Towards healing from abuse (3): Bridging the body-mind gap with massage

I seem to myself, as in a dream,
An accidental guest in this dreadful body." 
— Anna Akhmatova (The Complete Poems of Anna Akhmatova)

​Very often the only thing people who had suffered abuse want to do is to escape their own bodies as though their body betrayed or turned against them.

Massage can bring people back to themselves to create a healthy and nurturing self-connection and help them create a compassionate relationship with themselves and with their bodies. 

Read here to find out how massage can help bridge the body-mind gap caused by trauma.

According to Melissa Soalt, psychotherapist who has worked with many survivors, “the trauma from abuse typically results in dissociative numbing or repressive mechanisms that can leave survivors feeling ‘empty’ or vacant on the inside.

She considers body work a valuable tool to help them reconnect and re-integrate and reclaim their body-mind. 

“Because the body is such a direct medium, body-work can help facilitate this process of re-entry and one’s ability to feel more present, " she says.

The problem with numbing as a survival skill, says Chris Smith, who developed Trauma Touch Therapy, is that it not only numbs out the pain and horror of trauma, but also people’s capacity to enjoy life, to enjoy their bodies.

​They no longer feel alive nor safe in this world.

TOWARDS CONSCIOUS AWARENESS
Body awareness via massage can help rebuild the oneness of the body, emotions and thoughts. It can encourage embodied self-awareness - really experiencing our movements, sensations, and feelings as well as a conscious awareness of interactions with the environment and world.

As the authors of the journal article, Body Awareness: a phenomenological inquiry into the common ground of mind-body therapies write, it is this awareness that leads to self-organization and wholeness.

How do they know?

This group of researchers had investigated mind-body approaches, such as yoga, TaiChi, Body-Oriented Psychotherapy, Body Awareness Therapy, mindfulness based therapies/meditation, Feldenkrais, Alexander Method, Breath Therapy and other modalities by speaking to practitioners and patients to find out what the concept body awareness in mind-body therapies meant to them.

Their conclusion?

That there is a growing body of evidence that body awareness-enhancing therapies may provide psychological and pain-related benefits for patients suffering from a variety of conditions.

HOW DOES BODY_MIND INTEGRATION HAPPEN?
Becoming aware of your body even during a massage, involves both physical and mental processes.

The mental functions include attention, interpretation, appraisal, beliefs, memories, conditioning, attitudes and affect focused on external and internal body sensations. ​​

All of these mental processes are affected and have effects on the body in many ways.

​According to the authors of two articles on the subject of mind-body connection, the connection between mind and body act on multiple levels:  
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HOW DOES BODY_MIND INTEGRATION HAPPEN?
I have looked at five ways in which the mind-body connection shows itself:

1. On the cellular level
2. Connections among structures of the brain
3. The role of feedback system
4. Introceptive communication
5. The role of neurohormones
6. Dealing with stimuli from our environment via our touch, vestibular and proprioceptive systems.

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​1. The connection between mind and body influences us at cell level.
At the basic cell level the body-mind connection influences the process by which information from a gene is used to synthesise gene products like DNA.

2. The connection between mind and body changes the brain
It supports interactions among central brain regions leading to change in the brain structures (neuroplastic changes).

3. The connection between mind and body is a two-way street
The connection between body and mind are made up of 1) top-down and 2) bottom-up feedback loops between the brain and the body organs including the skin, the heart, blood vessels, the immune systems and particularly via the nervous system. 

• Top-down mechanisms are  initiated via mental processing in the cerebral cortex of the brain. In other words it starts off primarily from conscious and intentional mental activities.  Think of therapies like clinical hypnosis, imagery, and meditation.  
• In contrast, bottom-up mechanisms are initiated by stimulation of various receptors in the body such as  those in the digestive system, chemo and sensory receptors.

All mind-body therapies actually involve a combination of both top-down and bottom-up mechanisms according to the authors.  

For example: Progressive muscle relaxation involves:

• bottom-up pathways activated by peripheral sensors which are responding to what is happening in the different organs of the body e.g. reduced muscle tension and blood pressure as well as;
• top-down pathways activated by focused attention and the intention to relax. 

4. The connection between mind and body listens to your heart ... and other organs
Mind-body connection affects our awareness of our own internal regulation responses also known as  interoceptive communication,  such as being aware of our breathing, hunger, heart rate, and the need to visit the bathroom.

5. The connection between mind and body is linked to circulating neurohormones 
Neurohormones are substances that regulate other hormones. They pass along nerve-cell extensions or axons of a nerve cell and are released into the bloodstream.

These neurohormones is the link between sensory stimuli and the chemical responses or endocrine secretions that act on other tissues in the body. Just like neurotransmitters, neurohormones are released by neurons but like hormones, neurohormones travel in the bloodstream.

 Neurohormones secreted by our bodies include:

•  Cortisol - involved in a variety of physiological functions including blood pressure regulation, immune system functioning and blood glucose regulation as well as the stress response . 
•  Oxytocin - affects trust and bonding between people, also body temperature, activity level and wakefulness. 
• Vasopressin - regulates the body's water retention.

•  Endorphins - help lower stress levels, improve mood and feeling of pleasure and support the immune system. It also moderates pain response and appetite.
• Dopamine - controls the heart rate and supports perception as well as figuring out what is real and what is not. Dopamine is also responsible for reward-driven behaviour and pleasure seeking. ​

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6. The connection between mind and body links us from the outside in
​Not only information gathered from inside our bodies are vital to maintain homeostasis and survival. The body has different sensory systems that keep us in touch with the outside world too.

The tactile or touch system
Receptors in the skin and even in the mouth, send messages to the central nervous system about  touch, different textures, whether a surface is wet or dry, smooth or rough.  The tactile system is also responsible for the processing of pain and temperature.  

The vestibular or balance system 
This system provides input about our movement and where we are in space.

​ It is related to our:

1. gross motor movement
2. posture
3. visual development
4. auditory processing and the 
5. self-regulation of the nervous system.  

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​Vestibular input alerts us to danger and threat but can also calm down the nervous system. 

Proprioception 
This is  the sense that provides feedback on the position of different parts of our body, in relation to each other and where it is in space. 

It lets you know whether or not your body is moving, if it is moving with enough effort to achieve your goal (e.g. picking up a mug of rooibos tea - too little and you won't manage it, too much and you can spill the hot liquid burning yourself). 

Proprioceptive receptors are located all over our bodies in the joints, muscles, and tendons and are activated by elongation, compression, or traction.  

These sensors play an important role in muscle memory  or the ability to reproduce a particular movement without conscious thought and acquired as a result of frequent repetition of that movement. 

​According to US massage therapist, Lind Fehrs the physical body retains a memory of what the mind experiences and the mind, or brain and nervous system, retain a memory of what the body experiences.​​

PULLING IT ALL TOGETHER 
A physical trauma like physical assault or sexual abuse results in a reaction from our entire being - mind and body.

• The instant flight, fight or freeze response is the result of neurohormones and nuerotransimtters like cortisol and norepinephrine telling  the autonomic nervous system that we are being threatened.
•  This affect the digestive process, heart rate, blood pressure, breathing as well as other body functions.
• At the same time these hormones gather stored energy to mobilise muscles.
• Meanwhile a state of hyper-vigilance is declared among different parts of the brain. Sometimes this state of hyper-vigilance is maintained long after the actual threat is over. 
• Brain structures such as the amygdalae which stimulates the hippocampus to store long-term memories related to emotional events. According to Linda Fehrs if the trauma, "whether physical or emotional (or both) is not addressed early on, the result can be Post Traumatic Stress Disorder (PTSD) as well as chronic pain." 

Long after the trauma, deep within the brain, the subconscious mind remembers. Within the limbic system lies the memories associated with the event or injury. The smells, the sounds, the tastes, the textures, the visuals – all the senses are stimulated during a trauma and stored to form a kind of emotional picture within the brain
- Linda Fehrs, Massage Therapist

​The good news is that the process also works in the reverse - as the soft tissue, nervous system and posture are altered during a massage, the negative body memories and emotions are modified too.

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1.  BioMed International journal , Physiological Effects of Mind and Body Practices  and
2. Explore; Top-Down and Bottom-Up Mechanisms in Mind-Body Medicine: Development of an Integrative Framework for Psychophysiological Research;