Massage Therapy Journal Fall 2025

Fall 2025 • 39

How You Can Help Reframe A Client’s Personal Touch History

Adapting —Techniques according to observations and discoveries: • Providing choice through positioning, supportive touch Acknowledging —Degree of tension, holding, pain: • Evidence of history (if known) • The need to feel safe Respecting —Client choice about positioning, depth or pressure, duration, technique or supportive touch: • The right to refuse treatment Information adapted from Dryden & Fitch (2000; 2007); Korn (2013); Levine (1987).

Rather than exploring client emotion directly, massage therapists respond to client vulnerabilities by: Noticing —Client responses to touch, including: • Guarding • Pulling away from the therapist’s hand • Hypersensitivity (holding breath) Relating —Client personal history to expressions of vulnerability or discomfort: • Family that never touched means client may have no frame of reference for what feels safe • History of inappropriate touch means the client may not recognize the right to stop or change a treatment

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Mental health issues such as anxiety or depression share links with psychological wounding, trauma, neglect or abuse. When such issues surface, self-regulation becomes more challenging. Self-regulation for a traumatized client may be as simple as discovering how to take a deep breath whenever stressful or painful feelings become overwhelming. Trauma, however, might also make self-regulation more complex, like learning to stay present in the face of anxiety or learning to avoid dissociating after experiencing a touch-triggered response. 25,26 Space, Proximity and Trust Issues Recognizing the potential for the presence of trauma or other mental health issues helps massage therapists respond appropriately. Three key issues linking common triggers for emotionally vulnerable clients include 1) staying in confined spaces 2) within close proximity to people in positions of authority 3) who don’t appear to be trustworthy. 27,28,29,30 Massage therapy requires clients to build some level of trust on all of these fronts, asking clients to

volunteer to stay in a confined space, even when they may not always feel safe. For example, clients must remain in close proximity to massage therapists who are in positions of authority, and they may hold preconceived notions about what massage therapy represents, believing that they must undress in front of the massage therapist and that the massage therapist will judge them. Massage therapy also asks a person to trust the intentions of the massage therapist, who oftentimes is a stranger. Additionally, some clients cannot easily take instructions. They cannot hear what the massage therapist says because internal self-talk and psychological “noise” make decisions difficult. 31,32,33 Some emotionally vulnerable clients may also discount what the massage therapist says because they don’t believe the massage therapist fully appreciates their experience. 34,35,36 Clients may behave defensively, or express grief, anger or resentment. Some clients might exhibit surprising or alarming responses to otherwise normal questions. 37,38,39,40 And in response to confined

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