Massage and PTSD


The DSM 5 defines Post Traumatic Stress Disorder (PTSD) as “persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). Markedly diminished interest or participation in significant activities.”

The symptoms of PTSD vary from person to person depending the nature of the traumatic event and the personality of the person afflicted. These symptoms include but are not limited to:

  • Insomnia
  • Chronic pain
  • Fatigue
  • Flashbacks
  • Nightmares
Researchers have found that PTSD causes chemical imbalances in the brain triggered by the emotional stress. Can massage alleviate some of these symptoms?

The short answer is, yes, with qualifications. Massage can encourage relaxation and relieve the muscle tension resulting from chronic stress. Massage improves circulation and releases neurotransmitters that reduce cortisol levels which can improve sleep.

However, massage therapists working with sufferers of PTSD must be cognizant of triggers that may come up before or during the session.

One of the biggest things that suffers of PTSD deal with is a lack of control so it’s important to allow the clients to set the boundaries.

Keep these things in mind when working with clients that suffer from PTSD.
The client is in control of the entire session. From questions about the intake to work during the session including stopping before the session has officially ended. The most important thing a massage therapist can bring is the skill of listening and responding appropriately and within their scope of practice.

Establish a relationship. If the client needs to ask more questions than you are accustomed to, allow that. Trust is important for every client. Multiply that by 100 for those suffering from PTSD.

Seek experience. Take continuing education courses; reach out to therapists who have more experience in this area than you do. Learn about what the triggers are and how to deal with them.

Communicate. Keep communication open and fluid at all costs. If the pressure is too deep, adjust; too light adjust. If the client feels overwhelmed, for whatever reason, take a beat and ask whether the client wants the session to stop or continue. However, always keep in mind that we are NOT psychotherapists.
We do not provide information or counsel outside of our scope of practice. If the client opens up, listen. If you have alliances with psychologists or psychiatrists give the client options for talk therapy.

Proceed slowly. The environment inherent to receiving a massage (confined, quiet and dark) can trigger someone suffering from PTSD. Lying prone (on the stomach) may feel more vulnerable than lying supine (on the back. With training and experience, you will understand these reactions and acquire the skills to handle these issues if they arise. Allow clients to adapt to the environment and change some aspects if necessary, i.e. keeping the door ajar or turning the lights up. In addition to this, let the client know that he/she can undress to their personal level of comfort. If the client wants to keep all of their clothes on, work with that.

The most important thing to remember is to stay within our scope of practice. Massage is very intimate and clients often open up and tell us things about themselves. We listen but we don’t offer advice.

Establish relationships with psychologists, psychiatrists or social workers and create a network of appropriate referrals. We deal with stress reduction and relaxation not psychotherapy.
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Book Authored by Deidre Ann Johnson

Keep this handy book by your desk while working or in your carry on when travelling for tips to keep you flexible and pain free.

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