The Stress Solution Page 6

  We’re all living ultra-connected lives. In our pockets we have tiny technological miracles through which we can communicate, instantly, with anyone on the planet. We’re blessed to have such amazing power at our fingertips. We’ve never been so connected to the rest of the human race. At least, this is what we’re constantly told. But I don’t buy it. The nutritional equivalent of the kind of connection we’re having today is a can of fizzy pop and a chocolate bar for breakfast. It’s industrialized, transactional and inhuman. So many of the stress-related problems I see in my surgery have as a root cause a chronic lack of connection. This lack of connection is a major stressor in our lives and is having a devastating effect on many of our relationships.

  But nourishing relationships can also help us destress. We feel happy when we are connected to friends, family and those around us. Social constructs have evolved to facilitate and improve the way we live as a community, but now ‘social’ media has exploded. As a result, we are no longer feeling connected in the same ways and are more isolated than ever before. We need more ‘social’ and less ‘media’.

  In this pillar, we will explore three distinct areas that I have found, over the years, to be major sources of twenty-first-century stress: a lack of human touch, the insidious erosion of intimacy and the deprioritization of friendship. In each section, I will give you actionable strategies that will improve the quality of your relationships, from simple ways to nourish your brain with more human touch, to one of my personal favourites, the 3D greeting!

  Chapter 4

  HUMAN TOUCH

  As a young GP I used to really struggle when I had to give someone bad news. When there was a diagnosis of cancer, say, the thing that helped most of all was sitting close to the patient and putting my hand on their arm or shoulder. That small gesture was a comfort to me and, far more importantly, to the person I was speaking to. The sad thing is, we’re living in a world that’s becoming averse to touch. While there are reasons for this, I’m beginning to worry that we’ve gone too far. These days, I’m extremely nervous about making even the slightest physical contact in my clinic. Simple touch is now seen as crossing a personal boundary. I understand why this has become the norm, but have we lost something vitally important in the process?

  Humans are mammals, and touch is part of our deepest mammalian systems. It is the very first sense we develop as a foetus. Being touched as a child helps form vital neural pathways and feeds emotional connections. A lack of touch can have devastating consequences. Up until the 1990s, appalling orphanages existed in Romania in which the children were fed and watered but grew up without experiencing any touch at all. They were later studied by psychologists, who found that almost all of them had developed serious behavioural problems. As adults, they had difficulties attaching to others and some even suffered delayed development of the gut. Interestingly, the children who had even the briefest moments of affectionate touch from volunteers didn’t suffer these problems to the same degree.

  Studies on rats have found that pups whose mothers lick them a lot grow up to be relatively calm. These pups have cortisol receptors that are more sensitive, which means they can better regulate their response to stressful experiences. In contrast, pups whose mothers don’t lick them enough grow up to be hyper-responsive to stress. If these pups were humans, they’d be the kind of person for whom every little thing is a stressor. They’d always be looking at the negative and would have a generally pessimistic and anxious outlook.

  Studies on humans confirm the primal importance of physical touch. Members of basketball teams who use more hands-on interactions with each other perform better, ending up higher in their leagues. If a waiter taps you on the shoulder as they give you a bill, you’ll be likely to tip more. When people visiting a library were treated in a tactile way, they reported a much more positive experience than those who weren’t touched. Researchers at University College London found that affectionate touch reduces feelings of social exclusion, which is one of the most painful experiences a human can have. That study’s lead author, Mariana von Mohr, wrote, ‘As our social world is becoming increasingly visual and digital, it’s easy to forget the power of touch in human relations.’ Human touch can slow down our heart rate, lower blood pressure and reduce our cortisol levels. It even raises the levels of Natural Killer (NK) cells. NK cells are part of our body’s innate immune system – that is, the hard-wired branch of our immune system that we are born with. They are a key part of our armoury to fight off threats, such as infections and cancer cells.

  And, even beyond the data, we know how good we feel when we get a hug. You feel a warm sensation rushing through you. The skin is giving information that things are going well in our social world. Without touch, we’re not accessing this rich network of systems that evolution has put there for a specific purpose. One of the world’s top researchers in touch, Professor Francis McGlone at Liverpool John Moores University, has said that touch is ‘not just a sentimental human indulgence, it’s a biological necessity’. A lack of touch is a physical stressor on the body and helps throw you into a stress state.

  GET IN TOUCH WITH HUMAN TOUCH

  Amazingly, there’s still much we don’t know about the workings of affectionate touch in the body. We do know, however, that it has functional similarities to pain. Humans have two different types of pain nerve fibres: fast and slow. The fast nerve fibres give us basic anatomical information, simply letting us know where exactly the pain is so that we can take immediate remedial action. The second type of nerve fibre is the slower one. This gives the pain its emotional quality.

  You’ll probably recognize the two different pain responses if you think about what happens when you grab a hot pan. Firstly, you have an immediate form of pain that tells you it’s too hot and causes you to drop it. That’s the fast pathway. A few seconds later, the second, slower pathway kicks in. This is the emotional component – you feel shocked, upset, you might wail or even cry. I recognize this two-step process whenever I see my daughter fall over. Initially, she’s a bit bemused by what’s happened and might put her hand on the area that’s been hurt. But a few seconds later, when the ‘emotional’ quality of the pain has reached her brain, she starts to cry.

  This same two-step process occurs with touch. There is a fast nerve fibre that simply lets us know where we’ve been touched, giving us the physical sensation. But there’s also a slow nerve fibre system that feeds our brain on a much deeper level. These slow nerve fibres go to one of the most primitive systems in our brain, the limbic system, which helps mediate our emotions. This system is what gives touch its deep, nourishing quality and is especially triggered by stroking.

  THE STROKES

  Back in December 2017 I was lucky enough to visit Professor McGlone’s lab as part of a BBC documentary series I was filming. I was blown away by what I found. These slow nerve fibres are called the C-tactile (CT) afferents. These CT afferents take the touch signal from the skin to the limbic system, deep within the brain. They respond to a specific kind of light, stroking touch that occurs at a speed of roughly five centimetres per second. Any faster or slower, and these nerve fibres become less responsive.

  If you ask someone to stroke a wooden arm, the pace and the depth of their stroke will be all over the place. But if you ask that same person to stroke a human arm, they automatically lock into a stroke whose speed is approximately five centimetres per second. It turns out this is exactly the same speed that people rate as most pleasant. This shows how deeply embedded affectionate touch is in our biological and neurological systems. It’s not learned, it’s primal. Mothers intuitively caress their babies in this way.

  This is why applying cream or moisturizer to the skin can be so soothing. It’s also why, when infants are stroked at that particular speed, their heart rate decreases. The CT afferents are connected directly to the hypothalamic–pituitary–adrenal (HPA) axis, which acts as our stress broadcast service (see here). When we’re stressed, it broadcasts a series of
messages throughout the body which ultimately put it in a stress state. McGlone is finding that, simply by stroking the skin, we can directly soothe the HPA axis and lower our cortisol levels. Pleasant, affective touch also directly lowers our stress levels by increasing the tone of the parasympathetic nervous system, which puts us into a thrive state.

  The Benefits of Affectionate Human Touch

  Lower heart rate

  * * *

  Lower blood pressure

  * * *

  Reduced cortisol levels

  * * *

  Raised levels of Natural Killer cells (one of the immune system’s defences against infection)

  * * *

  Increase in parasympathetic tone, which puts us into thrive state

  However, it is important to remember that not everyone appreciates being touched. We all have our own experiences and cultures that shape the way we interact with each other. It is important to respect others’ personal space – an unwanted touch, however innocent, can be perceived as threatening by another person.

  REWARD PATHWAYS

  Professor McGlone also told me about a touch version of a well-known study called the Marshmallow Test, which is used by psychologists to judge willpower in children. Youngsters are offered a sweet treat and are told they can have it right away or wait for a certain amount of time and have a larger portion. The test is famous because it’s been shown that the longer children are able to wait – the more willpower they show – the better their lives tend to turn out in the long run, in terms of health, happiness and wealth. In this version, the person offering the child the treat touches them on the shoulder. When the child is touched like this they’re able to defer the reward for longer, when compared to a control group. McGlone speculates that this is because, with that simple touch, the children have had their internal reward systems topped up.

  What’s really interesting about this is that we have a particularly high concentration of these specialized touch receptors on our back and on our shoulders, which is exactly where the children had this brief moment of human contact. It’s remarkable that we have so many of these receptors on areas of the body that we struggle to access easily ourselves. These touch receptors give us pleasure and by being present on hard-to-reach areas, they would have promoted behaviours that would have ensured that those body parts got touched. Evolution must have placed them there so we could receive touch from other people.

  But for these receptors to have stayed on our back and shoulders through millions of years of evolution, there must also have been a benefit for the giver of touch. Indeed, we know that those who give affectionate, gentle touch are rewarded with increased levels of endogenous opioids, compounds made by the body that act on opiate receptors and are associated with improved mood, decreased pain and lower anxiety. These are the same effects we get from exogenous opioids such as morphine. I find it incredible that evolution has gone to such lengths to promote us being with others, and it is hard to make the case that we have evolved to be anything other than social beings. This is the theme running throughout the Relationships pillar – we are designed to live and exist with others. The quality of our relationships is key, and touch plays a critical role.

  Although this chapter is primarily focused on human touch, these touch-giver benefits are well known to those with pets. Although not a pet owner myself, I have spoken to many patients and friends who tell me that when they are feeling stressed they spend time stroking their pet and their stress levels immediately plummet.

  McGlone believes a lack of touch from others could be at the root of some of society’s biggest problems. He feels that if the brain does not get appropriate nourishment from pathways that have been honed over 3 million years of evolution, it will crave that nourishment elsewhere. This could be a contributing factor behind rising levels of addictive behaviour, such as the misuse of drugs and alcohol, and gambling. McGlone also believes that touch could help reduce the stress schoolchildren experience when taking exams. He’s started investigating whether increasing peer-to-peer touch helps buffer them from the effects of stress and cortisol induced by examination pressure.fn1

  THE TOUCH TRADE

  One of the reasons touch feels good is that it triggers the release of serotonin, commonly known as the ‘feel-good chemical’. Many antidepressant drugs work by trying to increase serotonin. The recreational drug ecstasy acts on the serotonergic pathways and is one of the reasons why ecstasy users have a heightened sense of touch and find touch more rewarding when under the drug’s influence. Touch can also change levels of the so-called ‘cuddle chemical’, oxytocin (see here), as well as endogenous opioids (see here).

  Given that touch is so essential, and feels so good, it’s hardly surprising that an industry is growing up around it, with professional ‘cuddlers’ and ‘touch’ workshops increasingly available. Massage therapy is also becoming incredibly popular. There are many types of massage, and they differ in force and velocity. However, all of them are known to have benefits on the way that we feel and on our stress levels. Light-touch massage probably stimulates the CT afferent nerve fibres, and there’s evidence that it stimulates the release of oxytocin too. High-force massage such as Thai massage is thought to release endogenous opioids.

  HEALING TOUCH

  Just by coincidence, in the weeks leading up to my meeting with Professor McGlone, my seven-year-old son had started saying, ‘Daddy, stroke me,’ as I was tucking him into bed. I wondered where this had come from. I now know that my son was craving that deep and powerful CT afferents response. Since then, I try to ensure that I spend a bit more time every evening stroking both my children on their upper back or arm. I’ve come to believe that the touch I give my children is just as important as the food that goes into their bodies and the physical activity they do.

  It also gave me a new idea of how to help a tricky patient, Ivy, who I’d been seeing for over a year. She’d come in with a thyroid problem and I’d been helping her change her lifestyle. Ivy would frequently contact my surgery. If even the smallest thing went wrong, she was desperate to get hold of me instantly. She was single and told me she always seemed to attract men who were in relationships already and only interested in seeing her on the side. I felt that I’d done as much with her physical wellbeing as I could, so I started exploring her emotional world. It turned out that Ivy was never touched as a child. Her parents never showed her love, either verbally or by stroking her. As a child, she always craved affection. Her environment was giving her the information that she wasn’t good enough, and that’s what she came to believe. It occurred to me that this lack of physical nourishment was a significant Macro Stress Dose and perhaps at least partly responsible for her constant worrying. She had some close girlfriends who she saw regularly. ‘When you see them,’ I asked, ‘do you hug them?’ She bristled at that. It was as if I were suggesting something revolting. As an experiment, I asked her to start hugging them. A few months later she told me she felt much warmer towards her friends and she’d even started forcing herself to hug her mother. While this turned out not to be a solution to her wider problems, I suspect it significantly raised her personal stress threshold, because I’m no longer getting as many panicked phone calls as I was.

  KEEP A TOUCH DIARY

  Touch nourishes our body in crucial ways, much like food does. Just as you need to eat every day, you need human touch every day. And remember, there are benefits for the giver as well as for the receiver.

  I’d like you to keep a touch diary to discover just how many times you give and receive gentle, warm, affectionate human touch. Tally your total by the end of the first week. By the end of week two, double it. Then, by the end of the month, triple it.

  SIX WAYS TO GET MORE TOUCH

  1. Hug someone close to you each day, if possible – family, friends, even work colleagues.

  2. If you have children, make an effort to hug them at every opportunity. This is important whatever their age – not only for babi
es or young children, but also for older children, above the age of ten.

  3. If you have an elderly friend or parent, try to ensure some level of physical touch whenever you see them, such as a prolonged warm embrace.

  4. Try roughhousing with your kids – play-fighting involves a lot of human touch and it’s thought that this kind of play helps children develop emotional resilience. You can do this with adults as well!

  5. Book a massage.

  6. Give someone a pat on the back when giving them praise.

  Chapter 5

  GET INTIMATE

  Reni and Saul were not having sex and it was damaging their marriage. Despite being only in their mid-thirties, they found themselves feeling increasingly distant, emotionally and physically, from each other, and this was making them bicker. They both worked for the same tech company, putting in long hours, usually into the weekends. Reni was looking for a quick-fix solution. ‘How does Viagra work?’ she asked. Her husband glanced at her reproachfully.

  ‘Well, before we think about that, have you tried scheduling?’ I said.

  ‘What, scheduling sex?’ asked Reni, clearly horrified.