This blog post is reproduced in its entirety from the Terra Rosa website, posted here with full permission. I wished to repost it here, on my blog, for a few reasons. First, the Terra Rosa website/blog is an Australian-based one with less exposure in North America. Many of my readers reside in North America. Second, the original blog has its comments section closed and I wanted to open it up for dialogue here in North America (and potentially beyond). Some may see my posting this negativity-based behavior, as the content disagrees with most of what I was originally taught in my myofascial release (and craniosacral) continuing education. While it certainly does disagree with much of my past learning, I am posting it as what I hope will become a spark for discussion. As I state near the end of the article, emotional response occurs with manual therapy intervention. I think it occurs even more often if we prime the patient to expect it, to anticipate it, to even view it as a necessary aspect of their healing. I think it become more common when the therapist states concepts such as, “true healing will not occur until the emotions are faced”. While emotive, cathartic expression can be quite useful, MUST they occur in order for a person to get better? I think not, though many will disagree. Are manual therapists the right professional to take a patient through the process of the past? I again think not. The therapist need not stop somatic expression through bodywork, but advertising the need to get to the root of pain and dysfunction through emotional work is just plain inaccurate and bad practice. Give it a read and let me know your thoughts. Might it cause you to rethink how your website is worded? Have you, as a bodyworker, been trained in emotional work? If you practice in this fashion, do you feel you are practicing fully within your legal and ethical scope of practice?
Walt Fritz, PT
One of our previous blog post articles discussed whether fascia or musculature holds somatic memories of the body. This topic is important because many manual therapists have experienced that when they touch on a particular area of the client’s body during a therapeutic session, it provokes memories or traumatic events from the client’s life. Many manual therapists explain this phenomenon as memories being stored in fascia or musculature. However, literature overwhelmingly states that memory is in the nervous system, specifically the brain. This article explores how traumatic memories can be re-experienced based on the physical state of the client, including how these memories may be triggered when the client is touched.
State-Dependent Memory
Noa Logan Klein wrote a PhD Thesis titled “Loving Touch: Therapeutic Massage, the Socialization of the Body, and the Healing of US Culture” at UC Santa Barbara in 2010. One of the chapters of her thesis looked into the role of massage therapy in healing trauma.
Noa described that in psychology studies, memories of traumatic events, because of their high emotional charge, are more likely than ordinary memories to be “stored in a state-dependent fashion” as implicit somatic memories, meaning that they consist of sensation, affect, behaviour, or images that are difficult or impossible to verbalize, can be forgotten for long periods of time, and can also be quickly and vividly recalled given the appropriate state or stimulus. When the state prompted by external stimuli matches the bodily state at the time of memory encoding, this evokes “state-dependent” recall, which can be involuntary and, in the case of traumatic memories, can be extremely disturbing.
This memory recall is also related to our experience, at one time or another of experienced state-dependent sensory-based memory recall triggered by a song, taste, or smell. Hearing a memorable song or smelling a familiar aroma can trigger strong emotions and sensations—somatic memories—associated with specific events in one’s life. The so-called state-dependent recall can also be triggered by bodily states such as physiological arousal (heart rate, breathing patterns), emotional states, and even physical postures.
Re-Lived…
Traumatic memories are often experienced as “relived” rather than remembered, which is why people experiencing them react as though they are re-experiencing the situations in which they were traumatized. When a traumatic memory is triggered, the somatosensory experience of the person reliving the memory can be powerful; the whole body “remembers” and replicates the sensations of the trauma, including sympathetic nervous system fight, flight, or freeze responses. The psychophysiological experience is of reliving the trauma, what we call a flashback. In this situation, the client often effectively dissociates from the present reality and is caught in the state of re-living the traumatic memory.
Whereas memories of ordinary events, even those containing somatosensory and emotional components, do not have the somatosensory texture and depth of flashbacks, making it much easier to remain connected to external stimuli and to experience being present in the moment while simultaneously feeling (remembered) sensations or emotions.
Massage as a Trigger
Massage and bodywork can trigger this state-dependent recall of the sensations and emotions of traumatic events, particularly if touch is itself a stimulus associated with the trauma. Manual therapists often refer to memory “locked in the tissue” and “released” when that part is worked on. In psychology, there is a parallel term that is referred to as trauma “locked into” the body. However we should not take these terms literally.
Neuroscience
There are also some evidences from neuroscience that point to the relationship between touch and the brain, a study found that the part of the brain that is in charge of processing our senses is also responsible, at least in part, for storing emotional memories. Another study showed that human brain can remember several touch sensations at the same time and consciously retrieve the touch if concentration is focused on these touches. The study found that new touch does not erase the memory of a previous touch from working memory. Rather, new and old tactile memories can persist independently of each another, once a person’s attention has registered the touches. The memory of different touches takes place in the frontal lobes.
Perhaps we should look further into psychological and neurological explanations of this “tissue memory” rather putting too much emphasis on supposed memories stored in the physical myofascial tissues themselves.
Comments by Til Luchau:
There are many explanatory models for memories and emotions that sometimes surface during hands-on work. The (now somewhat quaint) Reichian explanation was that since we tend to contract our musculature and hold our breath against the expression and experience of unpleasant emotions, over time, this immobilization would “armor” the body into a chronically immobile and unfeeling state. Deep hands-on work (and hyperventilation) was used by Wilhelm Reich to “break up” this armor, leading to recall of memories and cathartic expression of the “held” emotions. Ida Rolf and many others referenced Reich’s model as an explanation for the memories and emotions that surface during their systems of deep bodywork.
The state-dependant memory model discussed above is more nuanced and sophisticated, and so arguably more useful. It brings to mind a book I’m currently reading: Lisa Feldman Barrett’s How Emotions are Made (2017, Houghton Mifflin Harcourt. ISBN 9780544133310). In her “theory of constructed emotions,” Barrett builds on the idea that our brains are structured to predict what we will see, taste, here, and feel. Apparently, there’s good evidence that the brain only processes things it does not predict. In this model, preloaded but widely networked caches of information (concepts) and meaning (valence) are used to minimize the brain’s energy use and maximize processing time.
Interestingly, she writes that the brain’s wiring causes internal sensation and body signals (interoception and proprioception) to reach the brain’s processing centers before external perceptions (exteroception), such as sight, hearing etc. This sets up the brain to rapidly predict what it’ll perceive exteroceptively, based largely on past bodily experience (as well as language) what’s going to happen outside. In other words, we take in sensory information only until our brains can predict what will happen.
This is the proposed mechanism behind both perceptions and emotion: for example, in this model, we are not reacting to our perceptions with emotions, we are neurologically predicting what will happen, and it is our predictions that shape our perceptions, emotions, and actions.
This model sheds an interesting light on phenomena like phantom limb pain; baseball batters’ ability to hit a 90mph fast ball (which requires most of the batter’s swing to be complete before the ball has even left the pitcher’s hand); police seeing non-existent guns in hands of threatening suspects; and maybe expectancy and conditioning (which are the mechanisms of many placebo responses), psychological projection, traumatic memory, and more.
From our somatic perspective, the role of interoception in her model is particularly interesting. Though I’m only part way through her book, so am probably speculating well beyond the author’s scope, it could be that bodywork-induced memories are another prediction-based phenomenon: our bodies and brains “producing” a memory by matching present sensory phenomenon to neurally stored (but somatically informed and predisposed) presets of past experience and meaning.
Comments by Walt Fritz:
The points and clarifications made both in the original article as well as Til Luchau‘s thoughtful comments are moving the conversation on emotional response during a manual therapy session in the right direction. This sort of factual and science-informed exploration of emotional expression in the therapeutic environment needs to be encouraged within the professional dialogue of our shared professions. For too long the occurrence of emotional feelings/responses during a manual therapy engagement have been twisted to be seen as a statement and belief that emotions are somehow stored with the tissues being treated. While touch is powerful and helpful, caution needs to be taken not to confuse safe therapeutic touch allowing an emotional response, as outlined in the article, with stories of how fascia/muscle/etc. are the vessel of those emotions. Unfortunately, these beliefs are still actively being taught in continuing education across the globe with no regard to scientific accuracy or patient safety. Worse, it arms the therapist with a false sense of their place in unearthing these emotional holding patterns.
Christopher Moyer, PhD, in a recent talk he gave at the 2016 RMTBC Manual Therapy Conference, spoke to the concept of transcendental experiences and how common they can be, not only in massage/manual therapy (MFR and CST included), but in also in the large world of, yes, psychotherapy, but also dance and other forms of somatic expression. Being a witness or even facilitator of such emotional reactions or transcendent experiences should not empower the therapist to believe they are the correct person to work their patient through the struggle. Support and allow feelings and expression, yes, but much of the continuing education addressing these emotional experiences encourage therapists to far-exceed their legal and ethical scope of practice, not to mention offering potential harm to the patient.
Reproduced with permission from Terra Rosa (2018)
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