title: Time, touch, and compassion: effects on autonomic nervous system and well-being.
abstract: OBJECTIVE
  Compassion is critical for complementary and conventional care, but little is known about its direct physiologic effects. This study tested the feasibility of delivering two lengths of time (10 and 20 minutes) and two strategies (tactile and nontactile) for a practitioner to nonverbally communicate compassion to subjects who were blind to the interventions.
  
  
  METHODS
  Healthy volunteers were informed that we were testing the effects of time and touch on the autonomic nervous system. Each subject underwent five sequential study periods in one study session: (1) warm-up; (2) control-with the practitioner while both read neutral material; (3) rest; (4) intervention-with practitioner meditating on loving-kindness toward the subject; and (5) rest. Subjects were randomized to receive one of four interventions: (1) 10 minutes tactile; (2) 20 minutes tactile; (3) 10 minutes nontactile; or (4) 20 minutes nontactile. During all interventions, the practitioner meditated on loving-kindness toward the subject. For tactile interventions, the practitioner touched subjects on arms, legs, and hands; for nontactile interventions, the practitioner pretended to read. Subjects' autonomic activity, including heart rate, was measured continuously. Subjects completed visual analog scales for well-being, including relaxation and peacefulness, at warm-up; postcontrol; immediately postintervention; and after the postintervention rest and were asked about what they and the practitioner had done during each study period.
  
  
  RESULTS
  The 20 subjects' mean age was 24.3 ± 4 years; 16 were women. The practitioner maintained a meditative state during all interventions as reflected in lower respiratory rate, and subjects remained blind to the practitioner's meditative activity. Overall, interventions significantly decreased heart rate (P < .01), and although other changes did not reach statistical significance, they were in the expected direction, with generally greater effects for the tactile than nontactile strategies and for 20-minute than 10-minute doses.
  
  
  CONCLUSIONS
  Two strategies are feasible for blinding subjects to nonverbal communication of compassion; even with blinding, nonverbal communication of compassion affects subjects' autonomic nervous system. These results should be replicated in larger samples, including patient populations, and mechanisms sought to explain observed effects. Compassion is not only good care; it may also be good medicine.
authors.affiliation: Center for Integrative Medicine, Wake Forest University Health Sciences, Winston-Salem, NC, USA.
authors.forename: Hossam A
authors.initials: HA
authors.lastname: Shaltout
authors.forename: Janet A
authors.initials: JA
authors.lastname: Tooze
authors.forename: Erica
authors.initials: E
authors.lastname: Rosenberger
authors.forename: Kathi J
authors.initials: KJ
authors.lastname: Kemper
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology*; D004645:Empathy; D005121:Extremities; D005260:Female; D006339:Heart Rate; D006801:Humans; D008149:Love; D008297:Male; D019122:Meditation; D008603:Mental Health; D009633:Nonverbal Communication; D011932:Reading; D012063:Relaxation; D056152:Respiratory Rate; D012146:Rest; D019124:Therapeutic Touch; D013995:Time; D014110:Touch; D055815:Young Adult