Conversation – an approach to trauma-informed touch therapy

Touch is a wonderful tool and in the case of complex health and trauma, can be incredibly restorative.

Rather than approach touch from any one modality, I like to approach touch from a conceptual perspective. When we look at touch as a conversation, it changes the way that we approach the body and progress through a session. Here are some simple guidelines for navigating the touch conversation with your client

1. Deciding on a ‘topic’ of conversation

Before a touch therapy session commences, it is very important to agree with the client, on a topic for the ‘conversation’ and provide parameters for the experience.

Seeing as touch is non-verbal and can delve into much of our unarticulated or suppressed right brain experience, there can be some fear around both giving it and receiving it… because we don’t really know what will happen!

When we take time to decide on the topic of conversation and set intention for a touch session, this can alleviate the fear of the unknown. It provides the therapist with a clear intention. It provides the client with a road map for what to expect. In a way, therapist and client are on the same page, and start from a place of agreement and resonance. (In the context of relational trauma, this in itself can be very healing, because with all relational trauma there is some form of dissonance in relationship).

Example:

Today, I am going to create an experience of ‘support’, so all you need to do is feel into the support and follow your experience.

Here, the topic of the touch conversation is support.

2. Permission and context (for the client)

There is a lot of scope during a touch therapy session to experience either greater states of relation, or greater states of activation and expression than would be ‘normal’ during day to day life. For some clients, permission and context are required.

If you can imagine a very stressed, hyper-vigilant or unexpressed person, is very used to their particular way of being. So to relax, un-tense muscles, relax the jaw, lengthen the breath, twitch or cry would not even be a consideration – either consciously or unconsciously.

It can be helpful to explain what the client may expect during the session. Letting the client know that all of these experiences are ‘normal’ and welcome can also go a long way.

Example:

‘Sometimes, when we connect to support, there can be an experience of relief, there can be breathing changes, there can be emotional release, twitching, full body unwinding, or you may go into a sleep-like experience. Any of these are just right and welcomed here.’

Here you are granting the client permission to explore their response to the touch session; rather than to unconsciously cling to their way of being in daily life or follow the pattern of previous therapeutic experiences.

3. Consent 

Consent is implied when someone opts in to a touch session. However, it may be helpful to seek two other kinds consent

a) Explicit verbal consent

By asking the client if its ok to touch, an increase in trust arises, which goes a long way to somatic resonance on the table. If you know that the client has a history of physical abuse or injury, this concept can be expanded on by asking about the relationship to touch and if there are any areas of on the body that are in pain, hyper-sensitive touch, or that they do not wish to be touched. This exploration deepens the client/practitioner relationship, increases trust and also gives you a map of what areas may be helpful to touch, and what areas may be helpful to avoid during the session.

b) Somatic Consent

When we engage in a touch session, we are having a non-verbal, somatic conversation with the client’s body – soma to soma. As such, it is important to seek and receive somatic consent. Rather than touch right away, approach the body slowly, pause and feel what the client’s body is telling you. There are three key states to look for 

(i) Brace – when the body braces as you approach touch, this means that somatic consent is NOT available. Sometimes you can wait patiently and this will transform. Sometimes, this will indicate it is best to start at a different position. Sometimes, a conversation is required to address the brace. Bracing is a form of resistance. Similar to many therapeutic models, addressing resistance can be a huge part of the therapy itself. When a client braces, the somatic message is ‘I don’t feel safe’. We want to know why that is, why there is a difference in somatic and verbal narrative and what the client needs to feel a little safer. So much can arise from addressing a brace in this way.

(ii) Neutral – when there is no change in the body as you approach it, this means there is not a clear ‘no’, but also there has not been a clear ‘yes’ to touch either. By waiting for the clear ‘yes’ to eventuate, you are providing an opportunity for somatic resonance to occur before the session begins which will accelerate the effect of the session, whatever the intention.

(iii) Resonance – There will be a palpable sense of softening and welcoming that indicates somatic resonance has occurred. As a practitioner, you may sense this in different ways in your own body. In terms of the client experience, you may notice relaxation of certain muscle groups, change in breath pattern or audible exhale, fluttering of eye-lids, or in some cases a show of emotion. This means that the client’s body is actively welcoming the touch session and further attunement.

It is important to note, that this assessment process can be completed at the beginning of the session, but it can also be integrated before every new touch hold. In this way, the entire session may offer deep attunement and total safety for the client. In the case of all trauma, but particularly developmental trauma, this is essential to accessing increased states of safety for suppressed content to emerge and process within a manageable level of activation.

4. Invitation

Every touch may be considered an invitation to the client. The invitation may be to relax into the support, it may be to draw attention to a particular area of the body, it may be to illicit movement, grounding, gentle release or integration. As a practitioner, we can set the intention to create conscious invitation with not just our hands, but our entire bodies. When we offer an invitation, we need to listen to the responses. As per points i), ii) & iii) under the section on somatic consent, there may be a brace, neutrality or resonance. As practitioners, we need to understand how each of these responses feel to touch and in our greater bodies so that we can respond accordingly. When brace is present, it means ‘back-off’. When neutrality is present it means ‘hang out and wait’. When resonance is present it means ‘I feel safe with you, keep guiding me here’. When we follow the principle of invitation, the touch session may become a beautiful harmonic dance.

Note: It can be helpful to use verbal invitation for clients that are new to touch or holding very deep bracing patterns. This can go a long way to somatization and re-integrating the mind-body split. In the case of many trauma clients, there may be a level of disassociation. For some, they have never truly felt their bodies and much of the emotional content stored there. By using your voice to gently guide the touch session, there can be an easier transition in to what may feel like unknown territory.

Example:

‘You may like to bring your attention and your breath to between my hands, knowing that they are supporting you.’

When I offer verbal invitation, I am drawing on indirect hypnotherapeutic language and phrasing, in order to suggest and invite, rather than commend and direct. This approach can be extremely helpful in allowing he client to be a position of empowered choice, which is very important in terms of trauma-recovery.

5. Self-Inquiry

As a touch practitioner, you will be trained to notice holding patterns in the body. Depending on your origins, you may be palpating at a physical lever or a more energetic/emotional level. When you sense holding patterns, it is important to bring awareness to them and allow the client to safely explore, rather decide what it is that they are holding and what to do about it. If there is a history as a bodyworker, there may be a desire to ‘release’ and ‘fix’ the ‘problem. In the case of trauma, this approach doesn’t work and may be re-traumatizing to the client if it is attached to a traumatic experience or suppressed emotional content. It is also incredibly disempowering to tell someone what is wrong with them or decide to take responsibility for their recovery and transformation process. In the case of all trauma, there is a level of disempowerment and the inability express, release and integrate certain experiences. So, we want to provide a space that offers the client to have an empowered experience of feeling, movement/expression, release and integration. Working with self-inquiry can be very helpful for this. If you sense something, ASK them, what they feel there? It may be that they don’t feel, or need some help to feel. It may be that is currently not safe for them to feel whatever is there. And this itself requires you to listen to their expression and act accordingly. Their response may come in explicit verbal form, via subtext or via somatic expression or avoidance. Learning how to deeply listen to all these cues will create the ideal environment for internal and relational safety, as well as an authentic empowered experience of feeling, expression, release and integration.

6. Integration

At the end of the ‘somatic conversation’, it is important to allow time to integrate the experience, both on a somatic level and on an integrated mind-body level. For many clients the experience can be deep and not easily put into words. Allowing some time on the table for integration is important. During this time, the nervous system can start to reorganize and settle. You may like to offer a hand under the sacrum or hold the feet during this time. You can also use your voice to strengthen the invitation to integrate. 

Example: ‘I am going to sit quietly and hold your feet, and you can just use this time to allow your experience to integrate, not needing to do anything at all.’

After the touch session, it can be helpful to come to a seated position and have a short verbal integration, that helps the client make sense of their experience and links up the right brain somatic narrative with the left brain, verbal narrative.

The process is fundamental to allowing changes to integrate beyond the therapy room and into real life.

In summary, when we approach trauma-informed touch as a very respectful conversation and adopt the position as an active listener and gentle guide, rather than a doer and a fixer there is potential for somatic resonance and internal and relational safety. It us under these conditions that recovery and transformation can occur. Ultimately, this is about safe relationship, which is often severely lacking in the case of trauma.

If you’re interested to learn more about trauma-informed touch therapy, drop me an email at natalia@illumahealth.org or join my mailing list.