Clients have many different goals when it comes to bodywork, and a perfectly valid one is the management of their stress/anxiety. What are the different types of psychological disorders you might encounter? What do you need to know about anxiety as a massage therapist?

This article, “Worrying About Worrying” by Ruth Werner, is a good primer on anxiety disorders and how they affect clients. (If you’re an ABMP member, you can see the full magazine version here).

It addresses what you can do as a massage therapist. You’re not a psychologist, but you can create a supportive, nonjudgmental space for your client to finally just unwind. Massage has pretty robust support in the scientific literature for reducing anxiety in the short- and long-term!

Anxiety vs. Stress

Something interesting about anxiety is that it’s very difficult to disentangle from a concept that we’re all familiar with: stress. “I’m so stressed out from work/school. I’m so stressed I can’t sleep. I’m so stressed that it seems like I can’t ever relax.” “Stress” is just a word that we use as a proxy for that fluttery, clenching feeling in our chest that pops up whenever we expect something to require a lot of mental or emotional resources.

This can actually be a useful feeling. If you have a presentation in an hour, stress can drive you to be on your A-game and spend that extra effort to prepare. It can give you a slightly euphoric feeling as you power through a research paper, or get ready to run a 5k. This is a phenomenon called eustress, which is that useful kick of nervous energy that’s enough to motivate, but not enough to overwhelm.

Then there’s plain old stress, also called distress in the psychological literature. This is the kind that haunts you while you’re preparing for something big, or involved in a project that’s draining the life out of you. This flavor of stress robs you of motivation, often causing people to turn away from the distressing project to less anxiety-provoking activities (often a big factor in procrastination). It leads to all sorts of maladaptive behaviors, like avoidance, aggression, and self-sabotage. It can morph into new things, like compulsive behavior, paranoia, and panic.

I have obsessive-compulsive disorder (OCD). Always have, probably always will. These days it’s just a little gremlin that rides in my hair and tells me not to touch anything in a public bathroom, but it used to be much bigger, and much more insistent. Time, counseling, and medication has put it in its place, and now I can choose to ignore it most of the time. When I’m stressed, however, it can suddenly get supersized again.

This is something that you can affect as a massage therapist. By providing me with an hour where you allow me to be myself in all my naked me-ness, you help me feel safe in my own skin. You help me feel like it’s okay to drop those recycling, negative thoughts for a short while. By applying knowledgable contact for an hour, you draw my attention to my body, allowing me to finally get out of my head. That new focus is like a vacation, and it shows me that I always have somewhere to escape to—myself.

It also promotes activation of the parasympathetic half of the autonomic nervous system. By applying kind, considerate touch, you’re “hacking” the brain manually, causing it to consider stimuli other than fear, worry, and pain. Studies show that massage regimens are useful for both “state” anxiety (how nervous you’re feeling right now) and “trait” anxiety (how nervous you tend to feel). That’s powerful stuff.

Y’all, the overlap between massage and psychology is real, and it’s something that we should embrace, because we can’t ignore it. By touching the body, you’re touching the mind. By creating a therapeutic environment, you’re allowing people to lower their shields and just be themselves. That can be a little scary for you and your client, but it can also be exciting. It’s a place for healing, even if you don’t know what to say, or what questions to ask, or how to respond to them divulging something intense. My advice is to just listen, and to let massage be your medicine.

Is stress something that you focus on in your practice? How do you react when a client tells you about their past experiences of trauma, or their current mental illness (be vague here)? If a client starts going through some serious stuff on the table, how do you proceed? Thanks for reading and participating!