Objectives:
- Demonstrate guided mindfulness of touch meditation.
- Identify how to intentionally place attention on touch experiences while caring for patients.
- Assess sensations taken for granted in caregiving that provide the basis for warm and compassionate touch relationships.
- Discuss attention as the “hand of the mind” that can provide nurses with the ability to get in touch with their bodily sensations and connect to experience.
- Identify how a greater sense of connection with their experiences will enable nurses to do their work with a greater sense of resilience.
Guided Practice
- When you place your left hand over your chest, how does this make you feel? What kinds of sensations come up for you in your body? What do these sensations tell you about yourself and the people for whom you care, including how you feel about yourself? Do any memories of people who took care of you and touched you in a nurturing way come up for you in this moment? Who was an especially important nurturer for you and how did they interact with you through touch? Might we share some of our experiences with touch and stories in this safe group setting?
- Working in groups of two, we will establish places on the body that are safe to touch? I want you to talk to each other before you touch the shoulder or hand of the person with whom you are working. You can ask if it is ok to touch their shoulder or hand. You can embrace if your partner finds that mode of touring safe. Or you might ask where they would allow you to touch. Can you use intention as you touch your partner to communicate healing and restoration? What are you experiencing as you do this? Can you talk about those experiences with your partner? How about sharing those experiences with the rest of the group?
- Can we think of people that we work with that benefit from touch? What groups of people need touch the most? When can touch be tricky? How can touch trigger past traumas?
The Neurobiology of Careful Touch
Touch engages CT afferents that flow into the brain stem up through vagal system and provide a calming and soothing pathway that activates parasympathetic nervous response. Touch nerve fibers are not myelinated and therefore transmit impulses to the brain stem and midbrain more slowly. You can calm patients through warm touch that is at the same frequency that mothers use to calm their children. There is a certain frequency of stroke that mothers naturally use across cultures, which has a calming affect on the child’s vigilance and threat detection nervous system mechanisms. When mothers stroke children at this frequency, it releases endogenous opioids and oxytocin in the brain, which affects limbic brain function. These chemicals are especially effective at dampening threat vigilance and amygdala functioning. They also change the activation patterns of the HPA axis and reduce cortisol levels. This use of touch promotes down-regulating or controlling negative emotional experiences and promotes the natural restorative properties of the body, which it does for both the person giving and receiving warm touch. Because touch is valued socially, warm touch also activates the orbitofrontal cortex and the anterior cingulate cortex, which are linked to positive emotions and the actions we take in pursuit of objects that we value. At the same time, warm touch works on our symbolic understanding of the world, because it enables persons receiving touch to perceive the social world as altruistic and caring. At the level of communication, warm interpersonal touch symbolizes a caring world.
