Issue link: https://www.massageandbodyworkdigital.com/i/1464088
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 71 challenges can overwhelm our normal resilience and equilibrium. Our clients have always come to us to find some respite from the "outside world," but at this moment, the oasis of peace and safety that massage therapists can offer seems more important than ever. To do this well means we must be conscientious about nurturing some skills that are likely to come naturally to us—many of the habits and attitudes that make excellent massage therapists are highly valued in the context of trauma-informed care. My hope is that we can hone these skills with purpose and intention, rather than just hoping for the best. Our clients need us to be good at this—now, more than ever. TRAUMA VOCABULARY The definitions of trauma and related terms are open to wide interpretation, since "trauma" can refer to anything from a grazed knuckle to surviving torture. A manual titled Treatment Improvement Protocols: Trauma-Informed Care in Behavioral Health Services is produced by the Substance Abuse and Mental Health Services Administration (SA MHSA), and it serves as a reference point for many clinicians working with traumatized populations. The SA MHSA document states, "Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual's functioning and physical, social, emotional, or spiritual well-being . . . traumas can affect individuals, families, groups, communities, specific cultures, and generations. It generally overwhelms an individual's or community's resources to cope, and it often ignites the 'fight, flight, or freeze' reaction at the time of the event(s). It frequently produces a sense of fear, vulnerability, and helplessness." 1 Clinicians who specialize in helping people injured by trauma make an important distinction: The event—whether it was being that target by violence, a natural TAKEAWAY: Trauma- informed care is a collaborative approach to health care that focuses on helping clients safely reconnect with themselves and their physical experiences in ways that may be more effective than seen with other kinds of approaches to care. disaster, or long-term abuse and neglect—is just the event. Resulting dysfunction depends on how the person is impacted by and responds to the event. In other words, it is the reoccurrence that creates the traumatization and all its consequences, not the event itself. In this way, two people may go through the same threatening incident but develop very different severities of ongoing dysfunction, depending on how each of them processes their experience. THE PHYSIOLOGIC CONSEQUENCES OF TRAUMA When a person's reactions to a traumatizing experience become ingrained, the autonomic nervous system may become locked into sympathetic flight/fight/freeze reactions. A person who lives with the aftermath of trauma is consciously or unconsciously hypervigilant: constantly scanning the environment for possible dangers. This is exhausting—mentally, emotionally, and physically. It may also lead people to filter out important information about their own physical experience. And it has negative repercussions on long-term health. "Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become an expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves." 2 Signs and symptoms of trauma can look a lot like posttraumatic stress disorder (PTSD), with hypervigilance, troubling flashbacks, problems sleeping, and other specifically stress-related challenges. Or symptoms can be vague, unpredictable, and hard to pin down. Headaches, gastrointestinal pain, and muscle aches may be related to ongoing trauma reactions. Of course, these not-quite-sick-but-not-quite-well signs and symptoms are familiar to many massage therapists, because people who live in this limbo often struggle to find helpful answers within conventional medical options, so they turn to massage therapy for relief. People who have been traumatized are vulnerable to many disorders and diseases related to long-term stress. Cardiovascular disease, autoimmune diseases, sleep and mood disorders, and even certain types of cancer are more likely to occur in people injured by trauma than in people whose challenges have been less severe or whose support systems have allowed them to deal with trauma more successfully. Further, traumatized people are often