The Psychology of Therapeutic Human Touch

An interview with Dr. Uliana Gout, Founder of the multi-award winning London Aesthetics Medicine (LAM) Clinic on Harley Street, and a leading global speaker, researcher, writer and advocate for innovation, evidence-based-medicine, and upholding safety.   

Dr. Uliana Gout is an internationally renowned educator and thought leader in aesthetic medicine, not only founding her own practice, but sitting on national and international boards, scientific committees and faculties of numerous congresses. She is Past President of the British College of Aesthetic Medicine (BCAM) and a Board Member and Secretary of the International Peeling Society. As the founder of the London Aesthetics Medicine (LAM) Clinic, she adheres to three pillars within her work – promoting and pioneering evidence based medicine, innovation, and upholding safety. However, her professional passion and expertise doesn’t stop there. Dr. Gout is also the Scientific Director of FACE Conference, the UK’s longest running educational event, Course Director for Monaco AMWC, and is a leading researcher and writer. Alongside numerous books and peer-reviewed research papers, she co-authored the First Consensus on Primary Prevention and Early Intervention in Aesthetic Medicine. Here, we spoke to her about the psychology of therapeutic touch and its importance in clinical care historically, the effects post-Covid, and their importance today.

The definition of health

Having grown up in a family of doctors, it’s clear from the outset, that Dr. Uliana Gout has a deeply felt love of her work, as well as an innate belief in the importance of interrogating the status quo in the pursuit of better patient care. Yes, she is one of the foremost practitioners in aesthetics medicine, describing her specialism as not simply being about non-surgical, cosmetic treatments and beauty, but about tissue health, wellbeing, regenerative medicine and, more recently, evolving into the novel arena of longevity and integrative medicine – something she has championed for more than 20 years. That’s what her books and conferences focus on, and it’s that emphasis that leads into her very deep and interconnected understanding of overall patient health. 

She says: “The WHO definition of health is not just about being disease free, it’s about social and mental wellbeing as well. For me, that includes targeting quality of life, functional wellbeing, tension relief, distress, positive body image whilst embracing prevention and regeneration – there are so many dimensions to consider. Quality of life is a big discussion point that I think will get more important over the next decade, especially given the recent global Covid crisis. The SATCC’s work is so valid because it is about treating wellbeing, and the importance of ‘therapeutic touch’ is at the forefront of delivering a better quality of life. Practitioners trained by the SATCC have that stamp of approval to show they know how to deal with this nuanced discussion – in cancer as well as immune issues and other areas of chronic disease management.”

Getting to know our patients

Dr. Gout’s interest in patient care has led her to adopt a highly personalised and holistic approach, that enables her to diagnose, treat, and support patients in a way that’s much more than skin deep. It’s that attitude that gives her a unique insight into the importance of the psychology of therapeutic touch in all areas of care. 

As a pioneer of protocols in the aesthetics industry, she firmly believes that care is something that needs to be built into practitioner training, and she is a staunch supporter of the SATCC’s mission to do just that when it comes to touch therapies for cancer patients. Recognising the complexity of that ambition, she notes that it not only takes time and carefully considered guidance, but also practitioners with an inherent desire to do more than treat disease:

She says: “In my grandmother’s day, doctors and nurses would do home visits and really get to know their patients. We now live in such a controlled world – and that encompasses spas as well – where we have to be so formal because of insurance and fear of litigation. However, we still need to define that point of professional and authentic care, and teach it early on in practitioner training. It’s not something you can just expect to learn as you get older; it needs to be inbuilt from day one. We mustn’t just teach professionals how to treat disease, but to deliver true holistic care centred on enhancing quality of life. To do that, it needs to be constantly implemented – not just inserted as a module in training. At my clinic we do personalised consults, which we call the LAM Hyperpersonalised Consultations, which explore my philosophy of the LAM Multi-Modal-Multi Layered approach. It requires taking time, personalising the experience, getting to know the full genetic history, lifestyle, habits and holistic history of the patient, which allows me to put a psychological context, social wellbeing context, mental wellbeing and physical context to the person in front of me.”

Dr. Gout notes that historically, medicine and healing were not just about treating illness. In a world where there were less medicines and cures available historically, healing often went hand in hand with the power of therapeutic touch, coupled with motivational and supportive attitudes to enhance overall mental wellbeing. 

“True holistic care is not always about healing the disease, but also the person,” she says, continuing: ” that’s where treatments taught by the SATCC members, like massage, aren’t just a nicety, but a therapy. A skilled therapist goes beyond the receptors and creates a powerful impact on quality of life.” 

Dr. Gout highlights that there are lots of scientific studies that show that touch in different forms can help reduce pain perception and alleviate anxiety. Indeed, across multiple peer-reviewed papers, consistent themes emerge: reduced pain, improved mood, better coping resulting from touch in medicine. For example, a large-scale systematic review and multilevel, multivariate meta-analysis published in Nature, provided quantitative evidence that various forms of touch, including stroking, hand-holding, consensual hugs, and massages, delivered mental and physical health benefits. Research from 2003 showed that massage or healing touch reduced pain, fatigue, mood disturbance; another study from 2016 showed that it improved pain parameters, and another from 2023 used meta-analysis to show massage relieves cancer pain.

When asked why people with cancer or chronic illness are especially in need of skilled, affirming touch, Gout says that these are people who live with persistent discomfort and psychological fragility, and for whom touch therapies bring relief and restore a sense of human connection. Her assertion is supported by studies including the PubMed paper titled Massage therapy can effectively relieve cancer pain: A meta-analysis (2023), where a systematic review/meta-analysis showed massage therapy relieved cancer-related pain across multiple tumour types. In addition, a 2017 paper from Lopez, G. et al. showed ~50% pain score improvements after oncology massage.

Dr. Gout discusses how some studies concluded that while touch protocols showed measurable improvement in sensation, anxiety, and stress levels in the short-term, we also have to understand their limitations in management of cancer or chronic illness, as the effects are temporary. She says: “I think it is very important for all professionals in the spa, wellbeing and aesthetic medicine sectors to understand that even a short-term improvement in ‘quality of life’ really matters and forms a part of the healing process – where serotonin and dopamine increase, cortisol levels drop, and patients truly feel a sense of relief and deep care. To me that is a quality of life improvement score that makes a real difference to the person’s experience of the world around them.”

Care in a post-Covid World

Not seeing her work on the skin as isolated from the person underneath, Dr. Gout takes a deeply holistic approach to everything she does, highlighting the power of therapeutic touch across medicine. In particular, she sees a shift in a post-Covid world that makes our understanding of care even more prevalent.

She says: “The power of therapeutic touch is so important, and the care we deliver needs to be even more enhanced post-Covid. In my clinic we deliver ‘Quiet Luxury’ – you walk in and someone shakes your hand with care and gentleness – there are literal touch points in that patient journey that pay attention to how individuals perceive sensations. Covid wasn’t just six to 12 months; it’s really been a five-year stint, with many long-term repercussions which are still noted today. It was a period in which we got so used to not being touched or cared for – everything was reduced to the minimum and we are seeing a real desire for human contact and connection than ever before.” 

One of the consequences of Covid was later diagnosis or misdiagnosis, especially when it came to cancer – something that’s resulted in long-term consequences for us all. For example, a 2020 Macmillan Cancer Support estimated that there are around 50,000 ‘missing’ diagnoses and hundreds of thousands of missed urgent referrals in the UK. Gout believes there is still a lot of distress resulting from that, and that there is a real need for authenticity in how we support people, with many craving human interaction. 

She says: “Of course, human interaction has to have authentic meaning – there’s a psychological element; it’s not just about literal touch. We have to make sure patients leave clinical environments feeling positive, cared for and motivated, so it has to be based on protocols, where we gauge their emotional and psychological wellbeing when they walk in, and again when they walk out. At my clinic, we want clients to feel soothed, relieved, positive, and motivated by the time they leave. We want those stress hormones down, serotonin and dopamine up, and we try to do that by addressing all the senses in the clinical setting.”

The call for validated frameworks and continuity of care

Dr. Gout began her work in the NHS, entering private aesthetic medicine almost 15 years ago and reinventing the medical journey to the one she always wanted to offer. She is a huge proponent of the work the SATCC conducts, namely the creation of validated frameworks and protocols when it comes to the management of cancer patients and those with chronic diseases. We discussed stark data points conducted by UK associations that have shown a significant number of patients with cancer being turned away by spas due to a lack of protocols and formal frameworks. 

She says: “The real challenge is fear of the unknown. Practitioners worry: ‘What if I harm them?’ It’s natural to worry about causing inadvertent harm – what matters is what we do about it. That’s why structured, peer-endorsed protocols are vital. The work of Sue Harmsworth and the Touch for Cancer programme has been essential, providing oncology-approved, specialist-validated frameworks. This gives practitioners confidence to say, ‘I can care for you safely, within clear limits.’ When practitioners are trained in such protocols, knowing where to avoid pressure – how to adapt for lymphoedema risk, how to liaise with oncologists and insurers -we pave the way for inclusive, holistic care rather than exclusion.”

In her own aesthetics work Dr. Gout sees similar responses to therapies, and is outspoken in her belief that cancer survivors should not be universally excluded from cosmetic or beauty treatments because blanket exclusion is fear-driven, not evidence-driven.

That said, she also recognises that delivering care is about more than learning processes. Before studying medicine, she recalls an interesting time when she was assisting in a volunteer programme, caring for patients with disabilities. For 24 hours at a time, volunteers would take on the role of carers, while full time carers took a couple of weeks of rest. The experience was formative for Dr. Gout, allowing her a deep insight into what it truly means to offer care – not just the physical time and energy when delivering care, but the emotional energy and holistic approach it takes as well. Recognising that although it can be exhausting to give that much of yourself, it’s also a privilege, it’s an experience she carries into her work today.

She says: “Care is not just about practicalities, and treatments are not just about functional results. It’s about creating an experience that elevates that person’s mood and motivation in life. We see authentic and inauthentic experiences all the time, and we feel it, quite literally, in our gut – in our microbiome, but how do you teach that kind of care? We can all become better over the years, but I think it has to start with someone genuinely wanting to offer that gift.”

Positive reprogramming

One of the key areas Dr. Gout discusses when she looks at the client or patient experience, is how messaging is delivered. She advocates for ‘positive messaging and reprogramming’ when it comes to encouraging healthy choices and changes, and has written papers on the power of positive or negative messaging in medicine. It’s something the holistic wellbeing sector can also learn from, both as practitioners and in understanding the treatments we offer. 

For example, positive messaging might be when you’re told that if you moisturise your skin, it will glow more, whereas negative messaging is about shock tactics – like the distressing images on cigarette packets. 

She says: “When you’re dealing with cancer and post cancer therapy, positive messaging is simply vital. It should be part of routine practice so that it is imprinted on the client’s memory. You want the treatment you’re giving to offer a space and experience that’s positive and motivating because a lot of psychological healing is based on positivity.”

That outlook influences Dr. Gout’s aesthetics work in itself. For example, Botox is one of the most popular treatments that she offers, often more for functional reasons like Tech-neck, teeth grinding, jaw clenching, shoulder spasms, knots, and tension headaches than aesthetic beauty alone. In doing so, she always makes sure not to block natural expressions of emotions, for example the Duchenne smile – also known as an authentic smile – because there’s a crucial link between our ability to express positive emotion, and how we feel.

She says: “It’s so important to maintain emotions on the face, but perhaps minimise and control negative expressions. Studies show that an individual’s quality of life goes up if they can’t frown as much for a prolonged period of time, because we then reprogramme the way we react to the world around us, and those around us also react to us differently when we do not appear so stressed. You can train yourself not to frown – actors and politicians do it a lot – I teach people to use certain muscles more and not use others, in order for them to have a more healthy interaction with the world. Furthermore, I believe in promoting positive body language and facial expressions in daily life as that also creates a more healthier interaction with the wider environment. I believe in smiling, especially when in-clinic with patients –  because I want people to know everything is alright.” 

It’s All about Treating People

The takeaway (if one is to choose just one) from speaking to Dr. Gout, is that the psychology of therapeutic touch in care is both incredibly important and multilayered. It’s not just about physical touch and the delivery of a treatment itself, but the body language of a practitioner, the approach, the mindset, and the practical skills that influence the experience that a patient or client has.

Therapeutic touch therapies are not just about physical touch, but delivering care in a contextual way – one that’s cortisol and adrenaline dampening and dopamine increasing. It’s also about the ongoing willingness to learn – both as individuals and as a sector – something we feel strongly about at the SATCC. That way, holistic care is not just about treating patients, but treating people.