Therapeutic Massage for Victims of Rape and Sexual Abuse

Trigger Warning

Sam Mishra qualified in Swedish massage and Preheat treatments back in 1997. Concurrently with massage, her main career was as a surgical nurse and then a midwife on a high-risk unit. After another 9 years of working with mainly physically disabled children and volunteering in disabled sports camps, she also qualified as a sports therapist. Her medical background has given her a good understanding of both physical and mental health issues and injuries for which massage treatments may be sought, and the ability to identify causes of muscle tension that other therapists may not be able to, knowledge which she now shares with her students.

Following my previous article about the use of massage in clients with unresolved trauma back in November 2021, this article explores more specifically, the use of massage in those who have experienced sexual abuse. As someone who has their own personal experience of rape, I can say that the extensive list of symptoms and coping mechanisms that we see with other forms of abuse, becomes even more complex, but when offered by trained therapists, massage can positively impact sexual abuse survivors, both physically and mentally. This is why massage can be such a valuable component of any therapy programme, because psychotherapy can open up a client to address traumatic memories of the abuse, but it can’t address the mind-body connection (or lack of) or increase the client’s capacity to receive touch in a comforting way.

The first month to three months following sexual abuse is crucial, as this is the period of time when the main goal is to forget what happened and move forward, hence the numbing coping mechanism is introduced, where we avoid thinking and feeling through fear of being reminded. When our mind can’t process what has happened, our bodies hold the trauma and so by introducing massage this early, we can help to prevent these unhealthy coping mechanisms from becoming established.

UK Statistics (From the Office of National statistics)

• 20% of women and 4% of men aged 16 years + have experienced some type of sexual assault since the age of 16
• approximately 85,000 women and 12,000 men (aged 16 – 59) experience rape, attempted rape or sexual assault by penetration every year i.e., 11 every hour
• around 85% of sexual assault cases remain unreported to the police
• approximately 90% of rape victims know the perpetrator prior to the offence
• only 5.7% of reported rape cases end in a conviction for the perpetrator

Types of Sexual Abuse

Rape

• Rape may involve physical force (8 out of 10 rapes involve no weapon), coercion, abuse of authority or vulnerable people who are unable to give consent 
• The majority of reports relate to male-female forms of rape and more research is needed on male-male and female-male assault. There is hardly any research on female-female rape
• four out of ten rapes happen in the victim’s home
• rape victims may suffer from physical injury, psychological harm, post-traumatic stress disorder, sexually transmitted infections and pregnancy, in addition to threats from the perpetrator, the perpetrator’s family/friends, and in some cultures, the victim’s own family.

Rape may be categorised according to specific factors:

• SPOUSAL RAPE 
• the perpetrator is a spouse or partner
• spousal rape victims suffer longer lasting trauma than those of stranger rape
• DATE RAPE
• non-domestic acquaintance rape where the victim knows the perpetrator
• drug-facilitated sexual assault, where the victim is unknowingly incapacitated with drugs by the perpetrator with the intention of sexual assault
• the majority of reported rapes fall into this category 
• INCAPACITATED RAPE
• the victim is incapacitated due to intoxication, a medical condition or sleep
• GANG RAPE
• one victim is raped by multiple perpetrators
• both perpetrators and victims tend to be younger and are more likely to be unemployed
• usually involve alcohol and drug use and occur at night 
• involve increased severity in terms of outcomes, higher suicide rates and subsequent counselling as they tend to be more violent
• more likely to be reported
• STATUTORY RAPE
• the victim is under 16 years old and considered unable to give consent
• often also includes sexual activity in an under 16, which does not involve violence or physical coercion 
• CHILD SEXUAL ABUSE
• any sexual acts on children who do not have the capacity to consent to or comprehend the acts, including non-contact acts such as child pornography
• usually involve manipulation 
• perpetrators of childhood sexual abuse vary: some may act out sexually to exert dominance over another individual; others may initiate the abuse for their own sexual gratification
• often unreported due to the shame and stigma associated with this type of abuse, particularly when it often involves incest

The usual effects of childhood sexual abuse generally fall into seven categories:

•  emotional reactions
• symptoms of post-traumatic stress disorder (PTSD)
•  self-perceptions
• physical and biomedical effects
• sexual effects
•  interpersonal effects
•  social functioning

Long-term effects of sexual abuseThe symptoms of sexual abuse can be complex, involving psychological, emotional, physical and/or social, lasting weeks or years, and both the victim and we, as therapists, must remember that there is no normal reaction to it. The long-term effects will be influenced by individual personal circumstances, but this discussion will cover the more common issues that may arise.

Depression

It is thought that the increased incidence of depression among victims of childhood sexual abuse may be due to an inability to externalise the abuse, meaning that they hold themselves responsible for it and think about themselves negatively. When this way of thinking continues over a period of time this leads to feelings of worthlessness, which will impact on them socially. Given that a majority of child sexual abuse cases are carried out by someone who is known and trusted by the child, the victim is often unable to blame the perpetrator, so there is no other option than to believe it is their fault, which leads to internalisation, self-destructive behaviours and a high risk of suicidal tendencies.

The commonly experienced symptoms of depression that often present in victims of past sexual abuse can include:

• prolonged sadness or unexplained crying spells
• significant weight/appetite changes
• loss of energy or persistent fatigue
• altered sleep patterns 
• lack of interest in activities
• social withdrawal
• feelings worthless, hopeless or guilt
• pessimism or indifference
• unexplained aches and pains 
• inability to concentrate, indecisiveness
• irritability, worry, anger, agitation, or anxiety
• thoughts of death or suicide

Stress, anxiety and disassociation

There have been studies which have equated the trauma of childhood sexual abuse to symptoms from war-related trauma in terms of how victims protect themselves by dissociating, whether this be mild environmental detachment to reduce stress levels, or extensive physical and emotional detachment leading to an altered state of consciousness. Dissociation may also involve:

• dissociative fugue – forgetting identity or assuming a new self
• depersonalisation disorder – altered personality and/or sense that self or the world is unreal 
• derealisation
• amnesia – loss of memory to dismiss the impact of the abuse, hence why the realisation that a victim was abused may not happen until receiving therapy
• dissociative identity disorder – otherwise known as multiple personality disorder, where one’s identity is separated into different streams of consciousness 
• complex post-traumatic stress disorder

Dissociation will arise whenever there is a perceived threat, bringing about various symptoms including confusion, flashbacks, and reduced capability to experience feelings.

 Flashbacks

Flashbacks will vary greatly, but the common factor is that they are a re-experiencing of past trauma, through sounds, smells, touch, images or emotions, which feel like a present trauma, causing anxiety, fear, and feeling powerless. 

Many times, the person may not even realize that they are having a flashback and may feel faint and/or dissociate. Both flashbacks and dissociation may occur as a result of encountering triggers, or a reminder of a traumatic event. To the extent that people are not aware of their triggers, flashbacks and dissociation can be incredibly disruptive and unpredictable events that are difficult to manage.

Relationship/intimacy problems

When the perpetrator of sexual abuse is someone who is known and trusted, this can introduce the belief that people the victim loves will hurt them, creating trust issues, fear of intimacy, a lack of interpersonal boundaries, sexual dysfunction, passive behaviours, and involvement in abusive relationships. Studies have shown that male victims have an increased risk of erectile dysfunction, premature ejaculation, and low sexual desire, whereas women become prone to arousal disorders.

It can be unclear as to whether sexual problems are due to traumatic sexualisation or a more general disruption of interpersonal relations. Women particularly view their partner as uncaring and controlling, and have limited capacity to develop their sexuality. Sexual identity isn’t the only thing affected. Sexual abuse at any age will affect the concept of a safe environment and trustworthiness in others, promoting relationship breakdowns due to detachment and insecurity. Communication difficulties are also seen in over 50% of victims, with an inability to confide in their partner. Viewing partners as controlling and uncaring could be due to the partner’s actual behaviour, but could also reflect the woman’s altered expectations and interpretations.

Sexual dysfunction

Studies have shown that those who have experienced sexual abuse in childhood struggle sexually in adulthood in the following ways:

•  less likely to find adult sexual relationships satisfactory
• experience a wider range of sexual activity and are more sexually active than the non-abused
• paradoxical promiscuity – the victim devalues herself and her sexuality and more likely to be judgmental about their promiscuity
• more likely to complain of infrequency or an unwelcome frequency
• almost twice as likely to report current sexual problems 
• unease about their own sexuality 
• heightened anxiety and avoidance of sexual relationships
• increased perception of negative attitudes in their partners contributing to sexual difficulties
• cohabitation/pregnancy at an earlier age (reflecting the need for love and affection in a safe environment 
• increased adolescent risk of sexually transmitted diseases, teenage pregnancy, multiple sexual partnerships, social ostracism and sexual revictimisation 
• increased risk of being raped and domestic violence as an adult

There is a correlation between the severity and persistence of the abuse and the age of abuse, with the incidence of long-term sexual dysfunction. When a child is used as a sexual object, the possibility of a ‘normal’ loving sexual relationship is tainted with exploitation and coercion.

Self-esteem

Studies have shown that child sexual abuse leads to poor self-esteem in adults, in terms of pessimism, an inability to influence external events, but feelings of self-worth, competence and self-acceptance will also be affected.

Long-term mental health

A history of sexual abuse in childhood directly correlates with increased rates of the following as an adult:

• depression
• anxiety 
• substance abuse 
• eating disorders 
• post-traumatic stress disorder

Alcohol abuse

While research has suggested that up to 84% of those in alcohol abuse rehab have suffered some form of childhood abuse, a history of child sexual abuse would not cause alcohol dependency, without additional factors, for example, a controlling mother, an alcoholic partner or use of alcohol as a sexual disinhibitor. The one certainty is that the complex connection between childhood sexual abuse and alcoholism in adulthood is greatly influenced by:

• the severity of the abuse
• the family relationships prior and subsequent to the abuse
• the adult victim’s preconceptions about alcohol reducing sexual anxieties 
• the drinking habits of their eventual partner

Understanding these interactions can be vital to effective therapy.

Eating disorders

It is thought that approximately 30 percent of those with an eating disorder have also experienced trauma, which could offer some explanation for the body image issues and feeling dirty or unattractive. While an eating disorder and trauma are two different issues, they may become connected due to their link with stress and the sufferer’s understanding of them.

Somatic symptom disorder

This disorder is characterized by multiple, recurrent and clinically significant somatic symptoms e.g.:

• pain (often pelvic)
• headaches
• gastrointestinal distress and swallowing problems
• sexual problems
• pseudoneurological symptoms e.g. amnesia
• breathing difficulties

Combined with increased anxiety in response to physical symptoms. 

We know that the mind can impact on the body, for example, mental fatigue causing headaches or cortisol levels during stress will impact on the immune system, and it is thought that Somatic Symptom Disorder (SSD) occurs when the body is pushed beyond its capacity to cope with psychological, emotional, and social stress, potentially explaining why SSD is often seen in those with irritable bowel syndrome and anxiety disorders. Another theory is that SSD occurs as a result of distorted negative thinking, where these thoughts are reinforced by supportive social connections, encouraging the person to believe that minor ailments indicate a serious illness. 

Rape trauma Syndrome

Rape trauma syndrome (RTS) is where the psychological trauma of rape interferes with physical, emotional and interpersonal behaviour, for months or even years after the incident. 

RTS can be experienced by men and women and lays the foundations for complex post-traumatic stress disorder. While the initial distress following a rape will often subside, some form of psychological distress can continue, increasing the risk of substance abuse, depression, anxiety disorders, obsessive-compulsive disorder, and eating disorders.

Three stages of psychological trauma

• the acute stage
• the outer adjustment stage
• the renormalisation stage

The Acute stage

Immediate symptoms can last a few days or weeks and often overlaps with the outward adjustment stage. While there is no ‘normal’ response to rape three responses have been suggested:

• EXPRESSED – agitation or hysteria, crying, anxiety attacks
• CONTROLLED – appears lacking in emotion, acts as if nothing happened 
• SHOCK/DISBELIEF – a strong sense of disorientation, difficulty concentrating, making decisions, or doing everyday tasks, often poor recall of the assault

Common symptoms in the acute stage include:

• reduced alertness
•  numbness
• dulled sensory, affective and memory functions
• disorganised thoughts
• nausea and vomiting
• paralysing anxiety
• pronounced internal tremor
• obsessive washing 
• hysteria, confusion and crying
• bewilderment
• hypersensitivity to the reactions of others

The Outward Adjustment Stage

A rape victim can resume their normal lifestyle, but still experience severe unresolved emotional turmoil, which may bring with it various coping mechanisms, lasting several months to many years after the trauma:

• minimisation (pretending everything is fine)
• dramatisation (cannot stop talking about the assault)
• suppression (refuses to discuss the rape)
• explanation (analyses what happened)
• flight (moves to a new home or city, alters appearance)
•  poor general health 
• continued anxiety
• sense of helplessness
• hypervigilance
•  inability to maintain close relationships
• the startle response (general response of nervousness)
• persistent fear and or depression 
• mood swings
• extreme anger and hostility (particularly in male victims)
• interrupted sleep, insomnia, vivid dreams, recurring nightmares
• flashbacks
• dissociation
• panic attacks

It is during this outward adjustment stage that victims may feel unsafe, hesitant to enter new relationships, experience sexual dysfunction and potentially question their sexual identity (particularly men raped by other men). Some victims will become promiscuous following rape, as a way to regain control over their sexual relations, whereas others will become very inhibited, particularly if experiencing flashbacks.

Increased long term health issues following rape include:

• acute somatoform disorders (physical symptoms with no identifiable cause)
• tension headaches
• fatigue
• general feelings of soreness or localized pain
• specific symptoms will impact in different ways depending on:
  
  
• the nature of the abuse
• the relationship with the perpetrator (a stranger instils fear, someone who is trusted instils feelings of guilt)
• the type and amount of force used
• the circumstances of the assault
• the area of the body abused e.g. oral rape may present mouth and throat issues

Despite trying to move forwards and not think about the rape and suppressing emotions, victims will often relapse and fears and unhealthy coping mechanisms may return. Common fears include:

• fear of being in crowds
• fear of being left alone anywhere
• fear of men or women 
• fear of going out 
• fear of being touched
• specific fears related to certain characteristics of the assailant, e.g. the smell of alcohol or cigarettes, type of clothing

These fears may need to be considered when a client comes for a treatment.

The Renormalisation stage

In this stage the victim begins to make sense of the adjustment phase, understanding the impact of the rape on their behaviour and identifying counterproductive coping mechanisms. The rape will remain part of their life but is no longer the focus, and negative emotions are resolved.

These behaviours and symptoms are coping mechanisms which are used to protect the victim from traumatic events and guard against overwhelming emotions. Any massage therapists treating such clients must understand that despite the fact that these strategies may contribute to health problems, by not comprehending the full picture and treating purely physical symptoms, there is a very great potential to misdiagnose, mistreat and cause further relapse of issues such as PTSD and rape trauma syndrome, as well as initiating an emotional response from the client that they are not ready to deal with. There are also biophysical changes which could impact on techniques used and how the massage is carried out, for example, lower pain threshold or chronic abdominal/pelvic hypersensitivity.

This is why extensive training is essential.

Possible long-term effects on male victims of sexual abuse

Many of the effects for men who have experienced sexual abuse as a child are the same as for women, but there are a few additional issues that may arise, although it shouldn’t be assumed that the presence of these symptoms is due to sexual abuse.

• anger
• fear
• homosexuality 
• helplessness
• isolation and alienation
• legitimacy
• loss
• masculinity Issues
• negative childhood peer relations
• negative schemas about people
• negative schemas about the self
• problems with sexuality
• self-blame/guilt
• shame/humiliation

The Important Role of Massage for Survivors of Sexual Abuse

While some women who have experienced sexual abuse function well, others can have long term interpersonal, social, physical, and psychological difficulties which often increase their use of the healthcare system. There is an increased incidence of:

• diabetes
• obesity
• arthritis
• asthma
• recurrent surgeries
• chronic pelvic pain
• irritable bowel syndrome
• back pain,
• headache
• eating disorders
• poor reproductive outcomes
• digestive problems
• hypertension
• venereal disease
• pelvic inflammatory disease
• respiratory problems
• gastrointestinal problems
• neurological problems

Research has shown that those with a history of childhood sexual abuse visited A&E more frequently and cost the healthcare system significantly more, and this further increased with mental health care. 

Also, some aspects of medical care for these issues e.g. gastrointestinal and gynaecological exams may trigger a posttraumatic reaction, such as overwhelming emotions, traumatic memories or feelings of detachment.  General touch, the power differential between patient and doctor, the removal of clothing, and the focus on pain can also be triggers. For these reasons repeated cancelling of appointments is also common.

Perhaps the most important goal of massage in trauma victims is to help integrate the mind and body, increasing the client’s awareness of underlying emotions, and reversing dissociation.

While massage therapy can facilitate healing following sexual abuse, there are certain precautions that must be taken in these cases, and should a client disclose sexual abuse during a session, we must, of course, maintain confidentiality, but we also have an ethical responsibility to refer to any other appropriate organisations.

Clients who have experienced child sex abuse will be particularly vulnerable in a massage environment, and there are things that we as massage therapists can do to identify when a client may be finding this difficult.

• Use non-invasive tough
  A client will feel your presence before you even place your hands on them and being observant at this stage will give some indication of how they might react to physical touch. Being able to read non-verbal signs are vital in assessing the situation and being able to provide a safe and healing, non-invasive environment. Non-invasive is not necessarily determined by the area of the body or the amount of pressure, but by understanding the readiness of the tissue to allow work to be done, rather than trying to force your way through any resistance, both physiological and emotional.

Victims of abuse have often never had a say in how they are touched, so it’s important to help them to regain control and recognise that their opinion matters by asking if they would like you to alter the pressure, for example if you sense that they are disconnecting from what is happening. Once a client feels in control again, they will increase their capacity to explore new ways of touch which is healthy for relationships, and to differentiate between healthy and inappropriate boundaries.

• Respect the client’s boundaries

By honouring both the physiological and emotional boundaries of the client and setting a clear intention, you will increase your capacity as their therapist to enable them to learn how to receive nurturing touch again and regain the mind body connection.

Time boundaries are also important as the nature and severity of the trauma, and the client’s need to be heard can encourage us as therapists to give a little more time, but this may not be beneficial. Clients who have been through any trauma often struggle to maintain boundaries, so by sticking to the time limit, we are not only helping our client to regain a sense of boundaries, but also helping with titration and preventing them from being overwhelmed, which will have a positive impact on the dysregulated nervous system.

• Remaining neutral while listening but showing compassion
  Massage clients often like to chat during their session, but in these cases we must sit back and really listen to what the client is saying, or not saying. It’s very easy to react to disclosures with our own emotions but this is not conducive to a client’s healing, and can potentially delay it by encouraging coping mechanisms such as dissociation. The biggest factor in a client healing from sexual abuse is feeling heard without judgement, and we must maintain the fine balance between being compassionate and being somewhat emotionally detached.
  
  
• Being present
  Victims of abuse often feel unsafe due to a dysregulated nervous system keeping them stuck in survival mode, and we can only help a client to feel calm and open to healing if we are in the right place energetically. We must set an example, in order to help the client re-establish in their mind, what is healthy. Grounding is essential to be able to transmit positive energy, helping the client to feel safe and open to healing.

As someone who has not only treated trauma clients myself, but also been a victim of abuse, I can say that massage is an extremely significant part of the healing process when your personal space has been violated, because what a client would usually find relaxing can trigger someone who has been abused. To receive a massage requires a much higher level of trust in your therapist, and also trust in your own judgement to be able to give consent, and to be able to logically process the involuntary emotions which may occur, overriding the fight or flight response. The therapist must be aware of issues that may arise for the client just before and during the treatment session:

• Trust issues

Sometimes the smaller actions, which may seem insignificant, are what really makes you seem trustworthy, for example, adjusting the lighting or the music, which may be part of a trigger for them. By asking the client, rather than assuming they want the same as other clients, helps them to have some control over the session. Of course, communication, both verbal and non-verbal, is the biggest factor in showing yourself to be trustworthy and it is worth considering the following:

–           predictability and consistency – ensuring no sudden changes and explaining any changes that should arise, with a repeat request for consent will help to build trust. This is particularly the case with any change in techniques being used, but also in terms of the way you communicate, payment, appointment times etc.

• open and honest communication – tell the client exactly what you are going to do, and then do exactly the same
•  explain everything, especially draping to ensure that they know you respect their modesty and will not overstep any boundaries
• Apprehension/discomfort during massage

We often come across clients who are nervous about taking their clothes off and being touched, maybe due to the gender of the therapist or because they haven’t had a massage before, and this is normal, but in the client who has been sexually abused, this nervousness may not fade as quickly as with other clients, and may suggest a deep-rooted fear of touch and intimacy. The therapist, therefore, should be aware of:

• stiffening during the massage instead relaxing (and this may be difficult to assess in some clients due to the nature of trauma-related tension)
  • a worried facial expression during the session
  • discomfort upon taking clothes off

Even if the first session goes well, there is still the potential for the client to suddenly become uncomfortable with you because of their trust issues.  Signs of this being a possibility may be a client who has seen numerous other therapists. 

Whereas most clients will gradually develop trust in the therapist and feel less vulnerable with each session, enabling a more effective massage, a client who has been sexually abused will suddenly fall back into their unhealthy defence mechanisms as they lower their guard. Therefore, even if you have introduced a new technique in a session, it may be that you have to take a couple of steps back to re-establish the trust again the next time, because those, particularly who have experienced child sexual abuse by someone they know, will have learnt not to trust their own instinct, be aware of and they may not be aware of why.

• Flashbacks and traumatic memories

Sometimes when clients finally relax and release stress and other feelings, they may become emotional and this is part of the healing process, but this is particularly the case in those who have been sexually abused. When the client finally starts to realise that they are in a safe environment and are able to experience positive touch, it is not uncommon for them to cry, often feeling embarrassed and not understanding why they are crying. Sometimes this happens because a certain memory of the trauma has been triggered by the therapist’s touch. When this happens, you may once again have to reassure the client that they are safe by:

• letting them know that it is a safe place for them to release emotions, which may include anger (do not take this personally as it is part of the healing process)
• allowing them to decide whether they wish to proceed with or stop the massage
• offering water and tissues
• remembering that you are not there to counsel but to help them to feel heard i.e. if they want to talk about it they can, but it is not your place to ask them to 

As the therapist we must also remember that the vulnerability of the client in terms of being unclothed and laying down, while the therapist is standing over them will greatly increase the risk of being triggered during a massage, and how your respond to this will affect the client’s trust in you and capability to continue through their healing process. If the client has a flashback, the following steps will help to maintain the trust and restore a safe environment for the client:

• stop touching them immediately and stand back away from the table
• remain calm even if they are angry so that they don’t perceive any action as a threat
• remind the client that they are reliving a past event 
• reassure the client that they are now safe and in control (this may need to be repeated)
• encourage them to focus on their breathing
• touch, sounds and smells can trigger flashbacks, but they can also help end them. If the client can’t acknowledge you, try to change their perception, for example, by increasing the volume of the music so that they can’t ignore it. This may divert their attention away from the perceived threat
• when the client can acknowledge your presence, you can also direct their attention to the room itself. For example, counting crystals in the room, the aim being to reorientate them to the present environment
• reassure the client again that their flashback is a normal response to the trauma they have suffered and there is no reason to feel embarrassed 
• let them know that they can keep coming to see you if they are comfortable to do so, but if they don’t feel ready then it’s okay to stop the sessions or change the duration or intensity
• if they aren’t already, suggest they seek help from a mental health practitioner

Through intuitive use of varying depth, direction, duration, rhythm, speed, and intensity of techniques, a client can develop awareness of their own body and its responses, becoming acquainted with any numb or tense areas. Massage can be a valuable tool to help the client communicate feelings and identify what they perceive to be positive or negative touch in a safe environment where they are in control. This is important because they may have spent years using numbing as a way to cope with their pain, and this means that they may have developed hypersensitivity to touch and low pain tolerance, in which case further care will need to be taken by the therapist. The therapist must be experienced in dealing with trauma to be able to diffuse these incredibly intense memories and sensations, by enabling the client to express their emotions while remaining in the bodily sensation. This ‘normalising’ of what would otherwise be painful touch is what leads to changing patterns and healing.

It is this reprogramming that makes massage so beneficial to the pregnant sexual abuse victim, enabling a positive, rather than traumatic birthing experience.

Massage for the Pregnant Victim of Sexual Abuse

It is well known that women who experience positive physical contact during pregnancy and labour will interact positively with their baby, so this encourages the idea that improving a sexual abuse victim’s body awareness during pregnancy may also help to reduce repetitive cycles of abuse that can occur with those who have been through trauma. Therapists dealing with this type of client, however, must be trained extensively in both the needs of a survivor of sexual abuse, and in pregnancy.

The pregnant sexual abuse victim can benefit from:

•          reduced pain

•          deeper relaxation and reduced anxiety

•          improved body awareness

•          positive touch experiences

•          resolved traumatic memories and feeling

•        physical and emotional preparation for childbirth and parenthood

Alongside the numbing defence mechanism come physical issues such as jaw clenching, diaphragmatic tension, which interferes with breathing, and tension in the chest, abdomen, inner thighs and pelvic floor. With plenty of patience, massage along with breathing exercises can ease this tension, helping to release pelvic tension and breathe more efficiently, helping and the woman to undergo vaginal examinations, to push more effectively and to be able to surrender fully to the birthing process. When traumatic memories are less present, the outcomes of both mother and baby are better.