Keywords

Fig. 3.1
An artwork depicts a woman sitting with her baby in a cloth wrap on her back.

Embodiment of the self. (Original artwork by Ana-Marcela Maldonado-Morales)

Full size image

This chapter addresses a number of questions regarding the transmission of culturally based patterns of interaction and how infants and young children are socialized into specific action patterns in the frame of different cultures. In any given culture, people relate to each other in unique ways: there are differences in interpersonal space, when, where, and how touch occurs between individuals and what strategies parents use to instruct, contain, discipline, and socialize young children.

We examine the meanings of the body: for the expecting parents, in terms of the representations of a “pregnant body,” and for infants, what is desirable or not, regarding body, intimacy, the embodiment of emotions, and its impact on the development of the child. We explore how cultural patterns are transmitted from one generation to the next and how children learn about physical closeness or interpersonal distance, relying on others (or not) and what these issues mean for the embodiment of cultural patterns, self-image, self-esteem, and feelings of competence.

An Ethological Perspective

Infants speak “the language of emotion,” which is analogical, as opposed to the “digital language” which is based on the exchange of words and sentences. The analogical language depends on intuitive understanding mostly of emotionality.

From the fetal stage, the baby is able to perceive sounds, evolving into recognition of familiar speech patterns—such as the mother’s—by the time of birth. During the first 2 years of life, the infant will be exposed to a constant language “diet” of words and sentences that will lead to the acquisition and development of the spoken language from the adults around him or her. Beyond the verbal-semantic component of language, there are also elements of pragmatic language—nuanced connotations and occult/subtle intentions within spoken language—and nonverbal language, the gesticulation of the body, closely linked to the emotions, gestures with which parents communicate and which they also “read” in their infant. In this analogical communication, the baby perceives the emotional tone of the discourse of caregivers and what they convey “without words” but with their body. The language of emotions is the lingua franca between infants and parents, which is the means to communicate distress and containment; it includes crying, smiles, laughter, postures, body movements, and different neurological states of alertness in the infant. Normally, parents have an “intuitive understanding” to interpret the infant’s bodily signals and emotions and respond accordingly, without the need for translations or training. Touch becomes one of the most important vehicles for this emotional communication between the parent and the infant (Stack 2010). Other vehicles include visual displays, auditory signals, smells, and pheromones among others (Wyatt 2014).

In the animal world, a complex system of signals to convey emotions and messages exists within species. Their behavior and appearance convey signals for dominance, submission, anger, fear, sexual arousal, etc. These messages are perceived by members of their species and often by members of other species. As an evolutionary feature indeed, interpreting those messages correctly can mean the difference between survival or not. These primary signals are called “honest signals” (Pentland 2008) and include showing fangs, lowering the head to show submission, presenting a sexual organ for sexual encounters, etc. (Plourde 2008). They may be reflexive or voluntary and can at times be purely autonomic (such as color change). The latter can also be included as mechanisms of “deception” in order to achieve other goals, like not to appear menacing, to go unnoticed, or to lure a possible prey; these are “dishonest signals.” Given developmental immaturity, human infants do not employ such strategies. The human equivalent to these—the aforementioned pragmatic language, like hiding emotions, or pretending they do not feel what they indeed are feeling—appears later in life.

The Tactile Experience in Recently Born Mammals

In the bestiaries of the middle ages, it was common knowledge that lion cubs were born without any form and only after birth, through the licking from the parents, lion cubs acquired their lion features, limbs, ears, tail, etc. Also, it was thought that the cubs were born dead and the adult lion had to lick the nose for the newborns to be revived (Hassig 1999). Although we do not presently adhere to those beliefs, it is still clear that the licking of their offspring that many mammals practice may be critical for the immediate survival and development of the newborn. Rat studies have shown that if the pups are not licked in a certain “normal” way, these will not release certain hormones and other chemical messengers, and they will have difficulty thriving and urinating (Lenz and Sengelaub 2006). If the licking is substituted by brushing the back of the pups (within a “critical period” after birth) with a wet brush, the effect is similar to the normal licking (Levine 2001). This reflects the probable importance of tactile stimulation between human caregivers and infants—as a primer to attachment—which in some mammals is so important that it can mean the difference between growing or not growing, or developing a higher risk of morbidity, and experiencing very high stress (Jutapakdeegul et al. 2003) if the offspring is not touched. Besides licking, the rat mother spends much time feeding the pups, in close physical contact with them, grooming, and retrieving them if they move away.

In primates such as gorillas, chimpanzees, and others, the infant is in constant physical contact with the mother (or other females) for extended periods of time and becomes very distressed if not in actual contact with them. This is thought to be an adaptive behavior to prevent predation and—in some species—to diminish the possibility of infanticide by adult males, which is a constant danger. What could be the representations of this or implications for human infants?

Touch During Pregnancy and the Postpartum

In most cultures pregnancy is considered a delicate period and one with considerable vulnerabilities. Many groups have developed rituals to diminish the stress in the mother, to help her be content, and to promote a good outcome for the future mother and the baby. These rituals involve diet, protections through amulets and magical means, and the avoidance of certain actions that are taboos. Some form of “therapeutic touch” has been developed in many cultures and has been used for centuries to help the expecting woman; usually this consists of some form of massage and applying specific healing or soothing substances, such as various ointments with attributed favorable effects on the woman and indirectly for the fetus.

In Mexico, Central America, and other American cultures, traditionally the woman was expected to participate in a ritualized touch called sobada (related to rub and soothe). These are most often performed by a specialized woman, and a specific technique is used, often with emphasis on the trunk and the limbs of the woman. The purpose of the abdominal massage is to “help the baby assume the right posture” and to soothe the expecting woman. The sobada is thought to have a protective effect, and at times it helps the anxieties of the expecting person as practiced by an “expert practitioner” who anticipates that things will go better after her ministrations. These ancestral strategies have been abandoned in many modern cultures as unnecessary at best or backward and cumbersome at worst. However, there is modern literature suggesting that the massage during pregnancy reduces the stress level of the expecting woman, increases the levels of endocannabinoids (which are associated with a relaxation response), and might be helpful in terms of the organization and mood of the newborn (Field et al. 2006; Moyer et al. 2004). It is well-known that higher levels of stress in the expecting mother have negative effects in her and on the child. In the latter, it is thought to be associated with diminished body weight, less organized behavior, excessive crying in infancy, and more disruptive behaviors in the preschool years (Huizink et al. 2004). Even though the traditional practice is often ignored, in some Western countries, the massage intervention has elicited recent interest and application (Stillerman 2008).

The massages are performed also after delivery to optimize recovery (Fuller and Jordan 1981). In the case of the Maya women of Yucatan, Mexico, the masseuse emphasizes manipulation of an area below the umbilicus of the woman, which is thought to be the center of the “human machinery,” and then proceeds to massage the back, the legs, and other body parts.

Touch and Bonding in the Human Infant

From the embryological point of view, touch is the first sensory system to develop—from the ectoderm (the same as the whole nervous system), and later on, the tactile receptors are extended throughout all the surface of the skin, the largest organ in our body—accounting for around 16–18% of the body’s weight (Montagu 1979). There is a higher concentrations of touch receptor in specific areas, such as the lips, fingertips, and others.

Several decades ago, Klaus and Kennel (Miller and Rodgers 2001) explored the importance of “allowing” mothers who had just delivered a baby in hospital settings to stay connected to their baby instead of the latter being taken to a separate room where the newborns were looked after by nurses. They suggested that the instinctive behaviors of mothers on the “first encounter” with the baby (now we would add the father) were important to promote empathic and compassionate maternal behavior and, to diminish the stress in the baby, help the child to regulate body temperature and “find the breast” and be fed on demand (Mizuno et al. 2004). Experiments in Sweden revealed that if the baby is placed skin-to-skin contact, shortly after birth on the mother’s abdomen, the infant was capable of “crawling” toward the breast and eventually finding one of them, not visually, but guided by smell (Varendi and Porter 2001). All of this reminds us of our ancestors and our animal nature, which at times is easy to ignore in the middle of all the technological advances, monitors, and computers that now attend the birth of a baby. Kennel and Klaus (Klaus and Kennel 1976; Kennell and McGrath 2005) recommended the institution of “rooming in” of mother and baby to allow these instinctual interactions to take place, undisrupted, and showed that even during the first year, the mother who had been permitted to do this undisturbed, tended to be more patient and more sensitive toward her baby than mothers who had been separated for considerable periods of time. This led to the institution of “baby-friendly” maternity units all over the world (Labbok 2012).

The First Encounter

Observing new mothers getting acquainted with the baby, in most cultures, there are some instinctive behaviors, such as holding the baby on the left side of the body by the vast majority of mothers (Huggenberger et al. 2009); smelling the baby (Kaitz et al. 1987), touching first the tips of the fingers, then the palms of the hands, and then the rest of the body (Trevathan 1981); and exploring carefully the face of the newborn and in general becoming familiar with its physical features. Later on, mothers (and fathers) are able to recognize, even when blindfolded, their baby and distinguish him or her from other newborns (Bader and Phillips 1999).

These “animalistic behaviors” such as touching, carrying, smelling, vocalizing to the baby, etc. seem to trigger a “bath of oxytocin” (Feldman et al. 2007) in the mother. This also is triggered by putting the baby to the breast, even if to express only colostrum. These actions also diminish the level of distress in the mother and promote the contraction of the postpartum uterus, and this leads to less bleeding and a sort of “falling in love” by the mother with her new baby. The father also falls in love, but his physiology has been less well-studied.

Many babies born in the United States in the past century, during the 1950s and 1960s, were born while the mother was unconscious, as she was totally anesthetized, which was a common medical recommendation. Physicians then also advised mothers to bottle-feed the infant with artificial formula, as it was thought to be “more scientific” to give a specified amount, and to not feed on demand but with a schedule. All of this was thought to be helpful for the child to develop a routine and a schedule and now has been largely superseded, although still many parents prefer to adhere to a schedule for feeding, napping, etc.

A further consequence of skin-to-skin contact between the baby and the mother is an analgesic effect (Gray at al. 2000). This has been shown in studies of procedures involving some pain to the baby, who shows a much less intense reaction when he or she is in contact with the mother, compared with lying on a crib.

Attachment and Touch

There is an extensive literature in attachment theory, which emphasizes the role of emotional security, parental sensitivity, physical proximity, and physical contact in very early childhood as a precondition to developing a feeling of security in the attachment relationship to a few caregivers. This literature will not be reviewed here, but in some Western countries, there is a new movement toward “attachment-based parenting” in which parents take an active role in responding to their child and assisting in the regulation of emotions and diminishing distress, to promote mentalization and empathy. This often includes strategies that involve touching, skin-to-skin contact between the baby and a caregiver, and soothing the child and helping to reduce his or her distress by touch, holding, carrying, etc. Something similar has been developed to help foster parents to be emotionally responsive to foster children in order to promote a sort of rehabilitation from emotional and physical deprivation and abuse; some of this includes physical proximity, responsiveness to the child, and human contact to reduce distress and anxiety (Dozier 2005). It has even been suggested that there might be a greater tendency to depression later on, during adulthood, if a child is rarely touched during infancy (Takeuchi et al. 2010). There is little research on the biochemical manifestations of touch in the infant and the caregiver, but the evidence from the attachment literature suggests that touch can be a powerful reinforcer of attachment security, in the sense that the mother, father, or other caregiver can use the touch to diminish the distress in the child and promote the sensation of being safe, and it has a calming effect. Other vehicles such as the mother’s or father’s voice, or visualizing them, can be also sources of reassurance particularly as the infant is a few months old.

The Infant and Young Child’s Experience of Being Touched and the Parental Response

In other chapters we have reviewed how mothers from traditional societies spend a lot more time in physical contact with their babies, through carrying and taking the baby on devices on their body even during work hours (for instance in the field, while the baby is on the mother’s back). The baby is fed on demand, and there is an intimate contact between the bodies. The mothers often learn to recognize the baby’s signals of hunger and the need to urinate or defecate by “reading the body” of the baby, its movements, tension, and other signals.

Two additional issues are explored, as they are common in many cultures: daily or ritualized massage as a part of the normal caregiving regime and also the types of “parent–child games” which often involve physical contact with the baby involving hands, legs, arms, the trunk, etc.; both parents and infants take pleasure in these transactions, which also may have implications later on in motor development (Jamain-Rabin and Wornham 1993), body schema, and the capacity to regulate emotions, as well as attachment.

In many traditional cultures, a ritualized massage is given to the baby to promote his or her development and strength, as in the South India (Stork 1986) and other parts of that country, as well as in Latin America. In some African cultures, the massage performed with specific oils is also thought to have a protective function against evil spirits, and it is also thought to eliminate impurities. In the Middle East and India, a sort of “makeup” is applied to the baby, as a form of decoration, to beautify the child, and thus foster that he or she will decide to stay in this world, as well as to celebrate the baby’s life.

Many parent–infant games are accompanied by rhymes and songs and are practiced in many societies, but perhaps they are tending to disappear with the advent of more “substitutes” for caregiving and electronic devices that occupy so much attention from parents and provide a repetitive music for the infant, such as electronic devices.

Traditionally among the Gujarati population in India, the postpartum mother is thought to be in an impure state and has to be carefully monitored for at least 20 days. She starts producing milk for the baby (which transmits wisdom from ancestors and is considered pure). At the same time, she is in an impure state in the lower part of the body. She needs to receive a massage from her mother or another older woman in order to recover her strength, and also she or a “professional massage” woman will perform daily ritualized massages on the baby (Spiro 2007), to cleanse the child who is at risk from the impurities of the mother, to purify the body and to make the baby strong. The massage can be quite intense for the observer but essential for those purposes.

In other traditional cultures, massaging the baby is practiced as a part of the daily routine, for instance in some cultures in West Africa (Jamain-Rabin and Wornham 1993). Observing women from West Africa, the researchers noted that the baby was exposed to daily massage and that rather strenuous movements, stretches, and vigorous massage were performed on the baby.

In other countries in South Asia, as in Nepal, the mother is expected to perform massages every day. The massage has the function of making the child brave and fearless; also it is thought to strengthen the bones, to promote weight gain, and to improve movement coordination (Reissland and Burghard 1987). In essence the mother is “shaping the child’s body” through the massage. The baby may be rubbed with an ointment (ubtan) that will lighten the skin color, making thus the child more beautiful. A special mixture may be placed over the fontanelle in order to strengthen it. A technique to promote fearlessness may involve holding the baby from the neck and dangling back and forth the rest of the body.

Tactile Interactions and Their Effect on Young Children

Cultural groups differ considerably in their nonverbal interactions and communications in many respects, including touch. Children learn by imitating the “codes” of interpersonal communication, obviously through verbal language but also through body language, movements, postures, gestures, and interpersonal touch (Eckerman and Whitehead 1999). The study of nonverbal communication takes into account factors like interpersonal distance. There are vast differences in how close adults get to each other in normal communication, be it within their family, in the workplace, or in social situations, an aspect that is called “proxemics.” This has been studied mostly in Westernized societies. One example is the interpersonal distance in Germany or Britain, which is is generally much larger than between people in Italy or Spain. Another dimension of nonverbal communication is “haptics”—the frequency and spontaneity with which people touch each other in their everyday interactions. Here again, some cultures seem to foster more spontaneous touch during conversation and play than others (McDaniel and Anderson 1998). The quality of the touch and the “meta-rules” associated with it also are determined by culture and context. There is some evidence that in the Middle East or South America, there is a higher frequency of touch between people than in some North European countries.

There are societies that are more oriented toward hierarchical social status and showing signs of prestige and reputation of power through signs of the body. The nonverbal language differs to show, for instance, triumph or dominance (Matsumoto et al. 2014). These signs are observed and then acquired, incorporated or embodied by children who learn to display those signals conveying different meanings. For instance, it has been shown that in preschools, children want to sit “next to” the more dominant or higher status members of the classroom; this applies to boys and girls (Howley 2003). Also, the children tend to look toward the dominant members of the class, and they also attempt to gain their visual approval and imitate their actions. This direct “ethological dominance” is modified by culture, as social cooperation may be taught and praised. Commonly, in preschools in Japan, children are encouraged from very early on to cooperate and help each other (Burdelski 2010) and do many things in teams, as opposed to individually. In those preschools, social status is also gained by showing more cooperation and social helpfulness.

Patterns of social interaction, gestures, and movements that connote meanings are “embodied” by young children and certainly by the socializing experience in group settings such as child care centers or preschools. As noted, some patterns are encouraged by adults, as in societies where prestige and high social status are valued, and in these “positive politeness” tends to be emphasized by parents and teachers. This is done by showing interest in others, finding common ground with others, and minimizing disagreement with peers. There are other cultures, that are more “other-oriented” in which individual prestige and success have to be shown in a different way. Often in these societies, there is a “negative politeness” in which children learn to show deference to others; emphasize honorifics (recognize those with higher social status and show deference), being indirect; and minimize imposition (Burdelski 2010). All of these behaviors are manifested by different styles of bodily interactions and gestures, as well as with spoken language (words, tones, rhythm of speech, etc.). Often, for instance, young women in Japan show politeness by talking in a high-pitched voice (Loveday 1981). Observing adults interacting with each other, children learn “politeness formulas” which are recognized in each culture. In more individualistic societies, adults prefer to use original expressions to show politeness, while in cultures with greater individual interdependence, adherence to formulaic expressions seems to be preferred to show politeness. These formulas involve words but also facial expression and body movements.

In American preschools it is common for teachers to teach children to say “no” or “stop” or ask for help when they do not want to share a toy or when another child takes it. In a very different culture, as in Japan, teachers may encourage children to share their toy if another boy wants it and to show politeness in lending it. This issue is often a question in families in which a younger child takes toys from an older sibling. In some cultures, children are socialized to “stand their ground” and in others to “share with a smaller child.” These differences in approach are easily misunderstood in the interaction between teachers and parents or between therapists and families from different backgrounds. A similar sequence could be observed when a small child requests to join a game.

In some cultural groups, teachers may “sculpt the body” of the child to teach certain behavioral patterns, like assist young children to bow in the presence of an authority figure, to greet, etc. In Japan, for instance, it is considered rude to pass some desired object with just one hand, and even a pencil has to be given with both hands, in a polite gesture. Teachers spend time modeling and reinforcing those “patterns of embodiment” that will help the child function socially and in which kindness is intensely reinforced.

In the United States and other industrialized countries like the United Kingdom (Piper and Stronach 2008), Australia, or Canada, there are considerable restrictions by attendants in preschool and child care settings about “touching children.” There are regulations about what is considered acceptable, like touching the children when there are other staff witnesses, etc. This is based on the fears of accusations of sexual molestation, which is a pervasive concern.

Even young children are discouraged from touching each other. The motto “keeping our hands to ourselves” is heard in many preschools in the United States (Field 1999). This is hard to achieve in preschools and nurseries, as young children exhibit the primate behavior of “play fighting” and hug each other, seek proximity when they are distressed, etc. This now extends in the United States even to some policies in hospital settings in which adult staff are discouraged from touching each other, as there is also a “no-touch policy.”

Children who might benefit from the stress-reducing effect of touch, or who are used to those patterns of interaction with their families, may feel “lost” in a child care or preschool setting where this is now allowed. In our clinical work, we have encountered children who feel unhappy and criticized because they “hug too much” or touch other children, who are not used to such interactions. The teachers also may feel inhibited from hugging or reassuring a child who is missing his or her mother at the beginning of school, etc., and the general emphasis is on “soothing oneself” without intervention from another person. Something similar can be said of children who are very angry, enraged, or oppositional, in which gentle touch by the teacher might help the child to regain control or calm, but the teachers request that the child accomplish this by him or herself. Often, in those same settings, teachers issue “long-distance commands” verbally to children to do something, or stop doing something untoward, but they do not use touch and calming strategies to redirect their attention or help the child to focus elsewhere, and it is expected, sometimes with very little success, that the child control himself on his own devices. Field (1999) has suggested that one of the factors that explains a higher rate of aggression between children might be touch deprivation, in general, and specifically in schools. The calming and appeasing function of touch may be lost due to concerns about litigation or accusations. Field has also suggested (Field 2002) that touch deprivation may be a factor in increased aggression among adolescents, due to their current deprivation but also to the possible deprivation of touch from infancy. Several studies have compared the frequency of interpersonal touch among preschoolers from different backgrounds. Puerto Rican and other Latin American children, as well as French and Italian children, touch each other more frequently than Caucasian children in the United States.

By contrast, in Sweden there is a long tradition of using massage for adults in various circumstances. Several studies have shown that practicing massage for preschool children tends to reduce the frequency of aggression between them (Von Knorring et al. 2008), and it is practiced in some preschools, sometimes from one child to another (Kagan and Hallmark 2001). This is hypothesized to lead to stress reduction and increased levels of oxytocin in the children.

Kangaroo Care

Kangaroo care was born out of sheer necessity and in a context of poverty. It represents perhaps a “leap of faith” on the part of the medical establishment to look at the traditional practices in their surroundings and “daring to implement them” even when it seems like going backward. It was in Colombia (Instituto Materno Infantil de Santa Fe de Bogota) in a hospital where there were not enough incubators to deal with the high number of premature babies that had to be cared for. As the incubators already had accommodated more than one baby per unit, the staff saw the need to try something else (Rey and Martinez 1983). They resorted to placing the premature babies, after a certain postpartum age, around 32 weeks, directly under the mother’s shirt and in “skin-to-skin” contact with her chest. The thinking was that the mother’s body would help the premature baby to not get cold and at least temporarily, while an incubator became available, and this might allow the baby to thrive. The mothers seemed to be quite satisfied with the experience, as they could become involved directly in taking care of their baby, quite in contrast with the regular experience in most neonatal intensive care units at the time, in which mothers were only permitted to “visit” for 2 hours a day. They had to trust the care of their baby to “strangers” (nursing staff) and had no control or involvement in their infant’s life except as visitors. Also, they were at times seen rather as an intrusion in the routine of the nursing staff that was conducting the “real medical care” of the baby.

The skin to skin (kangaroo) contact continued and was evaluated as to its possible benefits. It proved to have multiple benefits: it diminished the number of days the babies stayed in the hospital, and the infants tended to gain weight faster. The kangaroo care also promoted breastfeeding and diminished the frequency of infections and other complications; it proved to be better than “care as usual” in the incubator. The procedure was implemented readily in cultures in which people tend to have a community orientation, like Colombia (Conde-Agudelo et al. 2012), and then extended to other Latin-American countries, such as Guatemala and Mexico, among many others.

There were other benefits: mothers would be together in a group setting, talking among themselves, and getting to know each other. They often gave mutual psychosocial support, encouragement, and could discuss some of their problems in a sort of informal group therapy format. In addition to the reduction in infections and length of hospital stay, there was also a reduction in the rate of abandonment of infants in the hospital. This was theorized to be related to the “bonding” and intimate relationship fostered by the skin-to-skin contact between the mother and her baby. Later on, the practice was also implemented with fathers, when they were available (Lundqvist et al, 2007). Given the benefits of the method, it has been extended throughout the world, although different hospitals may or may not adopt it for multiple reasons.

Massage Interventions for Infants and Caregivers

A number of researchers interested in mental health approximately three decades ago became interested in the caregiving strategies they had observed in several regions of Africa, Asia, and South America, which seemed to lead to babies that appeared calmer and less dysregulated than infants who had spent a lot of time in child care settings at that time and who had received the routine “more distant” care in the United States. One of the pioneers in this area was Tiffany Field, who founded the Touch Institute in Miami; she and her research group conducted a number of studies on the possible benefits of touch and massage. Following on her work, numerous centers then have also studied the effects of touch and massage interventions and have proven a number of benefits for babies and older children.

What turned out to be surprising and reassuring is that the massage interventions also benefit the adults that “give the massage” and not only the ones who receives it. Field and others have demonstrated a beneficial effect on stress, stress hormones, and also in levels of depression in mothers who practice massage in comparison with those who do not. The same has been observed with fathers who practice the massages, as well as with elderly people, when they are given the opportunity to practice it and who often are themselves deprived of touch (Field et al. 1998).

The studies on the effect of massage have been extended to young children, preschoolers, school-aged children, adolescents, mothers and fathers, as well as the elderly. The evidence indicates that it benefits the high levels of stress in young children who are exposed to anxiety-provoking circumstances. Massage is often used to try to calm infants who exhibit sensory integration difficulties, such as tactile defensiveness and hypersensitivity in multiple sensory channels, and who then can relax and tolerate stimulation, make the transition to sleep, and modulate their discontent.

The massage has shown benefits in reducing dysregulated behavior, aggression, as well as diminishing anxiety, in preschool and school-aged children. It helps improve conditions like asthma and may assist in a better functioning of the immune system.

Playful Interactions in Early Childhood

Parents intuitively imitate infants and mark their emotions and promote their emotional and motor development through a number of games and in everyday interactions; thus parents reinforce certain behaviors and discourage others, in a way that is spontaneous (Kwon et al. 2013) unconscious, and intuitive. Caregivers unwittingly transmit from one generation to another certain gestures, ways of moving, of showing discontent, happiness, fear, etc. Some of the expressions, particularly of facial expression of emotion, might be universal, and some might be more specific to certain cultural groups.

The observation of toddlers in different cultures shows that they engage each other in games of imitation of actions and gestures, almost as if rehearsing “how to move,” how to play, etc. (Eckerman and Whitehead 1999). This may have to do with the evolution of “mirror neurons” which exist in many animals, and in humans they lead to innate and involuntary reaction to observing others move, enact, and react (Heyes 2010).

In many cultures, fathers play with their young boys or girls differently. In many, there is more physical interaction and play fighting between fathers and boys, while the transactions with girls are less physically intense. The responsiveness to the young child’s cues in fathers is related to the perception of what a father does but also to individual factors, such as the way the father grew up, how he has learned to behave “as a father,” and his level of stress, tiredness, etc. as with mother; oxytocin seems to make fathers more sensitive to the cues of their young child (Naber et al. 2010). Other factors are testosterone, cortisol, vasopressin, and prolactin, which in mammals seem to be mediators of the “parenting behavior” toward the offspring (Feldman and Bakermans-Kranenburg 2017).

The Infant’s Body and Inter-corporeity

By the time the human infant is born, there are already in operation “imitation mechanisms’ for gestures and actions that are thought to be “wired in” the brain and allow the newborn to automatically imitate the gestures of an adult who makes a sad face and a surprised face and who shows his tongue; and the newborn will tend to pattern his or her facial gestures after what is being presented, of course within certain limits. There is even a mechanism that is called “intermodal perception” by which the newborn can “transfer” what he is seeing into another sensory channel. For instance, the baby who is presented with the image of a triangle can “identify” a nipple with triangular shape and distinguish from other nipples with different shapes.

A few decades ago, Gallese demonstrated the existence of “mirror neurons” which led to much interest in the field of perception and learning (Gallese 2002; Heyes 2010). It seems that humans innately experience the activation of certain areas of the brain that “mirror” actions that they are observing in another person (Keyers, 2009). If one were to see someone riding a bicycle, the corresponding neurons associated with pedaling would be activated in the brain of the observer. This phenomenon has been associated with the concept of “inter-corporeity” as proposed by Merleau-Ponty much earlier than Gallese’s discoveries (Lupton 2012). Merleau-Ponty suggested that the body of another person has a distinct effect on the human who is in front of that person (Merleau-Ponty 1962). There would be a different “effect” for instance if a small and fragile person were in front of a very strong, tall, and vigorous person, as compared with the effect of a similarly small and thin one. This effect is unconscious—a “reaction” that one experiences when one is in front of another person, their movements, their voice, their gaze, etc.

One of the implications of this is that the infant is a “perceptual apparatus” that is constantly exposed to the interactions with a few caregivers and their actions, gestures, voices, etc. This may lead to what one might call the “embodiment of the self” which is constructed from the continued experiences with other people.

It has been shown that when 4-month-old infants are interacting constantly with a depressed mother, the infants themselves “look depressed.” This might be related to the diminished experience of joy and playfulness in the interaction with a depressed mother, who may be more “flat” in her emotions, withdrawn, and less responsive than a mother who enjoys more being with the baby and engages in mutual stimulation. Also, the infant of a very active father, who provides intense stimulation, lots of “hands-on” games with the baby, throwing him or her on the air, dancing, etc., will have a different somatic experience and exposure to sensations compared with an infant whose father is distant, hardly interacting with the child, and barely touches him or her.

In the cultural plane, different social groups will lead to a different “embodiment of experience” according to social codes, from the games and actions that are thought normative in each culture. For instance, as we described, the experience of the infant massage among the Gujarati, when observed by a person from a different culture, may seem almost extreme in the handling of the baby, who will be held from the head, dangling from the neck, squeezed vigorously by the masseuse, and will have air blown in the nose in order to “clean” those areas. Also, what are considered “normal maternal behaviors” may be very different among social groups, as well as the infant games between parents and infants.

An additional source of “inter-corporeal” input in many cultures is the constant presence of other children in the surroundings of the infant. In many societies older siblings may provide a significant amount of care and play interactions with the baby. When there are many cousins and other young children in the neighborhood, there are also many “bouts of imitative behavior” in which toddlers imitate each other in an intuitive fashion (Eckerman and Whitehead 1999). These imitation games are spontaneous and not staged. They are likely to occur also in child care centers in Westernized countries where infants may spend many hours in nonparental infant or toddler care. In these imitative bouts of interaction between young children, a boy throws a ball, and the one next to him also throws a ball, one jumps, and the next one also jumps. This tends to occur around 20 months of age and is related to the mirror neurons and the embodiment of the social experience in oneself. The activities that are permitted are dependent on culture and what is considered normative or adequate for “boys or girls” or for children of a certain age. In many cultures, traditional and Westernized girls are not permitted to be “too rambunctious” and are often rewarded for being quiet, sitting around, and playing with other girls. Boys may be encouraged to be “brave” and daring, and some might be admonished or ashamed for “being afraid” of jumping from a height or getting inside a swing. These patterns, while clearly modeled by culture, have not been studied abundantly nor the effects on the development of the self in the long term.

There is much to be learned about the influence of cultures and social practices on touch and interpersonal contact, also on the effect of such contact on emotional and neurophysiological development, the regulation of stress and the long-term effects of touch deprivation, aversive touch, or reassuring containment through tactile interactions.