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Senses of Touch: The Absence and Presence of Touch in Health Care Encounters of Patients with Mental Illness

Culture, Medicine, and Psychiatry volume 47, pages 402–421 (2023)Cite this article

Abstract

Touch is a fundamental sense and the most unexplored of the five senses, despite its significance for everything we do in relation to ourselves and others. Studies have shown that touch generates trust, care and comfort and is essential for constituting the body. Based on ethnographic fieldwork, this study explores the absence and presence of touch in interactions between people with mental illness and professionals, in health care encounters with general practitioners, neurologists and physiotherapists, as well as masseurs. We found that touch and physical examination of patients with mental illness is absent in health care encounters, leaving the patients with feelings of being out of place, misunderstood, less socially approved and less worthy of trust. Drawing on Honneth and Guenther, we conclude that touch and being touched is an essential dimension of recognition—both of the patients’ bodily sensations and symptoms and of them as human beings, detached from the psychiatric label—as well as contributing to the constitution of self and personhood. These findings confirm that touch works as an existential hinge that affirms a connection between the patient, the body and others and gives a sense of time, space and existence.

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Notes

  1. ’IC´ refers to the first author, who carried out the ethnographic fieldwork.

  2. The GP taking Jens under his wings is an exception in this study. According to the interlocutors, general practice care is associated with time pressure and short time slots, and in their experience,GPs sometimes seem uncomfortable managing psychiatric patients, which is confirmed in the literature (Fleury et al. 2012).

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Funding

The Novo Nordisk Foundation (NNF16OC0022038) funded the PhD study.

Author information

Authors and Affiliations

  1. The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, P.O. Boks 2099, 1014, Copenhagen K, Denmark

    Iben Emilie Christensen, Mette Bech Risør & Susanne Reventlow

  2. VIVE – The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen K, Denmark

    Iben Emilie Christensen & Lone Grøn

  3. General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Breivika, 9037, Tromsø, Norway

    Mette Bech Risør

Authors
  1. Iben Emilie Christensen
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  2. Mette Bech Risør
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  3. Lone Grøn
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  4. Susanne Reventlow
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Contributions

The ethnographic fieldwork was carried out by the first author Iben Emilie Christensen. All authors contributed to the study conception and design. Iben Emilie Christensen wrote the first version of the manuscript. All authors collaborated on developing the analyses and argument of this article, commented and wrote on previous versions of the manuscript, and read and approved the final manuscript.

Corresponding author

Correspondence to Iben Emilie Christensen.

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Conflict of interest

The authors have no conflict of interest relevant to the content of this article.

Ethical Approval

Approval was obtained from the ethics committee of University of Copenhagen and is in accordance with the ethical standards of the Helsinki Declaration. Furthermore, the study has been registered with The Danish Data Protection Agency. The study has been subject to ongoing ethical considerations. Fieldwork among people with mental illness, often in socially vulnerable situations, calls for humility, insight, and understanding. Reflections and adjustments were undertaken daily to secure and protect the interlocutors and avoid that they felt exposed or left out. As for formal ethical arrangements, the interlocutors gave written consent, and their names were changed to ensure anonymity.

Consent to Participate and Consent to Publish

Informed consent was obtained from all interlocutors included in the study. Verbal consent was obtained from head of institutions. All interlocutors have signed an informed consent declaration regarding publishing their data based on interview and fieldwork.

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Christensen, I.E., Risør, M.B., Grøn, L. et al. Senses of Touch: The Absence and Presence of Touch in Health Care Encounters of Patients with Mental Illness. Cult Med Psychiatry 47, 402–421 (2023). https://doi.org/10.1007/s11013-022-09770-9

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