Trauma-Informed Touch in Couple Therapy: A New Pathway for Healing and Connection

by Simon Banks, MA, PBANZ
PACT Level 3 Clinician

Introduction

A few months ago, I had an experience that subsequently inspired me to write this paper. My partner and I were at another couple’s house for afternoon drinks and nibbles along with their new neighbors who, unknown to us prior to the event, had also been invited. 

My partner, like me, is a PACT Level 2 practitioner, Somatic Experiencing practitioner, DARe practitioner, and yoga teacher. She also knows that social gatherings — especially with new people — can bring up anxiety and discomfort for me. This often manifests in ways like shutting down and not engaging, wanting to leave, or even dominating the conversation. 

As the six of us sat around the table engaging in the typical small talk that accompanies meeting new people, I noticed that my leg was jiggling involuntarily and that my hands were fiddling with the lid of a jar. A moment later, I caught my partner’s eye as she glanced at my hands. Seconds later, I felt her gently place her feet on top of mine under the table.

I immediately understood her intention. This simple gesture, something we had practiced during our Somatic Experiencing training as a grounding/orienting to safety intervention and was designed to promote regulation in the autonomic nervous system (Levine, 1997). The impact on my state of arousal was immediate: my leg stopped moving, I let go of the jar lid I had been nervously fiddling with, and my attention shifted. I became more present, suddenly attuned to what others were saying instead of worrying about how I might respond or contribute. 

I felt supported, noticed, and no longer alone. Her attunement to me and her ability to intervene in that moment provided what I had rarely experienced growing up — a sense of being seen and cared for. This experience became deeply corrective, aligning with the principle in Somatic Experiencing that completing the survival response is essential for restoring the nervous system’s balance (Levine, 1997). 

Similarly, PACT therapy emphasizes the importance of partners offering each other what was absent in their family of origin, creating opportunities for healing attachment wounds (Tatkin, 2016). Through her action, I experienced the two-person system at the heart of PACT therapy as fully alive and embodied in that moment; I could see she was taking care of herself and me at the same time.

This experience sparked a realization. In PACT, we guide couples to become experts on each other, to manage each other’s distress, and to respond in moments of dysregulation. I began to wonder how certain somatic interventions, such as the use of grounding touch, could be integrated into PACT to provide couples with additional tools to regulate and care for one another.

The Science of Touch and Attachment

The Role of Touch in Human Development

Touch is one of the most fundamental ways in which humans develop secure attachments from infancy onward. Research has long shown that physical contact between caregivers and infants shapes emotional regulation, stress responses, and secure attachment (Bowlby, 1969). Infants, as with all primates, rely on touch to form bonds with caregivers, experiencing physical closeness as a source of safety and comfort. This early physical connection builds the foundation for emotional security and the ability to form healthy attachments later in life.

However, trauma impacts our attachment style and experience of touch. Some trauma survivors develop complex relationships with touch, associating it with pain or fear, particularly if the trauma involved physical or sexual abuse (van der Kolk, 2014). This creates a challenge in adult relationships, where physical closeness is expected to be nurturing but instead may trigger fear responses or emotional withdrawal. In addition, many people who lacked touch during infancy may become touch-averse later on.

Trauma and the Body

According to Bessel van der Kolk (2014), trauma leaves an indelible imprint on the body. Individuals who have experienced trauma often remain hyper-vigilant, experiencing heightened startle responses or dissociation when triggered. Trauma survivors may have a heightened sensitivity to physical touch, which can be perceived as threatening rather than comforting.

Peter Levine (1997), the founder of Somatic Experiencing, elaborates on how trauma lodges itself in the body. His work emphasizes the need for body-centered interventions to help trauma survivors re-establish safety and bodily autonomy. Levine's model highlights the importance of safe, gentle physical contact in releasing trauma from the body and fostering a sense of control.

Stephen Porges' polyvagal theory (2009) provides a neuroscience-based explanation of how touch impacts the autonomic nervous system. The vagus nerve, which regulates the body's fight-or-flight and rest-and-digest responses, is deeply involved in social engagement and attachment. Safe touch activates the parasympathetic branch of the vagus nerve, promoting calm and social bonding. Trauma, however, often keeps individuals in a heightened state of sympathetic activation, where touch may feel overwhelming or dangerous.

In couple therapy, where the goal is to foster emotional attunement and attachment repair, the ability to co-regulate each other's nervous systems through touch can be transformative. Trauma-informed touch offers a pathway to help couples recalibrate their autonomic responses, fostering greater connection and trust.

Step-by-Step Framework for Introducing Trauma-Informed Touch

Step 1: Establishing Consent and Comfort

The first step in introducing trauma-informed touch is to establish clear boundaries and ensure both partners are comfortable. This involves having an open discussion about each partner’s trauma history, physical boundaries, and comfort with touch. The therapist should guide the couple in setting clear rules around consent and respecting each other’s limits.

Step 2: Guided Touch Exercises in Session

In the therapy session, the therapist can introduce trauma-informed touch exercises tailored to the couple's needs and comfort levels. Some of the exercises might include the following.

• Handholding for Grounding: Partners hold hands while focusing on slow, deep breathing. This exercise helps promote emotional connection through a simple, nonthreatening form of touch. It is useful for some that find eye contact too stimulating. 
• Back-to-Back Sitting: Partners sit with their backs touching, focusing on synchronizing their breathing and feeling each other’s physical presence without the intensity of direct eye contact. They find an angle that feels equal, without either one of them taking too much weight from the other.
• Feet on feet: Couples are invited to sit opposite one another while one partner places their feet gently on top of the other’s. Although removing shoes is preferable, it is not essential for this to be effective.

Step 3: At-Home Practice

Once the couple feels comfortable with touch exercises in session, they can begin practicing these at home. The therapist can provide specific instructions for safe, grounding touch exercises that reinforce what they’ve learned in therapy. These exercises should only be done initially when neither couple is activated in order to grow accustomed to what touch as a tool feels like. 

At-home practice might include sitting together back-to-back or holding hands during conversations to maintain emotional regulation. As they become more accustomed to the impact of these techniques, they can start to explore using touch techniques when one needs soothing. If both partners are in a state of high activation, trauma-informed touch may not be available. These tools are more about one partner who is regulated soothing another partner who is not. 

Step 4: Therapist’s Role as a Guide

The therapist's role is to observe and guide the couple's interactions during touch exercises, ensuring that the offering partner is attuned to the other’s needs and boundaries. The therapist can offer feedback and help the couple process any emotional responses that arise during the exercises. 

Step 5: Adapting to Trauma Histories

For some couples, direct touch may not be possible early in therapy. The therapist should offer alternatives, such as having a partner describe the touch: “Imagine that I am sitting next to you right now, that our arms are touching, and that you are not alone” might be something a partner could say to their activated partner.

Problem Scenarios & Case Examples

Problem Scenarios

Trauma-informed touch could be particularly useful in these common scenarios:

• One partner has experienced physical or sexual trauma and is triggered by touch.
• Couples have emotionally shut down and avoid physical closeness.
• One partner has avoidant attachment tendencies and resists physical contact as a defense against emotional vulnerability.
• Couples have spent decades interacting physically in particular ways and may take longer to feel safe enough to experiment with this.

Case Examples

Since my experience, described in the opening paragraphs, I have been incorporating trauma-informed touch into some of my work with couples. While these touch exercises may not be entirely new to the PACT model, what sets them apart is the intention and framing behind their use, combined with psychoeducational training to help couples understand the purpose and significance of these practices.

Case Study 1: Couple with Trauma Histories

In this case, one partner (Partner A) has complex PTSD, which impacts their ability to tolerate physical closeness. They grew up in a home where hitting was used to enforce discipline, and an uncle was sexually abusive. Partner A experienced very little touch other than that. 

Their relationship is marked by periods of emotional distance and intense dysregulation when under perceived threat, leading to shouting, throwing objects, and eventually going to bed, asking not to be disturbed. Despite emotional attunement work in therapy, their progress has plateaued due to the triggering nature of physical intimacy. Here, traditional couple therapy interventions focusing on face-to-face communication and emotional regulation may fall short.

In the sessions, Partner A would become activated with little stimulus — even at the request for a hug from Partner B. I began inviting Partner B, too, when they noticed that Partner A was becoming dysregulated, to wait for a pause and say:

“I can see how painful this is for you. Would you be willing to let me come a little closer and place my feet on top of yours. I won’t expect anything in return and, if you don’t like it, I can stop immediately.”  I added that I also had my eye on things to ensure their safety. 

Partner A nodded their approval. I had already instructed them to remove their shoes. Partner B did as I suggested and after ninety seconds Partner A’s demeanor began to shift. She exhaled deeply and gradually became able to look at Partner B, who I had invited to keep a neutral gaze and to look away every so often. 

Over the next few sessions (repeating this exercise), Partner B was eventually able to share that they would like to work on more affection without it sending Partner A into a state of dysregulation. They also reported practicing this at home with some success, staving off full-blown arguments and ruptures. 

By introducing trauma-informed touch in a controlled therapeutic setting, the couple continue to experiment with safe, consensual physical contact. By guiding them through attunement exercises, they have started rebuilding trust in their ability to touch without triggering trauma responses.

Case Study 2: Couple Struggling with Emotional Distance

Another couple, emotionally distant for years due to unresolved conflict and growing up in families where it was not okay to be vulnerable or show sensitivity. They avoided physical touch as it felt too scary. It was easier to keep up a wall. 

Despite progress in resolving verbal conflicts, they remained disconnected. In one session, Partner A became highly dysregulated at the complaint from Partner B, who wanted sex to be a part of their relationship again. I invited them to sit with their backs to one another on the couch in my office, leaning back as they did so, asking them to pause when they thought there was an equal share of the weight on one another. I invited them to share with one another the kind of physical touch they would like in their relationship by first instructing them to start with this sentence:

“I’m going to tell you what kind of touch I want, but please know there is no expectation or requirement for you to do it. I am telling you so you can know me more.”

What followed was an incredible connection where they were both able to be vulnerable enough to share what was true for them. It turns out they wanted the same thing (a thriving sex life) but didn’t know how to get there. Looking into one another’s eyes was too much stress for them. 

By feeling the weight of the other, their nervous systems were able to co-regulate, and the two-person system was nourished. Over the next few months, they progressed and now go to sleep spooning. This was a huge step for this couple who had not shared a bed for five years. 

Problem Scenarios

Trauma-informed touch could be particularly useful in these common scenarios:

• One partner has experienced physical or sexual trauma and is triggered by touch.
• Couples have emotionally shut down and avoid physical closeness.
• One partner has avoidant attachment tendencies and resists physical contact as a defense against emotional vulnerability.

Supporting Evidence and Client Demographics

Evidence from Other Modalities

Body-centered therapies such as Somatic Experiencing (Levine, 1997) and Hakomi (Kurtz, 1990), Rolfing and Feldenkrais have long used touch as a tool for emotional healing. These modalities emphasize the importance of safe, gentle touch in helping individuals process trauma and regulate their nervous systems. By integrating these principles into PACT, therapists can enhance their ability to help couples navigate the complex effects of trauma on physical and emotional intimacy.

Notes on Client Demographics

• Neurodiverse Couples: Touch may need to be introduced slowly and with clear verbal cues to avoid sensory overload.
  

For example, suggestions to these couples could include saying: “I’m going to place my hand on your back now — are you ready?” or “I’d like to hold your hand — can I do that now?” or “Touch coming on your left side.” Each of these cues gives the partner time to orient and prepare for the sensation.

• LGBTQ+ Couples: Physical touch may carry different cultural or personal significance. Therapists would be wise to consider this in their interventions. 

A common misstep is assuming that physical touch has the same meaning in LGBTQ+ relationships as in heterosexual ones, which can inadvertently overlook past experiences of stigma, boundary violations, or cultural norms within queer communities. Considerations around public affection and heteronormative expectations of “who takes the lead” are also important. Therapists can support couples by naming this awareness and offering multiple options for how they might approach, initiate, and respond to invitations for touch.

• Culturally Diverse Couples: Therapists must consider cultural nuances when introducing touch.

For example, if a practitioner is from a different background to the clients, they could say: “Is there anything important from your cultural background that I should know about how touch is given or received?” This invites partners to share whether touch is typically private, reserved for certain family members, associated with hierarchy or respect, or shaped by religious or gendered norms. By asking openly and without assumption, the therapist helps create space for partners to clarify what feels safe, appropriate, or potentially activating within their cultural framework.

Conclusion

Integrating trauma-informed touch into the PACT model enhances its capacity to heal attachment wounds, regulate the nervous system, foster the two-person system idea of being in each other’s care and creates deeper connections for couples. This approach holds immense potential for helping trauma-affected couples create secure, healing relationships. 

Again, I want to acknowledge that the idea of touch in PACT is not new. What I am proposing is the explicit intentionality behind that touch: to know that the touch is there to regulate one another’s nervous systems in more ways than some of the already known PACT practices. It is another way that partners can soothe one another.

References

Bowlby, J. (1969). Attachment and Loss: Vol. 1. Attachment. Basic Books.
Kurtz, R. (1990). Body-Centered Psychotherapy: The Hakomi method. LifeRhythm.
Levine, P.A. (1997). Waking the Tiger: Healing trauma. North Atlantic Books.
Porges, S.W. (2009). The Polyvagal Theory. W. W. Norton & Company.
Schore, A.N. (2003). Affect Dysregulation and Disorders of the Self. W. W. Norton & Company.
Tatkin, S. (2016). Wired for Love. New Harbinger Publications.
van der Kolk, B.A. (2014). The Body Keeps the Score. Viking.