Co-regulating touch: when the body learns safety in relationship
Touch has always sat at the edges of psychotherapy — powerful, intimate, and often misunderstood. Yet when we look closely at how human nervous systems develop and regulate, it becomes clear that touch is not an “extra”. It is one of our earliest languages of safety.
In somatic psychotherapy, we understand regulation as a relational process. From infancy, heart rate, breath, muscle tone, and emotional states are shaped in interaction — soothed and organised through another body. Long before words, the nervous system learns through contact.
Contemporary research is helping us understand why therapeutic touch, when safe and consensual, can support nervous system regulation. Studies summarised by the Greater Good Science Center show that supportive touch can reduce cortisol, lower blood pressure, and dampen threat responses — particularly within trusted relationships (Greater Good Science Center, 2023). More recent neuroscience demonstrates that social touch modulates brain networks involved in stress regulation, affiliation, and social safety (Nature Human Behaviour, 2024).
Touch does not regulate in isolation. Its impact depends on relational context, prior experience, and nervous system state. The same contact can soothe one person and activate defensive circuitry in another.
This is particularly relevant in trauma therapy in Australia, where many clients present with complex developmental trauma, attachment disruption, or chronic stress. Polyvagal and stress-system research (Porges, 2011; Kozlowska, 2017) shows that early trauma can sensitise defensive pathways — leading to hyperarousal (fight/flight), hypoarousal (collapse), or dissociation.
When the body has learned that closeness equals danger, regulation becomes solitary, vigilant, or shut down.
In my research exploring the lived experience of Functional Neurological Disorder, a central theme that emerged was that of relationally regulated selves — regulation and dysregulation unfolding within relational environments. When relational environments are unpredictable or shaming, the stress system adapts accordingly. When safety is co-created, regulation can widen.
In somatic psychotherapy, therapeutic touch — when carefully introduced — can offer an experience of borrowed stability: I do not have to manage this alone. It is not a technique applied to a passive body. It is a relational dialogue.
This reflects the broader evolution of psychotherapy away from interpretive authority and towards embodied relational presence (Meares & Hobson, 1977). The body is not an adjunct to therapy — it is part of how we know what we know.
Touch does not replace talking. It deepens the conversation.
When not to use therapeutic touch in trauma therapy
Because therapeutic touch can be powerful, discernment is essential.
There are situations where touch may dysregulate rather than soothe:
- When there is unresolved trauma involving boundary violation
- When dissociation is active or unrecognised
- When the therapeutic alliance is not yet secure
- When the clinician is not adequately regulated
- When cultural, personal, or contextual meanings make touch inappropriate
Neuroscience shows that social touch activates attachment and threat-detection networks (Nature Human Behaviour, 2024). If those systems are sensitised by trauma, touch may trigger defensive activation before cognitive awareness catches up.
What appears as calm may, in fact, be dorsal shutdown.
In trauma therapy in Sydney — and across Australia — it is essential that any use of touch is carefully assessed, collaboratively negotiated, and continually reviewed.
Why specialised training in somatic psychotherapy matters
Therapeutic touch is not casual contact. It requires specialised training.
In modalities such as Somatic Experiencing®, attachment-focused somatics, and other forms of somatic psychotherapy, clinicians are trained to:
- Track autonomic shifts moment-to-moment
- Recognise subtle signs of sympathetic activation or collapse
- Titrate pacing and intensity
- Establish explicit and ongoing consent
- Repair ruptures
- Maintain clear ethical boundaries
Touch communicates regulation — or dysregulation. Nervous systems read each other implicitly. Without adequate training, well-meaning touch can overwhelm rather than integrate.
For this reason, in my practice in Sydney, any use of therapeutic touch occurs within a clearly defined, trauma-informed, relational framework, grounded in specialised training and ongoing consent.
The research suggests that the regulatory power of touch lies less in pressure or technique, and more in attuned relational presence (Greater Good Science Center, 2023; Nature Human Behaviour, 2024). Without that presence — and without training — touch risks retraumatisation.
Like all powerful therapeutic tools, its value lies not in whether we use it — but in how, when, and why.
With Love
Andi
References
Greater Good Science Center. (2023). Hands-on research: The science of touch. University of California, Berkeley.
https://greatergood.berkeley.edu/article/item/hands_on_research
Kozlowska, K. (2017). A stress-system model for functional neurological symptoms. Journal of Neurological Sciences, 383, 151–152.
https://doi.org/10.1016/j.jns.2017.10.044
Meares, R., & Hobson, R. F. (1977). The conversational model of psychotherapy. British Journal of Medical Psychology, 50, 195–204.
Nature Human Behaviour. (2024). Social touch and the regulation of stress and affiliation networks. Nature Human Behaviour.
https://www.nature.com/articles/s41562-024-01841-8
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton.
Szasz, A., Korner, A., & McLean, L. (2025). Qualitative systematic review on the lived experience of functional neurological disorder. BMJ Neurology Open, 7, e000694.
https://doi.org/10.1136/bmjno-2024-000694
Szasz, A. (Unpublished manuscript). The body in psychotherapy.
