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Somatic Psychotherapy for Trauma and Pain Management

Trauma can occur physically and/or emotionally when a wound, shock or an injury occurs. It is not the incident itself that causes the trauma, but rather the impact it has on the individual. It doesn’t matter if the incident appears “minor” on the outside, or to someone else. If the body/brain perceives it as trauma, it is.

Trauma can result from surgery, motor vehicle accidents, slip and fall occurrences or any life-threatening situation. Chronic pain can be both the result and the cause of trauma.

Symptoms of trauma can include irritability, anger, anxiety, panic attacks, pain, feeling “on guard” insomnia. There may be an emotional numbness, depression or apathy. The individual may avoid people, places or objects that trigger a felt-sense response without even realizing why.

Sometimes, physical injuries, surgeries, accidents or falls unconsciously bring into the body buried memories and experiences of previous traumas – physical or emotional – that have not been processed. So the impact of the current incident can be intensified and seem out of proportion.

What happens is a brain-body connection that is basically a state of immobility coupled with fear. In other words, when one’s nervous system is triggered into a heightened state of arousal (fear), yet one is incapable of doing anything about the threat (creating immobility), the body responds.

To use a car analogy, it’s equivalent to slamming on both the accelerator pedal and brake at the same time. When this “coupling” occurs within us, the brain (and parts of the body) immediately lock in “data” in an attempt to use this information to prevent similar future events. This is an unconscious survival strategy with the best of intentions, but not necessarily the best of mental health results.

For example, imagine a person sitting in a parked car listening to a song on the radio when out of nowhere their vehicle is rear ended by another. Depending on the severity of the accident, post incident support, and subjective personal factors such as present state of mind and resilience – one possible outcome is the pairing of that song to the trauma. In such a situation, it is possible that when that individual hears the song in the future, it could trigger fear, anxiety, even pain related with this accident.

The neuroscientific explanation is, “Neurons that fire together, wire together!” The results are conscious and unconscious “wired” associations between events, environment, feelings, smells, colours, objects, physical sensations, sounds, etc. which when encountered at a later date, can lead to triggering the memory and associated distress.

During a somatic treatment (massage therapy, chiropractic, rolfing, osteopathy etc.) this “wiring” in the nervous system can begin to be uncoupled – which is good! However, if we only deal with the physical aspect of the trauma, without the psychological aspect, the imprint of the trauma- including the pain which has been wired to the brain and nervous system – can continue.

“Re-wiring” this unconscious survival strategy is far more difficult simply because the brain would rather be afraid or nervous or anxious and wrong, rather than, from its perspective, dead.
It is not necessary to relive and retell the experience – which can be re-traumatizing to the system. Effective intervention involves some talk therapy but primarily somatic (body awareness) therapy to uncover, uncouple, and complete the initially thwarted attempt at self protection – thus breaking through the immobility. The number of sessions needed will be a function of the complexity of the trauma and how the individual responds.

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