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
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as they are on an outdated separation between the functioning of the mind and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 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 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
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
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.
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.
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.
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 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.
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.