Massage provided by trained and experienced practitioners can have positive effects for sexual abuse survivors. Could your clients be among them?

When story after story about film producer Harvey Weinstein’s sexually abusive behavior began to be reported, it opened a floodgate of similar accusations against powerful men, ranging from politicians to actors to reporters and more.

The #MeToo movement has gained momentum quickly, and media of all types has been filled with articles and newscasts about the latest men to face accusations that might include inappropriate touch or talk, or even rape.

Mental health professionals who spoke with MASSAGE Magazine say that while this news saturation could bolster the confidence of some sexual abuse survivors—because they feel they are not alone—it can also reactivate trauma in some survivors, or at least re-stimulate negative memories and thought patterns.

Massage for Sexual Abuse Survivors

Massage provided by trained and experienced practitioners can have positive effects for sexual abuse survivors.

One study, for example, “Body-oriented therapy in recovery from child sexual abuse: an efficacy study,” found that massage supported psychological and physical well-being and body connection. Many massage educators specialize in training massage therapists how to work safely and effectively with sexual abuse survivors.
Los Angeles, California-based psychologist Nancy Irwin, PsyD., C.HT., who specializes in sexual abuse prevention and recovery, said many sexual abuse survivors actually feel empowered when they hear or read about revelations of sexual abuse in the news.

“Many begin to feel their shame and guilt, and self-blame decreases when they see the overwhelming number of victims, allowing them to feel they are not alone,” Irwin explained.

“That being said,” she added, “those who are triggered or re-traumatized more than likely are just beginning on the path of processing this issue.”

According to psychiatrist Gabriella I. Farkas M.D. Ph.D., when the news media increasingly shares survivors’ stories of sexual abuse, it can cause survivors to relive traumatic memories.

“The increased concern of re-traumatization would be better characterized as a post-traumatic stress condition,” Farkas said. “I don’t say disorder because victims may not necessarily meet the conditions for the disorder, but they may experience a varying number of symptoms.”

Those who have experienced trauma actively try to avoid any thoughts, feelings, symbols, representations, words, and images that remind them of their suffering, she added.

“Day to day, week to week, month to month, their main goal is forgetting, or at the very least moving on with life,” Farkas said. “Many experts assert that one month without symptoms of trauma is the essential first step to moving on—but with consistently new reports, any victims watching the news can struggle to escape reminders.”

News reports on TV and the radio, in newspapers and on social media can all reactivate some of the most common symptoms of post-abuse trauma, said Farkas, including nightmares, dissociative flashbacks, extreme distress and negative emotions.

“The more frequent these reports, the more persistent and pervasive the negative thoughts become,” she said. “The person may come to believe that while they are not alone in their suffering, the number of cases is growing and inescapable.

“Furthermore, they may disengage from reality and lose interest in activities as they immerse themselves in the whirlwind of news,” she added, “either hoping to feel camaraderie, or sinking into depression.”

The article below by Suzanne Scurlock-Durana, C.M.T., C.S.T.-D., will help you understand how massage therapy supports survivors of sexual abuse—and if you might want to specialize in working with this clientele.

MASSAGE editorial staff

Massage’s Important Role in Assisting Survivors of Sexual Abuse

My client, Martha (not her real name), arrived for her first appointment with me and let me know right away she has begun to recover memories of sexual abuse in psychotherapy and she wanted to augment that work by addressing the body component.

When a client makes this kind of declaration, we cannot be thrown off-guard. Martha is part of a growing population of people likely to seek you out as a massage therapist in order to release traumatic body memories and recover the capacity to receive nurturing touch.

The statistics are grim: According to The National Center for Victims of Crime, 1 in 5 girls and one in 20 boys is a victim if child sexual abuse. Further, each year in the U.S. 321,500 Americans ages 12 older are sexually assaulted or raped, according to the Rape, Abuse and Incest National Network. Forty-four percent of those people assaulted are under the age of 18. Eighty percent are under the age of 30.

Many of these assaulted people seek out massage and bodywork years after the fact, still hampered by the fear and trauma frozen in their bodies.

So the chances are someone will come through your office door wanting you to help him or her heal from this kind of trauma.

Are you prepared to help?

In my 30 years of working with this population, I have found three areas that are particularly important: Listening with compassionate neutrality, being fully present and utilizing noninvasive touch.

1. Listen with compassionate neutrality.

When someone has experienced the depth of trauma that occurs in sexual assault, to be heard is a fundamental need in order for healing to begin.

It is not our job to ascertain when the story needs to be told, or how it comes out—but if it does emerge in the course of a session, our job is to listen and bring compassion and nonjudgment to our witness role. This can be more difficult than it seems.

The following is a lesson I learned with my very first client who was a sexual trauma survivor. Intuitively, I did the basics quite well with her, but here is how I went astray in the process of witnessing her story, and how you can avoid making the same mistake.

Her father sexually molested this woman repeatedly when she was a child.

When her story came out in session, haltingly, with huge waves of accompanying emotion, I found myself feeling outraged for that small, unprotected child part of her. I wanted to let her know she did not deserve it and he was a monster to have done such a thing. (All of which was true, but not helpful in that situation.)

My outrage caused her to feel even more stirred up and she then had even more difficulty staying present with her healing process, to the point of dissociating at times.

While I did not cause her dissociation, my agitated, righteous presence contributed to it happening more frequently, I am sure.

The lesson here is when we bring our own emotional responses into the treatment room, they can often derail the client’s process. I had fallen into the trap of losing my neutrality, my perspective on the whole process. I was not able to be a neutral compassionate witness because I was so outraged by what had happened to her.

What I did well with her was to be a compassionate, loving presence in all other moments of our sessions—so she stayed with me as a client and eventually I realized I needed to contain my own emotional responses.

But looking back, I could have been a lot more effective from the beginning if I had listened and held a neutral witnessing stance, rather than an outraged, judgmental one.

What did I do with my outrage? I did a lot of research, until I became knowledgeable about the fact that abuse and violence are always part of a cycle, and the perpetrators of sexual assault have most often been violated and preyed upon themselves.

This does not excuse their behavior, but it helped me soften my righteousness, judgmental attitude about the abusers and the abuse.

2. Be fully present

The next area that is vital to successfully facilitating someone’s healing process is learning the steps to being fully present as a therapist. This means knowing how to feel steady within yourself and how to convey this steadiness energetically to the client, usually without words, so he feels calmer and safer in your presence.

This is especially important for sexual abuse survivors, who generally feel unsafe and locked in the fight-flight-freeze response most of the time, unconsciously—if not consciously.

They also need to have you model healthy connection and healthy boundaries in order to remember or learn how to do that for themselves. Sexual trauma is a deep boundary violation, and often the healing process has to do with re-establishing what healthy connection and healthy boundaries look and feel like.

This can be easily practiced in a number of ways while in the treatment process.

To be fully present, there are two measures I look at: grounding and healthy boundaries.

Grounding, by my definition, is the skill of being able to connect through your feeling senses—in a visceral way—to the earth under you or any other healthy energy resource.

As hands-on practitioners, when we have healthy energy habits such as grounding, it enables us to keep our inner energy reservoir fuller, which in turn leads to a steadier, calmer presence and more ease in everything we do.

For trauma-surviving clients, this steadiness is key. They are looking for someone who feels safe, and a centered, grounded practitioner radiates that message with her presence.

Another client, George (not his real name), came to see me after starting to recover memories of sexual molestation by his parish priest when he was 5 years old. He was appalled, but the memories explained a lot of his self-protective behaviors that he had never fully understood.

When he arrived in my office, the first thing he told me was he had tried to work with another touch therapist, but the therapist had not had the steadiness to hold his experience and she had felt ungrounded to him throughout the session. George simply did not feel the necessary safety net he needed to explore this very vulnerable process.

Given this opening, I simply sat with him before he got on the table and had him check out whether I felt safe to him. I grounded deeper in that moment and let him sense whether he felt like he could work with me. Then I made sure I stayed really grounded throughout the time we worked together.

Once during that first session, when he was approaching a moment that felt really scary, he asked me to “beef up” my presence, which I easily did by re-grounding in that moment and offering my presence in an even fuller manner.

In another moment he asked me to soften my presence, that it felt too intense. I was easily able to do this as well, without taking any of it personally or being thrown off center by his requests.

Trauma survivors often have very sensitive nervous systems that need to be listened to and honored. Being deeply grounded and present allows you the resilience and breadth to be able to make the adjustments needed to allow their healing process to unfold.

The other aspect of presence is having healthy boundaries and healthy connections in the treatment room.

This begins by honoring time boundaries. Start and end on time. Sexual-abuse survivors’ stories can often warrant a sense of needing more time because of the immensity of the trauma.

In fact, these clients often need you, the therapist, to help them titrate, or break down the process into chunks they can handle and integrate, not to dive in for longer periods and then end up feeling overwhelmed.

During massage sessions, check in with the client if you notice a sense of anxiousness in the room, or a sense of her disconnecting. Name what you are noticing without making it about them.

Such as, “I am noticing a sense of feeling more distant from you than I did a few moments ago. Do you need me to slow down or lighten up?”

This opens a discussion up and says to them, “How you are receiving my touch counts—it matters how you are feeling moment to moment, and you are in control of what you are receiving.”

This may be the first time these clients have ever been told that, particularly if they are survivors of repeated or early abuse. In any case, this attitude on your part, as well as verbalizing it in a clear, nonjudgmental way, puts them back in the driver’s seat of how they are touched.

This allows them to eventually explore what they do like in terms of nurturing touch. You are helping them re-establish healthy boundaries and discern healthy connections.

In a healthy connection they may feel warmth, nurturing, pleasure and relaxation. They also get to orchestrate how touch is given and received.

When someone has healthy boundaries, they can tell the therapist his touch needs to be lighter, softer or perhaps firmer in order for it to feel nourishing and nurturing.

3. Utilize noninvasive touch.

This key to what creates successful sessions with this population is vital because the ability to make a physical connection the client perceives as noninvasive, safe and nurturing is the centerpiece of what sets apart the work we do from non-hands-on therapies.

Remember, you are touching your client with your presence long before you ever come to the table. So notice how he is receiving that, even as you come into physical connection with him, with your hands.

Depth vs. lightness of pressure is not an indicator of invasive vs. noninvasiveness. I have had deep-tissue work that was noninvasive because the practitioner took the time to meet the tissue and let it open up under his hands when it was ready.

I have also had light touch that felt invasive because the practitioner had an agenda that was putting pressure on me that felt uncomfortable.

Honor Boundaries

Set your intention to really listen to and honor the touch boundaries of your clients in a deeper way. This enables you effect healing in this population of people who need it so much.

The extra effort and practice it takes to successfully assist these clients is worth it. It can be a rewarding and deeply satisfying experience to watch a client come back into her body fully, and regain or learn to receive nurturing touch as an outcome of your work together.

About the Author

Suzanne Scurlock-Durana, C.M.T., C.S.T.-D., is the author of Reclaiming Your Body and Full Body Presence. Her Healing from the Core curriculum. combined with CranioSacral Therapy and other bodywork modalities creates a complete, body-centered guide to awareness, healing and joy. . She teaches around the world and lives in Reston, Virginia. Scurlock-Durana is a frequent contributor to MASSAGE Magazine She most recently wrote “If You Don’t Listen to Your Body, Who Will?” for the December 2017 issue, and a series on listening to one’s heart for massagemag.com.

 

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