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The Application of Massage in Psychogenic Disorders

by Mario-Paul Cassar(more info)

listed in massage, originally published in issue 100 - June 2004

The fact that relaxation is the most beneficial effect of massage is indisputable, particularly amongst students and therapists of massage therapy. It is important that as practitioners of massage we periodically review the emotional states that present so often in our practice and the application of massage in these dysfunctions.

Some 'psychogenic disorders' are essentially manifestations of emotional angst, such as depression and stress. Other conditions can be more complex and may have psychogenic as well as neurological characteristics, such as behavioural problems. Behavioural disorders take into account dysfunctions where the subject, in most cases a child, has difficulty with maintaining alertness, communicating, social skills, physical contact and so forth. Although rather limited, research into the use of massage therapy for these patients indicates that it can lead to some positive changes. One of the most recent and detailed sources of research into the effects of massage has been The Touch Research Institutes (University of Miami School of Medicine and Nova Southeastern University, Florida, USA) headed by Tiffany Field PhD.

Massage is of immense benefit in several 'emotional' situations provided that its goals and limitations are well defined, both to the therapist and the patient. It can be applied in general mental-emotional states such postnatal depression, bereavement, anxiety, withdrawal from drugs, anorexia, sexual abuse and panic attacks. Whilst these emotional traumas have different aetiologies, the goal of the massage is more or less common to all of them. People under any form of mental-emotional stress can benefit from touch, support and relaxation.


Touch in itself is of tremendous value, and conveys an immediate message of caring, acceptance, nurturing and support. It is an essential factor in establishing a feeling of self-worth in recipients.

Accepting touch is a big step in the process of emotional healing, demonstrating that subjects are beginning to like themselves and to trust another person. It also helps to heal their psyche, and enables them to cope better with their problems or circumstances. Touch is also valuable in forming a bond between mother and baby; this closeness can be missing in some mental-emotional situations such as postnatal depression. Another benefit of touch is that it lessens the fear of imminent events, for instance in preoperative patients.


Relaxation is essential in counteracting many of the mental-emotional states, and massage is one of the best methods that can be used for this purpose. It is noteworthy that whilst relaxation is of great value it may not be appropriate in certain situations. For instance clinically depressed people are very lethargic and unmotivated; further sedation can therefore be counterproductive, and massage is only carried out with the approval of the patient's counsellor. A similar precaution is needed in postnatal depression. The mother may not want to be touched at all, in which case massage cannot be carried out. The anorexic person, on the other hand, may find difficulty in relaxing and the massage is consequently of great benefit.

Mind-body Connection

Muscle tension is frequently due to anxiety, in some cases subconsciously used as a form of `body armouring' or `guarding' against the outside world. With a recurrent or prolonged anxiety state, the muscle tightness can become chronic and characteristic of the posture. Tension in the muscles can also exacerbate other symptoms such as headaches, pain, difficulty in breathing, and panic attacks. Easing muscle tension reverses the `holding on' of rigid postural patterns.


Difficulty in breathing can be a feature of stress and, even more so, of anxiety attacks. The experience in itself can be frightening, and causes further stress. During an attack, massage to the back, in a sitting position, can be applied to help calm the person and restore a relaxed breathing pattern.


Another symptom of stress is insomnia, which is distressing and leads to fatigue. The relaxation that massage induces in the recipient is often followed by deep and uninterrupted sleep. Essential oils can increase the efficacy of the massage treatment. Lavender oil, for example, has been found to increase alpha brain-wave activity, which is an indication of a restful mental state (Tisserand, 1992). Promoting sleep in this natural way reduces the need for sedating medication.

Sleep is important to recover from fatigue and to enable the person to cope with stress; it also speeds up the healing process.

Connecting with the body

The continual thinking processes that are so much a part of anxiety mean that, in some mental-emotional states, subjects may be living not so much in their bodies as in their heads. By appreciating the physical movements of massage, clients are able to `make contact' with their bodies once more. By accepting the massage, clients are also accepting their own body and themselves. Such a step is essential in situations where surgery has been performed, as in mastectomy.

Changing the Body Image

A step on from connecting with the body is that of changing the body image. Anorexia provides a good example. This very complicated and delicate condition is not truly an eating disorder, but rather one of deep-rooted insecurity about the self and the outside world. The internal turmoil is deepened by a distorted body image, which is created through self-doubt and lack of self-worth. Agreeing to massage indicates that subjects are accepting themselves and, in turn, are changing their own body image. This transition is a vital aspect of recovery. It also applies in many situations, such as cancer and bone marrow transplant, where subjects wrongly see themselves as having a `debilitated' body.

Adapted from the book Handbook of Clinical Massage published by Churchill Livingstone


Field TM. Touch Therapy. Churchill Livingstone. Edinburgh. 2000.
Field T, Morrow C, Valdeon C, et al. Massage reduces anxiety in child and adolescent psychiatric patients. Journal of the American Academy of Child and Adolescent Psychiatry. 31: 124-131. 1992.
Harrison L, Olivet L, Cunningham K, et al. Effects of gentle human touch on preterm infants: Pilot study results. Neonatal Network. 15: 35-42. 1996.
Tisserand R. Success with stress. Int. J. Aromatherapy. Summer. 1992.


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About Mario-Paul Cassar

Mario-Paul Cassar DO ND is well established as a practitioner and teacher in osteopathy, bodywork, clinical massage and sports therapy. He has also written several article and books including the Handbook of Clinical Massage published by Churchill Livingstone available from Elsevier or direct from the author who may be contacted via

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