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The Power of Smell: challenges and opportunities in trauma informed practice

Anyone who has ever heard me teach about the importance of considering the senses to provide trauma informed practice will remember my story about the tyre swing.

Finding the smell of the tyre and removing it made therapy possible.

The smell or olfactory system is the quickest acting, shortest and most immediate pathway into the brain. It’s essentially important we learn more about this sensory system and how it lays down very strong almost indelible memories that retraumatise and provoke unsettling unconscious body feelings of trauma before language development and conscious memory.

Research literature about torture confirms the importance of smell on evoking the past. However and most importantly though, is how positive and happy memories and smells can do the opposite – creating therapeutic moments of calm and contentment, weaving through and wrapping round spaces to create places of recovery and escape, free from emotional and physical pain.

My earliest lectures about sensory integration in mental health, to in-patent teams and later our learner DBT team included information hard gathered from medical libraries, books and journals before Google. We still teach this information on our ASI Module 1 and in our mental health workshops, exploring the sense of smell, so essential to human survival and success.


My earliest learnings about the power of smell and trauma recovery shaped in the informal settlements and rural villages where I first worked in post apartheid South Africa.

Our sense of smell helps keep us safe. It is like vision and hearing an advance warning system. It tells us where it is safe to live, helps us find food, helps us choose the right partner and helps us to recognise our own baby.

Smell alerts us to danger, provoking action to ensure survival.

Research confirms that it warns us of longer term dangers. We know from experiences in life it is critical to ensuring we make ourselves safe from immediate danger. The smell of fire, bad food and illness alerts the brain into immediate avoiding or defensive actions.

Equally it can help to soothe and calm. Knowing this and building on the power of smell to support health and wellbeing changes lives. The smell of 4711 perfume will forever remind me of magical journeys up into The Faraway Tree, Kit Kat fingers and the safety of Granny’s lap.

Some therapies like DBT encourage the use of smell to supper mindfulness practice and tolerance of distress.

My clinical experience is that the power of smell can do much more than that. Over the last 20 years and more I have collected lovely case studies and stories about the power of smell when it is used wisely in clinical practice.

Smell evokes very powerful and individualised memories that should always be considered as part of trauma informed clinical practice.

The smell of evening, red dust and hot rain – a smell so strong that in Africa it had the power to create the sounds of crickets, evoke the warm encircling arms of safety and care, that wash away pain.

The smell of white musk from a famous body product shop in the UK that could calm and soothe, allaying fight and flight, reducing self-injury, dissociative events and attacks on others.

Smell evokes very powerful and individualised memories that should always be considered as caption

The smell of coffee, cinnamon and oranges facilitated peaceful sleep and calm, memories of a Mum and escape from nightmares; a way to self regulate and remain grounded in talking therapy. Not just in one session, on one day, but over time making sure that historical patterns of disengagement from therapy ceased.

The puppy breath and fresh mown grass were personal special memories belonging to one of the service users group who were helping us develop tools to assess sensory reactivity as part of sensory integration in adult mental health services nearly 20 years ago.

Morrison, Filomene & Dias, Brian & Ressler, Kerry. (2015)’s research; “Extinction reverses olfactory fear-conditioned increases in neuron number and glomerular size” and others published more recently support this work and confirms why the self soothe boxes, bags and spaces we created in therapy created powerful opportunities for therapeutic engagement and change. (Link to full article here)

Nowadays sensory integration and the power of the senses in trauma recovery is more mainstream. Using smell to create healthy environments that support participation and engagement in everyday life seems relatively simple to do. Smell is inherent or can be made to be inherent to almost any activity. From using a smell to support recall and reduce stress in exams, helping sleepy teens to wake up or calming elderly adults in their increasing moments of confusion.

The power of smell, like another powerful sense, proprioception should become and remain a subject of further research and development within occupational therapy practice.