Trauma can leave patients with minimal tolerance for therapeutic input. How can we as movement + manual therapists achieve clinical goals without further traumatizing the patient?
All change is challenging, even in the right direction. Right down to the cellular level, we can be in either bracing + defense mode or healing + growth mode...not both at once.
The solution to working through patient bracing is to create a space that feels safe, and work with them to unwind, rather than trying to forcibly do something to them (even if it seems like the right thing).
This may seem like common sense, but it really is that simple!
Creating safe space
Because all change is challenging (even in the right direction), it's imperative that we create an environment that is conducive to shifting into "healing" mode.
Individuals with a history of trauma may be in a state of chronic fight-or-flight mode, which means that all sensory sensitivity is heightened. This means things that may not irritate most people could be overwhelming for them. So you may want to get rid of sensory stimuli that may trigger a defense response, which could include lights, music and other sounds, and even smells like perfume or air freshener.
A resonance-based approach
One of the most common triggers into defense mode is the identification of a "non-self" entity creating dissonance. So if you, the provider, come in with your ideas of how the patient's body should be and you try to use your power to push through and make their system comply, that could result in the patient going into a defensive bracing mode. Try softening your approach, and think of it as less "bossing their body around" and more "making a suggestion for how it could be". Take a moment to notice where their body is at before you dive into pushing for a change. You could think of it a bit like partner dancing...yes, you're the leader, but you don't want to just drag them around by the wrist, yes? ☺
For more information about Integrative Therapeutic Resonance, a resonance-based approach to facilitating sustainable change, visit biotensegrityglobal.com.