[libribook.com] Traumatic Scar Tissue Management 1st Edition

Scope of Practice Considerations
We began Chapter 1 with a quote from esteemed massage therapist and educator
Pamela Fitch – we are not just treating scars; we are treating people with scars –
because this encapsulates the very essence of our work –the totality of the person
must be considered during treatment.
People who survive injuries that lead to traumatic scarring can face a series of
multiple sources of distress which include emotional and monetary challenges,
disfiguring and debilitating scars and functional limitations and the challenge of
vocational and community reentry along with a feeling of isolation and feeling
alone after discharge from hospital or treatment center (Wiechman et al. 2015).
It is beyond the MT’s scope of practice to diagnose or treat psychological
symptoms. However, we routinely find ourselves at the treatment table assisting
those with traumatic scars and addressing how their distress manifests as
impairments that impact them on many levels.
It is well established that the mind and body are not separate, but intimately
intertwined, and thus MTs must be present and attentive to the person and their
scar on every level. It is beyond our scope of practice to provide psychological
counseling but it is not beyond our scope of practice to provide empathy,
compassion and care. And it is certainly not at all uncommon for the therapist to
be required to navigate somatic memory and emotional responses that occur
during treatment.
Somatic/Tissue Memory
In addition to trauma memory being stored in the various memory centers of the
brain, various parts of the CNS and nerve plexus, trauma can also be stored as a
form of somatic/tissue memory and expressed as changes in the biological stress
response (Barral & Croibier 1999, van der Kolk et al. 1997, Pert 1999).
Tissues can retain trauma memory and symptoms which may arise long after the
traumatic event, with or without apparent cause or direct stimulation (Minasny
2009, Bordoni & Zanier 2014).
According to Pert (1999), the science behind mind–body medicine suggests that