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The Trager Approach

by Deane Juhan(more info)

listed in trager, originally published in issue 26 - March 1998

Trager and Somatic Therapy in the U.S.

In spite of the fact that complementary healing approaches in the United States have not been as robustly accepted into mainstream healthcare as they have been in the United Kingdom, bodywork of various kinds continues to be America’s fastest-growing sector of health practitioners and consumers. Trager, Rolfing, Alexander Technique, Feldenkrais, Aston Patterning, Heller Work, and Swedish Massage are but a few of the modalities that have mushroomed rapidly during the last twenty to thirty years.

Milton Trager
Dr Milton Trager

I believe that this is a direct response to the increasing recognition of a wide variety of physical and emotional difficulties that are caused by the accumulation of stresses and mishaps of daily life, and by the debilitating aftermaths of major traumas that are too frequently given short shrift in the recovery process. Often these frustrations, shocks, pains, and limitations become chronic and degenerative if they are not dealt with effectively. And since there are no germs, genes, or obvious continued traumas to define their action and cure, there is very little in the technical, surgical, or pharmaceutical repertoires with which to successfully address them. Their numbers and variety are legion and they continually clog the healthcare system, absorbing time and resources and creating ongoing frustration for practitioners and patients alike.

The Trager Approach has proven to be a rapid, effective, painless, and indeed pleasurable method of deprogramming these accumulated negative feelings and behavior patterns, and of restoring the positive body image, feeling tone, and organized responses that are essential to healing and healthy development.

Dr Trager developed his approach independently for nearly fifty years before teaching anyone his methods. Since the founding of the Trager Institute in 1980, nearly 2000 practitioners have been trained in the US, Canada, Europe, Israel, and Australia. “The purpose of my work,” Dr Trager has said, “is to break up these sensory, motor, and mental patterns which inhibit free movement and cause pain and disruption of normal function.” The ingredients necessary for these positive developments are: Heightened sensory awareness, a calm and alert emotional state, more timely and accurate information about what my body is up to, and an increased capacity for constructive self-regulation. It is these qualities that the Trager Approach cultivates in the client.

A Trager Session

A session typically lasts one to one and a half hours. The client wears briefs or light, loose clothing, and lies on a well-padded table in a warm, comfortable environment. The practitioner makes touch-contact with the client, both as a whole and with his or her individual limbs and segments. This contact consists of gently coaxing elongations, softly penetrating compressions, and a pleasurable rhythmic rocking and jiggling, sending resonating ripples throughout the body’s fluid structure. Dr Trager has said:

My work is directed towards reaching the unconscious mind of the client. Every move, every thought, communicates how the tissue should feel when everything is right. The mind is the whole thing, that is all I am interested in. I am convinced that for every physical non-yielding condition there is a psychic counter part in the unconscious mind, corresponding exactly to the degree of the physical manifestation.

Trager consists of the use of the hands to influence deep-seated psycho-physiological patterns in the mind, and to interrupt their projection into the body’s tissues. My approach is to impart to the client what it is like to feel right in the sense of a functionally integrated body-mind. Since the inhibiting patterns are affected at the source—the mind—the client can experience long-lasting benefits. The result is general functional improvement.


During the course of a session, there are literally thousands of these light rhythmic contacts and sensations, and every moment of every movement is an opportunity in the moment to create and to deepen the feelings of lightness, freedom, relaxation, ease, and peace. Whenever the practitioner encounters restricted movement, rigid muscles, or defensive reflexes, he or she never responds by bearing down aggressively, working harder to soften them or forcing them to stretch. On the contrary, the response is to immediately become lighter, more sensitive, more searching and allowing. The specific edges of resistance are continually addressed, but never with force or discomfort.

The receiving experience of the client is always monitored, and no contact or movement is continued that is creating discomfort. Every touch is modified as necessary to ensure that it is pleasurable, or at the least comfortably tolerable. This avoidance of discomfort is of utmost importance to the Trager Approach, for three reasons:

1. Pain inevitably engages reflex muscular defenses, producing more restrictive patterning, not less.
2. Pleasuring the tissue is a powerful biofeedback message which leads to deeper relaxation, softening, and increased ranges of motion that come with that softening.
3. Trauma and pathology themselves have created pain and fear, frequently to the extent that the client can no longer imagine any part of their body as a source of pleasure, comfort, or strength.

The goal then is to create in the session a sense of safety and ease in which new and better patterns can be learned—a delicate process that can be easily disturbed by any increase in pain or discomfort. “Every shimmer of the tissue,” Dr Trager has said, “is sending a message to the unconscious mind in the form of a positive feeling experience. It is the accumulation of these positive patterns that can offset the negative patterns so that the positive can take over.”

Hooking Up

The essence of a Trager session is the projection of a calmer, more attentive, more meditative feeling state from the sensibility of the practitioner to the sensibility of the client. Dr Trager called this feeling state “Hook-Up,” a direct experience of connectedness with the present state of the body and mind and with their resources for initiating positive change. In his later years, Dr Trager was an avid practitioner of Transcendental Meditation, and he said that he could not really tell a qualitative difference between a private feeling state of deep meditation and his experience of being “hooked-up” with a client at the table.

The therapeutic significance of this calm, meditative state, in contrast to states of chronic stress, has been clinically demonstrated. Studying the effects of chronic pain and stress, Dr Hans Selye of McGill University in Montreal showed that they produce a sustained “flight or fight” response throughout the body: tense vigilance directed outward, accelerated heart rate, higher blood pressure, heightened muscular tonus, and a powerful stimulation of the sympathetic nervous system (the part of the autonomic system that deploys our internal mechanisms for coping with challenges). Sustained for long enough, these chronic effects eventually produce a wide variety of functional degenerations—negative psychological states, uncoordinated autonomic processes, the development of gastric lesions, tumors in various tissues, and eventually death.

In contrast, Dr Herbert Benson at the Harvard Medical school examined the physiological effects of Transcendental Meditation to see if there were complementary effects due to the elimination of high degrees of chronic stress—what he called “The Relaxation Response.” He discovered that subjects in a deep state of meditation have a physiological profile that is in many important respects the opposite of the stress response: calm attentiveness directed inward, slower heart rate, lowered blood pressure, generally reduced muscular tonus, and a powerful stimulation of the activities of the parasympathetic nervous system (the part of the autonomic system that rests the organ systems and replenishes their biological needs).

It seems reasonable to conclude from Dr Benson’s study that this meditative awareness is the feeling state—whether you call it Transcendental Mediation or hook-up—in which the mind can most successfully tend to the healthy regulation of the body. By projecting this feeling through every touch and every movement, the practitioner can produce the feelings and the cues that lead the client into this state of facilitated self-assessment and self-regulation very directly and very quickly. Again, Dr Trager:

Hook-Up is like measles. You catch it from someone who’s got it. I want you all to experience the subtle thing of your mind asking, “Well, how free is that? We-e-e-ell?” Pause a moment, come deeper into this state, and ask yourself again, “Well, what is even freer than that?” Technique—forget it. It is what you have developed in your mind.

We are lulling, we are lulling, and that is a wonderful state to be in. Compare on the other side of the fence the turmoil of daily living, the stress, the frustrations, the traumas. You can help people in the turmoil with this feeling—they can be different because they have felt, have experienced something different.


The process is much like rocking a distressed baby to sleep. Successful rocking is not a specific technique, or a diagnosis and protocol. It is not how many times you rock, or the precise amplitude of the rocks, or a specific tempo of rocking. Inducing the state of sleep consists of hooking-up deeply with the baby’s presence, hooking up with your own experience of what sleep feels like, and projecting that actual feeling of sleep into every movement. This is the information and feelings the baby picks up, and that its nervous system translates into the physiological state of relaxation and sleep.

Mentastics®: A Tool for Self-Development

Experiencing these positive sensations and feelings on the table is only the beginning for the development of the client’s abilities of self-assessment and self-regulation. Once the client is off the table and vertical again, the other half of the process is learning to generate those sensations and feelings for themselves, to effectively recall the physical and mental state of the session, and to continue the development of lighter, freer, painless movement on their own.

Dr Trager dubbed his self-development tool “Mentastics”—mental gymnastics, the conscious bringing of mindfulness to every gesture. It consists of learning to create the same gentle, pleasuring, bouncing jiggle of your tissues as you experienced from the practitioner’s hands on the table, and of continuing to pursue those movements and sensations into deeper and deeper states of internal connectedness and ease of motion.

Normal motor skills are developed for specific physical tasks. Mentastics is directed purely at self-pleasuring and self-exploration. Normal skills are highly regularized habits, and as such can become so automatic that they may ultimately limit us from other forms of movement, other repertoires of response. Mentastics is the active practice of ceasing to be compelled by these habituated patterns, and of cultivating spontaneous gestures and sequences of the widest possible variety.

Perhaps most significantly of all, Mentastics is the development of the art of not trying. Trying is effort, and effort is tension. Skills are competent men and women at work; Mentastics are vibrant animals at play. Skills adapt us to a niche, a job, a compensation; Mentastics adapts us to continually adapt.

As the homework of Mentastics is pursued by the client, dysfunctional habits can be dropped, old patterns can be cleaned up and made more efficient, painful movements can be eliminated and more effective compensations to changing conditions can be learned. And just as significantly, these developments have come about in the context of movements that are more and more self-exploratory and self-pleasuring. The growing knowledge that the body can once again be a source of comfort and pleasure, that it always has the capacity to develop some measure of wider and freer movement, and that there are ways to release it from compulsions and deeply habituated responses—all these experiences produce a remarkably positive mood. This mood is Hook-Up, and it can change a great deal in our lives.

Potential Applications of the Trager Approach

Three of the primary results of the sensory pleasuring, deep relaxation and sensory information imparted during the experience of Trager and Mentastics are the overall reduction of excessive muscular tension, increased range and ease of motion, and a general improvement in the coordination of motor patterns. And when these results occur, far more than our posture, gestures, and skills are impacted. Since we are made up of mostly muscle, and since muscular activity (or the lack of it) surrounds virtually every tissue and every physiological process, Trager and its improvement of muscular activity has a broad range of potential positive effects.

Perhaps the most obvious candidates are those clients with muscle spasms and disorganized patterns associated with traumas of various kinds. But similar chronic tensions and disorganized patterns can also be generated by any number of causes that have no apparent connection to specific traumas. Poor posture and restricted movement may be the result of unconscious modeling and imitation, seemingly innocuous habits, relatively minor but long-lasting emotional disturbances, occupational or recreational demands placed upon the body, temporary difficult episodes during otherwise healthy growth and development, the habitual acting out and embodying of various moods, attitudes, or personality traits, and so on. And through their impact upon the muscles, these subtle accumulations can contribute to many kinds of organic dysfunction.

The Trager Approach has also been used to enhance the management of many kinds of pain. The alleviation of muscular tension and pressure, the improvement of local circulation, and the improved feeling state of the individual as a whole can contribute powerfully to controlling pain. And the systemic pleasuring of the body and the subsequent calming of emotional and cognitive states can be of enormous benefit, since these psychological factors can often be dominant influences in our experience of pain.

Trager has also been used very beneficially for many individuals with permanent disabilities or incurable diseases. Chronic and degenerative conditions always involve two major difficulties. First, there is the actual tissue damage and resulting loss of function. Second, there is severe shock that inevitably accompanies both the event and the diagnosis. This shock can take many forms: fear, withdrawal, heightened anxiety, amplified pain, denial, repression, the sensory gating-off or numbing of problematical areas, the collapse of activities that may still be physically possible, the disuse of body parts that are still intact, and the exaggeration of the impact of subsequent minor events.

In such instances, Trager has been effective in restoring emotional balance, a positive and actively engaged outlook on life, a more accurate definition of the actual location and extent of the damage and its direct results, and the rediscovery that much of the individual’s body is still intact, can be source of pleasure, and can be used creatively to compensate in many ways that were not available when they were inhibited by fear and confusion. Certainly none of these effects constitute a cure, but just as certainly they do greatly enhance the possibilities of better management of pain, more effective compensations, the development of superior strength and resistance to further degeneration, better emotional coping, and a much improved quality of life.

These effects have been experienced and have proven to be very useful to individuals coping with the effects of chronic or degenerative conditions as diverse as asthma, post-polio sequalae, multiple sclerosis, muscular dystrophy, Parkinsonism, stroke complications, spinal damage and other severe physical and neural injuries, and various forms of cancer.

Again, let us be clear: No claim is being made for Trager as a cure for these or any other permanent conditions or incurable diseases. But in the absence of a cure, improved emotional balance, superior coping strategies, more compensations for disabilities, and a measure of self control will always be of extreme importance to these patients, and to anyone personally connected with them.

J.A. was a patient of Dr Trager’s with multiple sclerosis. She described her experience with his work this way:

Until the cure comes, our primary focus should be to make ourselves feel good. It is difficult, in the face of continual bodily destruction, to maintain a feeling of confidence towards our physical selves, and yet it is with our physical selves that all interactions with others take place. My concern has been to build an image of myself, something that radiates from within and then works to move my body with less effort.

T.M. was a psychologist who came to Dr Trager in the midst of a rapidly deteriorating phase of muscular dystrophy. He was able to provide more concrete data on the improvement of his situation:

The Trager sessions accomplished the removal of emotional blocks such as frustration resulting from muscle weakness, fear of progressive muscle weakness, and depression resulting from feeling helpless and hopeless. My belief system was changed in the direction of a positive expectancy of health and muscle strength, away from the negative expectation of progressive muscle weakness conditioned by the medical prognosis that “your muscle will continue to become weaker no matter what you do.”

On a physical level, I have gained 20 pounds. Previously, I was unable to gain weight no matter how much I ate. I feel that this weight-gain indicates a change in my metabolic processes. Two weeks before, and two months after seeing Dr Trager, I had isolated muscle strength tests done by the registered physical therapist working with the Muscular Dystrophy Association. The tests showed that 12 out of 18 muscles improved in strength, four stayed the same and only two became slightly weaker. Also, the hearing in my left ear improved 10–20% as measured by an audiologist.

I attribute the above physiological, emotional, and physical changes to the process of being put in touch with what healthy tissue feels like, and the neurological patterns of healthy tissue. In this respect, my body, through Trager movements, re-educated my mind to perform the necessary neuromuscular and metabolic functions of healthy tissue. On the spiritual level I feel much more aware of the vibrational frequencies correlated with healthy muscle response.


In all these instances and applications, Dr Trager contended always that he was not a “healer” in any esoteric sense of the word, and that his successes have nothing of the miraculous about them. The kinds of reflex responses, tissue changes, and behavioral changes his work is able to elicit are possible because of the intimate neurological associations between sensory stimulations, emotional feeling, attitudes and concepts, and the body’s motor responses to all of them.

• A listing of UK Trager Practitioners and information about training are available from: Trager Association UK, www.trager.co.uk

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About Deane Juhan

Deane Juhan is the author of Job’s Body: A Handbook for Bodywork, the standard text on the physiology of touch used by massage schools throughout the US, Canada, Germany and UK. He is a senior instructor for the Trager Institute. He currently resides and has a private Trager practice in Mill Valley, California. His website is at www.anatomytrains.com

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