The Complicated Practice of Healing Sexual Assault Survivors Through Touch

Adkison has attended yoga classes since she was a teen, and she continued to do so after she was sexually assaulted in college. Usually, she finds an instructor's hands soothing. But on that particular day, she details in a Medium post that the unexpected physical touch was jarring. "[Instructors] might think that if their touch is meant to be healing or soothing, it will automatically be received as such," Adkison tells Broadly. "This isn't the case, no matter the instructor's intentions, and in those moments when survivors are getting deeply in touch with their own bodies, they can be the most vulnerable to strong emotions and flashbacks to traumatic experiences."

With the mounting research showing the positive benefits of holistic therapies like yoga and meditation, which are touted as practices that can help you with everything from everyday stress to post-traumatic stress disorder (PTSD), survivors of sexual assault often turn to these practices to ease symptoms of their trauma. But what do you do when the practices that are meant to be healing actually hurt you?

About one in six women and one in 33 men in the United States have experienced attempted or completed rape in their lifetime. These incidents are often associated with psychological and physical aftereffects like anxiety, depression, hyper-vigilance, sensitivity to touch, and chronic pain, with more than a third of survivors developing PTSD as a result of their assaults. Therefore, wellness practices can deeply benefit clients—but practitioners have to be hyper-aware of their clients' individual needs.

"It's almost impossible not to receive someone in your space who's experienced some kind of trauma," says Manisha Tare, an occupational therapist in Washington, D.C., specializing in CranioSacral Therapy and therapeutic yoga. "It's a responsibility to understand what that might look like in a person and how you might do your own work so you can hold space for people."

That's why Molly Boeder Harris, a Portland-based yoga instructor and Somatic Experiencing practitioner-in-training, has made it her life's work to bring trauma awareness to the healing arts—a broad category including yoga, acupuncture, psychotherapy, massage, reiki, and more. In 2012, she founded The Breathe Network, an online resource for sexual assault survivors to connect with local practitioners who work specifically from a trauma-informed perspective. The premise of trauma-informed care is simple: Understanding how trauma functions and how it appears in the body is essential, not supplementary or tangential. In practice, it is highly varied, depending on the treatment modality and the unique needs of each person. The idea is that clients dictate their own healing, creating a greater emphasis on what works and what feels good rather than doing it "right."

"As instructors, we're generally taught more about how something looks, purely what people can see externally," says Lachrista Greco, a trauma-informed and adaptive yoga instructor in Madison, Wisconsin. But in her view, encouraging students to be present in their bodies and open to sensation is more important than achieving a particular shape.

While we often think of trauma's psychological and emotional impacts, "trauma is about what happens to the body," says David Emerson, director of yoga services for the Trauma Center at the Justice Resource Institute in Brookline, Massachusetts. Emerson, who coined the term "trauma-sensitive yoga," has spent the last 13 years developing and overseeing a clinical intervention yoga program for teens and adults with PTSD from chronic interpersonal trauma.

According to this approach, healing trauma through physical channels is necessary because trauma itself is a physical phenomenon. According to Emerson, it lowers activity in the interoceptive regions of the brain that are responsible for linking sensory perception to awareness of that experience. Examples of that connection at work include hunger, which prompts us to eat, or pain, which compels us to move our hand off of a hot stove. Regaining body awareness means learning to "notice, tolerate, manage, and reinterpret" sensations, and yoga is a practice space for this process—provided that one's external conditions are sufficiently safe and free of coercion.

In trauma-informed models, clients are told what to expect, so as not to be caught off guard. (For instance, Boeder Harris preps new clients with a detailed description of the building where she teaches. When they arrive, she orients them to the space, pointing out all bathrooms and exits.) Clients are also given choices, not commands—this contrasts with the very absence of choice that defines sexual assault or abuse.

Isabella Gitana-Woolf, a massage therapist in Easthampton, Massachusetts, who works predominantly with sexual assault survivors, says consent is fundamental. "When you go in for massage, usually you tell [the therapist] what's wrong, then you lie there and they massage you," she says, "as opposed to you being an active participant." Gitana-Woolf takes a more collaborative approach, initiating every client relationship with a conversation about boundaries. Some people, she learns, are comfortable with the use of her hand to indicate where she will massage next. Others prefer that she seek explicit verbal permission for each body area throughout a session. If she asks and someone says no, the question becomes, "What can we do instead? Do you want a break? Would you like to stop?"

When it comes to logistics of empowering, consent-based care, one size doesn't fit all. The Breathe Network is currently conducting a national study looking at the possibilities of, and obstacles to, survivors' use of the healing arts from acupuncture to chiropractic services to dance therapy. According to Boeder Harris, one significant insight of the study so far is that what one survivor takes comfort in (such as physical contact), another may find re-traumatizing. Therefore, it becomes difficult to establish a definitive set of best practices regarding specific protocols. The key for practitioners, then, is to have a framework that allows for flexibility tailored to clients' individual embodied experiences.

Boeder Harris hopes their findings will help make a case for incorporating trauma awareness into mainstream healing arts education (The Breathe Network is already using their research in practitioner trainings), and for the use of holistic therapies as viable healing options for all trauma survivors. "When the provider doesn't know about trauma and sexual assault, the experience can be re-wounding," she says. "[But] interactions between survivors and providers, when they're prepared with the right tools, go really well."

Yet, nearly every practitioner that spoke to Broadly said there were no discussions of trauma, let alone sexual assault, in their training programs. It has less specifically to do with their fields, and more to do with how our society handles the topic of sexual assault in general.

"Our healing arts schools are a reflection of larger society, and our larger society continues to treat [sexual assault] as a taboo topic," Boeder Harris says. "[We] treat it as a personal experience that you as an individual have to figure out. We have yet to say this is a community problem and that we all have a role to play in healing survivors and healing our society."