7 Factors to Fix Me ~ Remedial Massage

By Vanessa Hough, DipRM

Purple Sister Massage

Disclaimer: If you are experiencing psychological distress or suicidality, you should seek the services of mental health experts. The below article is presented in the context of holistic client care and is not a stand alone treatment for psychological difficulties or suicidality.

“Vanessa, my shoulder hurts.”

“ Vanessa, I strained my lower back.”

“Vanessa, I sprained my ankle.”

It is not uncommon for me to have a client come in after a complaint like those mentioned and say, “Fix me!” Sometimes that is easier said than done. When a client is living with mental illness, acute or chronic cases, it’s not as textbook as applying tape a certain way, releasing certain muscles, or giving stretching or strengthening exercises to “fix” the cause of pain or injury. While it isn’t completely necessary for a Remedial Massage Therapist (RMT) to know the intimate details of a client’s mental health issues, it is, however, important to have a clear understanding of the reason for treatment and the goals the client wants to achieve by incorporating massage into their mental health care plan. This allows the RMT to tailor the treatments specifically to the client.

The Touch Research Institute at the University of Miami recognises the many benefits of massage in the treatment of several mental health issues, including anorexia nervosa, anxiety, depression, PTSD, stress, digestive disorders, fibromyalgia and chronic pain. In my practice, I often have clients come to me with their physical symptoms and mention their mental health related issues on the intake form. They may not realise how the two are linked. In some cases, Mental Health Care Practitioners may overlook this link as well. So what do we need to know about the physical effects of massage that bring about positive changes in a mental health diagnosis?

During massage, the stress hormone cortisol is decreased, blood pressure lowers and the heart rate becomes more stable and calm. The hormones serotonin and oxytocin are released at a higher rate. Serotonin helps our bodies physically by stabilising our moods and promoting sleep. Sleep is a critical time in our daily cycle which allows us to do four things: rest, restore, repair and rejuvenate. Oxytocin is a “feel good” hormone, also nicknamed “the love hormone”, and it promotes feelings of relaxation, mental stability and lowered anxiety. Oxytocin is found to help generate feelings of trust. Trust is a critical component to the client-practitioner relationship. If my clients do not feel a sense of trust with me, then the partnership is unlikely to continue. When that sense of trust is established, massage allows feelings of mental and physical comfort to grow as a result of healthy, knowledgeable, consensual and caring physical contact.

Two types of massage I practice have been successfully incorporated into treatment plans for both physical and mental health care plans, Swedish and Hot Stone Therapy. Both styles of treatment can bring about relaxation, a reduction in physical pain symptoms, a sense of calm and an increased feeling of resilience. However, it is critical that the client’s mental health care provider and their RMT consider the following factors:

1. The client’s ability, willingness and consent are paramount to commencing and continuing to incorporate massage in their treatment plan.
2. If touch is an issue which contributes to the diagnosis, then the RMT needs to be involved in establishing a boundaries agreement with the client. This is imperative for both the client and the practitioner.
3. Consideration must be given to the potential that massage may increase the client’s feelings of stress, anxiety, etc and a plan established relating to duration of treatments , draping of client during treatment, pressure and oils used, especially if using essential oils as scents can trigger memories.
4. Clients must be capable of expressing verbally and non-verbally their needs and boundaries.
5. It is highly advisable that Mental Health Care Practitioners establish a list of qualified, reputable and trusted RMTs and recommend clients to their “best fit” RMT.
6. RMTs should be offered or have as a resource, a Mental Health Care Practitioner they can confide in should their own mental health be challenged. When clients feel they can trust their RMT, they are more likely to open up and share personal thoughts and experiences with the guarantee of confidentiality.
7. RMTs should remind themselves and their clients that they are not mental health care practitioners. In doing so, RMTs should also remember to be mindful of the level of personal information and experiences which are shared with clients during treatments. It can be a fine line between sympathy and empathy and being distant and cold. The balance is crucial in providing a safe, caring and trustworthy environment for the massage clients and for the RMT who provides the treatments.

It gives me great satisfaction to know my clients trust me, my abilities and the environment in which I provide their treatments. Thoughts, intentions, experience and intuition help to shape me and my practice. A client’s treatment begins long before they walk into the clinic. Knowing how massage can help someone physically and mentally, by incorporating the 7 key factors and by showing respect to all parties involved in the care plan, I have been able to provide clients with a healthy and sustainable treatment component within their health care plan.