Massage Therapy Journal Summer 2026

Summer 2026 • 21

only impacts our brain, but every system in our body through neurotransmitters (stress hormones). When you’re in a stressful situation, your body is flooded with adrenaline, norepinephrine/ noradrenaline, and cortisol, triggering what is commonly known as the “flight, fight or freeze” response. Serotonin and dopamine are suppressed because your brain thinks you’re in imminent danger. These stress hormones increase the force of skeletal muscle contractions, redistribute blood to the muscles and alter metabolism; regulate visceral functions, increase heart rate and blood pressure, and expand the lungs. Cortisol alone can contribute to high blood pressure, muscle weakness, changes in mood, tiredness and impaired brain function, and increases the risk of infection. But we’re not running from a bear. Instead, our bodies are reacting to a significant life changing event we are trying to process while also managing our usual—and sometimes stressful—day-to-day routines. So, what might a grieving client be experiencing? Some examples include: • Poor Sleep • Abdominal Pain/Digestive Disruptions • Brain Fog/Cognitive & Functional Impairment • Headaches/Muscle & Joint Pain • Anxiety/Depressed Mood • Colds/Flu • Infections • Increase in accidents & injuries Identifying Some of Your Clients Potential Coping Behaviors People who are grieving can be at risk for isolating themselves or engaging in coping or avoidance behaviors. Statistically, the most common coping mechanisms are drugs and alcohol, including mixing medication with alcohol, and abusing prescription medications. Cell phones, too, provide an easy avenue to distraction and allow people to sometimes rationalize avoidant behaviors, like staying in bed, not engaging with friends or family, and losing interest in their own health and well-being regimens.

To be clear, there is nothing wrong with having or using a cell phone—even when sometimes you are indulging in avoidant behaviors—but especially for people who are processing grief, being careful they aren’t endlessly scrolling on social media, becoming dependent on virtual relationships, gaming, gambling, shopping—any number of things—is essential. Massage therapists must also be aware of “decision fatigue,” a term coined by social psychologist Roy F. Baumeister, and used to describe the emotional and mental strain resulting from a burden of choices. “When humans are overstressed, we become hasty or shut down altogether, and that stress plays a huge role in our behaviors,” says Tonya Hansel, Ph.D., Associate Dean of Research at the University of Texas, Arlington. This type of fatigue typically leads to one of two outcomes, she adds—risky decision-making or decision avoidance. People who experience despair or whose lives are complicated by loss are especially vulnerable to mental health issues, including addiction disorders.

The Ethics of Working with Clients Who Are Grieving Massage therapist who work with clients experiencing grief need to always maintain their scope of practice and healthy boundaries. We do not give personal or professional advice or counsel, but we can offer resources for clients and help them find self care strategies they can do between sessions that might help extend the benefits of the massage session and give them a way of relieving stress on their own. The SAMHSA.gov website provides a variety of 988 crisis materials for free. You should also consider having an emergency contact on file for clients, as well as a list of professional therapists you might refer out to when needed.

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