Given the prevalence of trauma in our society, becoming trauma-informed is an important next step in the evolution of providing responsible wellness services. Bodyworkers and spa team members are going to be more effective with more people when adopting a trauma-informed approach.
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Given the prevalence of trauma in our society, becoming trauma-informed is an important next step in the evolution of providing responsible wellness services. Bodyworkers and spa team members are going to be more effective with more people when adopting a trauma-informed approach.
Essentially, this means understanding different forms of trauma and how they impact people’s lives; recognizing signs of trauma and skillfully responding to them; and resisting re-traumatization. Whether or not someone has experienced trauma, though, every person deserves compassionate, consent-based, tender care from bodyworkers and all spa
team members.
But First, What Is Trauma?
Lately, the word trauma has been used casually to the point of being a buzzword. While some things may be annoying or even tragic, that doesn’t necessarily mean they are traumatic.
According to the Substance Abuse and Mental Health Services (SAMHS) Administration:
“Individual trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”
Trauma is commonly defined as “experiencing or witnessing a potentially life-threatening or emotionally overwhelming event(s) such as childhood abuse, natural disaster, combat, sexual assault or car accident.”1 Experiencing systemic oppression, such as racism, is also a form of insidious trauma.2 Other significant events that can cause trauma include surviving birth trauma, combat, addiction, medical trauma, intergenerational trauma, mind control, religious or ritual abuse, childhood sexual grooming, abuse and sexual exploitation.
However, trauma doesn’t necessarily have to be “capital T trauma” in order for the event to impair the proper functioning of the stress-response system. At least 70% of adults in the U.S. have experienced some type of traumatic event at least once in their lives. That’s roughly 223.4 million people.3
Many people, particularly those in traditionally under-resourced populations, have repeated exposure to trauma over their lifetimes. Demographic and identity group factors, including race, gender, immigration status and profession (such as soldier or first responder), correlate with a higher risk for trauma exposure. Membership in one or more in-risk groups generally compounds trauma exposure and consequently increases risk for many chronic diseases.
How Trauma Can Present in Clients
Most people have experienced some kind of psychological, physical or emotional trauma in their lives. At some point, they experienced an event that was out of their control, which alerts the nervous system, the body’s command center, of impending danger. When the body/nervous system senses danger, it will fight, flee or freeze to maintain its survival.
“In other words, ‘the issues are in the tissues,’” says Sandra Emmanouilides, a trauma-focused holistic psychotherapist, licensed esthetician and founder of Trauma Touch Esthetics, a trauma-informed mental wellness signature coaching program.
Bodyworkers make physical, skin-to-skin contact with their bare hands on partially or fully naked human bodies. They also work on other vulnerable parts, including the back, glutes and thighs. Additionally, the client is lying face down, so they can’t see the person touching them. They’re often in a dimly lit room with the door closed, and often the practitioner is a stranger.
Massage school teaches the importance of proper draping and the ethics of touch, but practitioners also need to consider whether their client feels safe in such a vulnerable position on a treatment table. In the treatment room, bodyworkers often witness the following:
- Emotional flooding, crying, shaking, trembling;
- Dissociation, where the client has a trance-like appearance, seems detached or feels disoriented;
- Flashbacks, where clients feel young, vulnerable or regressed (out of time and place);
- Anxiety, panic, nit-pickiness or silence;
- Easily startled, angered or frustrated, even over small things;
- People pleasing;
- Sensory or body-related triggers and sensitivities, such as wearing a tight apron around their neck during a haircut, undressing for a bodywork session, closing their eyes or wearing an eye mask.
These responses are what triggers look like, and these scenarios elicit an enormous responsibility for practitioners to understand the sensitivity required to ensure that those customers in your care feel safe. Recognizing the behaviors and physical responses of someone in flight, fight, freeze or appease is crucial for understanding what is underneath a behavior.
Being a Trauma-Sensitive Spa Professional
If the practitioner is unprepared to handle these sensitive situations, the service can become an unsafe situation and may re-traumatize the client. With proper education, practitioners can feel confident about how to conduct the service, make modifications for common practices that might make clients uncomfortable and even avoid traumatizing themselves.
“We never know what our clients are going through or have gone through in the past,” says Tiffany Ryan, MSW, LMT, yoga teacher and co-founder of Yomassage. “Being a trauma-informed practitioner allows you to feel confident that you are providing a relaxing, restorative and safe experience for all of your clients.”
Trauma-informed care ensures the environment and services are primarily safe, empowering and healing—but also engaging and soothing. Jess Jackson, a trauma informed LMT and educator at Soft Path Healing, strives to be a soft landing space for folks who have been through trauma. “My work is infused with an awareness of trauma responses, knowledge of the ways the body can hold residual trauma, the nervous system landscape and lived experiences of trauma,” explains Jackson. “Trauma-informed care is incomplete without acknowledging marginalization, oppression, racism, sexism, classism, ableism, fatphobia, homophobia and so much more.”
It begins before the session, including marketing communications and intake processes. A trauma-sensitive intake form asks questions about guest preferences that could inadvertently cause triggers.
Ryan advises asking about scents, anywhere clients don’t want to be touched, if they are okay being face down, music preferences, lighting preferences—anything within the therapist’s control that may cause a potential trigger. “Appropriate questions might be, ‘Do you have a preference about lighting?’ or ‘Are there areas of your body that are especially sensitive to touch?’” adds Emmanouilides.
There are many trauma-informed practices that can make an immediate impact in the spa. During sessions, practitioners and employees might ask for consent, offer choices and adaptations (such as eyes open or closed, lights dimmed or not, clothed or draped massage, etc.), and be aware of known triggers. Incorporating pronouns and gender identity into practices like intake forms, name tags and introductions, shows a level of care.
Be mindful of the environment. For example, maintain a non-cluttered space or arrange furniture in a way that allows clients to have clear sight to an exit.
Communication is also key. Explain the plan for the session at the beginning, get the client’s feedback on that plan and then follow through on what you say—no surprises. This ensures that clients feel heard and in charge of what happens in their appointment.
Implementing trauma-sensitive/aware practices like these ensures that all team members can contribute to creating safer spaces for guests and build trust. Therapists will also be better equipped to recognize trauma responses and prevent further re-traumatization throughout the guest experience.
References:
1. Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatr Assoc 2013:271.
2. Williams MT, Metzger IW, Leins C, et al. Assessing racial trauma within a DSM- 5 framework: The UConn Racial/Ethnic Stress & Trauma Survey. Pract Innov 2018;3:242.
3. The National Council for Mental Wellbeing: www.thenationalcouncil.org/wp- content/uploads/2013/05/Trauma-infographic.pdf
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Irene Macabante is the CEO and founder of the Citrine Consulting Collective. A lifelong spa-goer and wellness product aficionado, she uses her 25+ years of branding, marketing and tech experience to create safe and inclusive spa environments that increase customer retention, foster belonging in teams and boost brand reputation.
