trauma informed massage therapy

Of all the modalities mentioned in the description of my practice “trauma informed massage therapy” may feel the least familiar to you.
So in today’s blog I’ll try to write a bit about trauma, trauma informed massage therapy, and how I personally integrate it into my practice.


Let’s start with some definitions, so we all are on the same page. According to American Psychological Association trauma can be defined as “an emotional response to a terrible event like an accident, rape or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea.” (1) I also found another definition, which I think, adds some more clarity: “trauma results from an event, series of events, or set or circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual well-being.” (2). As defined above, trauma is a reaction to an event, or a series of events that were harmful or life threatening. What is important to remember is that trauma is not only an emotional or mental reaction, trauma is all encompassing, so all kinds of reactions are possible. And that’s normal – it is how the body tries to make sense of what has happened. Trauma is also extremely individual, meaning that there are no rules stating what can and what can’t cause trauma. Trying to compare yourself to someone else, or being compared, is completely misunderstanding what trauma is. Trauma is more about the reaction, and less about what caused it. 

Trauma informed massage therapy is much like regular massage therapy in terms of massage itself, but with a couple of major differences in regards to everything else. Two of the most important qualities of trauma informed massage therapy are: 1) making safety, physical and emotional, a top priority, and 2) trust in the patient’s experience. By focusing on creating a non-threatening treatment environment, the risk of triggering a stress reaction is minimized. Treatment office is supposed to feel safe and welcoming – become a safe haven where patients can drop their guard, feel comfortable with all the different emotions and thoughts, but also certain that they will not be taken advantage of. So in a way trust and safety are like two sides of the same coin. Trust and acknowledgement of a patient’s experience is fundamental for feeling safe, and – on the contrary – lack of validation and not being taken seriously can be very detrimental. Another key element of trauma informed practice is 3) trauma awareness, which simply means an understanding of all the many ways people deal with their traumas, and all the different strategies people use to survive and cope with their situation. Impact of trauma on life, relationships, behaviors is widespread, and therefore understanding of these facts is necessary if the collaboration is to be successful. Trauma awareness is the therapist’s ability to recognize trauma in all its shapes and forms, and to be able to destigmatize it, as well as communicate it and reframe it. There is nothing worse than feeling ashamed and afraid of one’s own feelings and emotions. Finally we move on to 4) collaboration and empowerment. Trauma informed massage practice is a two way street, where both the therapist and the patient are on the same level. Each of them brings different qualities to the table, but they are all equally important and valuable, and there is no superiority of the therapist’s knowledge over the patient’s lived experience. Trauma informed massage practice is based on ideas of shared decision-making and equality between the therapist and the patient. There is another element of that as well – setting boundaries. What this means is that it is up to the patient to decide what the session will be like on a given day; there is no rush, and progression happens at a pace chosen by the patient. On the other hand, setting boundaries is a way to remain professional when people are at their most vulnerable, without creating unhelpful dependencies nor taking advantage of that vulnerability from any of the parties. Massage therapy is just one of many parts of the therapeutic process, and self-care is a crucial one for further improvement. Because of that there is a strong emphasis on fostering self efficacy and resilience. Just as I wrote above – trauma informed massage therapy is about the patient’s self determination and agency, so helping restore it is a very important goal. That’s why discussing home based practices, suggesting exercise ideas and group activities, but also maintaing professional setting, are just as important as hands-on techniques. Recognizing, and building on the patient’s strengths, setting meaningful and valuable goals is what furthers the progress of the therapeutic process.

Trauma informed massage therapy is more of an approach, the overarching framework, than a set of techniques. It is about your experience: do you feel safe? Do you feel trusted and taken seriously? Are you controlled by your therapist, or rather assisted in the journey? Do you feel better, more confident?

To me it’s about making my clinic a place where you don’t have to prove anything nor explain yourself. Whatever you come with, it’s up to you to tell me, if ever, what happened, I won’t try to fix it, it’s not my place – what I’ll try to do instead is to help you relax and feel better. My top priority is to help you feel safe and taken care of, even if just for an hour. That also means that you’re in charge of what the session will look like; if you don’t want to work on certain areas – that’s fine, if you want the session to be gentle one day, and deeper the other – again, that’s fine, if you want to talk – we will talk, but if you want to be quiet and focus on the session – you’ll get exactly that. How I understand trauma informed massage is that it is about being there for you, listening, being attentive, giving massages, being the right person at the right time, and helping take the edge off.

So, as you see, trauma informed massage therapy is not some fancy modality, it is, if anything, the most humane approach to massage therapy. I’m not a psychologist nor a chancellor, and my job is not to diagnose trauma or fix it, but as a massage therapist I can help you feel a little bit better, and experience something that you may have not felt for some time, maybe some joy, maybe even some piece of mind. Massage is a wonderful thing, so if you’d like to try it, but you’re worried that the session will be too intensive or trigger some stress reactions – a trauma informed approach may be what you need.

1. https://www.apa.org/topics/trauma

2. https://www.gov.scot/publications/trauma-informed-practice-toolkit-scotland/pages/4/

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