Therapeutic Massage and Homecare to Reduce Dissociation in Post-traumatic Stress Disorder: A Case Report

Dissociation is a transdiagnostic phenomenon common among trauma survivors. Key characteristics include depersonalization, derealization, absorption, and amnesia. Chronic dissociation is correlated with autonomic nervous system hypoarousal and other neurophysiological adaptations that impact survivors' ability to make gains in conventional psychotherapy. Therapeutic massage has demonstrated stimulatory effects on cortical regions that exhibit functional dysregulation in dissociation and post-traumatic stress disorder (PTSD). This case study explored whether therapeutic massage and homecare could reduce persistent dissociation in a client with PTSD.

The study participant was a 35-year-old Indigenous female who was diagnosed with PTSD at age 18. Intake assessment via the Dissociative Experiences Scale-II (DES-II) confirmed pathological levels of dissociation consistent with PTSD. Intervention comprised 10 sessions conducted by a massage therapy student over a period of 12 weeks. Each session included an initial interview, therapeutic massage, homecare prescription, and closing interview. Manual techniques were selected to promote parasympathetic tone while providing tactile stimuli; homecare techniques were selected to promote conscious proprioception. Dissociative progress was evaluated using four discrete DES-II samples, while somatic awareness was assessed during structured, 15-min massage periods in each session. Both tracked indicators showed improvement with intervention, with DES-II scores decreasing by 53.7% from initial baseline, and real-time awareness of somatic stimuli improving by 78%. These improvements were consistent with the participant's subjective reports of increased somatosensory awareness.

As a low-risk intervention, therapeutic massage shows promise as an adjunct therapy in PTSD recovery. While the participant demonstrated improvements in tracked indicators, further research is needed to isolate the effects of massage from those of homecare exercises and the data collection process itself. Collaboration with psychiatry would enhance future study rigor by incorporating diagnostic assessments beyond the scope of massage therapy.