TREATMENT APPROACHES
Manual therapy approaches Why does rehabilitation, specifically manual therapy, help people experiencing PTSD? Massage and physical therapeutic touch appear able to address long-term side effects of the sympathetic nervous system response, with patients showing decreased levels of stress hormones such as cortisol or norepinephrine. These therapies can also increase the parasympathetic response by increasing levels of relaxation hormones such as oxytocin. Therapeutic massage and exercise help release endorphins and boost serotonin that can help depression (Gasibat & Suwehli, 2017). In some cases, clients with PTSD cannot initially say whether touch, stretching, adjustments, or massage pressures feel good, bad, or painful. Gradually, over several treatments, clients learn to feel touch again and are able to interpret it as positive or painful. As therapists, it’s important to be understanding and patient with this population. Be aware of any suicidal thoughts the client may share with you, and be sure to help them refer to a psychotherapist and assure them they are in a safe space in your treatment room. Understand that sounds, smells, and touch can trigger PTSD symptoms, so it is important that you always give your client the option to disrobe to their level of comfortability, and only use aromatherapy and essential oils or scented lotions with explicit consent from the client. Keeping music neutral and without lyrics can also be a good way to create a safe and calm for your client (McCafferty, 2016). A recent meta-analysis showed that engaging in exercise led to decreased severity of PTSD symptoms. This effect was particularly pronounced when participants engaged in a higher volume of exercise, exceeding 20 hours, suggesting that there may be increasing benefits with greater exercise involvement, up to a certain threshold. Additionally, exercise demonstrated significant positive effects on depressive symptoms, sleep quality, decreased substance abuse, and enhanced overall quality of life (Björkman & Ekblom, 2022). A comprehensive review done by McGreevy and Boland (2022) explored touch-based interventions implemented in the treatment of adults experiencing PTSD symptoms. Evidence suggests that such interventions can significantly contribute to emotional regulation and symptom reduction in PTSD. The results of this review showed promise for use of therapeutic touch to treat patients with PTSD. If we apply Somatic therapies and PTSD Trauma has been shown to register in bodies on a cellular level. Elevated levels of cortisol are constant triggers to the amygdala in the brain to keep the body in constant “fight or flight” mode. These prolonged elevated levels and chemical imbalances result in physical symptoms in the body. Headaches, neck, jaw, back pain, dizziness, heart palpitations, sweaty hands, and panic attacks all manifest from stress-induced anxiety. Somatic therapy is a developing practice that works with the physical responses of the body to stress by “releasing” stored trauma in our cells. Fascial tissue has been shown to be the primary tissue where these triggers are stored. A somatic therapist may use interventions such as acupressure, dance, tapping, myofascial release, hypnosis, and verbal guided meditations to help the client develop awareness of where in the body particular traumas are being stored and release them. Somatic therapy can work on both psychological and physiological levels, combining both to be able to treat the trauma of the client (Salamon, 2023).
this study to our work as therapists, we can derive that our help with integrating physical touch, exercises, stretches, and being part of an overall wellness plan for the patient is incredibly beneficial to those suffering from PTSD. Cynthia Price, Ph.D., a massage therapist and psychotherapist who specializes in women’s healthcare and counseling, developed a bodywork protocol for adult survivors of sexual abuse to implement in her efficacy study: Body-Oriented Therapy in Recovery from Child Sexual Abuse . Published in 2005, the study showed dissociation and lack of bodily self-awareness are common among women who are survivors of childhood sexual abuse, and that “body connection” was an important motivating reason for women with a history of abuse to seek bodywork. The manual therapist and psychotherapist devote themselves to helping the client experience touch without dissociation, remaining “connected” with their body through the experience. Findings suggest that body-oriented therapy and massage have positive effects on physical and psychological well-being for these clients. Another study published by Collinge and colleagues (2005) reported results for 25 participants (20 male and 5 female) with histories that included trauma. The subjects participated in a brief program of complementary therapy activity accompanying ongoing psychotherapy. Clients receiving psychotherapy participated in a series of sessions of one modality of complementary therapy, including therapeutic massage, acupuncture, Reiki, and therapeutic touch. At its completion, participants were asked to answer questions regarding their satisfaction and perceived changes in four dimensions of trauma recovery: perceived interpersonal safety, interpersonal boundary setting, bodily sensation, and bodily shame. Clients reported high levels of satisfaction with the service and significant levels of perceived (self-rated) change on each outcome measure, as well as enhanced psychotherapeutic outcomes reported by mental health clinicians. The study concluded that the integration of complementary therapies into mental health practice has the potential to enhance mental health outcomes and improve quality of life for long-term users of mental health services. During the 1990s, a number of new modalities related to bodywork for the treatment of PTSD emerged. Three of these methods are Pat Ogden’s Hakomi integrative somatics, Peter Levine’s somatic experiencing, and Chris Smith’s trauma touch therapy. These modalities share the goal of integrated body awareness through a collaboration of manual therapist and psychotherapists. Four main types of psychotherapy have proven especially effective in treating PTSD: ● Anxiety management : Involving relaxation training, breathing retraining, positive thinking and self-talk, and assertiveness training. ● Cognitive therapy : Helping to change irrational or unrealistic beliefs associated with trauma. ● Exposure therapy : Helping you confront situations, people, or emotions which evoke trauma, for instance, asking a police officer for directions. Your fear will gradually begin to dissipate if you force yourself to remain in the situation rather than trying to escape it. ● Group therapy : Self-help groups can be very useful, especially if people who have been through similar traumatic experiences.
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Book Code: MLA1225
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