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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
’IC´ refers to the first author, who carried out the ethnographic fieldwork.
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).
Bjorbækmo, Wenche, and Anne Marit Mengshoel 2016 A Touch of Physiotherapy—the Significance and Meaning of Touch in the Practice of Physiotherapy. Physiotherapy Theory and Practice 32(1): 1–10.
Blake, Rosemary J.C. 2011 Ethnographies of Touch and Touching Ethnographies: Some Prospects for Touch in Anthropological Enquiries. Anthropology Matters Journal 13(1).
Bryman, Alan 2012 Social Research Methods. Oxford: Oxford University Press.
Burton, Arthur, and Louis Heller 1964 The Touching of the Body. Psychoanalytical Review 51(1): 122–134.
Champagne, Tina, Brian Mullen, Debra Dickson, and Sundar Krishnamurty 2015 Evaluating the Safety and Effectiveness of the Weighted Blanket with Adults During an Inpatient Mental Health Hospitalization. Occupational Therapy in Mental Health 31(3): 211–233.
Classen, Constance 1993 Worlds of Sense: Exploring the Senses in History and Across Cultures. New York: Routledge.
Classen, Constance 2012 The Deepest Sense: A Cultural History of Touch. Champaign: University of Illinois Press.
Cocksedge, Simon, Bethan George, Sophie Renwick, and Carolyn Chew-Graham 2013 Touch in Primary Care Consultations: Qualitative Investigation of Doctors´ and Patients´ Perception. British Journal of General Practice 63: 283–290.
Cooper, Amy 2015 The Doctor´s Political Body: Doctor-Patient Interactions and Sociopolitical Belonging in Venezuelan State Clinics. American Ethnologist 42(3): 459–474.
Davidsen, Annette, Johan Davidsen, Alexandra Jønsson, Maria Nielsen, Pia Kjellberg, and Susanne Reventlow 2020 Experiences of Barriers to Trans-sectoral Treatment of Patients with Severe Mental Illness. A Qualitative Study. International Journal of Mental Health Systems 14(87): 1–13.
De Hert, Marc, J. Dekker, D. Wood, Kai Kahl, Richard Holt and H.J. Möller 2009 Cardiovascular Disease and Diabetes in People with Severe Mental Illness Position Statement from the European Psychiatric Association (EPA), Supported by the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC). European Psychiatry 24(6): 412–424.
Desjarlais, Robert 1992 Body and Emotion: The Aesthetics of Illness and Healing in the Nepal Himalayas. Philadelphia: University of Pennsylvania Press.
Douglas, Christina 2021 A World of Touch in a No-Touch Pandemic: Living with Dementia in a Care Facility during COVID-19. Anthropology in Action 28(1): 8–15.
Dürr, Kenneth 2019 I Herning er bæltefiksering blevet erstattet med massage. Dansk Handicap Forum: https://danskhandicapforum.dk/2019/10/17/i-herning-er-baeltefiksering-blevet-erstattet-med-massage/.
Edwards, Christine 1998 An anthropological interpretation of nurses´ and patients´ perceptions of the use of space and touch. Journal of Advanced Nursing 28(4): 809–817.
Feld, Steven 1982 Sound and Sentiment—Birds, Weeping, Poetics, and Song in Kaluli Expression. Philadelphia: University of Pennsylvania Press.
Field, Tiffany, Connie Morrow, Chad Valdeon, Sandra Larson, Cynthia Kuhn, and Saul Schanberg 1992 Massage Reduces Anxiety in Child and Adolescent Psychiatric Patients. Journal of the American Academy of Child and Adolescent Psychiatry 31(1): 125–131.
Field, Tiffany 2014 Touch. A Bradford Book,. 2nd Edition. Cambridge: The MIT Press.
Fleury, Marie-Josée., Armelle Imboua, Denise Aubé, Lambert Farand, and Yves Lambert 2012 General Practitioners’ Management of Mental Disorders: A Rewarding Practice with Considerable Obstacles. BMC Family Practice 13(19): 1–12.
Franken, Roberto, and Marcelo Franken 2013 Hands as Diagnostic Tools in Medicine: Should Physicians Touch Their Patients? Arquivos Brasileriros De Cardiogia 100: 12–13.
Geurts, Kathryn Linn 2002 Culture and the Senses. Bodily Ways of Knowing in an African Community. Berkeley, Los Angeles, London: University of California Press.
Gleeson, Madeline, and Agnes Higgins 2009 Touch in Mental Health Nursing: An Exploratory Study of Nurses´ View and Perceptions. Journal of Psychiatric and Mental Health Nursing 16: 382–389.
Guenther, Lisa 2013 Solitary Confinement. Social Death and its Afterlives. Kindle for PC. Retrieved from amazon.com.
Harris, Anna 2016 Listening-Touch, Affect and the Crafting of Medical Bodies Through Percussion. Body and Society 22(1): 31–61.
Hayes, Joseph, Louise Marston, Kate Walters, Michael King, and David Osborn 2017 Mortality Gap for People with Bipolar Disorder and Schizophrenia: UK-Based Cohort Study 2000–2014. The British Journal of Psychiatry: the Journal of Mental Science 211(3): 175–181.
Henricson, Maria, Anders Errson, Sylvia Maatta, Kerstin Segesten, and Anna-Lena. Berglund 2008 The Outcome of Tactile Touch on Stress Parameters in Intensive Care: A Randomized Controlled Trial. Complementary Therapies in Clinical Practice 14(4): 244–254.
Herzfeld, Michael 2001 Anthropology: Theoretical Practice in Culture and Society. Hoboken: Blackwell Publishing.
Honneth, Alex 1995 The Struggle for Recognition. The Moral Grammar of Social Conflicts. Translated by Joel Anderson. The MIT Press, Cambridge, Massachusetts.
Honneth, Alex 2003 Usynlighed—om anerkendelsens erkendelsesteori. (Invisibility—About the Epistemology of Recognition). In Behovet for Anerkendelse, A. Honneth and R. Willig, eds., translated by M.C. Jacobsen. Copenhagen: Hans Reitzels Forlag.
Honneth, Alex 2006 Kamp om anerkendelse, sociale konflikters moralske Grammatik. (The Struggle for Recognition. The Moral Grammer of Social Conflicts). Translated by A. Jørgensen. København: Hans Reitzels Forlag.
Howes, David 1991 The Varieties of Sensory Experience: A Sourcebook in the Anthropology of the Senses. Toronto: University of Toronto Press.
Huss, A.J. 1977 Touch with Care or a Caring Touch? American Journal of Occupational Therapy 31(1): 11–18.
Iida, Junko, and Hiroshi Nishigori 2016 Physical Examination and the Physician-patient Relationship: A Literature Review. MedEdPublish 5(3): 14.
Jones, Simon, Louise Howard, and Graham Thornicroft 2008 ‘Diagnostic Overshadowing’: Worse Physical Health Care for People with Mental Illness. Acta Psychiatrica Scandinavica 118(3): 169–171.
Kelly, Martina Ann, Lara Nixon, Caitlin McClurg, Albert Scherpbier, Nigel King, and Tim Doran 2018 Experience of Touch in Health Care: A Meta-Ethnography Across the Health Care Professions. Qualitative Health Research 28(2): 2002–2012.
Korsmeyer, Carolyn 1999 Making Sense of Taste: Food and Philosophy. Ithaca: Cornell University Press.
Kristiansen, Søren and Hanne Krogstrup 2005 Deltagende Observation. Introduktion til en forskningsmetodik. 1(2). Hans Reitzels Forlag.
Kvale, Steinar 1996 InterViews: An Introduction to Qualitative Research Interviewing. Thousand Oaks, CA: Sage Publications.
Lafrance, Marc 2018 Skin Studies: Past, Present and Future. Body and Society 24(1–2): 3–32.
Leggett, Andrew 1994 A Survey of Australian Psychiatrists´ Attitudes and Practice Regarding Physical Contact with Patients. Australian and New Zealand Journal of Psychiatry 28(3): 488–497.
Lock, Margaret, and Judith Farquhar 2007 Beyond the Body Proper: Reading the Anthropology of Material Life. Durham: DUKE University Press.
Mason, Jennifer 2007 Qualitative Researching. London: Sage.
Nash, Michael 2013 Diagnostic Overshadowing: A potential Barrier to Physical Health Care for Mental Health Service Users. Mental Health Practice 17(4): 22–26.
Older, Jules 1982 Touching Is Healing, p. 86. New York: Stein and Day.
Otto, Ton 1997 Informed Participation and Participating Informants. Canberra Anthropology 20(1–2): 96–108.
Peloquin, Suzanne 1989 Helping Through Touch: The Embodiment of Caring. Journal of Religion and Health. 28: 299–322.
Porcello, Thomas, Louise Meintjes, Ana Maria Ochoa, and David Samuels 2010 The Reorganization of the Sensory World. Annual Reviews Anthropol 39: 51–66.
Pype, Peter, Katrien Pype, Angela Rowlands, Riya George, and Ignaas Devisch 2020 COVID-19 and touch in Medical Encounters. Patient Education and Counseling Amsterdam: Elsevier.
Rostgaard, Tine 2015 Failing Ageing? Risk Management in the Active Ageing Society in The Danish Welfare State: A Sociological Investigation T.T. Bengtsson, M. Frederiksen and J. Elm Larsen, eds., pp. 153–168. New York, NY: Palgrave Macmillan.
Routasalo, Pirkko 1999 Physical Touch in Nursing Studies: A Literature Review. Journal of Advanced Nursing 30(4): 843–850.
Salzmann-Erikson, Martin, and Henrik Eriksson 2005 Encounter Touch: A Path to Affinity in Psychiatric Care. Issues in Mental Health Nursing 26(8): 843–852.
Stoller, Paul 1989 The Taste of Ethnographic Things. The Senses in Anthropology. Philadelphia: University of Pennsylvania Press.
Stoller, Paul 1997 Sensuous Scholarship. Philadelphia: University of Pennsylvania Press.
Stoller, Paul 2004 Sensuous Ethnography, African Persuasions, and Social Knowledge. Qualitative Inquiry 10(6): 817–835.
VanDongen, Els, and Riekje Elema 2001 The Art of Touching: The Culture of ´Body Work´ in Nursing. Anthropology and Medicine 8(2/3): 149–162.
The Novo Nordisk Foundation (NNF16OC0022038) funded the PhD study.
Conflict of interest
The authors have no conflict of interest relevant to the content of this article.
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.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
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