Touch, temperature, and relief: a multilevel integrative model of hedonic regulation in massage and thermal therapies

Touch, massage, and thermal practices are widely used to promote relaxation, pain relief, and bodily restoration. Yet the mechanisms that make these practices feel pleasurable or restorative are usually explained in separate literatures, including somatosensory neuroscience, pain modulation, autonomic physiology, psychoneuroendocrinology, placebo research, and social psychology. This article proposes the Multilevel Integrative Model of Hedonic Regulation (MIHR) as a conceptual framework for linking these domains. The model synthesizes established findings on tactile and thermal signaling, descending modulation, reward and stress systems, and contextual meaning, while adding a testable account of how pleasure and relief arise when sensory input, bodily state, regulation, and context become aligned for the recipient. The same pressure, stroking velocity, warmth, or cold may feel soothing, neutral, intrusive, or aversive depending on expectation, perceived control, interpersonal trust, cultural familiarity, prior experience, and current bodily state. Relief is central to this account. In massage, sauna, bathing, and contrast exposure, positive affect often comes not only from pleasant stimulation itself, but from the easing of tension, pain, cold, heat, or bodily unease. The MIHR is presented as a testable framework rather than a validated mechanism. Future studies should manipulate sensory and contextual variables together, distinguish anticipation, stimulation, offset, and recovery phases, and combine subjective reports with autonomic, endocrine, and neurobiological measures. The model also separates immediate hedonic pleasure from broader eudaimonic wellbeing, which may emerge when repeated practices support recovery, agency, social connection, and a more secure relation to the body.