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feet. Touch is essential to the early development of object relations and to differentiating the self from the external world and other individuals. Self versus non-self is also a major aspect of reality testing and the sense or feeling of what is real. The significance of touch and its relationship to both cognition and affect is embedded in the common metaphors of “touch” as indicating emotion, “feel”, “feelings”, and “grasp”, meaning to understand, related to cognition. Individuals of any age are affectively engaged, emotionally touched by fine art, literature, music, etc. They “feel” sad or happy, dance with romantic feelings, feel the sadness of a funeral march. They are thin skinned if they have hurt feelings, thick skinned if insensitive. The psychoanalytic literature specifically addressing the significance of touch is relatively limited. Touch, however, is intrinsic in Freud’s formulations on dreams, the pleasure-unpleasure principle, instinctual drives, and ego-instincts (which in later theory were ego functions). Freud (1923) was only implicitly referring to touch in his statement: “The ego is first and foremost a bodily ego. It is not merely a surface entity, but is itself the projection of a surface” (Freud 1923a, p. 26). Touch was elaborated on by Merleau-Ponty (1945), a philosopher and child psychologist. In his posthumous notes, “The Intertwining and the Chiasm”(1945) he described the double perception involved in clasping one’s own hands, with a dual registration of touching and being touched . Touching one’s self is differentiated from touching another. Touch perception is vital to knowing the world. The importance of touch is implicit in the works of Donald Winnicott ’s (1953) discussion of the transitional object and John Bowlby ’s (1969) description of the infant’s clinging in its attachment to the mother. Also relevant is the study by Jean Piaget (1954), “The Construction of Reality in the Child”. Noting that the grasp reflex is present at birth, he stated that the grasping of objects including parts of the body, coordinated with vision, facilitates the development of object permanence and knowledge of external reality. The monkey experiment of Harry Harlow and Margaret Harlow (1965) indicated the importance of soft contact by touch and grasp in primate development. Rene Spitz (1965) stated that not only is receiving nourishment essential, but being touched, held, and fondled are also necessary in infant development. Infant and mother establish a primordial dialogue . Esther Bick (1968) discussed the significance of touch in describing the skin contact of holding the baby at the breast or against the parent’s face, fostering emergent object relations . Didier Anzieu (1985) formulated the concept “ skin ego ”, developed in the dyad as a container or “psychic envelope”, under the impact of the skin-to- skin contact of the baby and the mother, and under the impact of the sound of the mother’s voice and breath, as a narcissistic basis of well-being. The skin ego forms an envelope of the self, connected to ego function, self, identity, object relations, and a defensive protective boundary or membrane (Anzieu 1989). Harold Blum (2019) noted the significance of touch and holding for the development of self and object constancy . The sensory and proprioceptive registration of touch is necessary for the emergent body ego with its surface, particularly the skin (Chinn, et al., 2019).
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