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 Post-Traumatic Stress Disorder

(PTSD)

 

How massage can help the ten physical symptoms of PTSD

 

The French have an expression — ‘être bien dans sa peau’ — which literally translates as "to be well in one’s skin" meaning "to be at ease with oneself." If you suffer from post-traumatic stress disorder, you will know that you are no longer at ease. Aside from the flashbacks that torment your waking hours and the nightmares that haunt your sleep, there is an overriding sense that you are not yourself. It is bad enough that you feel disconnected from other people, but worse you feel detached from yourself. Not only is your mind playing tricks on you, but you can no longer trust your body because now it’s stiff when it used to be supple, it’s tired and weak when it used to be strong and a lot of the time you just can’t feel it at all.

 

Post-traumatic stress disorder is classified as a mental health diagnosis and the primary methods of treatment involve anti-psychotic and anti-depressant medication and talking therapies. Yet, despite its classification, PTSD is a prime example of the body and mind working as an integrated whole, where changes happen in tandem on a mental, physical and physiological level. In other words, PTSD exists in the mind and the body. This means that the current treatment models for PTSD, based as they are on an outdated separation between the functioning of the mind and body, overlook the physical symptoms of this disorder. Recovery from PTSD is not just about minimizing or eradicating the psychological symptoms, it’s also about feeling yourself again, which means feeling in charge of your body and being able to trust it again. This article will review the physical symptoms of PTSD and consider how touch therapy (massage), as a complement to medical and psychotherapeutic treatment, can help you regain your sense of self.

 

 

The Physical Symptoms of PTSD

 

There are ten physical symptoms commonly associated with PTSD so let’s look at each of them in turn and consider how regular massage can help to address them.

 

Insomnia

 

Insomnia is itself a symptom of the hypervigilance experienced with PTSD — it stands to reason that if you’re always on guard and you never switch off then you’re going to struggle to get to sleep and stay asleep. The physiological reason you are hypervigilant is that your sympathetic nervous system is in overdrive. The sympathetic nervous system is made up of the parts of your brain and body that kick in when you’re in danger and control whether you fight back, flee or play dead. Positive touch stimulates the parasympathetic nervous system — the parts of your body and brain that are activated when you are relaxed and experiencing something that gives you pleasure. The rhythmic stroking and kneading of the body that takes place during massage activates the parasympathetic nervous system and induces a feeling of sleepiness. This feeling normally starts a short while into a massage and is accompanied by a sense of well-being which should last for several hours after the massage has finished. In fact, it is not uncommon for a person to feel the effects of a massage for a few days afterwards so you can see how regular massage could really help someone with PTSD to overcome insomnia.

 

Exhaustion

 

Exhaustion as a symptom of PTSD is partly the knock-on effect of insomnia, but also a result of the body being stretched to its limits because it is always on alert. Massage deactivates the parts of the body and mind that are stimulated when under threat and effectively reverses the effects of hypervigilance. Instead of feeling wide awake and jittery you feel sleepy and calm; instead of working in overdrive your body moves into cruise control and eventually slows down into sleep. If this happens regularly it reminds the body that rest is possible and desirable so over a period of time you start to wake up feeling refreshed instead of exhausted.

 

Accelerated Heart Rate & High Blood Pressure (Hypertension)

 

In order to maintain the heightened state of readiness demanded by the sympathetic nervous system in a person with PTSD, the heart beats faster so it can quickly pump blood to where it is needed most — the larger muscles to get them ready for fight or flight. One of the factors in high blood pressure is an accelerated heart rate, which is why hypertension is commonly found in people with PTSD.

 

Massage effectively switches off the sympathetic nervous system and activates the parasympathetic so the heart slows down, breathing becomes deeper and a feeling of well-being spreads through the body. There have been several studies showing how regular massage can help to keep blood pressure at lower levels.

 

The hormone cortisol is known to be a factor in hypertension and is also evident in high levels in people with PTSD. Although it is not yet fully understood how cortisol contributes to either PTSD or high blood pressure, what is known is that cortisol levels drop following massage.

 

Muscle tension

 

Chronic muscle tension is caused when muscles contract and do not return to their natural state. Over time, the muscle fibers stick together reducing the blood flow to this area and causing pain. This is usually caused by repetitive patterns of movement and for a person with PTSD this could either be as a result of the muscles repeatedly tensing in readiness for fight or flight or as the body re-enacts movements it performed during the traumatic experience. Although severe or chronic muscle tension can occur anywhere in the body, it usually occurs in the neck, shoulders, back and legs. Muscles should have elasticity, but those in the grip of severe tension feel hard to the touch and are stiff and inflexible; often the tension is accompanied by a reduced range of movement, a hot burning sensation, but over time massage can help to reverse these effects.

 

Massage manipulates soft tissue by kneading, stretching, tapping, stroking and vibrating. When these techniques are applied directly to areas of muscle tension the muscle fibers soften, the blood flow to that area increases and range of movement is improved. Initially, there may be some discomfort as the muscles are being moved in ways that are not familiar, that do not necessarily feel natural because they have become so used to a different pattern of movement, but this passes and the muscles become supple and move more easily. Regular massage can help the body to forget the patterns of movement associated with the traumatic experience and over time PTSD sufferers can experience renewed flexibility, greater ease of movement and a reduction in pain levels.

 

Constipation

 

While some parts of the body are working at full tilt when affected by PTSD, others can almost shut down completely. The digestive system slows significantly when a person is in mortal danger because digestion isn’t a core function of survival and all the body’s energies are diverted elsewhere. With PTSD, the body and brain get stuck in fight or flight mode, which is why digestive transit can be very slow for those affected. Massage of the abdomen not only feels deeply soothing it is also very effective at increasing the speed of digestion. This is partly because some of the strokes used mimic peristalsis (the wave-like pulsing action of the intestine which breaks down food and allows nutrients to pass into the blood stream) and partly because stimulation of the parasympathetic nervous system activates the digestive system. During a massage, a person will start to salivate, will swallow more frequently and may hear their stomach gurgle, all of which is in sharp contrast to the dry mouth and knotted stomach of a person in the grip of terror.

 

Numbness

 

Some people may experience areas of numbness in their body as a result of their traumatic experience, but in some cases massage can help to re-introduce feeling to those areas affected. For instance, people with PTSD sometimes find their hands and feet get cold as their overall circulation becomes less effective because the body is on alert and the blood supply is diverted to areas most needed. Massage stimulates the circulation bringing blood and feeling back into the parts of the body affected.

 

Pain

 

Massage is an instinctive response to pain – as a child if you fall over we talk of "rubbing it better." How does something as simple and natural as touch help to alleviate pain? Pleasure and pain are transmitted to the brain via neural pathways. Pleasure travels more quickly than pain and this can have the effect of shutting off the pathways that carry pain. This is known as the Gate Theory of Pain. Positive touch is experienced as pleasure by the brain so it follows that massage can be used as a way of relieving some types of pain.

 

Headaches

 

Headaches are prevalent amongst PTSD sufferers and massage may help to prevent them by easing muscle tension in the shoulders and neck and may help to shorten their duration because of the effects of Gate theory of pain. Self-massage can be just as effective in this regard as seeing a professional. Try gently and slowly circling your temples with your fingers or the heels of your hands and resting your eye sockets on the heels of your hand can bring relief to tired eyes.

 

Compromised immunity

 

Any one of the physical symptoms we’ve looked at so far might become difficult to cope with if experienced regularly so the debilitating effects of coping with several symptoms at once, sustained over extended periods of time, is pretty obvious. When added to the psychological effects of PTSD – nightmares, flashbacks, and dissociation to name but three – you can see that over time the body’s functioning almost inevitably becomes strained and compromised. With so much going on in the mind and body of a person with PTSD, there is the potential of getting sucked into a vicious cycle of deteriorating health so using massage as part of your armory of defenses is a smart move. Massage is experienced as pleasure and pleasure makes the body produce endorphins which is why people feel good after a massage. Much more research needs to be done in this area, but what seems to be the case is that feeling good helps to boost immunity.

 

In conclusion, massage can be very helpful in managing the physical symptoms of PTSD and in so doing it can help a person to rebuild trust in their own body which, over time, can help to re-establish a sense of ease with themselves and those around them.

 

Kimberley Pledger is a touch therapist practicing in London. She specializes in mental health and the body and is the only massage therapist in Great Britain to be a member of the UK Register of Trauma Specialists.

 

  

    

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