Massage Therapy Journal Fall 2025

38 • Massage Therapy Journal

AMTA Continuing Education

unprepared for the personal disclosures or behaviors of emotionally vulnerable clients. For clients to feel wholly safe and accepted, they may need to express their feelings in a given moment, and so massage therapists must have the knowledge and experience to respond appropriately, compassionately and safely. Discomfort with expressions of emotions or a client’s affect may explain why some massage therapists declare that they cannot work with emotional clients. Some massage therapists have suggested that listening to client’s stories is “not in their scope of practice” or that therapists “cannot act as psychotherapists.” A psychotherapist is someone who facilitates exploration of a person’s feelings, emotions and personal history. While it is true that massage therapists are not trained to engage in psychotherapy, they do need to be prepared for possible emotional responses in the treatment room. Massage therapy can cause an emotional response in some clients and, in some situations, may prompt clients to share detailed personal stories or experience emotional outbursts. 15 Actively listening while responding empathically and appropriately to a client in distress forms a central role of a massage therapist. Shutting a client down because a therapist feels uncomfortable with client expressions of emotion is not helpful. Working With Traumatized or Emotionally Challenged Clients Massage therapy for traumatized or emotionally vulnerable clients does not look all that different from the massage therapy many clients incorporate into their overall wellness regimens. The same framework, process, assessments and techniques may be used. But when a massage therapist understands, respects and accommodates a client’s personal history, the experience of massage therapy can deepen and provide more positive support for a client. Most importantly, clients with trauma or mental health issues may need their massage

therapists to work collaboratively as a part of the client’s health care team. “Massage therapy intended to reduce anxiety and depression may have more in common with psychotherapy than has been commonly considered, which would have important ramifications for both education and research.” 16 Massage and Self-Regulation At its most basic level, massage therapy is designed to help clients rest. The goals of a massage session may focus more on decreasing a sympathetic nervous system response than on promoting parasympathetic function, but the ultimate goal looks the same: The client breathes more deeply and rests more comfortably. The ability to do what is necessary to ensure one’s well-being is called self-regulation. If people are unhappy, then they self-regulate by finding ways to feel calmer and more settled. Leon Chaitow suggested that the overarching work of massage therapy is to facilitate client self-regulation. 17,18 Chaitow broke this guiding principal into three distinct outcomes: • Improved function • Reduced load • Alleviated symptoms The concept of encouraging self-regulation is also discussed considerably in the trauma literature. 19,20,21,22 Because trauma can impair a person’s ability to self-soothe or allay anxiety, facilitating self-regulation becomes an important goal of massage therapy for people who have been traumatized. If a client’s ability to function day-to-day is impeded by increased anxiety, then a desired outcome might be to help the individual learn how to self-soothe while being massaged. 23 If the “load” that a client suffers includes depression and insomnia, then encouraging relaxation and promoting sedation becomes a key part of the session plan. 24 If the client suffers from chronic pain, then the therapist may help to alleviate symptoms through manual techniques, as well as promoting self-care strategies and relaxation.

But when a massage therapist

understands, respects and

accommodates a client’s personal history, the experience of massage therapy can deepen and provide more positive support for a client.

amtamassage.org/mtj