Ken Waide

Pathology
Essay #2
Trauma- and Stressor-Related Disorders
Traumatic events, such as fire, earthquake, bombing, and hurricane, occur daily. Such
devastating circumstances often cause an acute reaction of fear and terror for individuals who
experience them. War, rape, and physical assault or abuse, whether of a child or an adult,
produce equally frightening results known as post-traumatic stress. It occurs when traumatized
individuals cannot safely assign to the past what has happened in their life. The experience of
trauma undermines ones expectations of safety and security in the world. Traumatized
individuals continue to be aware of what others known to be true but tend to keep hidden from
their consciousness: That life is fragile and can be gone or forever changed in an instant, and
that our expectation of control in the world is often an illusion.
The DSM-V now classifies these types of disorders as their own set of disorders. Previously
they were considered to be a subtype of anxiety disorders. The word disorder carries a stigma
which may be a stressor in and of itself, which is why some advocates for military personnel
suggest PTSD be changed to posttraumatic stress injury, instead.
Women seem to be more susceptible to PTSD than men, while overall 30% of men and
women who spend time in a war zone develop PTSD. It seems as though everyone experiences
some amount of PTSD during their lives even though the reported amount of children is 4% of
all boys and 6% of all girls.
PTSD happens to people who have experienced a shocking, scary, or dangerous event,
often life-threatening. It is natural to feel fear after a traumatic situation. Fear triggers many
split-second changes in the body to help defend against danger or to avoid it. This
fight-or-flight response is a typical reaction meant to protect a person from harm. Exposure to
traumatic stimuli leads to activation of the amygdala, hypothalamus, and several other
structures, leading to sympathetic responses with accompanying changes in hormone
secretions.
Different types of trauma- and stressor-related disorders are as follows:
PTSD: Someone with PTSD has been exposed to death, actual or threatened injury, or
violence, either as a participating or as an in-person witness. It may also affect close relatives or
friends of the person in the trauma. Professionals who are repeatedly exposed to the effects of
violence, like first responders or caregivers to the victims of child abuse, may also be
vulnerable. PTSD may subdivide into Dissociative PTSD, which is when a person feels
detached from his mind or body, or as though the world is unreal or distorted. Scientists believe
that this dissociation may be modulated by inhibition of limbic system activity. This distinction
may allow for more effective treatment options.
For someone to be diagnosed with PTSD, an adult must have all of the following for at
least 1 month:
At least one reexperiencing symptom
At least one avoidance symptom
At least two arousal and reactivity symptoms
At least two cognition and mood symptoms
 Acute traumatic stress disorder: Has all the hallmarks of all stressor-related disorders,
but symptoms develop more quickly.
Adjustment disorder: reaction to a traumatic or non-traumatic stressor can be acute or
chronic after the termination of the stressor. May be a precursor to PTSD.
Reactive attachment disorder: This is a childhood stressor-related disorder that leads to
a person being pathologically withdrawn and inhibited: a pattern that lasts through adulthood.
Patients have reduced responses to their environment and they tend to neglect themselves and
their responsibilities.
Massage can help those with trauma- and stressor-related disorders. Massage Therapy
has the ability to create homeostasis within the mind and body. It can offer support for what
Saakvitne and Pearlman call the five basic human needs:
The need to be safe.
The need to trust.
The need to feel some control over ones life.
The need to feel of value.
The need to feel close to others.
Nowhere else can such extraordinarily intimate surroundings be of such help than in the
massage therapy treatment room. Clients who, from time to time, experience emotional
reactions to being touched often respond to simple human soothing. Crying, being held, being
reassured by the massage therapist, There, there. Its over now. You are safe with me. This
can most often bring a client back from the terror of remembered trauma and sadness to
present reality. The world and the massage proceed as before.
Those who have experienced a deeply traumatic event may not be so easily soothed by
simple words or touch. For them, trauma continues to live on in their body and spirit, as if it were
still happening in the here and now. Soothing seems hollow, not to be trusted. The loss of
confidence in the bodys ability to keep them safe is experienced as the ultimate betrayal of all
that they have come to know and trust about the world and other people. The longing for safety
remains but is buried very deeply under the guard of perpetual mistrust and fear.
Establishing trust is essential when working with clients with PTSD. Establishing trust is
essential when working with clients with PTSD. In order to treat them successfully, the massage
therapist must understand the nature and essence of the therapeutic relationship and behave at
all times in a trustworthy manner. It is the therapist's role to create a safe place in which the
client can regain confidence in herself and in her body.
As van der Kolk wrote, "Treatment of PTSD needs to address the twin issues of helping
patients: Regain a sense of safety in their bodies, and complete the unfinished past. It is likely,
though not proven, that attention to these two elements of treatment will alleviate most traumatic
sequelae."
Philosophically, engaging in massage therapy represents a commitment to wellness on
the part of the client and the therapist. It is a caring, safe way for individuals to experience touch
and receive release from pain. It offers intimacy that is nonsexual, thereby providing an
opportunity for clients who are fearful of intimacy to experience it safely. Massage therapy
communicates support, acceptance, positive regard, and pleasure, through the modality of the
therapist's hands, and it empowers the client to take charge of how she wants her body to be
touched. Respectful touch can be healing. Massage therapists offer a safe place to clients, who
in turn, may learn to trust that touch does not have to be associated with pain, fear, or anger.
Massage therapists offer a safe place to clients, who in turn, may learn to trust that touch does
not have to be associated with pain, fear, or anger.
In a healthy therapeutic massage relationship, the client participates in creating
accomplishable treatment plans. Decisions for her care are widely discussed, and the process is
one of consensus and cooperation. This approach is critical for the successful treatment of the
client with PTSD. For her, safety needs to be paramount. She needs to know unequivocally that
she has the power to stop, change, or modify a treatment at any time. By having choice over
how she wants her body to be touched, the client with PTSD discovers in both a kinesthetic and
cognitive way that the trauma is in the past and that here, in the present, she is in charge.

Werner, Ruth. A Massage Therapist's Guide to Pathology. Philadelphia: Wolters Kluwer, 2016.
199-200. Print.

https://www.amtamassage.org/articles/3/MTJ/detail/1817/recovering-body-and-soul-from-post-tr
aumatic-stress-disorder

http://www.pacificcollege.edu/news/blog/2014/10/27/massage-treatment-post-traumatic-stress-d
isorder

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml