CVT Embarks on a Study Centering Trauma-Informed and Culturally-Responsive Bodywork

Written by: Dr. Jennifer J. Esala, CVT senior researcher, Sarah Lawrence, CVT program evaluator and Sara Phillips, CVT social worker & massage therapist

When it comes to health concerns of CVT clients, chronic pain is a significant one. It can be caused by various factors, including physical injuries sustained during torture. Chronic pain can significantly impact quality of life, disrupt sleep, hinder mobility, exacerbate feelings of depression and heighten anxiety.

Studies show a high prevalence of chronic pain among torture survivors. This pain can manifest in various ways, with headaches, migraines, and back and joint pain being common.

Anne Eichmeyer, CVT Healing Hearts program manager, sheds light on the impact of chronic pain on their clients. “Most of our clients report having pain and often share this as their presenting problem when they first come to utilize our services. Often their pain seems to co-occur with and/or compound their symptoms of depression, anxiety or post-traumatic stress disorder (PTSD),” Eichmeyer said.

“We find that often as a result of our clients’ pain, they are unable to work and have difficulty meeting their basic needs. Many of our clients who experience pain also frequently use emergency services.”

The good news? Massage and bodywork have been found to reduce pain in both general populations and groups that have experienced trauma, including refugees, war veterans and survivors of interpersonal violence. 

“We have learned so much in recent decades about neuroscience, the body and trauma. So much trauma is stored in the body, so it is an organic outcome that many trauma-focused mental health interventions are now focused on the body in some way. Massage is a promising option,” said Leora Hudak, LCSW and CVT migration partnerships program manager.

So much trauma is stored in the body, so it is an organic outcome that many trauma-focused mental health interventions are now focused on the body in some way. Massage is a promising option.”

Leora Hudak

Because of this promise, CVT applied for and received a grant from the Massage Therapy Foundation to conduct a research study. The goal of this study is to develop and test an approach to massage therapy that’s tailored to the needs of torture survivors, refugees and asylum seekers from diverse cultural backgrounds. 

What is TCI-Massage?

This new approach, called Trauma-Informed and Culturally-Responsive Integrated Massage Therapy (TCI-Massage), is designed to be sensitive to the trauma history, cultural considerations and language needs of CVT clients.

Because pain is a central concern for many survivors of torture, pain education is integrated into each massage session. This education is based on Mindful Awareness in Body-Oriented Therapy, and includes: 

• Breathing exercises
• Body awareness
• Self-compassion

The TCI-Massage model is designed and implemented within a trauma-informed framework, which includes the foundational principles of safety, trust, offering choices, autonomy and communication in the context of the therapeutic relationship. 

An Addition to the CVT Menu of Services

CVT offers a comprehensive range of services to its clients, and massage therapy is envisioned as a valuable complement to their existing care model. 

Léonce Byimana, CVT director of U.S. clinical programs, emphasizes the importance of individualized care. “Because survivors have experienced different types of torture, have various levels of resilience and have different cultural backgrounds,” Byimana explains. 

“It is important for CVT to offer a menu of services that survivors can choose from, depending on their needs,” he said, highlighting how body-oriented therapies like massage can complement psychotherapy in addressing the complex trauma CVT clients often experience.

Beyond Pain Relief

In addition to chronic pain, mental health challenges like depression, anxiety and PTSD are also common in torture survivors. Because the benefits of massage and bodywork extend into emotional regulation, the TCI-Massage model offers a dynamic approach to supporting mental well-being for CVT clients. 

By directly impacting the sympathetic nervous system, massage can create a sense of ease and relaxation. This relaxed state can be beneficial for psychotherapy sessions, allowing clients to feel more grounded and open to therapeutic work. 

“Massage is a familiar entry point to an unfamiliar or stigmatized process of psychotherapy,” said Hudak.

When we meet our clients where they are at, in this case with a familiar way of healing, we have the opportunity to build trust and rapport and eventually open up to a variety of forms of torture rehabilitation.”

Leora Hudak

Addressing Chronic Conditions

The potential benefits of TCI-Massage also reaches into management of chronic conditions like heart disease. Trauma experience, chronic pain and mental health issues are all linked to an increased risk of heart disease, and there’s a growing body of research suggesting that massage can positively impact heart health.

For instance, refugees have a higher risk of heart disease but, encouragingly, research shows that massage can improve blood pressure and heart rate – two key indicators of heart health. 

Recognizing this potential, CVT is partnering with the University of Minnesota’s Neurobiology of Emotion, Sleep and Trauma Lab in this research to study the impact of TCI-Massage on heart health among CVT clients.

Culturally-Resonant Treatment

Many torture survivors and asylum seekers face significant challenges when attempting to access adequate and culturally-appropriate healthcare. And, even when they do access healthcare, the quality can be subpar. 

Language barriers, logistical hurdles and a lack of familiarity with local healthcare systems can create a frustrating experience. Inappropriate use of interpreters (such as asking children to translate for their parents) and culturally insensitive treatment models are all too common. 

One of the reasons CVT initially explored massage therapy as a service for clients was because it already resonates with many survivors’ cultural backgrounds, and TCI-Massage stands out as a model that addresses these concerns head-on.  

Massage is culturally familiar to many of the communities CVT works with…sometimes mores so than talk therapy.”

Leora Hudak

Eichmeyer said, “We have heard from a lot of our clients that they use massage techniques at home –  often on and with family members – in order to heal various ailments, address pain or for relaxation. Massage has been a part of traditional medicine and healing in Southeast Asia for centuries.” 

TCI-Massage represents another step in supporting the well-being of torture survivors, refugees and asylum seekers. It acknowledges the complex interplay between physical and emotional trauma, offering a holistic approach to healing. 

By combining the power of touch with cultural sensitivity and trauma awareness, we hope that TCI-Massage will serve as a tool for survivors to reclaim their bodies and find solace on their journey towards a brighter future.