Massage Therapy Journal Fall 2025

36 • Massage Therapy Journal

T he effects of trauma are commonly present in massage therapy treatment rooms, but often, massage therapists have little opportunity to reflect and consider the consequences of their actions with this population.

Being aware of cultural and religious differences regarding touch and being in close proximity to another helps massage therapists appreciate the complexities of client histories or the way clients seek or avoid care. Also, the experience of depression, anxiety and mental illness crosses socioeconomic lines, and occurs in people of all ages. Massage therapists likely never wholly understand every nuance a client brings to their table, and so they need to be aware of issues that aren’t immediately visible or known that may affect how a client receives touch. Knowing how to safely and compassionately contain a client’s massage therapy experience, no matter what conditions exist, represents a pillar of responsible care. At the same time, remaining true to one’s professional scope and boundaries is essential for the safety of both therapist and client. Indeed, knowing the difference between biopsychosocial factors related to states of anxiety or depression and responding in a professionally affirming way requires that therapists reflect their scope of practice at all times. Trauma-informed care shifts the focus from “What’s wrong with you?” to “What happened to you?” 5 The Significance of Personal History and Context Touch instinctively evokes a person’s history and sensory experience. 6,7,8,9 Like pain, touch is subjective, and encompasses physical sensation, personal touch history and relationship to the toucher. Each sensation gains meaning when compared with a person’s other experiences of touch. There are a variety of verbs to describe ways of touching through the sensate experience of the action: • Contact for comfort: pat, rub, stroke • Percussive, successive contact: hit, tap, tickle • Primitive or animalistic contact: paw, scrub, wipe • Perceive with the fingers and hand: feel, handle, palpate, probe • Intimate contact through touch: brush, caress, graze • Observe kinaesthetically: examine, inspect, explore

When massage therapists become “trauma informed,” they are able to consider trauma related symptoms and behaviors holistically. Instead of working with symptoms individually, trauma-informed massage therapists recognize that the issues a client is looking to manage may relate to a bigger picture. They also acknowledge the prevalence and pervasiveness of trauma and ensure that their practice environment, intake process and massage protocols support client empowerment and consent. In this course, readers will gain understanding of how to better navigate massage sessions that include difficult client histories that affect a person’s comfort level with touch, and explore common clinical situations that may occur with clients who are emotionally raw or tested by mental health issues. Providing Responsible Care Quite literally, massage therapists hold the context and touch history of each client in their hands. If clients have been touched gently and positively throughout their lives, the context of these experiences helps them interpret massage therapy as nonthreatening and safe. 1,2 Even if clients have never received a massage before, they can usually imagine the soothing associated with someone rubbing their backs or placing hands on their necks, as a mother would when bathing a baby. On the other hand, when individuals experience neglect or inconsistent or frightening care at an early age, they encounter a world that does not feel safe or secure. 3,4 This explains why clients with traumatic touch history would likely find massage therapy daunting and uncomfortable. It also confirms the importance of reflecting explicitly on the biopsychosocial factors that contribute to client experience.

amtamassage.org/mtj