sneezeHandshakes, High Fives, Fist Bumps, And Hugs

“We need four hugs a day for survival. We need eight hugs a day for maintenance. We need twelve hugs a day for growth.” – Virginia Satir

In 2008 Barack Obama and his wife, Michelle, gave each other a fist bump after a well-received campaign speech in Minnesota. The gesture went viral. It became the new handshake. Now, according to some, it may be trending as a health initiative.

There is a movement coming from the Journal of the American Medical Association (JAMA) to ban handshakes in hospitals. The research is clear. Handshaking is an unnecessary risk of infection and needs to be replaced.   Despite the daily vigilant efforts and campaigns by hospital infection control teams, hospital workers simply can’t wash their hands well enough to stop the spread of infection. It seems they only get it right 40 percent of the time. According to the U.S. Centers for Disease Control and Prevention the type of infections spread by health care providers kill 75,000 people each year. Stopping the spread of infection may give the fist bump the final justification to replace the handshake.

But wait. It makes sense that JAMA would promote a ban — but is the fist bump actually the best alternative? Research on the spread of infections shows that the high five alternative only cuts the spread of infection in half, and the Obamas’ fist bump passes on only about 1/10th of the germs of a handshake. When it comes to contact and infection what could be better than 1/10th the risk?

How about an interactive exchange that actually prevents infections?

I recently came across some intriguing research from Carnegie Mellon University that suggests more contact — in fact, much more contact — may not only cut the risk of infection, it may actually serve to strengthen the immune system and make us less vulnerable to germs. The new alternative to a handshake? Hugging.

Hugs seem so much a part of life we may not realize how powerful they really are. Of course there are the evolutionary factors. It is one of the first interactive bonding communications to help mothers and infants attach properly to each other. A hug activates oxytocin, the cuddle hormone that not only helps with bonding and reduces stress, but also seems to stimulate powerful neurotransmitters such as dopamine and serotonin. These brain chemicals are often associated with the regulation of mood. Lower levels of these neurotransmitters have been linked to depression, self-doubt, and lack of motivation. Higher levels tend to make us feel good. Hugs have the ability to boost these levels. The longer and more frequent the hug, the greater the effect.

There are also physical benefits that come from hugging. Haven’t you felt it when you receive a good hug? Your muscles relax, and the warmth and safety creates a calming effect. Research also shows it can help increase circulation and even reduce your heart rate. A hug is typically a reciprocal act, which builds trust and safety between the huggers — both benefiting from the one event. Yet, the other side of this coin is also true. When people are in conflict, they hug less. The stress-induced reaction makes them more tense, and, according to research, less able to ward off cold viruses.

Proof Positive

To investigate this, Sheldon Cohen, the Robert E. Doherty University Professor of Psychology in CMU’s Dietrich College of Humanities and Social Sciences, led the research on whether hugging is a type of social support, which protects people from getting sick. The research focused on hugging as an indicator of social support because to hug someone typically signifies a more intimate and closer relationship. The article, published in Psychological Science, found that those who received more frequent hugs and social support were more protected from infections associated with stress, and also experienced less severe symptoms when they were sick.

They investigated over 400 adults through questionnaires about the frequency of interpersonal conflicts and hugs. They then intentionally exposed the participants to a common cold virus and monitored the degree to which they got infected and showed symptoms. The risk of infection accompanying conflicts was reduced when perceived social support was greater, with hugs responsible for one-third of the protective effect. Regardless of whether they experienced conflicts, greater perceived social support and more frequent hugs both resulted in less severe illness symptoms among infected participants.

“This suggests that being hugged by a trusted person may act as an effective means of conveying support and that increasing the frequency of hugs might be an effective means of reducing the deleterious effects of stress,” Cohen said. “The apparent protective effect of hugs may be attributable to the physical contact itself or to hugging being a behavioral indicator of support and intimacy … Either way, those who receive more hugs are somewhat more protected from infection.”

So there you have it. The fist bump is the best if you want to reduce your risk, but nothing beats a hug when it comes to prevention:

Hug Early. Hug Often. Live Longer.

I’ll have the bumper sticker made this week.

Further reading

Cohen S., Janicki-Deverts D., Turner R.B., Doyle W.J. Does Hugging Provide Stress-Buffering Social Support? A Study of Susceptibility to Upper Respiratory Infection and Illness. Psychological Science, 2014; DOI: 10.1177/0956797614559284

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