Dimensions of Holistic Massage

Dimensions of Holistic Massage

Copyright 2009, Associated Bodywork & Massage Professionals, Inc.

by  Linda G. Means, Ph.D. CMT

Peacehope Healing Arts, Monroeville, PA




For modern-day massage therapists, the concept of “holistic massage” may seem very 21st-century, but in fact for millennia, healing bodywork was intended to balance the physical, emotional, mental, energetic, and spiritual bodies.  Just as virtually all ancient medical bodies of knowledge incorporated a multi-dimensional model, all ancient massage practices also addressed the holistic organism.  When Swedish massage was developed in 19th-century Europe, the Swedish focus on the physical body probably helped massage therapists gain acceptance in the modern-day physically-oriented medical community, but unfortunately neglected to educate therapists in the holistic potential of the work. 

In the late 20th century, as American massage schools began to include a variety of energetic healing modalities in the curriculum, the massage community began to return to its holistic roots.  However, Swedish massage is still often regarded primarily as a physical practice.  Let’s take a look at a 21st-century model of Swedish massage which provides for a holistic approach. These principles can be applied to any sort of a bodywork session, from deep tissue to hot stone massage.

A holistic massage session employs a variety of strategies to work specifically with the client’s physical, emotional, mental, energetic, and spiritual needs.  Deep relaxation and effective therapeutic results occur most readily when the client feels 100% safe, comfortable and nurtured, when the client’s and therapist’s mental activity is quieted, and when clear energy flow is facilitated. 

The Mental Body

Herbert Benson, M.D., Associate Professor of Medicine at Harvard Medical School,  defines the “relaxation response” as “a physical state of deep rest that changes the physical and emotional responses to stress (e.g., decreases in heart rate, blood pressure, rate of breathing, and muscle tension).”1  This is a measurable physiological response that is the opposite of the fight-or-flight stress response.  This effect may account for many of the diverse medical benefits that have been measured in clinical studies of massage therapy. 

This relaxation is not achieved solely by physical manipulation of soft tissue, nor by the body being at rest.  According to Dr. Benson, who has devoted over three decades to studying the relaxation response, this effect occurs when mental activity is slowed to a quiet, relaxed state.  This is the state generally associated with the practices of meditation and yoga.  In this state, the electromagnetic waves of the brain slow down to a frequency of 8-12 Hz, which is called an alpha wave state.  The alpha wave frequency is also associated with parasympathetic nervous system dominance and hypnotic trance states.  Hypnotic trance is a state in which the organism is receptive to suggestions for positive change, so the client’s healing intention may be fulfilled more readily in this state. 

During any massage session, we can use specific strategies to subdue various types of mental busyness which prevent the slow brain wave frequencies associated with relaxation:

“Monkey mind” is a Buddhist term for the usual walking-around kind of mental activity which occurs during most of our waking hours.  Monkey mind is characterized by an endless stream of thoughts about anything and everything.  Monkey mind produces a beta brain wave state: >12 Hz, which prevents the relaxation response.  We can help the client reduce monkey mind thought streams by providing a relaxing input for her to focus on, especially at the start of the session:

Ÿ         Consider using music as foreground sound instead of background sound.  Enchanting melodies with gorgeous instrumentation and lots of movement and suspense can captivate the client mentally, drawing her attention away from whatever was on her mind before she got on the table.   Sing along with your own sweet voice to really grab her attention!

Ÿ         Some music is specially formulated to induce alpha wave activity in the brain.

Ÿ         A stroke or movement that is highly soothing and unexpected may attract the client’s attention and help her to focus on the pleasurable feelings in her body.  Gentle rocking is very nurturing, and according to Shiatsu therapist Carl Dubitsky, extended rhythmic oscillation slows brain waves.2  Whole-body rocking under the sheet can provide a gentle, non-threatening start to a massage.   Drumming on the body is an effective way to draw the client’s attention to the body, especially when combined with beautiful drum music.  Try using a six or seven-minute track from David & Steve Gordon’s Drum Medicine CD, for example, drumming with the music and moving over the whole body.

Ÿ         Bringing the attention to the breath and slowing the breath can help the client to move his attention out of the mind and into the body, and to slow the brainwaves. Slow, deep breathing provides this effect for the therapist as well as the client.  I sometimes make my long slow breathing slightly audible, so that the client will hear it and match it, without my having to say a word.  Clients have often commented that hearing my breath helps them to breathe deeply themselves.

Ÿ         When the client begins the session in a prone position, she may be less inclined to talk, because of the difficulty of communicating from inside a face cradle.  Also the face cradle provides a bit more sensory deprivation, because ambient light is not coming through the eyelids and the eyes cannot open.  So the prone positioning may help to induce a quiet mind state more readily than a supine position.  Also, for clients who have asked for help with back tension, the prone position enables you to give attention to the problem area immediately at the start of the session.

 “Worry mind” refers to thought patterns that carry concerns about the bodywork session itself.  If your client has had painful massage experiences in the past, you can relieve worry mind with reassurances that you do not want to cause pain, and by checking in occasionally to be sure the client is comfortable, so the client can feel safe and let go of this fear mentally.  If your client mentions a specific body area that needs attention during the intake, he may continue to worry about that area until he feels your touch there.  If you tell your therapist that your lower back is killing you and the therapist doesn’t even touch that area for the first 40 minutes of the session, you may lie on the table wondering whether you were heard, or whether you should say something again, and your attention may stay focused on that discomfort until it is attended to.  As a therapist, you can relieve this worry thought pattern by beginning the session on that part of the body.  Similarly, if the therapist has the habit of only visiting each body part once during a massage session, the client may feel disappointed after the therapist covers up the worrisome area:  “that felt so good, it was just what I needed, but now it’s over…”.  By returning frequently during the session to the area of concern, you can help the client to feel that the attention there is never-ending.

“Tracking mind” is the phenomenon of noticing where the therapist is working and anticipating what she will do next.  This mental activity is especially likely if you do the same massage routine during every session, or do the same massage sequence on the right and left sides of the body during one session:  “okay, now she’s going to flex the ankle, then she rotates and tractions each toe… yep, there’s the first toe… second toe… next toe… next one…”.  You can defeat tracking mind by working in a way which is not predictable.  If the work cannot be tracked, tracking mind gives up thinking about it.  You can also deter tracking mind by continuing one lovely, soothing stroke or movement for a ridiculously long time:  “that feels great but I know she’s almost done, she only does that four times… wow, she’s still doing it… wow, that feels so good, and it just goes on and on…”.  Eventually the mind surrenders the expectation that the good feeling should stop soon, and relaxes into pure pleasure.

“Social mind” comes into play when the client feels an obligation to be engaged conversationally with the therapist, which is not relaxing neurologically!   The brain activity involved in chatting generates beta brain waves, preventing slower frequencies.  You can encourage clients to enjoy therapeutic silence by addressing this in your “How to Receive a Massage” literature, and by not allowing yourself to be drawn into chatting during a session.  I sometimes respond to a client’s chatty questions by saying, very softly, “I’d love to talk to you about that later.  Let’s take a couple of deep breaths right now…”.  Conversation about what is happening during the session is sometimes necessary of course, and keeps the attention focused on the bodywork happening in the present.  

Recent scientific discoveries in neuroplasticity have demonstrated that the human brain has tremendous capacity to change its patterns even in adulthood.  Brain reorganization occurs in response to repeated new patterns.  According to Sharon Begley, “the actions we take can literally expand or contract different regions of the brain, pour more juice into quiet circuits and damp down activity in buzzing ones.”3  In this regard, if our clients experience slow brain wave states for extended periods of time during massage sessions, this may also stimulate their brains to adopt new, healthier patterns.  We can help our clients begin to develop the brain patterns and health benefits of trained meditators!  I have a regular shiatsu client who goes into an extremely deep trance state during each session.  Recently he said to me at the end of the session, “My brain just stops thinking, I lose all track of time and place, there are no thoughts in my head at all during our sessions,”  I replied, “That is what meditators spend years trying to achieve.  You are doing advanced meditation on the massage table.  Good job!”

The Emotional Body

By providing an emotional sanctuary during the massage session, we can help the client to relax deeply and let go of emotional armoring which may be associated with health issues.   Emotional openness comes from a feeling of being nurtured, accepted, listened to, and appreciated.  We can gain the client’s emotional confidence in many ways, before, during and after the treatment session.

Before the massage:

Remember that the session really begins at the moment the client walks through the door, at the first contact with you and your environment.  Do you welcome the client warmly?  Do call him by name as he enters your space?  Are you glad to see him?  Does the client experience your full attention from the time that you greet him?  Try to get your treatment room set up completely before greeting the client, so that after you turn your attention to him, you have no need to take your attention away to light candles, say, or to close the window blinds or turn on music.

A thorough intake discussion assures the client that you are taking all of her concerns into account.  Even a regular weekly client needs to know that you are basing today’s session on what her needs are today, and that you are listening attentively to fully understand her needs.  Asking clarification questions about the client’s issues or repeating what the client has told you indicates that you are really, truly engaged with the client’s concerns.

The intake discussion also provides an opportunity to reassure the client that the treatment will be a safe experience.  In order to surrender fully to a state of deep relaxation, the client needs to believe that the therapist will not hurt her during the massage session.  We can frame the client’s expectations for the session by saying upfront that we do not intend to cause pain or discomfort, because the body tenses up in response to pain.   You can ask your client to please let you know if anything feels uncomfortable in any way, so that you can adjust the work to suit her. This indicates that we welcome feedback during a session, without regarding it as criticism or complaint, helping the client to release any fear of the therapist.  When we clearly convey our intention of providing client-centered massage instead of therapist-centered work, the client feels secure in knowing that her needs will be met fully.  When a client says, “Do whatever you like,” I respond with, “I’d like to do whatever you would like!”  My friend Annette Sand tells her clients, “It’s all about you!” … and she really means it.

During the massage:

Imagine the feeling of sore muscles that have been aching for touch.  Then imagine that exquisite feeling of relief when a caring therapist makes the first soothing contact with those needy muscles.  Activate your own emotional body, fill your hands with the feeling of “help is here,“ and pour that feeling into your client’s body.  This engages the client’s emotional body as well as the physical body, creating strong emotional harmony between therapist and client.  Peggy Horan, massage teacher at the Esalen Institute, describes the experience of emotional harmony in this way:  “I loved that the work was received on deep levels, way beneath the skin, closer to the soul, where clients experience their sense of real self, their feelings, and their emotional home inside their body.”4

As you work, the quality of your touch informs the client of how carefully you are listening to the body, to detect the perfect level of work.  The emotional body does not feel safe with touch that feels aggressive, reckless or inattentive; we recoil from people who scare us or cause us pain.  The client can feel the difference between a robotic massage where the therapist’s hands are on autopilot and the therapist’s mind is elsewhere, and a massage in which the client’s attention is fully engaged in the interaction and the hands are responding to what they feel.

Attention makes all the difference with deep tissue work, where the therapist’s inattention makes the client feel unsafe.  When deep tissue work is done slowly and attentively, the client’s body intelligence detects your sensitivity to what is happening beneath your hands.  Deep compression done too quickly or automatically can blow past the point of resistance and cause pain, which may also blow the client‘s feeling of emotional security, and increase her fear and resistance toward your work.

Checking in with the client about the comfort level of pressure, temperature, how far to take a particular stretch, etc. demonstrates that you are actively engaged in trying to adapt the work to accommodate all of your client’s needs as they arise during the session. 

After the massage:

Even if you have time pressure in your work schedule, you can create the feeling of lingering in the client’s field after the treatment session ends.  Try leaving the feeling of your touch on the client by releasing your final contact so gently and gradually that the client still feels you there after you are gone.   Allow even just a minute or two after the session to bask with the client in his state of joy and pleasure, and to allow your client the opportunity to express his feelings and experiences in private with you.  Remind your client that the body will continue to respond and unwind over the next couple of days, to help him carry the effects of the work home with him. 

The Energetic Body

A Swedish massage session can be designed to clear energy blockages and induce a strong clear flow of energy throughout the body, which moves all physiological processes back toward normal.   Energy blockages are associated with muscle tension, pain, and inflammation, physical discomforts which we are trying to relieve during the session.  Swedish massage techniques frequently help to release these blockages.   Neuromuscular techniques, for instance, may help a muscle to release tension; now the excess energy that was released from that muscle needs to be dispersed to fully relieve the client’s symptoms and promote total healing.  We can accomplish this by clearing the energy pathway leading from that area through the limbs that connect to that area.  In the case of neck tension, for example, after releasing the neck we can stimulate energy dispersal through massage work on the scalp, shoulders, arms, and hands to enable the released energy to flow freely out of the neck.  Tension released from the lower back can be directed out of that area via the hips, legs, and feet, and also via the upper back, shoulders, arms, and hands.  Joint mobilization helps to release energy blockages, and long stretches that traction the whole length of the body help to stimulate energy flow through the longitudinal meridians.

Brushing off the body energetically also helps to disperse excess energy.  This can be most effective at the end of the session, after all of your good work in releasing energy blockages.  Energy brushing can be done either touching the body or with the hands off the body, beginning at the head, grabbing excess energy and smoothing energy flow all the way through the neck, the torso, legs, and off the ends of the feet, and from the shoulders down the arms and off the ends of the fingers.  Shake off your hands at the end of each stroke to remove the excess energy from your field.

Our choice of music influences the energetic effectiveness of bodywork.  Yin bodywork uses deep quiet touch to relieve anxiety and sedate overactive energy.  Quiet, unstructured music provides a good energetic complement to yin therapy.  Yang bodywork uses rhythmic movement to stimulate energy flow and address deficient energy conditions.  Rhythmic, moving music supports the therapeutic energy of yang bodywork.

Most massage sessions benefit from a combination of these energetic approaches, so it is useful to choose a music playlist which alternates between yin and yang energetic blueprints, creating a holistic energetic arc for the session.  In the 21st century, we are lucky to have laptops and MP3 players to specify music playlists, so we are not constrained to use the predetermined music burned onto a CD.  You can customize the music very specifically for each session through your observation of the client’s energetic profile.  If a client shows indications of an excess energy disorder, such as anxiety, you may want to use predominantly yin music, particularly at the start of the session, interspersed with some yang work to promote overall energy flow.  For a deficient energy disorder, such as fatigue, predominantly yang music may be more therapeutically effective, with yin music used strategically for quiet moments such as deep tissue work, or slow work on sensitive areas like belly, neck, and face. 

“Vibrational resonance” refers to changes in the frequency of an energy field in response to an external energetic stimulus.  Resonance results in vibrational synchronization between two energy fields.  As therapists, we can create in ourselves a healthy, balanced vibrational field for the client to harmonize with, by approaching the client in a calm, relaxed, centered, grounded state.  When we work with a quiet mind, focused on our connection with the client, our brain waves slow down and provide a relaxed vibrational target for the client’s brain frequencies.  When we work with gratitude and compassion, the client’s emotional field resonates with our joyful, loving state.  These are not metaphorical constructs, they are actual vibrational manifestations of our experience, which can transfer to the client through our close, extended contact during a massage session. 

I once gave the following feedback to a student after receiving a shiatsu session from him:  “Your work was beautiful technically, the pressure was perfect, the meridian work was spot on.  But what are you so angry about?”  He responded with surprise: “How did you know that I’m angry?”, and he went on to tell me about the intense difficulties he had been experiencing in his life recently.  I told him that I could feel the anger in his touch, and advised him that he needs to develop the practice of leaving his own emotional imbalances outside the door of the massage room, because no matter how expertly he works technically, clients will feel uncomfortable with his negative emotions intruding into his work.

Dr. Norman Shealy and Dr. Dawson Church describe calm emotional states as one of the characteristics of a master healer: “Healers … who regularly induce feelings of peace and tranquility in themselves -- and have a spiritual practice focusing on love and compassion -- are more likely to enter the kind of physiological state associated with healing… A master healer, in the healing state, is typically tranquil inside, even if their outer actions are animated.”5

The Physical Body

Working holistically on the physical body entails addressing the body as a whole unit, instead of a collection of parts.  The arm does not end at the wrist, it continues energetically and psychologically through the fingertips.  The leg does not end at the upper thigh, it continues over the hip and into the lower back.  If we uncover one leg, work on it in isolation as far as the upper thigh, cover it back up again and don’t return, we are telling the leg that it is a separate entity from the upper body.  By physically connecting the leg with the hip, the back, the arm, the opposite leg, we awaken the body’s memories of how everything is connected and works together. By returning to the leg again and again during the session, we remind the leg again and again that it is part of the whole organism.

Numerous techniques can help the client to feel the body as a whole:

Ÿ         Long strokes that travel the entire length of one side of the body, from toes to fingertips,  help the client to feel that whole side as one unit.

Ÿ         Long bilateral strokes, traversing the entire length of the body on right and left simultaneously, help the client to feel the connection between left and right as well as the connection of upper and lower body.

Ÿ         Whole-body rocking helps the entire organism to feel the same rhythm.  There are many hand-holds which can be used to create movement in the entire body, on the feet, sacrum, shoulder blades, etc.

Ÿ         3-D work, contacting the posterior and anterior parts of the body simultaneously, helps the client to feel the wholeness of a region of the body.  When working with the client in a supine position, for example, we can help her to feel the whole abdomen by slipping one hand beneath the lumbar spine while massaging the belly with the other hand.  When the entire session contacts each region of the body as a whole unit, instead of a front or a back, the client may experience a greater sense of body integration.

The Spiritual Body   

Compassion is the hallmark of the spirituality of massage.  Our clients feel our compassion and nurture and attention in our hands, or the absence of it.  If you engage in your practice as sacred work, your client’s spirit will respond with gratitude and healing.

The groundbreaking work of Dr. Masaru Emoto demonstrates irrefutably the physical effects of love healing.  Emoto’s photographs of crystals formed in water treated with compassion and gratitude provide visible evidence of the transformational power of love.  Given that the human body is composed of over 70% water, it is clear that the compassionate touch of a spiritually-oriented massage therapist can potentially induce the state of vibrant, radiant wholeness seen in Emoto’s crystals.  As Dr. Emoto says, “If we fill our lives with love and gratitude, this consciousness will become a wonderful power that will spread throughout the world.”6  In our role as massage therapists, we are given a license to touch people with kindness.  We are indeed the lucky ones to have the job of guiding clients into a space of peace, relief, and contentment.  Your gratitude for your work may be the key to your success as a health care provider.

The holistic massage approach heals more than just tight muscles.  Holistic massage guides the client -- and the therapist -- into a place of wholeness, connection, communion, bliss, where the client feels loved and listened to, accessing the body’s deep intelligence to release limitations and old patterns, allowing muscle tension to fall away naturally.  Welcome to the 21st century!


1 Benson-Henry Institute for Mind Body Medicine, http://www.mbmi.org/basics/whatis_rresponse_TRR.asp

2 Carl Dubitsky, Bodywork Shiatsu (Rochester, VT: Healing Arts Press, 1997), 101.

3 Sharon Begley, Train Your Mind, Change Your Brain (New York: Ballentine Books, 2007), 8.

4 Peggy Morrison Horan, Connecting Through Touch (Oakland, CA: New Harbinger Publications, Inc., 2007), 4.

5 Norman Shealy and Dawson Church, Soul Medicine (Santa Rosa, CA: Elite Books, 2006), 92.

6 Masaru Emoto, The Hidden Messages in Water (New York: Atria Books, 2001), 146.