Therapeutic Bodywork for Survivors of Trauma and Sexual Abuse
Treatment for survivors of trauma and childhood physical and sexual abuse is a highly specialized field, in part because of the complexity of issues involved in both the original trauma and in the psychological and physical symptoms that can emerge in the aftermath. Resolution of the trauma is never final; recovery is never complete. The impact of a traumatic event continues to reverberate throughout the survivor’s lifecycle. With each new life event comes the potential of a stress-induced return of traumatic memories.
Psychotherapy has been and continues to be the first-line order of treatment for survivors and is essential in working through deep-seated impairments in trust, relationships, body image and self-perception. For many, the adaptations they created to cope with the abuse will later emerge as maladaptive barriers to healthy functioning in adult life. While verbal therapy is critical to retrieval and integration of the fragmented mind, there is another aspect to recovery that has more recently gained attention and validity: that of retrieving the body as well.
Recognition that the body holds the scars of trauma has led to increasing use of bodywork as a valid treatment for survivors. In addition to traditional massage, some therapists have developed specialized modalities. Other somatic therapies integrating aspects of body awareness and emotional release as part of a body/mind approach are also helpful. Since the body was integral to the trauma, it must be integrated into the healing process.
Quite commonly, the traumatized person resorts to defensive coping mechanisms, dissociation, that can carry into adult life. With any future stress can come a tendency to escape through dissociation and a separation from awareness of the body’s experience. While dissociation may temporarily serve an adaptive function, in the long term, lack of integration of traumatic memories seems to be the critical element that leads to the development of the complex behavioural change that we call Post Traumatic Stress Disorder.
The effects of abuse on regulation of bodily and emotional states are well documented. Chronic hyperarousal and attempts to adapt can lead to disturbances with sleep and digestion, eating disorders, and other forms of body distress. Survivors are prone to experience depression and anxiety, and in some cases resort to self-mutilation to block out emotional pain. As the child grows up the fragmentation of self, both in body and mind, increases fragility as the adult tries to navigate life with maladaptive defences. What occurs is a gradual breakdown of defences, surfacing as problems in maintaining relationships, jobs; alcohol and substance abuse, or even suicidal thoughts.
As the body was integral to the trauma, it is also integral to the healing process. In the past, psychotherapy was a stand-alone treatment, and it remains a necessary element for processing and reframing the psychological effects of abuse. But with the growing understanding of body/mind connection, there has been increased interest and practice of providing bodywork to facilitate wholeness. For some clients, after years of verbal therapy, there comes a time when they need and want to reclaim the body.
It is important to note that not all survivors are appropriate candidates for this approach. Several factors can influence suitability, including ego strength, the readiness to embrace change, level of dissociation, potential for psychosis, and a desire to explore this option for resolution at a deeper body level.
As a backlash to abuse, aversion to touch leaves some victims touch-deprived. The experience of touch is an other important benefit of bodywork. It involves learning that touch can be pleasurable and positive experience. Even for those in a relationship, may have difficulties with intimacy, receiving touch and feeling comfortable sexually.
The therapist will find the appropriate touch for each individual client. Asking for constant feedback, clients can assume ownership of their body within this safe environment and determine their boundaries. What pressure to use and when to touch, when hold you, when to stop and do absolutely nothing. Bodyworkers engaged in this type of therapy will have a good understanding of the psychological dynamics involved and there is a moral, ethical, and legal obligation to keep the client safe. It’s the immediacy of touch, the caring and nurturing it conveys, that makes it highly therapeutic and there are “miraculous” examples of survivors who had been shut down in their body and after bodywork, were able to regain that connection.
A male therapist?
When there is a history of emotional, physical or sexual abuse, the lack of trust is often coupled with a general fear of men. In therapeutic massage the empathic witnessing by a male therapist is in itself a reparative relationship, and can provide the quality of touch and presence that can restore health in mind and body. The quality of this presence will also create safety and in this safe space healing can happen. Thus the very source of the wounding can also be a powerful source of healing and growth.