Trauma-Informed Care in Massage Therapy: A Guide for Practitioners
“This topic might be out of scope for massage therapy.”
This was a comment I recently received about an ad for my class on trauma-informed care. It’s a perfect example of why I offer this class.
The Foundation: What We Know About Massage and Psychology
To understand trauma-informed care in massage therapy, we must first acknowledge a fundamental truth: massage has psychological effects. When clients seek relaxation through massage, they're already engaging with the psychological dimension of our work. This connection between physical touch and emotional response isn't just anecdotal—it's an inherent part of the human experience.
Consider what happens in a typical massage session. Some clients experience deep peace and joy, while others might unexpectedly find themselves processing grief or sorrow. These responses happen whether we intend them or not, showing us that the psychological impact of massage is not optional—it's inevitable.
Understanding the Spectrum of Approaches
Within our profession, perspectives on handling these psychological effects span a wide range. To better understand these viewpoints, let's examine them carefully:
At one end, we find practitioners whose natural empathy and desire to help leads them to want to address their clients' psychological well-being directly. This impulse comes from a beautiful place—the same caring instinct that likely drew them to massage therapy in the first place.
Many of these therapists have witnessed the profound emotional relief that can come through bodywork, perhaps even experiencing it themselves. Some practitioners have found traditional psychotherapy lacking in their own healing journeys and discovered that somatic practices like massage provided them with a deeper sense of connection or aliveness. This personal experience can make it tempting to view massage as a psychological healing tool.
At the other end of the spectrum are those who, concerned about maintaining professional boundaries, might hesitate to engage with the psychological aspects of massage at all. Their caution reflects a valid commitment to practicing within scope.
The Critical Distinction: Informed Care vs. Treatment
Here's where we reach a crucial understanding: recognizing that massage has psychological effects does not qualify us to use it as a psychological intervention. Think of it this way: we know that exercise affects mood and can help with depression, but this doesn't make personal trainers mental health professionals.
This distinction becomes especially important when we consider trauma. While massage training provides us with valuable skills, it doesn't provide the psychological expertise necessary to navigate trauma treatment. Moreover, equating heightened physical sensation or emotional release with healing represents a dangerous misconception. For someone with trauma, unexpected or intense bodily sensations can actually be retraumatizing rather than healing.
The True Meaning of Trauma-Informed Care
So what does it mean to provide trauma-informed care while staying within scope? Let's use an analogy that many massage therapists will understand:
When we work with clients taking blood thinners, we don't treat their cardiovascular condition —but we absolutely need to understand how their medication affects our work. We adjust our pressure, monitor for bruising, and maintain open communication about comfort. We could call this "blood-thinner-informed care."
Trauma-informed care follows the same principle. We're not treating trauma, but we're:
Understanding how trauma might affect a client's experience of being cared for
Recognizing signs that a client might be becoming overwhelmed
Knowing how to maintain appropriate boundaries while fostering a sense of safety
Understanding when and how to modify our approach to prevent retraumatization
Conclusion
As massage professionals, we have a unique responsibility. Our work involves touch—perhaps the most intimate and powerful form of professional interaction. This privilege requires us to understand its impact fully. If any profession needs to be trauma-informed, it's massage therapy.
This understanding doesn't mean overstepping our scope—quite the opposite. Proper trauma-informed education helps us recognize and maintain appropriate boundaries while providing more effective care within those boundaries. It helps us understand when to refer clients to mental health professionals and how to work collaboratively with other healthcare providers.
This is why I offer a class on trauma-informed care. The goal isn't to turn massage therapists into trauma counselors, but to help us become more knowledgeable, effective, and responsible practitioners within our scope of practice. By understanding trauma's effects on the body and mind, we can better serve our clients while maintaining appropriate professional boundaries.
In doing so, we honor both the power of our work and its limitations, creating a safer and more effective healing environment for all our clients.
Author
Dr. Mark Olson holds an M.A. in Education and a Ph.D. in Neuroscience from the University of Illinois, specializing in Cognitive and Behavioral Neuropsychology and Neuroanatomy. His research focused on memory, attention, eye movements, and aesthetic preferences. Dr. Olson is also a NARM® practitioner, aquatic therapist, and published author on chronic pain and trauma-informed care. He offers a variety of courses at Dr-Olson.com that provide neuroscientific insights into the human experience and relational skill training for professionals and curious laypersons.