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Calatonia arose out of necessity in the harsh realities of World War II. Hungarian physician Pethö Sándor began developing this somatic approach while working as a doctor for the Red Cross in refugee camps and later in German hospitals after the war. He treated a wide range of patients in general infirmaries: people recovering from surgery, individuals with phantom limb pain, and those experiencing nervous breakdowns, depression, compulsive reactions, and other complex medical and mental health conditions. Over time, his careful experimentation with gentle, structured touch led to the development of what came to be called Calatonia. In the 1950s, after relocating to Brazil, Sándor integrated Calatonia into psychotherapeutic practice, and by 1969 he described the method in a Brazilian academic journal—predating the formal recognition and diagnostic framing of war trauma and PTSD that would emerge decades later.
In the early and post-war years, Sándor faced several challenges that shaped Calatonia’s development. First, many refugees were unwilling or unable to engage in existing methods of relaxation, such as Edmund Jacobson’s progressive muscle relaxation or Johannes Schultz’s autogenic training. These approaches required active physical and cognitive participation, which many war survivors simply could not muster. Some were deeply discouraged and apathetic; others seemed to resist active cooperation in ways that resemble what is now understood as moral injury—the profound inner conflict that arises when people feel they have violated their own deepest values under extreme circumstances. Such moral injuries affected soldiers, resistance members, civilians who had to kill in self-defense, and those who felt they had abandoned loved ones. The resulting guilt and sorrow often undermined their motivation for self-care. Even those who did cooperate seldom achieved a satisfying level of relaxation (Sándor, 1969).
Second, the context of the time offered no assurance of returning to a stable “normal” life. Many refugees faced an uncertain future—lost homes, scattered families, damaged communities, and the daunting prospect of adapting to new cultures without time to grieve or recover. War was not a concluded chapter but an ongoing reality whose effects would continue unfolding for years. This situation parallels contemporary struggles faced by refugees and survivors of armed conflict worldwide, now amplified by instant global news and a world that is, in many ways, more divided and less welcoming.
Third, Sándor was determined to help restore self-regulated states without using traumatic material as the primary entry point for treatment. He believed that beginning directly from traumatic states risked making trauma an intrinsic part of the new, emerging patterns of experience. Instead, he sought to re-establish a baseline of regulation grounded in the person’s innate capacity for well-being and resilience. He understood that trauma has many layers—some immediately accessible, others requiring greater ego strength and developmental maturity. In his view, it was vital not only to widen the “window of tolerance” for traumatic symptoms, but also to restore a sense of developmental normalcy and internal stability before addressing specific traumatic memories.
In response to these conditions, Sándor developed Calatonia as a passive technique. It did not depend on willpower, cognitive strategies, or active behavioral participation—only on the person’s consent to receive gentle, non-invasive touch. In an interactive, exploratory process, he asked patients for permission to see if he could ease their pain and discomfort by lightly manipulating the neck and extremities of the body, complemented by small, passive movements. He sought continuous feedback on how they felt when he supported, moved, or touched specific distal areas such as the lower legs, feet, forearms, hands, and head (Sándor, 1969). From this ongoing dialogue emerged a structured sequence of delicate touches and movements that was formally named Calatonia.
Sándor observed that with regular application, Calatonia’s effects were cumulative and enduring. Gradually, the intensity of traumatic impact softened. By helping to support new neural connectivity linked to well-being, safety, and healthy interpersonal regulation, Calatonia contributed to the restoration of trust—both in others and in oneself. For many postwar patients, this approach offered a pathway to more adaptive, connected, and livable lives after profound adversity.
