In this blog post (part 5 of a series) we will look at trauma massage warnings.
Please go to part 1 of this series on reclaiming healthy touch to read from the beginning.
This blog post is part of the term paper I wrote in July 2003.
Reclaiming Healthy Touch Series
Trauma Massage Warnings – Part 5
Boundaries are the single most important thing that should be considered when working with trauma survivors and specifically with survivors of domestic violence or child abuse. Permission to touch the trauma survivor should never be assumed and should always be given before touching a survivor. Touch in survivors of abuse can reenact the abuse and so the utmost care should be taken to lay the foundation of trust and safety with the individual.
Since emotional memories are not just stored in the areas related to the abuse or trauma, any area of the body can bring up these things. Even though there is an area of the body that might seem safe to a body worker, you should never assume that this is safe for the individual.
Touching Sensitive Body Areas
It is also important to avoid touching sensitive areas. When it is necessary to touch an individual in these areas, a body worker may incorporate different ways of doing this. You could have the individual touch the area and relay back what they sense, or you could have your hand on top of their hand with the individual knowing that they can push your hand off of them at any point.
Again, you should always do everything possible to keep a client safe. You should never infringe on their boundaries unless they specifically say it is okay. At the same time, a body worker needs to be very aware of the feelings they experience while touching the client. A body worker may feel the anger and horror at what has happened to the individual.
However, projecting those thoughts on to the client runs the risk of transmitting the feelings to the survivor. A body worker can be compassionate, but they need to separate their feelings about the trauma from the work they are doing in order to be effective and not harm the client further.
Building Safety And Trust
One way to build trust and safety with the client is by employing the STOP exercise that Jean Schuna talks about in her article, “Massage and Bodywork with Survivors of Torture”.
One of the most powerful exercises that I do is the “stop” exercise, which is as follows: Before the client ever enters the treatment room, they decide on a word or gesture to use to tell me to stop touching their body. This could be the word “No” or “Stop” or a raising of the fingers of the other hand. I sit next to the client and place my hand on their arm.
When the client is ready they say the word or give the signal. This simple exercise often brings about nervousness, tears, and a great sense of release once it has been practiced enough times to begin feeling somewhat comfortable. Some clients begin to revel in the feeling of control and want to practice it several times with increasing glee in saying “No”. This may be done during just the first visit, or reinforced at subsequent visits if needed. 8
Are You A Licensed Counselor?
Working with a psychotherapist or counselor is very important when dealing with the things that arise out of bodywork sessions with a trauma survivor. A massage therapist is not licensed to be a psychotherapist or counselor and should never try to fill that role without the proper training. However, sharing insight with the client and the therapist will help to bring greater healing from the traumatic events. For a client to understand or hear the connection between what the body worker experienced and what the client actually felt will go a long way toward healing.
Is A Client Ready For Trauma Massage?
Another thing to be aware of in working with trauma or child abuse survivors is where they are at in their emotional healing from these events. If they are at a volatile place in their emotional healing, you may want to get clearance from a psychotherapist before you proceed in bodywork with the individual. Too much of the right thing at the wrong time could not only be ineffective but it could also be harmful to the individual and slow their healing as well. Just take into consideration where they are and make sure that they have adequate means of support from friends, family, and a professional therapist.
One thing you may notice while working on a client is that they become very quiet when maybe they had been talking before, or they become very distant. Another way to describe it would be that they were far from their body or not connected to their body, as if their body shut down. You may see this as non-responsive, or if you ask them how the pressure is or maybe even if you ask them to focus their awareness on a certain body area, they would struggle to even reply or to give any type of coherent, logical, and real information back to you. In those times, you have to trust what you feel and what you sense.
You may want to change what you are doing or see if you can gently inquire as to what they are experiencing. If the client does not know you well, they may be very apprehensive in sharing this information with you, so remind them to always talk with their counselor or psychologist about their experiences in the massage.
One final thing to keep in mind when working with trauma survivors is the emotional release. An emotional release is any type of bodywork or activity that frees up energy or emotions which are blocked, in order to bring a new awareness to the individual. The expressions may range anywhere from something as simple as a sigh to crying, trembling, shaking, or screaming.
These things should never be suppressed nor should they be influenced. Stay with the person and be there for them, or let them be somewhat by themselves if they need to and let everything play out to completion. When the emotional release is over, the individual may feel much more relieved.
If you feel things may be going too far, you might try to help bring a person back to the present by asking them questions about their current awareness of their body. However, if you can stay with a person and let the emotional release complete, it will be a much more healing time for the individual.
Part 6: Trauma And Massage
- National Domestic Violence Hotline – National Statistics.
- Beyond Surviving -A Safety Program toward a movement to prevent child sexual abuse © MS Foundation for Women, Gillian Murphy. Pg 3.
- Answers to Your Most Frequently Asked Questions about PTSD – www.4therapy.com (this website appears to no longer be in service).
- Compassionate Touch (Pg 34) Dr. Clyde W. Ford North Atlantic Books © 1993, 1999.
- Compassionate Touch (Pg 11) Dr. Clyde W. Ford North Atlantic Books © 1993, 1999.
- Compassionate Touch (Pg 22) Dr. Clyde W. Ford North Atlantic Books © 1993, 1999.
- Compassionate Touch (Pg 18) Dr. Clyde W. Ford North Atlantic Books © 1993, 1999.
- University Of Washington Medical School (Webpage) Jean Schuna, MIT, LMP Massage and Bodywork with Survivors of Torture.
- The Hakomi Institute (Webpage) – www.hakomiinstitute.com
- Compassionate Touch (Pg 43) Dr. Clyde W. Ford North Atlantic Books © 1993, 1999
- Touch Research Institute University of Miami School of Medicine, Miami, FL., Dr. Tiffany Field, Ph.D. Study: Effects of sexual abuse are lessened by massage therapy