ScarWork by Joy Carey
“Healing is bringing together parts that have been separated.”
Bert Hellinger
Founder of the Family Constellation Movement
“It’s all good tissue, just not in the right place.”
Sharon Wheeler Creator of ScarWork
After an event that leads to a scar, we can look back at the time before as a snapshot of our embodied state, a likeness that we can never get back to. This method, ScarWork, aims to shift the way in which we perceive scars, to change the story through which our clients relate to their own body’s trauma. Perhaps, with enough interest and practice, we can shift the way in which scars are treated in a medical context.
A scar reveals the nature of trauma through which it occurred because it is a portrait of how the tissue could no longer keep healing. It distorts our body’s fabric and how that fabric functions. The work of ScarWork signals the body to keep knitting, keep doing the repair, by providing the appropriate techniques and added energy, giving the tissue a propensity to restore its own architecture.
In order to understand what a scar is, we need to take a dive into the organized chaos of our bodies, our living matter at a cellular level. The nature of our form can be explained by the fascial network and its physical properties. If we could shrink down into the molecules in our fascia, we would see a world that abides by uncommon laws of physics, a world of shifting geometry, like the moment we twist a kaleidoscope to reveal a new image. Densely packed shapes spread into sliding pyramids where the sides disband into an evolution of the next shape, and then the next. A paradigm in which tumbling formations bloom, fold in, unfurl, and float, as their movement ripples through various layers of tissue
Form and function
The state of our fascia determines our form. It is the overarching structure that is responsible for our nonlinear adaptability; why we can bend, twist, bounce, jolt, run and relax into deep peace. With every inhale, our web of fascia unfolds its origami shapes. It opens into myriad polyhedrons of collagen, where the strands stretch and split off to form new shapes. On the exhale, this network of fibers folds back into an original tone, yet the arrangement of shapes is never the same. Our web of collagen and elastin fibers relates every cell to every other cell, in every corner of the body, enabling a never ending murmuration that expands and contracts throughout our structure.
This network of fibers underneath our skin allows the layers of cells nestled within it to have a buoyant quality. It organizes vital tasks such as fluid fluctuation, electrical exchange and building proteins. It provides the graft through which we maintain our infrastructure: blood vessels, nerves, and lymphatics. They meander through this ever-changing web, facilitating each cell’s quest for equilibrium.
Living matter can usually reconstruct itself enough to perform basic functions after it’s been broken. On its own accord, without outside help, our body’s physical matter can rarely restore itself back to its previous state of living synchronicity. We need help from someone else’s hands, another intelligent system, to teach our cells how they might belong together in harmony once again.
When trauma occurs
Our skin, the dermal layer of our fascial web, insulates this micro world. When the skin breaks, everything changes. Synchronicities collapse. The organic motility within our form loses all its tethering, loses its leverage for propelling its waves. Any breach in the continuity of this fabric halts the entire system’s industry. Events such as the surgeon’s scalpel, or when the camera on the end of a tube is removed, or traumas such as a soft human body hitting the pavement; events such as these create disruption for the whole fascial network. To save their lives, locally the cells reconfigure their nature, and in doing so, they save our life as our entire fabric adjusts to the rupture.
What we see as a scar on the skin, the tattoo at the site of injury, shows that a much wider phenomena has spilled into the body, where the dermis broke and the outside air could momentarily filtrate in. The cells and fibers touched by the air immediately change state in a process called oxidation. The base of support for the dermis gives way, as the fibers of collagen stiffen and elastin recoils into glue. Damage from the event continues after the exposure. Our blood flow covers the area, closing it off to protect from more disruption, and unfortunately, secluding this area from a plethora of resources that could be used for repair. The greater the upset and destruction, the poorer our restoration job will be.
During the healing phase of the wound, our soon-to-be scar tissue reduces what can enter the scene. The damage from the air rushing in forever changes the chemistry so it now lacks permeability and connectivity with the rest of the fascial web. The wound cannot adapt to movement elsewhere in the body; the rest of the body adapts to it. What will become scar tissue is now fascial strands that were dried out through oxidation and then milliseconds later, saturated with blood; like uprooted trees thrown about in the winds of a storm followed by a downpour of rain.
Messiness of our healing process
A sequence of healing strategies; debridement, edema, exudation, and then granulation start to occupy the area. Beginning automatically, and unselectively, our system recruits the cells necessary to safeguard the wound from further harm. Each phase creates a more resilient construction that somewhat resembles what the tissue used to be. After about a week, inflammatory cells have protected the area so that local fibroblasts can secrete enough collagen to build a shoddy highway of lymphatics and blood vessels. These throughways clean out dead cells as thoroughly as possible, and begin the final process of building a new layer of ground substance. Ground substance is the space between cells that allows for our layers to exhibit omnidirectional movement. It’s what gives our facia its foam-like capabilities, which allows this whole-body organ to expand and contract throughout our structure.
The edges of the divide in the dermis begin to create more tissue, to close the gap. These cells bring the sides back toward each other, filament by filament. Incomplete fusion in the skin will keep the layers underneath in the process of cleaning out debris. Like in any construction project, sometimes the jobs do not concur in a seamless manner. Each phase can be left incomplete and chaotic. Sticky and humid adhesions congest the tissue so that our infrastructure must maneuver around them. Pockets of swelling and fragments of collagen clutter the area. Hyper vascularisation creates bulky vessels that can’t untangle from each other on their own. Fluids and bubbles surround various strands because the tissue cannot keep up with the pace of gas exchange that the environment requires.
Some cells will never move into the tissue building phase, leaving a vacancy where no supportive threads are rebuilt. Another area may look as if a bomb went off, with clumps of glue glommed onto the surrounding tissue. Not far from the explosion, we’ll see remarkably thick and dense fibers criss-cross through an open space, as if the joists of a house split and were suspended in the air. On their own, these fibers have no hope of disentangling. To complicate the process, our collagen fibers like to hold onto foreign bodies such as plates, plastics, dissolvable stitches, and screws. In contrast, one centimeter over, we might see that a meticulous healing process continued without a hitch. This part of the scar has pink and fluffy cells that have room to move around while staying connected to their neighbors.
In essence, scarring reveals the disorganized timing in the healing process.
What we currently consider a fully healed scar is actually the tension lines from the original opening leftover. Hair follicles often tell the condition of the tissue underneath the scar. Hair roots will lose their footing to stand up in the dermis because the collagen beneath can no longer support their verticality. Imagine a tree falling through soil that’s lost its compactness; this image has a similar quality to what the hairs around a scar reveal. Hair follicles sink and eventually they fall over and become flat to the skin. The scar on the surface, whether it’s raised or depressed, tensioned with a zig zag, or stretched flat; it reveals the constraints and abandoned processes underneath. Under the surface of a seemingly fully healed scar, we will often find cobwebs of unfinished jobs, hiding out and uninvolved with the adjacent areas of fascia.
Left to our own devices, the body restores itself rather crudely. Wounds, for most people, simply heal into scar tissue. Most scarred areas can provide essential nutrients to the tissue. The healing process, without any outside help, usually suffices to restore primitive vital functions. Capillary beds move red blood cells through. Local peripheral nerves can tell our deeper nerve roots what’s happening closer to the surface. Our lymphatics can drain the area, often very slowly in comparison to the flow in the rest of the system. The fascial network develops a localized integrity, eventually, so that force vectors can still transmit movement.
However, often enough, scars cannot reach maturity due to an irritation or not enough nutrients reaching the area. The tissue healing process can stop suddenly if somewhere else in the body needs more focus. Each part that’s not integrated into the fascial matrix becomes unbalanced, and the scar won’t stabilize, and so it can’t fully heal. The rest of the body also continues to adapt to the incomplete phases.
When scarring terminates in a tendon, ligament or directly onto a bone, that joint becomes fixed in a pattern. The scarring in one joint can affect the patterning of the entire joint system of our skeleton. A small scar on the skin can reach deep into the body and obstruct freedom in the fascia from head to toe.
Tissue can remain in an incomplete healing phase under the surface of the skin for weeks, months, years, and even decades. The state of our system during the breach, in addition to the nature of the impact or cut, informs our immune system how to heal. As a result of oxidation and bleeding, we reconstitute without the intelligence of the whole system to inform the process. The lack of integrity in the wound siphons it off from the mechanical and chemical signals that the affected area would otherwise receive. Our scars go along for the ride of our motion, perhaps indefinitely, or until a treatment can touch in to restore full-body innervation.
We may not lose functionality in the scarred tissue, however, the dancing polyhedron nature of our fascia rarely returns on its own. The pliability within our strands do not restore themselves by their own means because our nervous system concludes that the area of the scar can no longer mold into the rest of our form. Mechanically, the scar cannot usually respond to movement elsewhere in our body.
We need help from an outsider to integrate our scars into the rest of our fascia. In a ScarWork session, the practitioner attunes to what’s happening in the tissue with their hands. The treatment applies specific techniques, which are light and sometimes barely detectable, in order to fine-tune the current state of the scar. The treatments restart the healing process so that it can continue where it left off. More differentiated cells migrate to the area to restore the tissue into having a healthy feel; buoyant, fluffy, and responsive to movement. Often the color of the skin normalizes as well. These techniques complete the reconstruction of the wound, restoring flexibility, mobility, hydration, and drainage.
A ScarWork treatment aims to reintroduce harmony to a paused healing process, so that the area can weave itself back into its wider network of synchronicity; so that movement can tumble through the fascia seamlessly once again. Collagen and elastin regain their innate qualities, gliding against each other like silk strings. A successful session aids the scar in reincorporating the natural dexterity that the tissue had before the opening. After a treatment, what was stuck together can start to peel apart, and what was dispersed can come together.
