Trauma & dissociation｜recognizing and understanding the body’s reactions

This article deals with a complex but essential subject for massage therapy practitioners: traumatic dissociation. Although sometimes difficult to grasp due to its subtle and little-understood mechanisms, this topic deserves your full attention. As a massage therapist or future massage therapist, it’s essential to understand that the body can reflect deep, sometimes invisible wounds linked to psychological trauma. This condition, often unrecognized, can significantly affect a person’s sensory and emotional experience. By better understanding this phenomenon, you’ll be better equipped to adapt your practice and offer your clients a safe, respectful space.

What is traumatic dissociation?

Traumatic dissociation is an exceptional protective mechanism activated by the brain in response to extreme stress or repeated violence. When a person is confronted with an unbearable situation, their neuro-biological system acts to protect them from a vital risk. Among other things, this process disconnects the cerebral amygdala – the emotional response center – from other parts of the brain.

This uncoupling leads to emotional and sensory anesthesia: the victim becomes unable to feel emotions or bodily pain in a normal way. While in the short term this mechanism enables the victim to survive an unbearable situation, when it becomes chronic it has serious consequences for mental and physical health.

Physical and emotional signs of dissociation

For touch professionals, dissociation can manifest itself in several ways:

1. Bodily anaesthesia: The person may have a very high tolerance to pain, or appear insensitive to pressures or tensions that you detect as important.
2. Persistent muscular tension: These tensions may be the body’s unconscious way of “containing” unexpressed emotions.
3. State of absence: Some clients may appear “disconnected”, with a blank stare or an absence of emotional expression during treatment.
4. Paradoxical reactions: despite an apparent state of relaxation, flashbacks, traumatic memories or inexplicable sensations may invade the mind.

These manifestations reflect a body and mind caught up in a state of traumatic shock, where the usual markers between sensations, emotions and thoughts are altered.

The link between traumatic memory and dissociation

Dissociation is often accompanied by traumatic memory, where memories of the trauma remain frozen and disconnected from temporal reality. These memories may manifest themselves through flashbacks, unexplained pain or intense emotions arising in seemingly incoherent ways.

For the massage therapist, this may translate into unexpected behavior: a crying fit, sudden fear or prolonged silence. These reactions should not be interpreted as a rejection of your treatment, but as the expression of a system struggling to regain its balance.

How can you adapt your practice?

Your role is not to diagnose or “treat” dissociation, but to adopt a posture of listening and caring:

1. Create a safe space: Make sure the session environment (temperature, light, position) is as comfortable as possible.
2. Adopt a progressive approach: Start with gentle, respectful touches to assess bodily reactions without invading the client’s personal space. Too much pressure or insistence on a sensitive area can reinforce feelings of danger or provoke withdrawal.
3. Value active listening: Take the time to explain each stage of your care, and encourage the person to verbalize their feelings, even if they are unclear or difficult to express.
4. Encourage reconnection with the body: Using breathing techniques or enveloping gestures, you can help your customers reconnect with their bodily sensations in a safe way.
5. Collaborate with other professionals: If you identify signs of significant dissociation, refer your clients to mental health specialists for further support. It’s not advisable to encourage the person to talk: without an appropriate framework, this narrative can be painful and violent, with no assurance that it will be beneficial for the future.

A profound impact on well-being

By being aware of the symptoms of dissociation, you help to provide an environment where your clients can gradually reconnect with themselves. Although massage cannot “cure” trauma, it can play a key role in reclaiming the body and sensations, a fundamental step in the resilience process. Some research suggests that massage, as a body-centred practice, can contribute to the reintegration of body image. This process could explain the beneficial effects observed in people who have undergone traumatic experiences, such as victims of sexual abuse.

Your practice then becomes a supportive space, where every gesture counts to restore the link between body and mind.

To remember:

• Traumatic dissociation is a neurobiological response to situations of extreme stress or violence. It leads to emotional and sensory anesthesia.
• It can take the form of insensitivity to pain, persistent muscle tension, a state of disconnection (blank stare, emotional absence) or paradoxical reactions such as flashbacks or unpredictable emotional outbursts.
• Massage is not intended to heal trauma, but it can help reintegrate body image and sensations.
• By adopting a caring and reassuring posture, the practitioner helps restore the link between body and mind.

Sources :

• Field, T., Hernandez-Reif, M., Hart, S., Quintino, O., Drose, L. A., Field, T., Kuhn, C. M., & Schanberg, S. M. (1997). Effects of sexual abuse are lessened by massage therapy. Journal of Bodywork and Movement Therapies, 1(2), 65-69. https://doi.org/10.1016/s1360-8592(97)80002-2
• Geri, T., Viceconti, A., Minacci, M., Testa, M., & Rossettini, G. (2019). Manual therapy: Exploiting the role of human touch. Musculoskeletal Science and Practice, 44, 102044. https://doi.org/10.1016/j.msksp.2019.07.008
• Traumatic memory and victimology – Traumatic dissociation. Website: www.memoiretraumatique.org
• Price, C. (2007). Dissociation reduction in body therapy during sexual abuse recovery. Complementary Therapies in Clinical Practice, 13(2), 116-128. https://doi.org/10.1016/j.ctcp.2006.08.004
• Salmona, M. (2013). Traumatic dissociation and personality disorders: or how we become strangers to ourselves. In R. Coutanceau & J. Smith (Eds.), Les Troubles De La Personnalité En Criminologie Et En Victimologie. https://www.memoiretraumatique.org/assets/files/v1/Documents-pdf/La-dissociation-traumatique-et-les-troubles-de-la-personnalit-Dunod-2013.pdf