The Bodywork World Needs to Center Itself Around Trauma-Informed Care, or how firing a "chronically emotionally needy" client is NOT a best practice

I read an article in Massage & Bodywork Magazine entitled Emotional Release on the Massage Table. This is in an issue that also featured The Importance of Attuned and Compassionate Touch, so I had high hopes that the bodywork field was highlighting a trauma-informed approach to bodywork. While the article promises best practices for emotional releases that occur during a bodywork session, in actuality it does not offer a trauma-informed, sensitive, or compassionate standard of care.

This piece begins: “Massage therapists sometimes wind up with a client who is chronically emotionally needy.” The article has just begun, and already this sentence is judgmental and loaded. Let’s keep reading.

It goes on: “Other times, a client who is usually pleasant or reserved -and isn’t normally the type to share the details of their personal lives - may appear unusually upset. Perhaps they’ve just received bad news, had a death in the family, are going through a breakup, or lost a beloved pet.”

The author wonders aloud: “What are we to do?” and suggests that “In the case of the chronically needy client, the best thing you can do is release them as a client.” They are missing what I hoped would be an obvious step. When a client exceeds our capacity and scope of practice, instead of firing them as if they are the problem, we might wonder if they need more and/or different supports. While it’s true that we can’t be expected to be the right fit for each client, and while we can’t work outside of our professional scope of practice, we do have the ability to refer clients to other practitioners (whether a trauma-informed bodyworker or a therapist) that can better meet their needs.

There is one exception in the recommended knee-jerk reaction to fire a client prone to emotional releases. When it comes to a “usually pleasant or reserved” client, the author muses that they might be going through something traumatizing, such as a death, a breakup, or loss of a pet.

Why do they not extend this same kind curiosity to the “emotionally needy” client? It feels clear to me that if someone appears to be “chronically emotionally needy” - they have a lot of emotional needs, and the emotional needs are there for a reason and need attending to. (Hint: the reason might be Complex Post Traumatic Stress Disorder.) Wouldn’t it make sense to wonder what THEY have been through? Instead, as happens all too frequently in healing arts and medical fields, folks in distress due to trauma are further distressed by an approach that is the opposite of trauma-informed, the judgments and narrow-mindedness adding insult to injury.

I wish our bodywork field would better equip practitioners with skills for working with clients who have experienced trauma. I have seen this short-sighted approach all too often in trainings, and in bodywork school, where we were told “not to let emotional releases happen” because they are out of the scope of practice. The fact is that some clients will have an emotional release on the table, and before we can have the conversation about making a possible referral, there is a human who needs our care and sensitivity in that moment.

I fear for massage therapists who read this article, and, rather than glean best practices for when emotional releases occur, ascertain that the approach depends on whether the client is “usually pleasant or reserved” or “chronically emotionally needy”.

For clients whose emotional releases on the table are considered “out-of-the-ordinary” - the article notes, ”you don’t need to do anything except be present and compassionate.” This is in stark contrast to the “emotionally needy” client, who they recommend firing. Where, may I ask, is the compassion for someone coming to us in turmoil and emotional distress? Why is the best practice of “just be kind and caring and provide a safe space for [the usually pleasant clients]” not also a best practice for all clients, including the “chronically needy”?

I also fear for clients who, like myself, often experience emotional release during massage sessions due to a history of Complex Trauma. While it’s unreasonable for massage therapists to be expected to be therapists, our standard of care should absolutely be trauma-informed and we should relate to folks experiencing pain (physical or emotional) with respect, professionalism, and sensitivity. Even if the best possible outcome is to no longer work with this client, it’s possible to treat clients with dignity, respect, and compassion. Even as we refer them to another provider because what they need is out of our scope of practice.

No matter a client’s history, demeanor, or likeliness to cry during a session: quality care is what we all deserve. I wish the world of bodywork would catch up. And it stands to reason: clients are waiting, too.

Touch is a Relationship

it’s not nothing, to receive bodywork. especially from new hands and a new practitioner. especially if we have a history that includes harm and violation via touch. especially if our nervous system is keyed up, our muscles guarded.
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for some people, this isn’t a big deal. it’s no thing, to be massaged by someone, anyone. but for a lot of us, it’s the biggest dang deal. because our body and our skin and our nervous system remember things that have happened to us before. we bring those experiences with us into the session, onto the table, on our skin and under the sheets.
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often i remind first-time clients that we’re in a new relationship. trust doesn’t need to come right away. clients can decide how much touch (if any - somatic work can happen without touch, and same goes for energetics), what kind of touch, what pressure, all of that. clients might want to remain clothed, or keep more clothing on. this is all okay. accepted. allowed.
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often for the first massage we don’t do super deep work. it’s more of a hello. here i am, a therapist who is engaging in a relationship and negotiation with you around touch. i am gentle. i am always gentle (though potent) but especially gentle for the first session.
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touch is a relationship and there can be a lot to navigate within that therapeutic relationship. a lot is happening. more than touch is happening, because our physical contact touches deeper layers and because an alchemy exists between the client and practitioner. because, ideally the client and the bodyworker are co-regulating, a safe hum of the nervous systems syncing and connecting. and a safe container needs to be built to hold this hum.
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If touch is a lot for you, i see you. i am you. and in my role as a somatic practitioner and trauma-informed bodyworker, i honor the hell out of that.

You Don't Need to Survive Your Massage

You don’t need to survive your massage
✧if the pressure is too deep
✧if the pace is too fast
✧if you feel panicky while you’re “supposed” to be relaxing

Your bodywork session is for YOU. To meet your needs. Your body, your nervous system. A massage isn’t something to survive or endure. There’s enough of that in the world.

So if you find yourself pushing through, your bodyworker might be pushing too hard. Or there might be anxiety or big feelings on top of the muscles and tissues (and we’ll get to this part soon, pinky promise). It’s okay to ask for a pause. Ask for less pressure. Ask for more pressure. Change positions. Ask your bodyworker to slow down. Take a moment and get in touch with your breath and what’s coming up for you.

Whatever. You. Need.

It’s okay. Truly. Because a massage is not something to survive.

Let's Talk Bodywork and Massage

Hi friends. I’m going to start sharing about trauma-informed b o d y w o r k, because it’s kind of my thing. Don’t worry, there will still be moody poems and memes because those are also my thing. We’ll get into what the heck trauma-informed bodywork is, how to begin when your body holds so much trauma you’ve avoided working with it, and we’ll explore massage myths.
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For now, let’s talk b o d y w o r k, which means: let’s talk massage because guess what they’re the same thing, basically.
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mirriam-webster says:
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mas·​sage, noun: manipulation of tissues (as by rubbing, kneading, or tapping) with the hand or an instrument for relaxation or therapeutic purposes
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bodywork, noun: therapeutic touching or manipulation of the body by using specialized techniques
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I like to use the word b o d y w o r k because it feels wider to me than what we think about when someone says massage. We might think about a relaxing swedish massage at a spa (fluffy robe, warm oil, long soothing strokes) or a sports/medical massage after an injury (deep tissue, trigger points, gentle stretching). But b o d y w o r k can be so very many things. It’s a wide world. It’s an ocean you can swim in. There are modalities that are relaxing, energizing, clearing (on energetic, physical, and emotional levels), and rehabilitative. There are modalities rooted in different places in the world. There is probably a modality out there that works for you even if you haven’t found it yet.
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In my integrative massage sessions, I love to blend modalities to meet the client’s needs. I’m often turning to swedish massage (those soothing strokes for tight muscles and a weary nervous system), craniosacral therapy (gentle holds, like a steady anchor the body and nervous system can move around), and fascial unwinding (witnessing and supporting the unwinding of body-held and tissue-held patterns). My hands are always holding energy, but I don’t identify as an energy worker. It’s just something that is always happening, and often an alchemy between myself and a client.
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I hope this helps clarify what the heck I mean when I say b o d y w o r k. This isn’t the end-all be-all definition, it’s just mine. What’s yours?