Stroke units hold a high therapeutic potential. Touch medicine takes advantage of this and successfully uses professional techniques in various areas. Good experiences have been made in the treatment of depression, among other things.
As early as the middle of the 20th century, researchers such as the psychoanalyst René Spitz were concerned with the development of infants and small children in homes. Although the children received sufficient food and lived under good hygienic conditions, they received little physical attention. As a result, he observed a high mortality rate and significant behavioral problems in the children.
Available approaches keep coming up once morest their limits
Conversely, studies have shown that a lot of skin-to-skin contact can improve the physical and mental development of young children. Researchers also discovered a connection between the type and intensity of early physical contact and the risk of developing depression or other mental disorders later in life.
When it comes to treating people with depression, the drug and psychotherapeutic approaches currently available are repeatedly reaching their limits. This is one of the reasons why interest in complementary and integrative therapy options is growing. Touch medicine has appeared to be particularly promising for some time. It combines established techniques of physiotherapy, osteopathy, manual medicine and body psychotherapy. She pays particular attention to the psychosocial aspects of health and illness.
In addition to typical characteristics such as anhedonia and physical symptoms (pain, tightness of the chest, dizziness, palpitations, loss of libido, hot flushes, cramps, etc.), depression can also impair the subjective physical experience, the so-called interoception. Those affected describe their bodily sensations as blockages, heaviness, emptiness, alienation or paralysis in the head or in the whole body. A systematic analysis found evidence that patients with moderate depression in particular significantly underestimate their heart rate compared to healthy controls, which indicates a dampened cardiac interoception.
Intermediary role of the oxytocinergic system
Touch medicine opens up direct access to physical experience via the skin or the sense of touch. For this reason, appropriate techniques can not only have a regulating effect on physiological processes, but also have a positive influence on behavior, emotions and cognition. The antidepressive, anxiolytic and analgesic effect of special massage techniques (e.g. slow-stroke massage, psychoactive massage, affect-regulating massage) has been proven in scientific work and clinical studies. The mediation of the antidepressant and analgesic effects of massage is presumably carried out primarily via the oxytocinergic system. Even a gentle touch of the skin leads to the release of the peptide oxytocin, which is not without reason called the cuddle hormone. This results in activation of the serotonergic raphe nuclei and the dopaminergic neurons in the striatum and nucleus accumbens.
The activation of so-called C-tactile afferents, which in turn are connected to the interoceptive system, is also discussed. The CT afferents are a structurally and functionally independent group of low-threshold mechanoreceptors in the hairy skin. These CT afferents are not myelinated and respond to touch qualities that correspond to tender touch (eg, stroking, caressing, scratching, gentle massaging). On a psychological level, the activation of CT afferents is associated with a feeling of well-being that can be attributed to interoception. With optimal stimulation, mainly cortical limbic regions such as the posterior insula are activated. This in turn plays a central role in the integration of all individual sensations into a physical self.
The effects of healing touch are not only proven in psychiatry, but also in a variety of other disciplines, such as neonatology, pediatrics, pain medicine, oncology and geriatrics.
Müller-Oerlinghausen B et al. Dtsch Med Wochenschr 2022; 147: e32–e40
