Massage Therapy Journal Fall 2025

Fall 2025 • 53

• Detaching from self • Becoming unaware of surroundings • Disconnecting from the present • Becoming emotionally unresponsive • Being unable to remember significant aspects of trauma. Clients who dissociate describe feeling frozen with fear, nauseous, panicked or unable to put how they feel into words. They may have difficulty walking and feel weak or even paralyzed, and they may guard or hold their bodies stiffly, appearing oblivious to any touch by the therapist. These clients may also clench their fists, stiffen their legs, stare unblinkingly or squeeze their eyes tightly shut. They may shake or rock side to side, become hot to the touch, as if their temperature suddenly rose, or shiver uncontrollably. 141,142,143 Massage therapists may not recognize client dissociation initially because it appears as if clients are asleep. On closer examination,

dissociated clients seem distinctly absent, at times almost unconscious. 144,145 It is possible that a client may never have dissociated before experiencing massage therapy. On the other hand, it is quite possible that dissociative clients have done so in other triggering situations. 146,147,148 Client dissociation represents an important red flag to massage therapists because dissociated clients cannot provide informed consent. When dissociated, clients are no longer aware of what is happening in the treatment room, and when they cannot make eye contact or explain how they are feeling in response to pressure, proximity, touch or positioning, they cannot provide ongoing informed consent and treatment should be paused until they regain their faculties. Dissociation suggests that clients are early in their recovery. They likely require more support than a massage therapist can provide. No massage therapy

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