Mind the Gulf


There exists between bodywork and psychotherapy a gulf — an absence of sorts in the therapy world that calls out for a bridge. Nowhere is this gulf more apparent than in the treatment of trauma.

Because trauma so uniquely belongs to both body and mind — an experience that overwhelms the body and mind together — its treatment demands an approach that addresses both. But how to offer this treatment? How do we address this gulf between treatment of body and mind?

The issue boils down to one of focus, ideology and science. Psychotherapy seeks to treat by means of a “top-down’ model, working cognitively to name, understand, engage and overcome the breakdowns of our mental models of the world. Bodywork on the other hand offers a “bottom-up” approach, engaging with the felt sense of the person, understanding through non-verbal, sensation-based engagement with the immediate “now’ of the body’s experience. Each appeals to a different domain of experience and seemingly these two formats address widely different issues. However, when one comes to the experience of trauma, the barriers between domains begin to break down.

Trauma begins in the body — a patterned response of nervous system impulses, driven below the level of consciousness to threat.

In a moment of need, we often find ourselves in flight before our minds even have time to catch up to the threat we are reacting to. It is after that threat response is complete when its impact on our psyche becomes evident. It is then that the unresolved patterns of the trauma response begin to show as symptom, both physical and emotional.

Trauma’s current status in the public’s eye came about largely after Vietnam forced an awareness of the mental and emotional anguish brought back by wartime veterans. Treatment approaches like EMDR and Somatic Experiencing®, developed in the 1980’s and 90’s, started to focus the treatment of trauma on the body. Embraced slowly by the therapy community, these concepts have been even slower to impact the manual therapy community which has tended to focus purely on physical processes and their resolution through manipulation, movement and medical means.

In my own practice as a manual therapist however, it became readily apparent that there was another factor determining many of the physical woes of my clients. As I slowly understood this factor to be trauma acted out in body and mind, both my efficacy as a bodyworker and my awe as a student of the human system increased.

By working with the body through the lens of the trauma response, I finally understood that so much of what I perceived as problematic in the body was in fact a reasonable response to threat, arrested and held in the tissues and nervous system of the traumatized person.

By working in the gulf between bodywork and psychotherapy, I work on a sometimes unstable footing. Research is only beginning to illuminate the space within which I work. The edges of each modality fray as each realizes in turn that it’s descriptions of the how and why of its work have been mistakenly assigned. If trauma underpins much of mental illness than it means our categorization of mental illness according to symptom as the DSM attempts to do has been a misguided effort from the beginning. Likewise, if it is the brain and not the tissue that changes under the bodyworker’s hands, what then do we do with the causal explanations underlying our now disproven theoretical bases? It is an exciting time, but one that will rewrite both professions anew.