, Children in English Society.

366 References

Page and Line

Vol. 1: From Tudor Times to the Eighteenth Century (Lon
don: Routledge & Kegan Paul, 1970); L. L. Schucking, The
Puritan Family (London: Routledge & Kegan Paul, 1970);
P. Aries, Centuries of Childhood (New York: A. A. Knopf,
1962).

292:3-12 KURT W. BACK, Beyond Words (New York: Russell Sage

Foundation, 1972), p. 154.

: 1 3-14 Ibid., p. 46. For additional works on encounter and sensitivity
training see R. Gustaitis, Turning On (New York: The
Macmillan Co., 1969); D. Alchen, What the Hell Are They
Trying to Prove, Martha? (New York: John Day, 1970); J.
Howard, Please Touch (New York: McGraw-Hill, 1970);
B. L. Maliver, The Encounter Game (New York: Stein &
Day, 1972); L. N. Solomon and B. Berson (eds.) New Per
spectives on Encounter Groups (San Francisco: Jossey-Bass,
Inc., 1972).

: 15-1 8 J. R. GIBB, "The Effects of Human Relations Training," in
A. E. Bergin and S. L. Garfield (eds.), Handbook of Psycho
therapy and Behavior Change (New York: Wiley, 1970),
pp. 2114-2176.

: 1 8-2 1 C. R. ROGERS, Carl Rogers on Encounter Groups (New York:
Harper & Row, 1973), p. 146.

:24 to W. E. HARTMAN, M. FIFTHIAN, and D. JOHNSON, Nudist
293:4 Society (New York: Crown, 1970), pp. 278-86. See also J.

Howard, Please Touch (New York: McGraw-Hill, 1970);
M. Shepard and M. Lee, Marathon 16 (New York: G. P.
Putnam's Sons, 1970); B. L. Austin, Sad Nun at Syanon
(New York: Holt, Rinehart & Winston, 1970).

:17 to M. MEAD and R. METRAUX (eds.), The Study of Culture at
294:1 a Distance (Chicago: University of Chicago Press, 1953),

p. 107-1 15, 352-353; G. Gorer and J. Rickman, The People
of Great Russia: A Psychological Study (New York: Chanti
cleer Press, 1950).

:5-14 P. H. WOLFF, "The Natural History of Crying and Other

Vocalizations in Early Infancy,*' in E. B. Foss (ed.), Deter
minants of Infant Behavior (London: Methuen, 1969),
vol. 4, p. 92.

: 15-1 8 H. ORLANSKY, "Infant Care and Personality," Psychological
Bulletin, vol. 46 (1949), pp. 1-48.

:24 V. DAL, The Dictionary of the Living Great R ussian Language

(Tolkovyi slovar Velikomusskavo Yazkaya) (St. Petersburg,
1903).

References

367

Page and Line

:24to
295:25

:36-37

:37 to
296:20
297:17-19

:33-35

298:10-16
: 19-28

:31 to
299:8

:35 to
300:6
301:18-24

:25-31

302:11-14
303:10-18

:23-28
:29-32

304:16-18

:22-27

MEAD and METRAUX, The Study of Culture at a Distance
p. 163.

N. LEITES, The Operational Code of the Politburo (New
York: McGraw-Hill, 1951).

L. H. HAIMSON, "Russian 'Visual Thinking,' " in Mead and
Metraux, p. 247.

D. LEIGHTON and C. KLUCKHOHN, Children of the People
(Cambridge: Harvard University Press, 1947), pp. 24-25.

R. E. RITZENTHALER and P. RITZENTHALER, The Wood-
land Indians (New York: The Natural History Press,
1970), p. 29.

Quoted by Leighton and Kluckhohn, Children of the People,
pp. 29-30.

W. DENNIS, The Hopi Child (New York: Appleton-Century
Co., 1940), p. 101.

L. GALLEY, "A Baby on a Cradle Board/' Child and Family,
vol. 5 (1966), pp. 8-10.

J. E. RITCHIE, "The Husband's Role," Parents Centres
(Auckland, N.Z.), Bulletin 38, March 1969, pp. 4-7.

Ross D. PARKE, "Father-Infant Interaction," in Klaus,
Leger, and Trause, Maternal Attachment and Mothering
Disorders, pp. 61-63. See also M. H. Klaus and J. H.
Kennell, Maternal-Infant Bonding (St. Louis, Missouri:
C. V. Mosby Co., 1976).

D. W. WINNICOTT, "The Theory of Parent-Infant Relation
ship," International Journal of Psychoanalysis, vol. 41
(1958), p. 591.

GRAHAM GREENE, A Sort of Life (New York: Simon &
Schuster, 1971), p. 64.

L. K. FRANK, "The Psychological Approach in Sex Re
search," Social Problems, vol. 1 (1954), pp. 133-139.

CLAY, "The Effect of Culture . . . ," p. 278.

L. M. STOLZ, Influences on Parent Behavior (Stanford: Stan
ford University Press, 1967), p. 141.

R. E. HAWKINS and J. A. POPPLESTONE, "The Tattoo as an
Exoskeletal Defense," Perceptual and Motor Skills, vol. 19
(1964), p. 500; J. A. Popplestone, "A Syllabus of Exoske
letal Defenses," Psychological Record, vol. 13 (1963), pp.
1 5-25; H. Eberstein, Pierced Hearts and True Love (Lon
don: Derek Verschoyle, 1953).

F. ROME, The Tattooed Men (New York: Delacorte Press,
1975), p. 54.

368

References

Page and Line

:30to
305:10

: 19-20

306:5-7
:8-15
: 16-24

307:13-15

: 19-23

:29 to
308:2

309:10-13

J. H. BURMA, "Self-Tattooing among Delinquents," Sociol
ogy and Social Research. voL 43 (1959), pp. 341-345.

S. FISHER, Body Consciousness (Englewood Cliffs, New Jer
sey: Prentice-Hall, 1973), p. 91.

A. M. HOCART, "Tattooing and Healing,'* in his The Life-
Giving Myth (New York: Grove Press, n.d.) pp. 169-172.

For a good survey see W. G. SUMNER and A. G. KELLER,
The Science of Society (New Haven: Yale University Press,
1929), vol. 3, pp. 2130-2135. See also C. Jenkinson, "Tatu-
ing," in J. Hastings (ed.), Encyclopaedia of Religion and
Ethics (New York: Scribners, 1920), vol. 12, pp. 208-214;
Henry Field, "Body-Marking in Southwestern Asia," Pa
pers of the Peabody Museum of Archaeology and Ethnology,
Harvard University, vol. 45, 1958, pp. xiii-162.

These studies are summarized in Klaus and Kennell, Mater
nal-Infant Bonding, pp. 2-3.

H. KEMPE, "Detecting Child Abuse," Intercom (Washing
ton, D.C.), vol. 4, no. 11 (1976), p. 5.

R. HELPER, "The Relationship between Lack of Bonding and
Child Abuse and Neglect," in Klaus, Leger, and Trause,
Maternal A ttachment and Mothering Disorders, pp. 2 1-25 .

F. DUNBAR, Psychosomatic Diagnosis (New York: Hoeber,
1943), pp. 86-87; J. G. Kepecs, "Some Patterns of Somatic
Displacement," Psychosomatic Medicine, vol. 15 (1953),
pp. 425-432.

C. E. BEND A, The Image of Love (New York: Free Press,
1961), p. 162.

J. G. KEPECS, M. ROBIN, and M. J. BRUNNER, "Relationship
between Certain Emotional States and Exudation into the
Skin," Psychosomatic Medicine, vol. 13 (1951), pp. 10-17.

J, G. KEPECS, A. RABIN, and M. ROBIN, "Atopic Dermati
tis: A Clinical Psychiatric Study," Psychosomatic Medi
cine, vol. 13 (1951), pp. 1-9; H. C. Bethune and C. B.
Kidd, "Psychophysiological Mechanisms in Skin Dis
eases," The Lancet, vol. 2 (1961), pp. 1419-1422.

H. F. HARLOW and M. K. HARLOW, "Learning to Love,"
American Scientist, vol. -54 (1966), pp. 244-272, and nu
merous other papers.

H. F. HARLOW, "Primary Affectional Patterns in Primates,"
American Journal of Orthopsychiatry, vol. 30, (1960),
pp. 676-677; M. K. Harlow and H. F. Harlow, "Affection
in Primates," Discovery, vol. 27, January 1966.

HARLOW, "Primary Affectional Patterns in Primates,"

References

369

Page and Line

: 17-23

310:10-12

: 18-22

:24-31

312:1-12
312:22-23

:37 to
313:4

314:4-7

:27to
315:19

American Journal of Orthopsychiatry, vol. 30 (1960),
p. 683.

CLAY, "The Effect of Culture . . . ," pp. 281-282.

Ibid., p. 286.

H. F. HARLOW and M. K. HARLOW, "Learning to Love,"
American Scientist, vol. 54 (1966), p. 250.

H. F. HARLOW, "Development of the Second and Third
Affectional Systems in Macaques Monkeys," in T. T. Tour-
lentes, S. L. Pollack, and H. E. Himwich (eds.), Research
Approaches to Psychiatric Problems (New York: Gmne &
Stratton, 1962), pp. 209-229.

CLAY, "The Effect of Culture . . . ," p. 290.

See also C. Loizos, "Play Behavior in Higher Primates: A
Review," in D. Morris (ed.), Primate Ethology (Chicago:
Aldine Publishing Co., 1967), pp. 176-218; 0. Aldis, Play
Fighting (New York: Academic Press, 1975); P. A. Jewell
and C. Loizos (eds.), Play, Exploration and Territory in
Mammals (New York: Academic Press, 1966); S. Miller,
The Psychology of Play (Baltimore: Penguin Books, 1968).

T. R. WILLIAMS, "Cultural Structuring of Tactile Experience
in a Borneo Society," American Anthropologist, vol. 68
(1966), pp. 27-39.

A. TSUMORI, "Newly Acquired Behavior and Social Interac
tions of Japanese Monkeys," in S. A. Altmann (ed.), Social
Communication among Primates (Chicago: University of
Chicago Press, 1967), pp. 207-219.

K. R. L. HALL, "Observational Learning in Monkeys and
Apes," British Journal of Psychology, vol. 54 (1963),
pp. 201-206; K. R. L. Hall, "Social Learning in Monkeys,"
in P. Jay (ed.), Primates (New York: Holt, Rinehart &
Winston, 1969), pp. 383-397.

H. L. RHEINGOLD and C. O. ECKERMAN, "The Infant Sepa
rates Himself from His Mother," Science, vol. 168 (1970),
pp. 78-83.

R. HELD and A. HEIN, "Movement-Produced Stimulation in
the Development of Visually Guided Behavior," Journal of
Comparative and Physiological Psychology, vol. 56(1963),
pp. 872-876.

CLAY, "The Effect of Culture . . . ," pp. 308, 322.

INDEX

acne, 216-17

Ader, R., 23

Aftenas, M., 229

aging:

need for contact in, 320-22
skin changes in, 7, 145, 155, 320

Ainsworth, Mary, 251, 252

Aldrich, A., 157

Alexander, G., 20

algolagnia, 179-80

allergic rhinitis, 90

allergies, 215

Amatruda (researcher), 255

animals:

body contact in, 227
skin sensitivity in, 3
staring in, 248

See also Breastfeeding; Licking
behavior; Maternal behavior;
indiv. species

Anne, Queen, 214

anxiety, 76-77, 86-87, 217, 219,
277

apes:

breastfeeding in, 40, 66
gestation period in, 40-41, 42
grooming behavior, 28, 34
independent behavior in, 233
licking behavior in, 18
maternal behavior in, 40
neonatal immaturity in, 40
See also Monkeys; indiv. species

Arapesh, 256-57

Arms, Suzanne, 114
atopic dermatitis, 308
Auden, W. R, 285
Austen, Jane, Emma, 270-71
Austrians, tactility in, 286
autism. See Schizophrenia and
schizoid behavior

baboons:

dog-headed, 35

staring in, 248
Bach-y-Rita, Paul, 148
Back, Kurt W., 292
Bakwin, Harry, 82
Bali:

child rearing in, 114-15, 116-18,
119

music in, 117

sleeping habits and patterns in,
118

toilet training and attitudes in,

117

Balint, Michael, 219
Barclay, Andrew, 172-73
Barnett, C. R., 108
Barron, Donald H., 25, 56
Bartel, Helmut W., 209
Barton, William H., 210-11
Bateson, Gregory, 114-15
bathing, 153-54

in Bali, 118

hi India, 279

372

INDEX

bathing (cont'd)

of infant, 84-85, 106, 153, 271,
279

in Japan, 280-81

and masturbation, 154

sensual component in, 153-54

singing and, 154

in United States, 153, 271, 281
behaviorism, 120-23, 125, 155
Bell, R. W., 26
Benda, Clemens, 307
Benjamin, John D., 187
Berenson, Bernard, 246-47, 248
Berezin, Martin, 151
Berkeley, George, 250
Berkson, Gershon, 134
Bettelheim, Bruno, 104
Birch, H. G., 19
Birdwhistell, Ray L., 87
birth process, 38-39, 40, 47, 48-49,
56-58, 60, 62-63, 107

cesarean deliveries, 52-56

husband's role in, 107

mechanization of, 109-10, 111,
125-26, 136, 233-34, 263

postterm births, 46

and prematurity, 51-52, 54,
108-9

as shock, 194
Blake, William, Everlasting Gospel

The, 112
Blase, B., 132-33
Blauvelt, H., 21
Blinder, M. G., 162
blindness, 8, 79, 80, 146-47, 150,
213, 229, 251

See also Vision
Bloch, Marc, Royal Touch, The,

214

boils, 10

Boverman, H., 132
Bower, B. D., 250
Bowlby, John, 186, 218-19
Braille, Louis, 147
brain, 1, 2, 3, 7-8

central gyms, 102

fetal, 41

growth of, 44-46

hypothalamus, 20

brain (cont'd)

postcentral gyms, 8, 9
precentral gyrus, 8
tactile area of, 9-10
See also Central nervous system
Braque, Georges, 219
breastfeeding:

immunity conferred by, 6465

letdown reflex in, 66

primary function hypothesized,

31

breastfeeding (animal):
apes, 40, 66
hares, 66
monkeys, 66
rabbits, 66
tree shrews, 66
breastfeeding (human): 31, 59-75,

78, 112, 240n
in Arapesh, 256-57
and behavioral development,

73-74, 104
benefits of, 63-65, 67-69, 70,

71-72

vs. bottlefeeding, 67, 69
breast care in, 72
considered indecent, 61-62
contraceptive effect of, 44, 67
decline in, 126, 176, 266
early weaning in, 68
erotic component of, 62, 161
Freudian interpretation of, 95-96
function of, 63, 66
in Ganda, 251
immunity conferred by, 6465,

67, 70
intimacy felt as uncomfortable,

62

in Japan, 281, 282
in IKung Bushmen, 254, 255
in Mundugumor, 257-58
in Netsilik Eskimos, 236
and orality, 93-94
rooting behavior in, 98-99
sensual component of, 97
and smiling, 7475
and speech development, 69-70
suckling behavior in, 69, 73, 85,

94, 96, 101-2

Index

373

breastfeeding (confd)

superiority of infants, 65, 67

thumb-sucking as substitute, 174

weaning from, 68
breathing:

and anxiety, 92

and cutaneous stimulation, 90-91

in infants, 84-85, 91-92

learned nature of, 92
Brennemann, J., 79
Bridgman, Laura, 80, 81, 146-47
British Medical Journal, 109
Broad, Frances, 69-70
Brody, S., 169-70
Bronfenbrenner, Urie, 189
Brooke, Rupert, 291
Burma, J. H., 304
Burton, Arthur, 219, 223
Bushmen. See IKung Bushmen
Butler, Samuel, Hudibras, 152

Galley, Louise, 298-99
Canadians, tactility in, 293
Carlyle, Thomas, 152
Carpenter, Edmund, 136, 238, 239,

243

Carrighar, Sally, 136
Carson, Elizabeth, 278
Carson, Samuel, 278
Casler, Lawrence, 186
cats:

licking behavior in, 17, 18

stroking appetite of, 26
Caudill, William, 267, 268, 279-80,

281
central nervous system, relationship

to skin, 2-3, 7-8, 9, 230
cesarean deliveries, 52-56

and emotional disturbances, 55

and speech defects, 55
Chapin, Henry Dwight, 77, 78
Charles X, 213-14
chickens, 3
child abuse, 279, 304-07

See also Spanking
Children's Clinic (Dusseldorf), 78
chimpanzees:

finger-grooming in, 35

gestation period in, 40

chimpanzees (cont'd)

handshaking in, 288-89

handstroking and caressing in,
35

neonatal weight, 41

tactile deprivation in, 227
Chisholm, Brock, 124-25
Christian tradition and taboos, 249
Chu, Josephine, 53
Citizen Kane, 271
Clay, Vidal Starr, "Effect of
Culture on Mother-Child
Tactile Communication," 185,
190, 261-63, 264, 265, 272,
284, 303, 309-10, 311-12,
314-15

clothing, 142^6, 264
coitus. See Sex and sex differences
colic, 91

Collias, N. K, 21
Collins, Carter C, 148
colostrum 42, 61, 232

immunity conferred by, 64-65
commensal association, 28
Conklin, P. M., 23
Constable, John, 247

Leaping Horse, The, 247
Cooke, R. E., 85
Coppola, August R, 212, 290
coprophilia, 184
cows:

colostrum of, 64

hand milking of, 26, 72

milk-fed calves, 71
cradleboards, 296-99
cradles and rocking, 78, 119-22,
124, 125, 127-28, 318-19

attacked by behaviorists, 120-23

benefits of, 77, 126

cribs substituted for, 122, 124,
125

physiological effects of, 128-32

relationship to music and dance,
135^2

as sedative, 127

self-rocking behavior, 134-35

waterbed as, 143-44

See also Cribs
crib death, 126

374

INDEX

cribs, 67, 122, 124, 125, 126, 127,

234, 318
crocodiles, 28
Croxton, James, 61
cutaneous alagia, 8
cutaneous stimulation. See Touch

dance, 135

biological roots of, 139-40

"Milk Dance," 139

"touch dancing," 137

See also Music
dark:

experiments in, 211-12, 213, 229

fear of, 100-1

Darwin, Erasmus, Zoonomia, or
the Laws of Organic Life,
73-75, 202-03
deafness, 8, 79, 80, 213, 246

See also Hearing
de Boer, Richard James, 235-36,

237
Debussy, Claude, L'Apres-Midi

d*un Faune, 135
deer. See Fallow deer
Denenberg, Victor H., 26, 54
dermatographia, 14748
dermographia, 147-48
"dermo-optical perception,"

146-47, 149
De Vore, Irven, 90
Dill, D. B., 92
dogs:

importance of gentling, 25

licking behavior in, 15, 17

stroking appetite of, 26

use of, in therapy, 278-79
dolphins, 27
Douglas, Alfred, 285
Draper, Patricia, 253
Drillien, C. M., 51, 54
DuBois, Cora, 259
Dunbar, Flanders, 205
Durdin, Peggy, 245
Dusun (North Borneo), 259-60,

312-13
Dylan, Bob, 136

eating, as substitute for love, 96

echidnas, 28

Eckerman, C O., 313-14

ectoderm. See Skin

eczema, 215

Eden, William, 271

Egypt, tattooing in, 305

Elder, M. S., 85

elephant, gestation period in, 39

Elizalde, Manuel, 245

Ellis, Havelock, 181

encounter and marathon groups,

291-93
England:

boarding (public) schools in, 270,
285-86, 302, 304

Elizabethan, 291

lack of warmth and tactility in,
269, 270-71, 283-85, 293

upper classes, 269-71, 284-85,

286

epidermis. See Skin
Erasmus, 291

Erikson, Erik H., 173, 185
Escalona, S., 196, 197, 199, 200,

203
Eskimos, 235-44

Aivilik Eskimos, 238-39, 243

breastfeeding in, 236

Copper Eskimos, 240-41, 242

hearing and auditory perception
in, 242, 243^4

Iglulik Eskimos, 241-42

licking behavior in, 37, 243

Netsilik Eskimos, 235-38

poetry of, 240-41

Polar Eskimos, 37

sexual behavior in, 242

sleeping habits and patterns hi,
242

smell, sense of, in, 242

spatial faculties of, 238-39, 243

stress-coping in, 239

toilet training and attitudes in,

237, 238

exhibitionism, 181, 182, 183, 184
extended family, 271-72

Index

375

exterogestation, 44, 47, 232-33,
234-35

Fagot, Beverly, 183-84

falling, fear of, 217

fallow deer, gestation period in, 39

Feldman, Sandor S., 290

Fenichel, Otto, 82-83, 167, 206-07

fetus:

brain growth in, 41, 44

rhythmic orientation of, 137,
138-39, 232-33

See also Birth process; Infants
Fischer, J. L. and Fischer, A., 185,

269

flagellation, 179, 180
Flaubert, Gustave, 245
fleas, possible function of, 28
Flye, J., 229

Forer, Bertram, 221-22, 223
Forster, E. M., 270, 285

Howard's End, 209
Fraiberg, Selma, 306
Frank, Lawrence K., 136, 170,

171-72, 175, 303
Frazier, W. H., 55
Frederick II, 81
Freedman, D. G., 132
Freedman, N., 132
French, tactility in, 283, 287-88,

291, 293

French Canadians, tactility in, 293
Freud, Anna, 156, 161, 274
Freud, Sigmund, 95-96, 167, 170,

221, 222, 292
Friedman, Myra, 168
Fries, Margaret, 298
frottage, 184
Fuchs, Lawrence H., 136
Fuller, J. L., 25
Furman, R, 111

Ganda (East Africa), 251-53
Gardner, L. L, 193
Gardner, Martin, 146
Garner, A. M., 226
Geber, Marcelle, 252, 253
Geldard, Frank A., 149

Gergen, Kenneth, 210-11
Gergen, Mary, 210-11
Germans:

Nazis, 303-04

tactility in, 286
Gescheider, G. A., 246
Gesell, Arnold, 255

child development tests, 253
Gibb, J. R., 292
Gibson, James, 240
Gill, Eric, 143
Gilmore, Raymond, 28
goats, licking behavior in, 21-22,

56

Goldberg (researcher), 185
Gordon, Suzanne, Lonely in

America, 210
gorillas, 174

finger-grooming in, 35

gestation period in, 40

handshaking in, 289

handstroking and caressing in,
35

neonatal weight, 41

staring in, 248
gray whales, 27-28
Greenacre, P., 195
Greene, Graham, Sort of Life, A,

302

Greene, William, Jr., 131-32
Gregg, Lee W., 149-50
grooming, as evolutionary

development from licking, 35

See also indiv. species
Grota, L. J., 54
guinea pigs, 3, 42
Gunner, A., 28

Hahn, J. F., 150
Haimson, L. H., 295-96
Hair, 143
hair:

facial, 142-43

long, 142-43
Hall, E. T., 218, 268-9
Hall, G. Stanley, 95
Halliday, James L., Psychosocial
Medicine, 76-77

376

INDEX

Hamili, R., 77
Hamerman, $., 216-17
hands (and fingers):
laying on of, 213-14
tactile importance of, 8, 102,

105-7, 147

handshaking, 288-91, 302
Hardy, M. C, 67
hares, 66

See also Rabbits
Haring, Douglas, 281-82
Harlow, Harry R, 22, 29-32, 34,

97, 153, 160, 176, 263, 308,

310
Harlow, M. K., 32, 97, 153, 160,

176, 310

Harris, Charles S., 251
Hasselmeyer, E. G., 133
Hartman, W. E., 144-45
Harvard Child Study Center, 51
Hayes, Helen, 217-18
hay fever, 90
Head, Henry, 196
health, definition of, 157
hearing, 244, 249-50
See also Deafness
Hearst, William Randolph, 271
hedgehogs, 28
Hediger, H., 35
Heinicke, C. M., 156
Heinstein, Martin I., 94
Heifer, Ray, 306
Hendrix, G., 26
Henley, Nancy, 272, 273-74
Henry, Jules, 244
Hersher, L., 21-22
Hey (researcher), 83, 84
Hobbes, Thomas, 197-98
Hocken, Sheila, 251
Hoefer, C., 67
Hofer, Myron A., 112-13
Holland, Jimmie, 209
HoUender, Marc H., 162, 163,

164-65, 168, 169
Holt, Luther Emmett, Sr., Care

and Feeding of Children, The,

78, 121-22, 121n, 123

homosexuality, 244, 283, 285-86

Hopi Indians, 298

horses, human handling of, 26

hostility, expressions of, 301-04

Housman, A. E., 285

Huang, L. T., 165

Hughes, Robert, 247

India, childrearing and maternal

behavior in, 124, 279
Infant Care (U.S. govt.

publication), 62

infant mortality, 77-78, 79, 126
infants:

anxiety and rigidity in, 87
bathing of, 84-85, 91-92
body awareness in, 207-08
brain growth in, 44-46
breathing habits, 91-92
crying in, 157, 301
early conditioning in, 87-90,

169-70, 190-94
ego formation in, 202-03
grasping and learning in, 1 1 5-20
influence of heartbeat sound on,

138
need for contact, 190-94,

308-11, 313-19
neonatal immaturity, 30, 40,

42^3, 46-48, 58, 64-65, 76
orality in, 93-94, 95, 182
prematurity, 51-52, 54, 108-9,

132-33
psychological disturbances in,

218-19
relationship formation in, 87-90,

227-28
responsiveness to mother, 94-95,

250

rooting behavior in, 98-99
sensory development in, 249-50
smiling in, 7475
spatial orientation of, 230-40
stresses in, 203-04
temperature regulation in, 83-84,

85
tune sense in, 199-200

Index

377

infants (cont'd)

touch in, 47-48, 50-51, 54,
103-4, 195-96, 197-98,
199-201, 226
trust in, 199

See also Man; Maternal behavior
intercourse. See Sex and sex

differences

Iraq, tattooing in, 315
Irwin, O. C, 142
itching and scratching, 150-53
erotic component of, 151-52, 153
in mammals, 153
psychosomatics of, 150-51, 215

James I (king of England), 151

Japan:

bathing in, 280-81
breastfeeding in, 282
expression of feelings in, 282
intimacy vs. distance in, 268-69
maternal behavior in, 279-83
sexual attitudes and behavior in,

282-83
sleeping habits and patterns in,

267-68, 280
texture consciousness in, 218

Jay, Phillis, 18, 34

Jews:

body rocking in, 134
Jewish mother, 286-87
tactility in, 286-87

Jivaros, 260

Johnson, Samuel, 214

Jolly, Allison, 35

Jones, Blurton, 66

Jones, Frederic Wood, 3

Joplin, Janis, 168

Jourard, S. M., 273

Kabongo (Kikuyu chief), 75

Kahn, Fritz, 184

Kaingang (Brazil), 244

kangaroos, 46

Kantor, Robert E., 219, 223

Karas, G. G., 25-26

Kazda, S., 68

Keller, Helen, 8, 80, 81, 146-47

Kempe, Henry, 306

Kennell, J. H., 108, 110-11, 112,

133-34

Kepecs, J. G., 307
kinesics and kinesic behavior, 87,

90, 115
kinesthetic sense, in infants, 82,

86-87

King, Cecil, 271
King, Truby, 70-71, 72
Kipling, Rudyard, 245
Kitzinger, Sheila, 109-10
Klaus, M. H., 107, 108, 110-11,

112, 114, 133-34
kleptomania, 184
Kluckhohn, Clyde, 297, 298
Knox, J. H. M., 78, 155
Konner, M. J., 255, 256
Krecek, Jiri, 68
Kritzler, H., 27
Kroeber, Alfred, 248
Krohn, Bernard, 68
IKung Bushmen, 253-56

labor. See Birth process

Lacombe, P., 87-88

Landauer, T. K., 203-04

Lang, Raven, 99, 106-7

langur monkeys, maternal behavior

in, 34

Larsson, K., 188
Latins, tactility in, 283, 287-88,

291

Lawrence, T. K, 285
Leboyer, Frederick, 279
leg, "falling asleep" of, 8-9
Lehrman, H. C., 17
Leiber, Lillian, 210
Leighton, D., 297, 298
Leites, N., 295
lemurs, grooming in, 35
Leon, M., 72
lesbianism, 163, 183, 184
Levin, R., 72
Levine, S., 26, 188
Levinson, Boris M., 278
Levitsky, Abraham, 100
Lewis, G. W., 26

378

INDEX

Lewis, M., 185

Liberson, W. T., 55

licking behavior (animal), 15-22,

35-36, 57-58
in apes, 18
in cats, 17, 18
compared to birth process in

man, 48-50, 56, 57-58
and disease resistance, 20
in dogs, 15, 17
in goats, 21-22, 56
and genitourinary system
maturation, 15-16, 48
in monkeys, 18

and mortality rate, 15, 16, 25, 37
in newborn animals, 15, 28, 37
in rats, 17, 18, 19, 33, 57
self-licking of mother, 17, 18-19
in sheep, 20-21, 22, 25
licking behavior (human):
birth process as parallel, 38-39
in figures of speech, 37-38
in Polar Eskimos, 37
in Tibet, 37
Liddell, H. S., 21
Lilly, John, 27
Linn, T., 26

lions, gestation period in, 40
lips:

role of, in breastfeeding, 93-94
sensitivity of, hi fetuses, 93
significance of smacking, 99
tactile importance of, 8, 102
Lipton, R. C, 191, 215
loneliness, 210
Lourie, R. S., 197
love-bites, 180-81
Lowen, Alexander, 166, 168, 172,

217
Betrayal of the Body, The,

205-06, 207
Lowenfeld, V., 174
lullabies, 119, 139, 141
See also Music

McBride, A. F., 27
McCaghy, C H., 183
McCance, R. A., 16, 56-57

Maccoby, E. E., 185
McGhee, J. B., 164-65
McGraw, M., 195
McKinney, B. M., 22
McLuhan, Marshall, 248
McPhee, Colin, 117
Madsen, C. K., 246
Mahler, M. S., 292
Maier, R. A., 21
Maliver, Bruce, 166
Malmquist, C. P., 162-63
man:

erect posture, consequences of,

41-42

exterogestation in, 44, 47
gestation period in, 40, 42,

43-44, 46

health, definition of, 157
neonatal immaturity of, 39, 40,
42-43, 46-48, 58, 64-65, 76
neonatal weight, 41
perinatal mortality in, 46
skin stimulation hi, 12
uterogestation in, 44, 46, 47
See also Birth process; Infants;
Maternal behavior (human);
Skin; Touch
marasmus, 77-78, 79
Marcuse, Herbert, 249
Marler, Peter, 34
Marshall, Lorna, 254
masochism, 184
Mason, Marie K., 80
Mason, William A., 134, 277
Mason, W. M., 227
masturbation, 154, 170-71, 174,

282

maternal behavior (animal):
defined, 22-23
development of, 33-34
in dogs, 15, 17, 22
in hens, 21

in monkeys, 22-23, 32-33, 34
and need for contact, 32, 33, 34
in rats, 19, 33
synchrony in, 33-34
warmth of young in, 85

Index

379

maternal behavior (cont'd)

See also Breastfeeding; Licking

behavior

maternal behavior (human), 76-137
anxiety in, 76-77, 86-87
in Arapesh, 256-57
in Bali, 114-15, 116-18
behaviorists' influence on,

120-23, 125, 155
and child development, 97-98,

169-70

coldness in, 94, 201
cultural influences on, 230,

231-32

in Dusun, 260
and father's role, 299-301
in Ganda, 251-53
implications of early separation,

22, 57, 60-61, 77-78, 109-15,

125-26
importance of early tactile

stimulation, 28-29, 35, 57, 58,

70, 74-75, 76, 79-83, 98, 99,

104-5, 160-62, 190-94,

198-99, 208-09
in India, 124, 279
infant holding position, 137-38
and infant mortality, 77-78
influenced by 19th-century

experts, 78, 79
influence on I.Q., 191
in Japan, 279-83
in Kaingang, 244
in IKung Bushmen, 253-55
in Mundugumor, 257-58
in neonatal period, 57, 58
in Netsilik Eskimos, 235-38
in Pakistan, 124-25
self-rocking and, 134-35
sensitive period in, 111, 114
symbiotic nature of, 47, 61,

62-63, 66, 70, 73, 75, 97-98,

105, 218, 226-27
in Tasaday, 244-45
touch in, 104-8, 109-10, 218
in United States, 184-85, 196,

261-63, 264-66, 279-83, 303,

309-10, 311-12, 314-16

maternal behavior (confd)

and warmth, 82-83

in West, 118-19

See also Bathing; Breastfeeding;
Sleeping habits and patterns;
Toilet training and attitudes
Mead, Margaret, 114-15, 116,
184-85, 256-57, 271

Study of Culture at a Distance,

The, 294-95
Mears, W. G., 246
meconium plug syndrome, 54
Meerloo, Joost, 139-40, 217

"Milk Dance" concept, 139-40
Meier, Gilbert W., 53
Meissner's corpuscles, 3, 320
Mercer (researcher), 164
Mercuric, Mrs. Herbert, 129
Metraux, R., Study of Culture at a

Distance, The, 294-95
mice:

enzyme development in, 42

in experiments, 23-24

importance of gentling, 23

See also Rats
Milne, A. A., Now We Are Six,

211

Mirkin, A. S., 246
Mitchell, W. E., 26
Moloney, J. C, 174, 216
Moltz, H., 72
monkeys:

breastfeeding in, 66

contact behavior in, 35

grooming behavior in, 28, 34, 35

independent behavior in, 233

infant-holding position in,
137-38

licking behavior in, 18

staring in, 248

See also Apes; indiv. species
Montagu, Ashley, 10, 224-26
Montaigne, Michel de, "Of

Experience," 151
Moore, A. U., 21-22
Moss, H. A., 265
Mundugumor, 256, 257-58
Mundurucu Indians, 245

380

INDEX

Musaph, 151

music, 135-36

culturally determined aspects of,

140-41, 240-42
lullabies, 119, 139, 141
and mother's heartbeat, 138
rock 'n' roll, 135-37, 139, 141
See also Dance

myths, 239

narratophilia, 184

Nash, Ogden, "Taboo to Boot,"

152

National Guidance Marriage
Council (England), 286
Navaho Indians, 296
Nazis, 303-04
Neal (researcher), 130
necrophilia, 184
Newman, John Henry, 160
New Zealand Christchurch Parents

Centre, 275

Nissen, Henry W., 227
Nolan, Finbarr, 214
nose:

importance of, in psychological

development, 90
in literature, 93
picking of, 90, 92-93
psychocutaneous disorders of, 90
self-stroking, 90-91, 92-93
stimulation of, in breastfeeding,

92-93
nudism and nudity, 143, 14445,

154-55

associated with sex, 145
and skin damage, 155
symbolism of, 155
nursing. See Breastfeeding

Obermayer, Maximilian,

Psychocutaneous Medicine, 10
O'Connell, B., 83
O'Donovan, W. J., Dermatological

Neuroses, 10
oncophilic behavior, 219
Ong, Walter, 100
opossums, 46

oral -genital contacts, 102

orang-utans, gestation period in, 40

Ortega y Gasset, Jose, 101

Osier, William, 226

Otley, M., 16, 56-57

Our Bodies, Our Selves, 167

pacifiers, 67

Pacinian corpuscles, 4, 246

Painter, William, 69

painting, tactile quality of, 24548

Pakistan, childrearing and maternal
behavior in, 124-25

pangolins, 28

Papousek, H., 108

paraphilias, 184

parathyroid, 12, 13, 14

Parke, Ross D., 301

Parker, H., 248

Passman, Richard, 276, 277

Patton, R. G., 193

Pedersen, F., 265

Peiper, Albrecht, 67, 127

perceptual deprivation, 186-94
experiments in touch
deprivation, 209-10
findings in animals, 187-90
findings in infants, 190-94

Petersen, Clarence, 152

pets, 224, 277-79

Phares, R., 165

Philippine Negritos, 145

philobatic behavior, 219

pictophilia, 184

Pieper, William J., 54-55

Plath, David, 267, 268

Pollock, C. B., 177

Pottenger, Francis J., Jr., 68

premature infants, problems of,
51-52, 54, 108-9, 132-33

Prescott, James H., 177-78, 260

Pressman, Mark E., 209

Price, Lisbeth D., 120

primates. See Apes; Man; Monkeys

promiscuity, 163, 175

Province, S., 191

psoriasis, 10

Index

381

psychosomatic illness, 10-12, 90,

91
See also Skin, disorders of; indiv.

illnesses

psychotherapy, touch in, 220-24
Puritanism, 269-71

See also England; United States

Quilligan, Dr., 114

rabbits, 66

Rado, Sandor, 96

Rasmussen, Knud, 241

rats, 3

importance of gentling, 13-14,

20, 23, 24, 25-26, 85, 187-89
licking behavior in, 17, 18, 19,

33, 57

maternal behavior in, 19, 33
maternal separation in, 112-13
temperature importance for, 85

Reisner, G., 26

Reyniers, James A.:

germ-free experiments, 15-16

Rheingold, H. L., 17, 313-14

rhesus monkeys:

contact and play in, 310-11
infant development in, 308-1 1
maternal behavior in, 22-23,
32-33, 34, 176-77, 263-64,
308

surrogate mother experiments,
29-32, 134-35

Rhine, Larry, 16-17

Ribble, Margaret, 91, 101, 196

Richards, Audrey, 252

Richmond, J. B., 21-22, 215

Rilke, Rainer, "Palm of the
Hand," 291

Ritchie, James R, 258, 299-300

Robson, K. S., 265

Rock, Irvin, 251

rocking. See Cradles and rocking

Rogers, Carl, 292

Roland, Paul, 220

Romains, Jules, Vision
Extra-Retinienne, 146

Rome, Florence, 304

Rosenblatt, Jay S., 17, 18, 33-34
Rosenthal, Maurice J., 215
Roth, Lorraine L., 18, 33
Rousseau, Jean- Jacques:

Autobiography, 179

Emile, 149
royal touch, 213
Rozanov, V. V., 93
Rubin, Reva, 104-5, 106, 107, 108,

185, 263, 273
Rudinesco, Jenny, 216
Ruesch, Jurgen, 168
Russell, Bertrand, 6
Russell, Brian, 152
Russians, tactility in, 283, 293-96

sadism, 184

Saleeby, C. W., Sunlight and

Health 154-55
Salimbene, Fra, 81
Salk, Lee, 137-38
Salmon, M., 23-24
Sarton, George, 38
Sayler, A., 23-24
Scandinavians, tactility in, 284
scatophilia, 184
Schachtel, Ernest, 249
Schaeffer, R. W., 85
Schapiro, Meyer, 248
schizophrenia and schizoid

behavior, 205-06, 216
breakthroughs caused by body

contact, 220

Schlossmann, Arthur, 78
Schneirla, T. C., 17
Schwing, Gertrude, 220
Scopes, J. W., 83
scopophilia, 181, 182-83
scratching. See Itching and

scratching
scrofula, 213, 214
seals, gestation period in, 39
Sears, R. R., 185
Seashore, Marjorie J., Ill
security blankets, 29, 274, 276-77
Segal, Sydney, 53
Segonzac, Andre Dunoyer de, 246

382

INDEX

Seitz, Philip F. Durham, 88-89,

90, 151

self-esteem, 208-09
self-rocking:

in infants, 191-92

and maternal stimulation,

134-35

Selye, Hans, 24

sensitivity training groups, 291-93
sex and sex differences, 158-85
affect-hunger and, 161-65, 166,

210

in behavior, 218, 265, 266
contact and pregnancy, 163,

164-65

contact as prelude to sex, 166-67
cultural differences, 165-66, 183,

242, 244, 245

disturbances of, 178-83, 184
as highest form of touch, 158-60
intercourse as means of contact,

161-63, 167-68, 169
in male and female infants,

170-71, 172-73, 176, 183-85
maternal behavior and
subsequent sexual
development, 160-62, 169-70,
172, 174-78, 181
physiology of, 158-60, 167, 180
promiscuity, 163, 175
in salutations, 291
as tension release, 175
twin-bed syndrome, 266-67
violence and tactile deprivation,

176-78
See also Homosexuality;

Lesbianism; Masturbation
Shakespeare, William, Coriolanus,

150-51

Shaul, Ben, 66
sheep:

commensal association with

birds, 28
licking behavior in, 20-21, 22,

25

Shevrin, H., 192
Shirley, Mary, 51-52, 54
shock, 194-95

sight. See Vision
Silver-man, Alan F. } 209
skin:
adaptivity and reactivity of,

229-30
in aging process, 7, 145, 155,

320

at birth, 4

as compensatory sense organ, 8
disorders of, 205, 213-14,

216-17, 307-08
ectoderm, 2
electricity of, 145-46
in embryo, 2
epidermis, 3-4
erotogenic view of, 170
functions of, 3, 4-5, 8-9
growth and development of, 3
as lining of orifices, 1
in literature, 5
in nonliterate people, 145
in poetry, 5
as protector, 1

and psychosomatic illness, 10-11
relationship to central nervous

system, 2-3, 7-8, 9, 230
seeing with, 146-47, 148, 149
as sense organ, 1-2, 3, 4, 7, 8-9,

10, 145, 148-50, 246
size of, 4, 7
and sleep, 156-57
stimulation of, 12
variability of, 31
versatility of, 5
weight of, 3, 4
Skipper, J. K., Jr., 183
Slater, Philip, Earthwalk 69
sleep, feedback during, 9
sleeping habits and patterns,

156-57
in Bali, 118
and contact, 156-57
disturbances of, 156-57
in Eskimos, 242
in Europe, 268
in Ganda, 253
in India, 124
in Japan, 267-68

Index

383

sleeping habits (cont'd)

lambskin rugs, use of, 275-76

in Pakistan, 124

security blankets, use of, 276-77

twin beds, 266-67

in United States, 266-67, 280

in West, 118-19, 122, 124,
274-77

See also Cradles; Lullabies
smiling behavior in infants, 7475
Smith, Lillian, Strange Fruit, 267
Smith, Sydney, 288
Smith, Theobald, 64
sociality, 208
Sokoloff, N., 132-33
Solnit, A. J., 134
Solomon, Joseph C, 130-31, 135
Southworth, R. T., 77
spanking, 179, 180, 303, 304-07
spinal cord, 2, 4, 7

See also Brain; Central nervous

system

Spitz, Rene, 99, 161, 201, 215
Stael, Madame de, 146-47
staring behavior, 248
Steele, Brandt R, 177
Stefansson, Vilhjalmur, 242
Steinschneider, A., 215
Sterne, Laurence, 301
Stewart, Dugald, Outlines of Moral

Philosophy, 228
Stewart, Kilton, Pygmies and

Dream Giants, 145
Straker, M., 55
stress, 24-25, 26

strippers, paternal rejection in, 183
sudden infant death syndrome, 126
swaddling, 83, 204, 293, 294
Swinburne, Algernon, 285
Sylvester, E., 126, 198-99
Symonds, J. A., 285

tact, meaning of, 228-29

Talbot, Fritz, 78

Tasaday (Mindanao), 244-45

tattooing, 304-05

television, tactile quality of, 248

Temerlin, M. K., 195

tenderness, meaning of, 174

See also Touch
Tennyson, Alfred, 135

In Memoriam, 201-02
Terkel, J., 33
thalamus, 7
Thevenin, Tine, Family Bed, The,

275

Thiess, George, 137
thigmotropism, 239-40
thymus, 20
thyroid, 12, 13
Tibet, licking behavior in, 37
Tobach, E., 17
toilet training and attitudes, 182

in Bali, 117

in Netsilik Eskimos, 237, 238

in United States, 196
tongue, sticking out of, 102
Toomey, J. A., 64
touch:

and affectionate behavior, 213

in alleviation of stress, 24-25, 26

and breathing, 91

class and cultural differences,
272-74, 283-88

cold vs. warm, 102-3

in dictionary, 102-3

in embryo, 1-2

as feedback mechanism, 8

and hair follicles, 4

importance of, 249-50

and information, 249-51

in mammals, 26

in neonatal period, 47^8, 50-51,
54, 103-4, 195-96, 197-98,
199-201

orientation toward, 219

passive vs. active, 240

psychophysics of, 150

in psychotherapy, 220-24

as sensory system, 1-2

and sound, 245

in speech, 5-7

as substitute for other senses,
79-80, 81

tactility in painting, 245-48

as test of reality, 100-1

384

INDEX

touch (cont'd)
in theater, 217-18
See also Maternal behavior; Sex

and sex differences
Toussieng, P. W., 192
toys, as human substitutes, 271,

274-75

tree shrews, 66
Tsumori, A., 313

United States:

bathing in, 133, 271, 281
class differences in, 264-66,

279-83, 303, 310
diapering in, 196
maternal behavior in, 184-85,
196 261-63, 26^66, 279-83,
303, 309-10, 311-12, 314-16
New England Puritanism in, 269
sex differences in tactile

experiences, 184-85
sleeping habits and patterns in,

266-67, 280
tactility in, 279-83, 284, 287,

288
toilet training and attitudes in,

196

uridinism, 184
urophilia, 184
urticaria, 10
uterogestation, 44, 46, 47

Vambery, Arminius, 140-41
Van de Velde, H., 180-81
Van Gogh, Vincent, 246, 247
Van Valck, J. D., 26
Veblen, Thorstein, 31
vernix caseosa, 84-85
Victoria, Queen, 291
Vinokurov, Yevgeny, 210
violence, and tactile deprivation,

176-78
vision:

as dominant sense, 208, 213,
249-50, 251

and perceptual deprivation,
186

sensory receptors in, 148-49

vision (cont'd)

sight orientation, 219

tactile quality of, 248

through skin, 146-47, 148,
149

See also Blindness
von Haller Gilmer, B., 149-50
voyeurism, 181, 184

Waal, N., 220

Wagner, Richard, Liebestod, 135

warmth, importance of, 85-86

Washington, George, 207

waterbeds, 143-44

Watson, John Broadus,

Psychological Care of Infant
and Child, 122-23
Weiner, Herbert, 207
Weininger, O., 24-25

Weinstein, Helen, 279-80, 281

Weintraub, D., 132-33

Weisberg, Paul, 276

Weiss, L., 142

Welles, Orson, 271

Wenar, C, 226

Werboff, J., 23

Westermarck, Edward, 289

Westheimer, L, 156

Whimbey, Arthur K, 23

Whiting, J. W. M., 203-04

Wilde, Oscar, 285

Williams D., 20

Williams, T. R., 259-60, 312-13

Winnicott, D. W., 205, 301

Wistar Institute:

rat experiments, 12-15

Wolff, Peter, 294

Woodcock, J. M., 130
"worrybeads," 216

Yaffe, S., 132-33
Yarrow, C. J., 98, 191

Zahovsky, John, 120, 128-29
Zaporozhets, A. V., 250
Zarrow, M. X., 54
zoophilia, 184
Zubek, J. P., 229

ABOUT THE AUTHOR

Ashley Montagu is the author of some forty-five books and over
two hundred articles in scholarly and scientific journals. He has
taught at Harvard, the University of California, and at New
York University and was formerly Chairman of the Depart
ment of Anthropology at Rutgers, the State University of New
Jersey.

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