I am a drama therapist practicing through a pleasure-affirming lens. I advocate for those who are often desexualized or hypersexualized in society and thus at risk of violence, such as older adults, people with physical disabilities and people with intellectual delays, and underhoused LGBTQ+ folks.
As a mental health therapist in a long-term care facility, I have witnessed the social and emotional benefits of intentional physical contact in a consensual, non-judgmental space. I have found that opportunities for meaningful expression of intimacy increases well-being and bodily autonomy, which can help reduce individuals’ vulnerability to harm.
This article explores findings on the importance of touch, impacts of physical abuse and neglect on the nervous system, development of older adults, and benefits of group drama therapy. Trauma-informed contact and touch can be integrated into drama therapy to enhance intimacy, to help ease isolation, and rebuild autonomy for older adults in assisted living residences.
Touch and Intimacy
Touch has a range of meanings, often defined as bringing a body part into contact to perceive it through the tactile sense, or to handle with the intent to understand or appreciate. Further, it can stand for any meaningful relationship with one’s own or another’s body, ranging from eye contact to tactile connection. It also means to be in relation with or to influence, regardless of physical proximity.
Intimacy has a similarly diverse definition, broadly thought of as any meaningful connection to the self and to other people through sharing knowledge, emotional understanding, physical closeness or contact.
‘At any life stage, the absence of touch or the presence of negative touch disrupts developmental growth.’
Physical touch is a basic need at all stages of life. It is vital for well-being and can be used to calm, reassure, hold, contain, and otherwise make contact with another person. It signals to the body that it is safe in a relationship, making it possible to be calm and present with another person. Intentional, consensual physical touch has been proven to contribute to optimal human development throughout the lifespan, and contributes to high physiological quality of life. For example, physical touch can help decrease pain in inflammatory conditions like fibromyalgia and migraines. However, if the individual has felt repeatedly afraid or neglected, the brain learns to manage those overwhelming feelings by automatically responding with protective survival strategies of fight, flight or freeze when perceiving a threat from the outside world. These are characterized as trauma responses.
Trauma
At any life stage, the absence of touch or the presence of negative touch disrupts developmental growth. Individuals who have experienced trauma may suddenly withdraw from friends and intimate partners when feelings of trust begin to form, to protect themselves from potential harm or disappointment. While this defense spares the individual from being judged by others, they lose access to physical or emotional pleasure gained from intimate contact or touch.
When people living with trauma are equipped with verbal and non-verbal body language to express their safety and social needs, they are less isolated, more aware of and able to articulate their personal boundaries, and more likely to create strong social and intimate bonds, reducing the risk of being targeted with violence.
Drama Therapy
Playing in a therapy group with a trauma-informed framework can help participants build an empowered self-image as they try on new roles, find flexibility in their body language and emotions, and practice meaningful connection between peers.
As a facilitator bringing playfulness and creativity into therapy with older adults, I walk a fine line between empowering and infantilizing, so I am mindful of my verbal tone, gestural language and choice of tools and materials. Furthermore, intentionally reconnecting to touch with clients who have complex trauma might trigger a stress response in the nervous system and so must be explored gently to avoid re-traumatization.
‘Playing in a therapy group with a trauma-informed framework can help participants build an empowered self-image as they try on new roles.’
This requires an openness to listening to participants’ verbal and embodied feedback and offering modifications. By fostering a structured, safe-enough environment that models humor and respectful communication, I have witnessed participants grow as individuals and as a community.
Below are a few activities ordered from least to most physical proximity. It’s important to restate that touch needn't be physical. Modify as needed and allow ample time for reflection after each activity.
Activities
Interoception Focusing:
This is a slow and gentle practice from Gendlin of contacting the felt sense—the body’s internal landscape—to identify emotions and non-verbal cues that are often numbed as a result of trauma. Place a hand on the belly and one on the chest and attend to the pace and depth of breath, of heart rate, areas in the muscle armor holding tension or softness, temperature in different areas, and gut sensations. In guiding clients through this practice, encourage expressing words, colors, images and sounds associated with arising sensations.
Body Map
This builds creativity and metaphor onto interoception, with the intention to empower clients in their bodily autonomy. The clients can each draw a basic body outline and then lie down or sit comfortably. After a general body scan, bring awareness to the physical body (temperature, tensions and so on). Then to the emotional layer (sadness, longing, power, rage or whatever the group may be working through), and finally into the metaphor layer (animals, plants, landforms, climate).
After this guided exploration, the client marks these areas with drawings, symbols or scribbles. Writing words is discouraged, although two or three is fine. After completing the map, the clients can share what the map might reveal about their relationship with their body and the journeys that have shaped it.
Self-Compassion Hug
The therapist can model the movement as they say something like: First take your left hand and place it under your right shoulder, and then put your right hand over your left arm. Now squeeze with a medium firmness, so it feels secure. You might notice your breath change or your muscles relaxing. You may feel your upper body swaying. Holding this posture for 20 seconds or more can help your brain to release the same chemicals into your body that are activated when another person you trust is hugging you.
Waking Up the Hands
Taken from the amazing Betty Martin, this is a practice in receiving sensation. Sit comfortably, with a cushion in your lap. Choose an ordinary object you can be comfortable while holding, and for 2–5 minutes feel the object with your hands. Notice weight, texture, temperature. Feel for the surfaces and edges where the hands want to linger. Try going slower than usual. Then for another 2–5 minutes, reflect on the experience with a partner using words, body movement, or art making.
Compassionate Touch Spa
A five-step sequence for one to three participants. For groups of two or three, each member goes through the sequence swapping roles as receiver and giver. Communicate what areas are not to be touched. Each motion goes top to bottom, whether that’s head to toes or wrist to fingertips. Touch, whether from others or solo, can feel vulnerable. To create more comfort, bring gentle humor into the exercise, so each step has a name fitting the theme.
- Healthy rinse: gentle tapping with the fingertips.
- Nourishing shampoo: quick medium-firm circular rubbing motion with a flat hand.
- Deep conditioner: firm squeeze using the whole hand with the intent to really hold each part.
- Squeegee: pulling-down and flicking-off motion with the edge of the hand as if you're getting water off a fine suit.
- Boutique brightening: light brushing motion with the fingers.
Final Thoughts
Touch is a basic human need, and when it is absent or negative, there are long-term impacts on developmental health that show up as rigid survival responses in the body and mind. The playful body-based drama therapy interventions outlined here aim to build a sense of safety to help participants move toward intimacy. The use of touch in therapy offers moments of social success, positive and meaningful connection with other participants, and feelings of empowerment to increase quality of life, particularly for those suffering with isolation and complex trauma. By fostering a structured safe-enough environment of levity and communication with consent, participants will have space to grow as individuals and as a community.
Susie Showers (she/they) is a drama therapist and Canadian Certified Counsellor and has been an arts facilitator and adult sex educator in a range of community settings. They create theater, film and puppetry with people who have dis/abilities, challenges with under-housing and lived experience in the sex trade. They live and play in Tiohtià:ke / Montreal, Canada.
Photo credit: Shutterstock/Benjavisa Ruangvaree Art
