What is PTSD?
According to the Diagnostic
and Statistical Manual of Mental Disorders, the American Psychiatric Association (APA) considers PTSD an anxiety disorder
developed after being exposed to, either by direct experience or witnessing, an extreme or overwhelming traumatic event where
they felt intense fear, helplessness or horror.
In our anatomy and physiology classes we learn that our nervous systems usually react to threatening situations with a “flight or fight
reaction.” But researchers studying PTSD found some people react with a kind of “freeze” reaction instead,
feeling helpless and hopeless during the trauma. Unable to either defend themselves or run away they, in effect, play dead,
becoming numb to the experience. Though the memories of these experiences fade from everyday thoughts, they remain hidden
in the nervous system and muscles where they become deeply imbedded.
Sometime after the initial experience, either
almost immediately or in some cases much later, the person shows signs of PTSD, including hyper-vigilance, avoidant behavior
and intrusive thoughts. These affect their everyday lives and those of their families, friends and co-workers. They may become
depressed for prolonged periods, abuse drugs or alcohol, have obsessive/compulsive behaviors, anxiety attacks, flashbacks
or simply withdraw from normal activities.
Bodywork and PTSD
People
want massage for a variety of reasons, but you will not usually hear “I want massage for PTSD.” They may not even
be aware of it and instead come for a variety of other reasons such as stress, anxiety, having chronic pain or simply someone
gave them a gift certificate.
You then proceed with a full-body Swedish
massage, only to find they don’t relax into it, but remain tense and alert, or completely dissociate from the experience.
They may cry or have some other unexpected reaction. Even a thorough intake may not alert you that this person experienced a traumatic event that wounded not only their mind and spirit, but
their body as well.
Even if the event doesn’t directly
involve the body, it remembers, on a visceral level, what the mind experienced. In working with the body, we can help heal
those wounds. Working in conjunction with physicians and psychiatric professionals specializing in PTSD, massage therapists
can help them be comfortable in their body, to learn to relax and be in the present moment.
A Treatment Plan
If
PTSD has been diagnosed, you can develop a plan of treatment that slowly introduces non-intrusive bodywork and leaves them
feeling less vulnerable
Chair massage is an easy way to establish trust
between the massage therapist and the PTSD client with the person clothed, and sitting, not lying down. A chair massage can
be as complete and relaxing a massage as one on the massage table. Initial sessions might be 15 minutes and over a period
of time increase to 30 or 45 minutes.
Later you might introduce Shiatsu, bringing the bodywork from a sitting position, to one of lying on the floor, still fully clothed. Encourage the
client to wear something loose and comfortable, such as a sweat suit or yoga attire to allow for stretches during the session.
Your sessions may never go beyond this phase,
or might graduate into work done on the massage table such as cranial sacral work or polarity therapy, both of which can be done while the client is clothed. These techniques are non-intrusive and help re-harmonize
the energies and rhythms of the person’s body. They may also help reinforce work done with other medical professionals.
Lifelong Recovery
Massage
therapy doesn’t cure PTSD. Nothing cures it completely; sufferers merely learn how to live with it. But studies show
that massage does improve associated symptoms such as chronic pain, immune system deficiencies and stress. PTSD sufferers
have also been found to have elevated levels of cortisol, which leads to cognitive impairment, poor glucose management and
lowered immune response, as well as interruption of homeostasis. Massage helps reduce cortisol blood levels, according to
studies by the Touch Research Institute, and so lessens the damaging effects.
PTSD is not new, only newly defined and
reexamined. It has been around, using different terms, for a very long time. It is a disorder with no hard and fast rules.
For many it is a lifelong problem. Compassion, understanding and patience are a massage therapist’s most valuable tools
in helping to assist the healing of their internal wounds.
