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A Helping Guidebook for Physiotherapists


Recently, Chris and I were a part of a wonderful workshop at a local Massage Envy in East Providence Rhode Island, where we discussed many of the possible triggers that survivors could face when seeking treatment at either a physical or massage therapy clinic. As survivors, we have all experienced triggers at unexpected, and sometimes embarrassing, times and I have often been asked by my own massage therapist what would be the best actions for a therapist to take if a client is suddenly experiencing a trigger. For therapists that work in a setting like physical therapy and massage therapy clinics, they are in close intimate contact with their patients or clients. Many survivors do not particularly like being touched by someone who is a veritable stranger and sometimes that touch, even within a therapeutic environment, can be a trigger for a survivor to have a bad, and often confusing, reaction.

Think about this scenario: a massage or physical therapist attempts to begin their session and touches a part of the client’s body. Without warning, that client is suddenly off of the table, probably shaking and/or crying, and across the room in a fetal position. That can devastate the therapist because they start to think “what did I do?” The answer is simple: absolutely nothing. That simple touch was a trigger for the client, possibly combined with some other type of external factor, like lighting or a smell, and they react as if they are being touched by their attacker or abuser. That would have to be very distressing for the therapist.

At the workshop, we discussed some possible tactics that can be utilized if they are ever faced with something like this. The first thing they should do is acknowledge that something is happening (“are you ok?”); then give them space (“I’m going to step out for a minute to let you breathe and get your bearings and then I’ll be back to check on you. Is that ok? Can I get you a drink of water?”); ask if they would like to continue the therapy (“would you like to continue?” “would you prefer to have a female/male therapist come in?”); and if they feel the need to talk, let them talk (“I’m so sorry that this happened to you. Is there anything that I can do for you?”). The idea is to keep the focus on them and not on the fact that you, the therapist, are completely freaked out by what just happened.

That fact is, this is a somewhat normal occurrence in this field, but very few people have spoken about it within their profession. If the national statistics are 1-in-4 women and 1-in-6 men have been victims of sexual violence at least once in their lives, the odds of having at least one survivor for a client is very high. If the therapist is armed with the knowledge of what to do in a potential trigger occurrence, the better for the survivor because we won’t continue to feel so alone in the way we process things.