A researched, evidence based report, generated with the support of AI - please engage in due diligence​ In a world where health care is evidence based on validated research being able to assert the beneficial applications of holistic, alternative and complimentary therapies is essential for to be taken seriously. ​ The impact of Domestic Abuse and Violence (DAV) and Intimate Partner Violence (IPV) extends far beyond the moment of physical aggression, giving rise to complex, chronic trauma. For many survivors, the cessation of violence does not equate to the end of distress; rather, they may endure a state of protracted hypervigilance known as Continuous Traumatic Stress (CTS) (Fletcher et al., 2023; Pulice et al., 2023). Effective recovery, therefore, requires a strategic, multidisciplinary approach that moves beyond traditional cognitive psychotherapies to incorporate interventions addressing the somatic embodiment of trauma (SAFE Austin, 2021). Holistic, Alternative, and Complementary Therapies (HACTs), including touch-based, energetic, and expressive modalities, provide vital tools for stabilizing the nervous system, thereby preparing the individual for deeper trauma processing. Neurobiological Rationale and Mechanistic Action The rationale for integrating HACTs is firmly rooted in neurobiology. Complex trauma induces a persistent state of autonomic imbalance, characterised by sympathetic hyperarousal and diminished parasympathetic capacity (Breit et al., 2018). Measurable indicators in Post-Traumatic Stress Disorder (PTSD) patients include reduced vagal tone, a key mechanism of stress regulation (Breit et al., 2018). Mind-body HACTs, notably Trauma-Informed Yoga (TIY), directly target this deficit. TIY, through focused breathwork and posture (asanas), is theorised to increase vagal tone, thereby enhancing resilience and mitigating mood and anxiety symptoms (Breit et al., 2018). Furthermore, practices such as yoga are associated with positively altering neurochemistry, specifically by increasing the inhibitory neurotransmitter γ-aminobutyric acid (GABA), which plays a significant role in anxiety relief (Sharma & Haider, 2013). This "bottom-up" regulation is critical: by fostering a sense of safety within the body and reducing physiological arousal, HACTs create the necessary foundation for survivors to successfully engage in "top-down" cognitive processing therapies (SAFE Austin, 2021). The Dual Role and Ethical Constraints of Touch-Based Therapies Touch-based HACTs, such as body massage, Indian head massage, and reflexology, address the pervasive somatic consequences of chronic stress, including muscle tension, headache, and chronic pain (Al-Amin et al., 2023). The therapeutic effects of massage are hypothesised to involve the modulation of the hypothalamic–pituitary–adrenal (HPA) axis, leading to the regulation of stress hormones like cortisol, alongside reported reductions in general anxiety and irritability (Al-Amin et al., 2023). For survivors navigating continuous distress, this physical intervention can offer a valuable sense of respite and "escapism" (Hogg et al., 2019). Similarly, reflexology shows promise in alleviating common trauma sequelae, such as sleep disturbance and general anxiety (Yuan et al., 2020). Energetic modalities, such as Reiki, offer therapeutic benefits with minimal physical invasion. Preliminary research indicates that Reiki may reduce anxiety and body pain in highly vulnerable populations, such as survivors of child sexual abuse (CSA) (Mott & Epstein, 2010 cited in Hogg et al., 2019). Given that chronic, embodied pain is a common and resistant feature of complex trauma, energetic therapies may be vital for addressing centrally sensitized pain components (Hogg et al., 2019). Crucially, the implementation of any touch-based therapy for survivors of physical or sexual violence mandates strict adherence to Trauma-Informed Care (TIC) principles (Wilson et al., 2015). Because abuse strips the victim of bodily autonomy, the recovery process must centre on restoring control (Domestic Violence Handbook, 2021). Practitioners must undergo specialised training to ensure continuous, explicit consent, making the survivor the absolute expert of their experience, thereby transforming potentially triggering physical contact into an empowering process of reclamation (Wilson et al., 2015). Olfactory and Expressive Pathways for Emotional Regulation Non-touch sensory and expressive HACTs offer powerful tools for emotional regulation and accessing non-verbal trauma memories. Aromatherapy, for example, effectively targets hyperarousal and anxiety through the olfactory system’s direct connection to the limbic system (Huang et al., 2023). Systematic reviews confirm that specific essential oils, including jasmine and lavender, are effective anxiolytics, capable of reducing both subjective anxiety and physiological markers such as heart rate (Huang et al., 2023). The synergy between modalities is also evidenced: aromatic massage demonstrates a heightened efficacy in reducing anxiety compared to aromatherapy alone, maximising therapeutic benefit through combined sensory and somatic input (Wei et al., 2022). Furthermore, creative expression—including art, writing, and movement—is essential when trauma compromises the neural capacity for verbal communication (SAFE Austin, 2021). By using metaphor, imagery, and colour, survivors can externalise overwhelming emotions safely and symbolically, bypassing the language centres affected by traumatic stress (SAFE Austin, 2021). This non-verbal processing approach has been evidenced to significantly reduce trauma-related symptoms in survivors of domestic violence, promoting improved emotional regulation and self-esteem (AATA cited in SAFE Austin, 2021). The Imperative of Cultural and Structural Healing A genuinely holistic framework, often termed Trauma- and Violence-Informed Care (TVIC), must recognise that IPV is frequently intertwined with structural violence and oppression (Pulice et al., 2023). Effective healing, therefore, must address the systemic context and actively restore cultural identity and community agency. The success of culturally adapted interventions for Indigenous women with histories of IPV exemplifies this imperative. The "Reclaiming Our Spirits" (ROS) program, which integrated health promotion with Elder-led Circles focused on traditional teachings, yielded significant, sustained improvements in Quality of Life and trauma symptoms. The blending of traditional Indigenous Healing practices with mainstream counselling models has also been shown to reduce historical grief alongside trauma symptoms, confirming that cultural restoration is a non-negotiable component of sustained healing (Reading et al., 2016).   Conclusion and Future Directions The evidence confirms that HACTs provide mechanistically sound and clinically beneficial support for survivors of domestic violence trauma, particularly for stabilization, regulation, and somatic symptom management. While rigorous clinical evidence for HACTs specifically targeting IPV remains scarce (Duffy et al., 2014), the demonstrated physiological effects and cultural efficacy mandate their integration into comprehensive care. Future research must prioritise high-quality trials that incorporate objective physiological endpoints (e.g., HRV) and specifically investigate the optimal sequencing of HACTs alongside established psychotherapies. By mandating trauma-informed certification and supporting culturally tailored, integrated programs, service systems can strategically leverage HACTs to transform the recovery process, moving beyond simple symptom management towards deep, embodied healing and the restoration of agency. Reference List Al-Amin, M. M., Das, S., Ghorai, R., Majumder, M., Hassan, Z. and Akter, R. (2023) ‘The effects of massage therapy on post-traumatic stress disorder and its associated symptoms: A systematic review’, International Journal of Therapeutic Massage & Bodywork, 16(1), pp. 58–69. Breit, S., Kupferberg, A., Rogler, G. and Hasler, G. (2018) ‘Vagus nerve as modulator of the brain–gut axis in psychiatric and gastrointestinal disorders’, Frontiers in Psychiatry, 9, p. 44. Domestic Violence Handbook (2021) Trauma-Informed Care Best Practices and Protocols for Domestic Violence Programs. Ohio Mental Health and Addiction Services. Duffy, L., Adams, J., Sibbritt, D. and Loxton, D. (2014) ‘Complementary and alternative medicine for victims of intimate partner abuse: A systematic review of use and efficacy’, Evidence-Based Complementary and Alternative Medicine, 2014, p. 963967. Fletcher, C. E., Spangaro, J., Zufferey, C., O’Connor, R., & Pfitzner, N. (2023) ‘“Continuous traumatic stress”: The impact of post-separation abuse on women who have experienced intimate partner violence (IPV)’, Frontiers in Psychology, 14. Hogg, G., Gibson, F. and Hughes, C. (2019) ‘Experiences and perceptions of benefits and harms of aromatherapy, massage, and reflexology in people with advanced cancer: A systematic review and thematic synthesis of qualitative studies’, Palliative Medicine, 33(5), pp. 509–520. Huang, Y., Cai, T., Yang, Y., Xie, H., Chen, Q. and Zhou, Z. (2023) ‘Efficacy and safety of essential oils for anxiety: A network meta-analysis of randomized controlled trials’, Phytotherapy Research, 37(8), pp. 3177–3192. Jackson, F. J., Varcoe, C., Ford-Gilboe, M., Grieve, J. and Wuest, J. (2015) ‘Reclaiming our spirits: A culturally-based intervention for Indigenous women who have experienced intimate partner violence’, Qualitative Health Research, 25(8), pp. 1109–1121. Lu, M., Li, J., Chen, T., Xu, X., Gao, B., Yan, C.,... and Lin, Y. (2023) ‘Efficacy of aromatherapy on pain intensity: A systematic review and meta-analysis of randomized controlled trials’, Evidence-Based Complementary and Alternative Medicine, 2023, p. 2854974. Mott, T. and Epstein, P. (2010) ‘Reiki and its value in the palliative care of cancer patients: A systematic review’, Palliative Medicine, 24(7), pp. 719–727. Pulice, P., Grodach, E., O’Rourke, H. and O’Doherty, E. (2023) ‘Trauma- and violence-informed care for intimate partner violence: An equity-oriented approach to policy and practice transformation’, Current Epidemiology Reports, 10(2), pp. 88–97. Reading, J., Jackson, R. and De Leo, D. (2016) ‘Impact of Indigenous healing and Seeking Safety on intergenerational trauma and substance use in an Aboriginal sample’, Canadian Journal of Public Health, 107(2), pp. e241–e246. SAFE Austin. (2021) ‘Healing through creative expression: Art as a tool for survivors’. [online] Available at: https://www.safeaustin.org/healing-through-creative-expression-art-as-a-tool-for-survivors/ (Accessed 10 October 2025). Sharma, M. and Haider, T. (2013) ‘Trauma-informed yoga: An emerging practice for treating anxiety and depression’, The Journal of Health and Human Services Administration, 36(2), pp. 248–261. Wei, Y., Ma, C. and Wei, Y. (2022) ‘The effect of aromatherapy on anxiety in cancer patients: A systematic review and meta-analysis of randomized controlled trials’, International Journal of Nursing Communication, 16(4), pp. 103396. Wilson, H., Rueda, S., Wilson, M., Vostanis, P. and Pinfold, V. (2015) ‘Bringing trauma-informed practice to domestic violence programs’, Women & Health, 55(4), pp. 372–390. Yuan, D., Wang, Q., Li, H., Yang, G., Wang, Y., Zhu, Y.,... and Hou, F. (2020) ‘The effect of foot reflexology on depression, anxiety, and sleep disturbance: A systematic review and meta-analysis of randomized controlled trials’, Evidence-Based Complementary and Alternative Medicine, 2020, p. 6792376.