Why I Hug My Patients

Over the many centuries of human existence, many social customs have emerged out of both necessity and leisure. The handshake is one custom that encompasses both of those origins. The handshake may appear little more than a formality to some, but to others it is a complete view into the personality of the person on the other end of the handshake. The handshake has also created nations and bought homesteads. However, in all cases it still requires two people to be executed correctly, thus causing an interaction to take place, which gives me the right, as a student of sociology, to investigate the handshake from a sociological perspective.

The Origin of the Handshake

The actual beginning of the handshake is as difficult to specifically determine as most events that happened before written history. However, there are many accounts that provide both comedy and insight. One origin offered by Herbert Spencer, in his book THE PRINCIPLES OF SOCIOLOGY, is that of two Arabs meting in a desert. They each reach for the others hand to kiss it in greeting. However, it is an insult to have your hand kissed by another individual, so both men try to withdraw from the lips of the other man. The end result of this meeting is the acceptance by both men that they wouldnt kiss the others hand, and thus they ended up only clasping the hand of the other, and the handshake was born. The mutual acceptance by the two men that the hands wouldnt be kissed shows the equality between the two individuals; however, that aspect will be discussed a little further down the page.

Perhaps a more practical origin of the handshake comes from medieval Europe, where kings and knights would extend their hands to each other, and [grasp the] others hand as a demonstration that each did not possess concealed weapons and intended no harm to the other (Hall). I say this is a more practical origin of the handshake, because it more closely resembles our current use of the handshake as a way to introduce ourselves to a person and open ourselves up to them for the purpose of interacting. Interestingly enough, the ancient Greeks used it similarly. It was a welcoming sign of friendliness, hospitality, and trust (Schriffin).

Still, despite the various possible and plausible origins that the handshake sprung from, the handshake has taken many diverse and, at times, conflicting meanings. The question as to the meaning of the handshake is what the next section of this page will address.

The Various Meanings of the Handshake

Why is the handshake so important in the business world? Why are most meetings between diplomats ended with a handshake? Why do secret orders, fraternities, and sororities include handshakes among their secret rituals? I believe Hall and Hall put it best when they wrote, The handshake represents an expression of equality.

Take, for example, the meeting of diplomats to discuss a peace initiative for two warring countries. With the handshake giving a sense of equality to the meeting, the playing field is leveled and the proceedings can occur, unhindered by feelings of inequality. Admittedly, most diplomatic meetings occur in times when one side has a dramatic diplomatic advantage over the other, however, the handshake can often serve to equalize the two diplomats with each other, rather than equalize the parties they are representing.

Another example of political use of the handshake to imply equality is in the Presidential debates, where the candidates face off in a discussion of current events and personal policy beliefs. At the beginning of the debates, the candidates shake hands, much like in boxing matches when opponents touch gloves before the first bell rings, and then again at the end, which Hall and Hall describe as a handshake of reconciliation, in which participants reestablish a sense of solidarity. However, in politics, the meaning of the handshake has been cheapened by politicians preying on peoples beliefs on the meanings of the handshake to help further their own political interests.

Politics isnt the only place in which the importance of the handshake has been made lesser in value. Over the course of the past two centuries of American existence, the importance of the handshake in the business world has declined from a once binding contract that pledged both your wealth and your honor, to little more than a business formality and tactical action. At one point in the banking industry, a person could lend and borrow money based on the palm-to-palm contact called a handshake.

Looking through the eyes of a symbolic interactionist, you could argue that the handshake is a binding agreement because it allows for the tangibility of feeling the other persons hand in yours and that contact and interaction is symbolic of the trust and reliance the two people are exchanging with each other. Because people develop a sense of personal space around them, physical contact between two people requires that this invisible barrier be suspended for the duration of the contact. Because the lowering of such a barrier requires trust in the person with which the interaction is taking place, the symbolic interactionist would say that the act of the handshake incorporates all those feelings into that one action.

A Goffmanesque Approach to the Handshake

Although in my research I never found an instance in which Goffman addresses the handshake directly, I did manage to gather some clues as to how he would probably view the interaction associated with the handshake. This section is dedicated to an analysis of the handshake from the most likely view Goffman would take. Note that these are not his direct applications of the various theoretical elements, but it is definitely a possible and accurate use of the theories. With that having been said, here is my analysis of the handshake through the eyes of Erving Goffmans various theories.

The act of shaking hands requires what Goffman calls focused interaction. This is where a person interacts with another person directly and pays attention to the responses and social cues given by that person. Instances of focused interaction are called encounters. As Goffman also states, encounters require openers, in order to show that both parties recognize the encounter that is now taking place, as well as closers, to signify the end of the encounter. The handshake serves both the purposes with little modification. Specifically in the business world, handshakes are often used at the beginning and end of business meeting, interviews, and whenever else people want to show that they have entered into the interaction (encounter) and are ready to listen and respond to what the other person has to say.

Another one of Erving Goffmans major theoretical concepts was that of the Dramaturgical Approach to interaction. Applying this theory to the act of the handshake can provide some interesting insights into the importance of the handshake in the modern business world. For instance, in an interview, there is a very set pattern of events that is to occur in order for the interaction to be perceived as normal. The interview begins and ends with a handshake, displaying the equality of the two people. This is a very important line in the script that guides this reaction. A weak handshake can often be seen as a departure from the script because it can signify inattentiveness, weakness, insecurity, or rudeness. After the interview has been concluded, the handshake is once again needed as if it were the finale of the play. This time the handshake is not that of introduction, but that of closure.

Conclusion
Another theory, although not one of Goffmans, that applies to the handshake and too business in general is that of the compulsion of proximity. This theory is credited to Deirde Boden and Harvey Molotch. The compulsion of proximity refers to humans need for face-to-face interaction. I discovered this theory while browsing through the textbook and thought that it had relevance to the handshake because despite the massive amounts of cheap long-distance communications technologies (i.e. fax, video-conferencing), there are still a lot of business travelers filling our airports day-to-day. I attribute this to the compulsion of proximity and to the importance of the handshake in the business world. Obviously there is still a high value placed on the value of the personal focused interaction and encounters that are enclosed by handshakes everyday. Many business coaches and personal behavioral books attribute to the handshake the role of encompassing your personality into a single action. This interaction cannot occur except in person. So, the price of this interaction is obviously worth the time and money it takes for these people to complete the interaction.

As you have read, the handshake is a very important part of the business world. A person would be foolish to overlook the importance of the handshake. So, to all those business students, professors, and anyone else interested in the importance of the handshake, remember that you are being judged on your handshake whether consciously or subconsciously, so make it count. Since starting my research, I have paid a lot of attention to how people shake hands and there is a lot to be learned through paying a little more attention every time you shake hands. So, remember this the next time you shake a hand and pay attention, it means more than you think.

The above was written by Keith Andrew and was found by doing a search on the web for the History of the Handshake.

Why I hug my patients

No where in the above article did I find the word 'intimacy'.  Doctors typically shake hands with their patients; a decidedly unintimate gesture; more busines-like.

My patients are faced with the challenge of infertility. They are medicated, talked at, poked and prodded, blood drawn, speculums inserted, and frequently disappointed by failed IUI's, ivfs and donor egg transfers.

Is intimacy only supposed to take place between the patient and her or his partner? Why can't a doctor have an intimate relationship with his or her patient?

Some definitions of intimacy that I found on the web
familiarity: close or warm friendship
closeness: a feeling of being intimate and belonging together
intimate - marked by close acquaintance, association, or familiarity; "intimate friend"
intimate - familiar: having mutual interests or affections; of established friendship

There is no intimation of 'sexuality' here. Only a close bond.  Shouldn't a patient and his or her doctor or health-care provider have a close bond? Is not having a close bond clinically important?

I believe in intimacy; warmth, compassion and love for my friends, family members and my patients: that is why i hug my patients; men and women: it is an intimate, connecting, comforting gesture.
Love and blessings and hugs!

mike berkley, L.Ac.