Massage therapy research, and the acceptance of massage in general, might not be where it is today if not for the landmark work of Tiffany Field, PhD.

Giving Us Voice (and Legitimacy)

Field will quickly remind you she was not alone in her research endeavors, and was not without support along the way. But if not for Field’s work detailing the benefits of touch on premature infants in the 1980s, the media might not have been as interested in massage as early as it was (there is no better feel-good story), large corporations might not have sponsored millions of dollars of massage research when they did (Johnson & Johnson’s brand was eager to attach to touch studies), and a public gun-shy with unrealized new-age promises might have taken much longer to show widespread public acceptance for therapeutic massage.
Through the work of Field and her research colleagues, the world saw massage in a new, tangible, science-based light.
As a professor in the departments of pediatrics, psychology, and psychiatry at the University of Miami School of Medicine and director of the Touch Research Institute (TRI), you’ll find Field’s name appears in most textbooks about massage theory and massage research, and is synonymous in many ways with pediatric massage—not for technique, but for validating the science behind it.
And she believes as strongly today in the therapeutic value of massage as she did 30 years ago. As she wrote in The Guardian in 2014, “Like diet and exercise, everyone needs a daily dose of touch.”1
From the New York Times, to Life magazine, to the New Yorker, Field and her colleagues are the ones sought after for comment and quotes about the benefits of massage, largely because of her published works and her place at the head of the massage research table. Hers has become the founding standard for massage research, and she remains an icon to many in the massage research community today.

Creating a Researcher

Research was not necessarily the path Field was originally headed. With degrees in psychology and occupational therapy (and a bit of dinner theater) under her belt, Field and a fellow actor set off for a two-year sailing journey around the world in 1972. The two adventurers made a 31-foot Golden Hind sloop their new home for the trip. “We watched it being built in Plymouth, England,” she recalls.
The journey had its slow moments—“the ocean crossing was boring”—and its exhilarations—“traversing the Mediterranean and the Caribbean was very exciting with its fickle winds.” Already a researcher by nature, she surveyed fellow sailors at the end of her adventure to discern how both sexes responded to the peaks and valleys of the global crossing. “I did a survey at the end and men said once around the world was enough—they were bored—and women said they would do it again. They enjoyed the cooking, reading, and sewing sails.”
She remembers one of the strangest moments from her travels: “We met another sailboat in the middle of the Atlantic (the doldrums) and the guy was on the same page of the same book as me—Thomas Hardy’s Far from the Madding Crowd.” Field set out to make Thanksgiving dinner for the small group—pheasant in burgundy sauce in a can and rotten creamed onions—“but by morning the other boat had drifted out of sight and we never saw them again.”
So how did this journey create a new path for Field? As one of the founders of the Psychiatric Institutes of America, Field was already part of a number of different therapies the group was offering to young people returning from the Peace Corps. “We found the therapies worked for some and not for others. While I was sailing, it occurred to me that we didn’t have research on these therapies, so I decided I would return and become a researcher.”
What followed on her return was another master’s degree in child studies, a PhD in developmental psychology, and her eventual appointment to the faculty at the University of Miami Medical School in 1977, where she remains today as one of its longest tenured professors.
Once just a traveler’s dream, today, research is Field’s fuel. With 400 published studies, more than 30 books to her credit, and numerous awards for her scientific endeavors, Field still has her lab coat on and has no plans for hanging it up.

Proving the Benefits of Touch

Field’s earliest research was embedded heavily in early childhood development and covered everything from high-risk infants to infant gaze to parent/child separation stress. And while tactile stimulation may have factored tangentially into some of those early studies, it wasn’t until her landmark 1986 study on the benefits of touch for the growth weight and development of premature infants that massage became more of a centerpiece in much of her research.
Building the research path toward that 1986 study meant taking her knowledge of early childhood development and her experience working in a neonatal intensive care unit (NICU) to connect the dots with massage.
In the mid-70s, at the NICU at Baystate Medical Center in Springfield, Massachusetts, Field and her team were working to help babies gain weight and go home earlier. “We let them suck on pacifiers because they were being tube-fed and we knew that fetuses had a natural instinct for sucking; they often have sucking marks on their hands when they are born. When the preemies sucked on pacifiers, they gained weight and were discharged earlier. So, we eventually argued that if they could gain that much weight by stimulating the inside of their mouths, they could gain more by having their entire bodies stimulated. That led to massaging them.”
At the same time, Field’s personal experience with her own child’s premature birth in 1976 gave her a lovable “guinea pig” on which to test her theories. Not familiar with professional massage at the time, but well aware of the tactile requirements infants need to thrive (as evidenced in the touch-deprived children discovered in understaffed and abusive Romanian orphanages), Field set to work giving her daughter daily massage.
But the path to her consummate work needed one more step to be complete. When Field and her colleagues found that growth hormones were stimulated when rats licked their pups, the way became clear. “We found that some researchers had tried stroking the [NICU] babies, but did not affect their growth. It was because they were lightly stroking them. When we applied pressure—moved the skin—the babies gained weight and were discharged from NICU earlier.” The pressure, she says, is ultimately the key.
Field and fellow researchers Cynthia Kuhn, Saul Schanberg, and several others published their results in Pediatrics,2 and new ground was broken for the massage community when we learned that with massage treatment for three 15-minute intervals each day for 10 days, premature infants were able to increase their body weight 47 percent more than those infants not being massaged and with the same food intake. They were also able to leave the hospital six days earlier than their nonmassaged counterparts.
For their work, Field, Kuhn, Schanberg, and laboratory technician Gary Evoniuk were honored with the Golden Goose Award in 2014, a national honor recognizing the “tremendous human and economic benefits of federally funded research by highlighting seemingly obscure studies that have led to major breakthroughs and resulted in significant societal impact.”3
The award description reminds us why Field’s work is so important: “Dr. Field did not set out to develop infant massage as a national health-care cost-savings measure. Her goal was to help save and improve the lives of babies born too sick or too soon to face the world outside of the NICU, and she was very successful in that regard. Her success did, however, also result in enormous cost savings. A recent analysis estimates that these savings amount to about $10,000 per infant, resulting in a nationwide annual health-care savings of $4.7 billion. Infant massage therapy is now used by close to 40 percent of NICUs nationwide, a number that is steadily increasing.”4
To this day, Field says that 1986 study remains the research she is most proud of.

Building a Legacy

By 1992, Field formally established the Touch Research Institute at the University of Miami School of Medicine with the help of a start-up grant from Johnson & Johnson. According to the TRI website, “it was the first center in the world devoted solely to the study of touch and its application in science and medicine.” And it’s through TRI that the community’s massage research literature grew exponentially when no one else was studying its effects.
TRI is synonymous with Field, and rightly so. It’s her baby. Out of TRI has come the extensive research we now take for granted. She says the most surprising effects of massage she’s found along the way “was the increase in natural killer cells and natural killer cell activity that happened in our HIV and breast cancer massage studies. Those were significant findings as natural killer cells kill bacterial, viral, and cancer cells. That led us to our underlying mechanism studies, which showed that relaxing the nervous system by moving the skin reduces stress hormones like cortisol, which then leads to several effects like increased natural killer cells and increased serotonin—the body’s natural anti-pain and antidepressant.”
Today, TRI’s wellness center continues to teach the value of pediatric massage, and volunteers even take the work into the teaching hospital, showing parents of prematurely born infants how to touch their children for maximum health benefits.
Field says she has written more than 100 grants over the lifetime of TRI, and once had great support for the work the institute was producing, including a lucrative grant from the National Institutes of Health. But times and administrations change, and now, TRI sits on the funding precipice.

The Song Remains the Same

In so many ways, massage therapy research has come a long way since Field’s 1986 landmark study. Researchers are looking at the benefits of massage and touch therapies at an ever-increasing rate, the public consumes more massage than ever before, and the legitimacy of this once-maligned therapy can no longer be disputed, and yet, Field says the financial challenges for researchers studying massage remain largely the same as when she first started out.
How hard was it to get funding for massage therapy research in those early days of TRI’s work? “Impossible,” she says, “and it still is.” While the affiliation with the university is critical to her work, it does not provide any monetary support for TRI. With important funding sources drying up, Field worries that TRI might soon have to shutter its efforts.
It takes approximately $100,000 a year to keep the TRI doors open, and while funding used to come from the National Institutes of Health, Johnson & Johnson, and even the Massage Therapy Foundation and Massage Envy corporate headquarters, those sources for TRI have vanished.
“The message is still not heard,” she says of the lack of resources devoted to this research. “It is going to take a lot more than our research to get the message out there.” But the problem, she says, comes from within.
While other countries pour money into their massage research, the US institute that helped legitimize an industry of healing professionals may no longer be able to keep its doors open for lack of funding, effectively shutting down Field’s decades of massage therapy research.

A Passion Fueled by Science, a Life Fueled by Joy

As yet undeterred, Field admits she’s a workaholic. It’s why, for this avid scientist, retirement is not part of her long-term plan. “I have never thought about retiring,” she says. And why should she? Her work is what fuels her passion and joy. “I’m a workaholic by nature and have so much energy and excitement about massage therapy effects that I want to keep researching them,” she says.
But self-professed workaholic or not, Field’s life is more full and balanced than most. Look at her daily routine and it makes sense. “I swim laps every morning at 6:30 a.m., teach tai chi and yoga, and do the treadmill or walk Coconut Grove every afternoon after returning from the TRI. I go to a breakfast club every morning (we mostly discuss politics) and a sailing club on the ocean every evening (we mostly do not discuss politics). I get a massage a week. So, I’m very much a creature of habit except for my teaching tours.”
Every August, she ventures northeast to see her now 42-year-old “beautiful, very smart, great writer, and farmer daughter,” where she spends most of the month helping her tend to her organic farm. “She is mostly in New York City getting a graduate degree at Union Theological Seminary, but in the summer she does organic veggie and medicinal farming. I spend most of August helping her on the farm and editing her papers for publication.”

TRI Today

Research with Field’s beloved preemies continues today at TRI, with other current research at the institute exploring massage for hip pain, and massage for veterans with PTSD to reduce their depression and sleep issues, the latter of which she is especially excited about.
And does her work continue to hold up to scrutiny? “Yes. There are hundreds of replications around the world, mostly on preemies and on pain syndromes. Every two years I write a review paper and I am amazed at how many researchers are studying the effects of massage—mostly outside our country.”
Yes, the massage profession owes much to Tiffany Field. Ultimately, however, it’s the preemie babies who get to go home earlier, the HIV patients whose immune systems are bolstered, the cocaine-addicted babies who are able to thrive, and the countless others whose lives were changed by the massage mechanisms Field helped prove throughout her storied career who reap the greatest benefit of her work.

What’s on your reading list?

“PubMed. It is a great search engine that gives me current research on new massage therapy studies. The literature increases abut 100 percent each year, so it’s hard to be current.”

What are some of your hobbies?

“My life is a hobby.”

Why are you researching yoga?

“I think it is a form of self-massage. That’s why I do yoga every day. I knew that massage helped children with juvenile rheumatoid arthritis, which we had studied, and I learned that yoga has very similar effects as massage therapy when we compared the two.”

Why are you in the Guinness Book of World Records?

“Johnson & Johnson just sponsored a teaching tour that resulted in the record for teaching infant massage to 400 midwives all in the same room, earning the designation as the World’s Largest Infant Massage Lesson. They used dolls for the class.”

Support for Touch Research Institute

For more information about how you can help the Touch Research Institute, visit www6.miami.edu/touch-research/Donate.html.

Notes

1. T. Field, “Why the Touch-Deprived Can’t Wait for Portland’s Cuddle Shop,” The Guardian, November 28, 2014, accessed July 2018, www.theguardian.com/commentisfree/2014/nov/28/portland-cuddle-shop-touch-deprived-depression-health.
2. T. Field et al., “Tactile/Kinesthetic Stimulation Effects on Preterm Neonates,” Pediatrics 77 (1986): 654–58.
3. The Golden Goose Award, “History,” accessed July 2018, www.goldengooseaward.org/history.
4. The Golden Goose Award, “Awardees,” accessed July 2018, www.goldengooseaward.org/awardees/rat-and-infant-massage.