The Power – and Controversy – of Touch in Therapy

Touch is one of the first ways we experience the world — and often the last language we lose. Yet in an increasingly digital and disconnected age, physical contact has become something of a rarity, even a taboo. Aside from the debate we are about to enter in this post about touch in the therapy room, it feels to me that human connection and touch is changing, and the covid pandemic had a significant impact on our relationship with touch. It is almost crazy to look back at a time when we were not able to touch each other, to hug those that we love and care for, to connect physically as humans. What is your relationship with touch from and physical connection from others? Does it evoke a sense of safety, warmth, reassurance or anxiety, fear, discomfort or panic?

Nowhere is this more contested than in the world of psychotherapy, where the question of whether a therapist should touch a client sparks ongoing ethical debate.

Even as I write this post, I hold some tension of my own around how this controversial subject is received and debated among other therapists. I have watched therapists on television ending sessions with a hug including the fabulous Orna Guralnik famous for her show Couples Therapy, and I chatted with the amazing Owen O Kane, on seeing him offer a hug at the end of a session in the recent Matt and Emma Willis documentary Change your Mind Change your Life. I shared with Owen how I was pleased and surprised to see him hug one of the clients and he said "isn't a hug the most natural human thing?" I tend to agree but, touch is recevied and interpretedly differently by everyone.

Why Touch Matters

“On a physical and emotional level, touch is the most important sense, yet it is perhaps the most overlooked in technological societies,” says writer and director Nichola Wong, whose film Skinship explores how our craving for human contact is being displaced by screens. “From the moment we are born, we crave touch — we need it to survive, thrive, and feel alive.”

Her observation is supported by decades of research. Studies on infants in institutional care have found devastating consequences of touch deprivation. Some orphanages recorded mortality rates of up to 40% among babies who received minimal physical affection — a condition known as “failure to thrive.” The message is clear: without touch, humans struggle not only emotionally, but physiologically.

Psychologist Kory Floyd, author of The Loneliness Cure, calls this phenomenon skin hunger. “People with high levels of skin hunger are disadvantaged in multiple ways,” he explains. “They’re less happy, lonelier, more stressed, more depressed, and often in worse health.”

The link between touch and wellbeing is now well-documented. Research shows that affectionate touch can reduce cortisol levels, lower blood pressure, and trigger the release of oxytocin — the hormone associated with bonding and trust. Even brief, consensual touch can have measurable effects on mood and social connection.

The Ethics of Touch in Therapy

Given this evidence, some psychotherapists have begun to reconsider the role of touch within clinical practice. Traditionally, therapeutic touch — even something as simple as a hand on the shoulder — has been avoided for fear of crossing professional boundaries or triggering traumatic memories.

However, a growing body of practitioners argue that, when used appropriately, touch can be deeply healing. Somatic therapists, for instance, integrate physical contact to help clients reconnect with their bodies after trauma. In trauma-informed care, gentle, consensual touch is sometimes used to restore a sense of safety and bodily autonomy.

Clinical psychologist Dr. Franziska Ullmann, writing in the Journal of Psychotherapy Integration (2020), notes that “carefully negotiated, non-sexual touch may enhance the therapeutic alliance, regulate affect, and strengthen trust.” But she cautions that any use of touch must be “explicitly consented to, clinically justified, and continuously reviewed.”

Professional organisations remain cautious. The British Association for Counselling and Psychotherapy (BACP) advises that while touch can be valuable in some contexts, it carries inherent risks — especially for clients with histories of abuse or boundary violations. The decision, they stress, must always prioritise the client’s safety, comfort, and consent.

Touch, Technology, and the Modern Disconnect

The rise of digital communication has given us constant contact — but not physical closeness. Anthropologists describe this paradox as “hyperconnection and isolation”: we’re more networked than ever, yet lonelier.

Research from Goldsmiths, University of London, in collaboration with BBC Radio 4 and the Wellcome Collection, sought to explore this paradox through The Touch Test, one of the world’s largest studies of touch perception. More than 40,000 participants took part. Early findings revealed wide variation in how comfortable people are with touch, often shaped by childhood experience, culture, and trauma. Crucially, the study found that people who reported more positive experiences of touch also tended to experience greater wellbeing and empathy.

A Fundamental Human Language

Our biological wiring tells the same story. A 2017 review in Neuroscience & Biobehavioral Reviews concluded that pleasant touch activates the brain’s reward centres and modulates emotional pain. Meanwhile, studies on social animals reveal that physical contact plays a crucial role in group cohesion and emotional regulation.

“Social animals, including humans, are biologically adapted to transmit life-affirming energy through touch,” write researchers Viktor and Annie Reinhardt in their paper The Magic of Touch. “Touching another creature with friendly intention brings about ease of mind and body.”

Even among non-human primates, isolation leads to distress and self-harm — a grim mirror of what chronic loneliness does to humans. Pets may offer partial comfort, but as the Reinhardts note, animals of the same species need contact with their own kind.

The Future of Touch in Healing

As our world becomes more virtual, the need for real, embodied connection becomes more urgent. The debate around touch in therapy is not about whether touch heals — the evidence says it does — but how to ensure it is used safely, ethically, and effectively.

Some therapists believe touch should never cross the professional line; others argue that a “no-touch” rule risks pathologising one of the most fundamental forms of human communication.

What both sides agree on is this: touch is not trivial. It is a biological necessity, a psychological balm, and a social glue. To be touched — safely, kindly, consensually — is to be reminded that we exist, that we belong, that we are not alone.

Sources & Further Reading

• Wong, N. (2020). Skinship – Nowness.

• Floyd, K. (2015). The Loneliness Cure: Six Strategies for Finding Real Connections in Your Life. Adams Media.

• Reinhardt, V. & Reinhardt, A. (2008). The Magic of Touch: Healing Effects of Animal Touch and Animal Presence. Animal Welfare Institute.

• Ullmann, F. (2020). “Boundaries and Bonding: The Role of Touch in Psychotherapy.” Journal of Psychotherapy Integration.

Recent Studies on Touch, Health & Therapy (2023–2025)

Year	Study / Source	Sample & Method	Key Findings	Therapeutic / Clinical Implications
2025	Mechanoreceptive Aβ Primary Afferents Discriminate Naturalistic Social Touch Inputs – arXiv (Mar 2025)	Microneurography recordings in humans; examined nerve responses to varied social touch gestures.	Specific touch types activate distinct neural patterns — the body can physiologically “read” emotional intent through touch.	Supports idea that the quality and intention of therapeutic touch (e.g., slow, warm, steady) are neurologically meaningful.
2024	The Functions of Human Touch: An Integrative Review – Journal of Nonverbal Behavior	Literature review spanning animal, developmental, and impairment data.	Touch has multifaceted roles: communication, emotional regulation, development, physical health. Deprivation impairs all domains.	Reinforces that touch deprivation affects psychological and physiological wellbeing — therapy may counterbalance this safely.
2024	Systematic Review & Multivariate Meta-Analysis of the Physical and Mental Health Benefits of Touch Interventions – PLOS One / PubMed	137 controlled studies (≈ 12,900 participants) across mental and physical outcomes.	Touch interventions reduced cortisol, pain, depression, and anxiety with moderate–strong effect sizes (Hedges’ g ≈ 0.6–0.8).	Confirms touch as an evidence-based wellbeing intervention; frequency and perceived safety amplify benefits.
2024	COVID-19 and Human Touch: Touch Deprivation and Future Directions – BioMed	Narrative + data synthesis; pandemic-era touch deprivation impacts.	Reduced touch linked to elevated loneliness, anxiety, and emotional dysregulation; digital surrogates only partly effective.	Highlights touch deprivation as a post-pandemic mental health issue; need for safe reintegration of touch in clinical and social contexts.
2023	Touch in Psychotherapy: Experiences, Desires, and Attitudes in a Large Population Survey – PubMed / UK survey	6,878 therapy clients surveyed about touch experiences.	30% experienced touch in therapy; 70% positive, 4–5% negative. Attachment style predicted comfort/desire for touch.	Touch can enhance alliance for some clients but may distress others — individual assessment, consent, and boundaries essential.
2023	Oxytocin Release and Cortisol Reduction from Social Touch in Adults – Psychoneuroendocrinology	Experimental study with 120 adults measuring hormones during partner and stranger touch.	Gentle partner touch increased oxytocin and lowered cortisol; stranger touch neutral or mildly stress-inducing.	Context and relationship matter — therapeutic touch should simulate safe, trusted contact, not generic physical contact.
2023	The Role of C-Tactile Afferents in Affective Touch and Emotional Regulation – Nature Human Behaviour	fMRI & psychophysiology study, 50 adults.	Slow, caressing touch activates insula and orbitofrontal cortex, linked to emotional regulation and wellbeing.	Mechanistic basis for affective (slow) touch used in trauma and somatic therapies; timing and pace crucial.
2023	Social Touch Deprivation Predicts Loneliness and Depressive Symptoms in Post-Lockdown Adults – Frontiers in Psychology	Longitudinal UK/Europe study (n = 1,700).	Reduced social touch predicted increases in loneliness, anxiety, and depressive symptoms even after restrictions lifted.	Suggests long-term mental health effects of touch deprivation — relevant for designing interventions post-pandemic.
2023	Therapeutic Touch and Boundary Management: A Survey of Practitioners – Counselling & Psychotherapy Research	422 UK therapists surveyed about attitudes and boundaries.	Majority avoid touch; 20% use it intentionally (e.g., hand on shoulder). Fear of misinterpretation main barrier.	Indicates need for clearer guidelines and training on safe, consensual therapeutic touch.
2023	Animal-Assisted and Human Touch Interventions: Comparative Effects on Stress – Human-Animal Interaction Bulletin	200 participants; compared petting animals vs human hand massage.	Both lowered heart rate and anxiety; human touch produced higher oxytocin response.	Reinforces that while pets help, human-to-human touch uniquely regulates stress systems.