This book discusses the aspects of human and animal social behaviour. The starting point is the assumption that human and non-human animals use comparable mechanisms of behaviour. By Russell Gardner, Jr., M.D., F.A.P.A., F.A.C.P. In a career as a psychiatric researcher (e.g., ethology of sleep and dream correlates) and as an educator of pre-clinical and clinical psychiatry, I and think-tank colleagues (Group for the Advancement of Psychiatry (GAP)) have suggested that the specialty could use a basic science akin to those utilized by other specialties in providing pathogenetic formulations for their ills (see Bakker et al for the succinct GAP statement).1 That is, in most of medicine, knowledge of the normal body workings informs one about the abnormal variants, or the dis-eases or dis-orders (dis = bad).If one knows how oxygenation of the heart's muscle must happen for it to continue its pumping, then one understands how rupture or clogging of the coronary arteries cause congestive heart failure and pain. In another system, crucial roles of bile for digestion on the one hand and the handling of by-products of hemoglobin on the other hand help explain the symptoms of gall stones clogging the common bile duct, not only abdominal pain but intolerance of fatty foods and change in fecal color. By contrast psychiatry (as well as clinical psychology and other not-usually-medical sister disciplines) presently focus on the individual as though that person's conspecifics (members of a same species) can be ignored or taken for granted. Rather the brain should be viewed as a "social brain." These clinical human disciplines would benefit by using front and center understandings of how human communication works on all brain and behavioral levels in reckoning with their ills. Mental illnesses and their treatments represent variations of human signaling amongst human conspecifics. Thus, mania can be seen as a communicationalstate in which a person exhibits a difficult to contain dominance state that shows a parallel to a human alpha state that when expressed normally other people find highly adaptive (Gardner, 1982).2 For another example, autism represents an affliction of childhood characterized by failure of usual communication. The authors present here a thorough-going investigation of the crucial and undervalued touch system that deals with caring, tender, gently caressing skin experience, what they call "tederheid," noting that English "tenderness" doesn't do the concept justice. I feel that their work on this under-examined sensory system provides powerful leverage for the better understanding of human psychiatric and psychological ills. Let me turn to a quasi-ethological anecdotal illustration observed naturally of touch and its concomitants in development. Sitting midmorning in a Madison, Wisconsin, coffee shop I see a mother enter with her son approximately four years old. Students from a nearby school arranging an art display temporarily left some precarious ceramic works on a small table next to a couch where the mother settles her son. She cautions him about the works' fragility, and comfortably goes to the next room for a cookie for each of them and coffee for herself. Waiting patiently, he sits on the couch's edge, placid, moving a bit, ignoring the ceramics, appearing to be very much "in touch" with the coffee-shop gathering place. His mother returned, settled next to him, casually stroking his hair in a quick gesture that startled me (because I was working on this foreword!) and prompted me to begin noting their interaction more specifically, although in fact, if asked, neither of them would probably have explicitly remembered that touch; indeed I myself would not have noticed were I not involved with this writing. They worked with pleasure on the two cookies, not only the taste, but later, as she again lightly touched the side of his face, as his appetite diminished, she seemed to guide a discussion about the spots on his cookie. Though not in earshot, I gathered that a small story ensued, perhaps a geography lesson. Then wrapping in paper his left over cookie,she let him play with toys on a nearby shelf, placidly sipping coffee. Attractive, wearing a wedding ring, she at one point made a brief call on her cell-phone, and then retrieved from the publication shelves a magazine. Relaxed, unhurried, she read in it while her boy continued with his vocalized play, knowing - I concluded - that he felt "held" by his mother's constant, sustaining, approving awareness, a state designed to provide him with confidence for later life, equipped in part by the signals of light touch that he undoubtedly experienced most days of his life so far, supplemented of course by innumerable other maternal stimuli occupying each of his senses. And I found myself assuming that her own mother and many others had touched her meaningfully in her own early and continuing life. The four-year old then came over to show her something he had worked on in his play. She admired it and told him that soon they would continue their errands and then go home. A little later he returned, apparently having some trouble with manipulations of a project-board; she patiently helped him out though now - so far as I could see - she didn't again touch him, but she fitted her audience-ship comfortably with his play, giving him what autonomy he needed as the play episode went on. Lucky young man, he will - bit by bit, I feel - gain strength in his various doings, able increasingly to solve the problems of his world with her in his sensory background, rich memories on many levels providing him with impetus, pleasure and power in doing what he will need to do at the varied life stages yet to come. For many people who consult with clinicians such apparently ideal mothering had not occurred. But palpable yearnings, however inchoate and wordless, cause searches that continue in all sensory modalities and on all levels of the cognitive apparatus such as planning and organizing. Communications opposite to those of the coffee shop mom, those that cut-down, put-down or make the recipient feel less valuable also contribute to the complex psychopathology seen in psychotherapy, counseling, and the family physician's consulting room. From what we saw the coffee shop mother provided and will continue to provide to her son if their family life persists on its present affluent relaxed trajectory; but if she had not, he would have wished she had. In ordinary lives, people less capably bear their burdens when they had too little in their own development what the coffee shop boy will take for granted. How these interpersonal systems operate at all levels - experience, all parts of body involved, learning, brain molecules, hormones - should commandeer the time of many researchers and the funding agencies that provide them with resources. But, while some behaviorally focused developmental researchers have begun to understand something of the processes of which Kortmulder and Robbers speak, and to which other human ethologists have paid some attention, most neuroscientists have to date paid little attention to these critical processes; such issues as tenderness and intimacy are tellingly too "touchy-feely."3 They yearn instead for "hard data" measurable from dissection or from analyses of test-tube contents, through x-rays and other imaging, or electrophysiology. Long held traditional biases skew the topics of interest away from clinical realities as we know them in the consulting room, though the psychopharmacological model of work puts the clinician in the broken or deficient molecule framework, far removed from how the patient feels directly. And commercial factors affect the central focus of investigation. Thus, the industries of international drug manufacture and, in the U.S. at least, the health maintenance companies, work via metaphors of economy to the effect that the fewest human contacts at minimal depths holder greatest value, that treatment as "relationshipless" as possible should optimally prevail. A thorough going appreciation of sociophysiology, the importance of relationships and communication at all levels, may reverse such trends. I became acquainted with one of the authors of the book you have in your hands via the pages of The Across-Species Comparisons and Psychopathology (ASCAP) Newsletter,4 initiated by me in the late 1980s but written in good part by members of the Birmingham Society led by human ethologist Michael R. A. Chance, first president of The ASCAP Society and the person to whom this book is dedicated. This group in the north of England met periodically for many years, producing a number of fruitful concepts, amongst them the idea of hedonic (relaxed, playful, pleasure-filled) and agonic (hierarchical, tense, competitive) modes of interaction that societies and other human groupings exhibit5 as well as John Price's labels for anathetic signals that boost the receiver (think of the coffee shop mother) and catathetic (put-down) communications via which one person reduces the value of another.6 Koenraad Kortmulder, an important member of that group, journeyed regularly to England for the meetings. To me from the U.S. midlands, this has seemed parallel to the famous Lunar Society of three centuries ago who found their way prior to electricity to their earlier meetings using the full moon to light their way. One of them, Erasmus Darwin, evolutionist, grandfathered Charles whose natural selection conception has radically altered our scientific world. His theory entailed on the one hand how species came to be, but on the other hand, depicted how emotional communications possessed continuity in many species over evolutionary time. The various revolutions in thinking that the Lunar Society produced may eventually have their parallels in the products of the Birmingham Society. I hope this book will help through its thorough documentation of the many levels of the tederheid sensory system. Can we understand more about what has happened to inhibit the delicate issues of touch? Let us now move to ritualized touch. The first view of such ritual, about five millennia old, stems from Homer and the other from a recent daily newspaper. First, Odysseus, an adult male benefitted from the ceremonial bath provided him as a high status guest.7. And soon [he heard] a call from the Bathing Mistress, who led him to a hip-bath, warm and clear -a happy sight and rare in his immersions after he left Kalypso's home - where surely, the luxuries of a god were ever his. When the bath maids had washed him, rubbed him down, put a fresh tunic and a cloak around him, he left the bathing place to join the men at wine in hall. In this experience written down by the Greeks in early stages of writing's history, a ruler, Alkinoos, and his family made sure that their distinguished guest experienced touch sensations via his body immersed in warm clean liquid; he is touched by women whose roles seemed to entail a nurturant purpose as they washed and rubbed him, perhaps akin to the coffee shop boy may well expect from his evening bath. In our less relaxed current western culture, Odysseus' bath and rubdown would often imply sexual arousal (e.g., "massage parlours") but such interests, expectations or demands didn't seem to have impacted Odysseus as an honored guest, at least as they had earlier from Kalypso when he had sojourned with her. Rather, these bath-maids tended to his "creature" comfort, fortifying and strengthening him for the later company of assembled people that involved story-telling (auditory and visual) and gift-giving (calculations of worth and indebtedness). In that era, such negotiations and display, however relaxed, seemed to have happened best after paving the way by stimulation of skin, brain and other components of the tederheid system in a description that from the context seemed a ritualized set of behaviors for high status guests. In contrast, in present U.S. society at least, fears of litigation include worries about accusations of inappropriate touch. Before the 2003 holidays, for instance, a local daily newspaper featured the topic of "hugging" at holiday parties with the byline that "Bosses should be careful." The article counseled that a newcomer to a social situation should observe the customs before engaging in either too perfunctory or too presuming of a hug, additional evidence for the enormous power that the touch sensations possess for interpersonal communication. Though the gesture communicates caring and affection, seduction and exploitation may also ensue if inappropriate or overly seductive, with the ready activation of the legal system to redress any wrongs. Bosses should take care before exploiting their position, something that easily and regularly happens. Now let me tell another ordinary example that illustrates the importance of intimate touch. Sitting on a New York city bus, I was "touched" (so to speak) by the sight of two women sitting near me, holding hands, both hands entwined through all fingers for both of them and with a feeling that seemed completely mutual. At times, the younger of the two gestured, thereby withdrawing her fingers, but then quickly returning to the former posture or a near variant. I felt them to be intensely and supportively connected, with intense conversation the gist of which I didn't quite catch (and I did feel some inhibition, given a sense of propriety that conflicted with my curiosity). But I did perceive that the younger woman spoke of her visits to a doctor who never seemed to get her name correct - doctor visits occupied their conversational topic in part though both women seemed the pictures of health, the gray hair of the older along with a few more lines the age-specific details in appearance that separated them. Later, the younger woman left the bus, and I moved to speak to the older one who turned out to be the other woman's grandmother, newly reconnecting with the younger person who - well educated and recently married to a high status husband - had just moved to Manhattan after growing up in California (where her mother, daughter of my interviewee, had lived during her own adult life). I asked if she herself ever lived in California. "Oh no, not me, I'm a life-long New Yorker!" So the two felt especially close with their new proximity healing the familial distance. That the younger woman was pregnant now (reasons for the doctor visits) further intensified their relationship. She spoke of having held her daughters' hands in the same way. This experience told me that the tederheid touch system discussed in this book possesses power not only in the lives of children and their mothers when we naturally assume the system to have powerful adaptive value for the next generation. But "tederheid" has power for adult women across the generations too. In the grandmother explanation of menopause, children and their mothers benefit from the attentions of older experienced women now menopausal who feel less hounded by their own reproductive passions, not to mention those of men who pursue them.8 They provide nurturant benefit and do this in part through touch. This leads to my concluding newspaper article, this one on poverty-ridden women in New York City who could not and did not depend on men. The grandmother hung condoms on the Christmas tree for her daughters' easy use to minimize the risk of future pregnancies. Their lives were hard and one wondered at their survival at the opposite end of the socioeconomic spectrum displayed by the hand-holding bus-riders. Yet the illustrative photograph showed three generations simultaneously providing touch signals - grandmother on the couch worked on her daughter's hair in the middle; that daughter in turn worked on her own daughter's hair. Nothing of this occupied the article, but the image, the icon, told me as a reader - prepared by Kortmulder and Rob...
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