Psychological effects of massage

What research shows

The strongest and most repeated findings for massage are psychological:

• After one session, people report feeling less anxious in the moment (lower state anxiety). Heart rate and blood pressure also dip (see Relaxation and the parasympathetic response).
• After a course of sessions, people report lower trait anxiety (their usual level of anxiousness) and fewer depressive symptoms. In one major meta-analysis these were the largest effects of massage. The same analysis did not find a measurable change in general “negative mood” after a single session, so mood benefits are better supported for a course of massage than for one visit.
• In pain populations, massage also helped anxiety and quality of life compared with other active treatments, though the benefits were small.

Why might massage help?

The mechanisms are not settled. Likely contributors include:

• Pleasant, caring touch
• A quiet, safe environment and time set aside for rest
• Attention and a trusting relationship with the therapist
• Expectation: people who expect to feel better often do

One common claim is that massage lowers the stress hormone cortisol. A careful review found the effect on cortisol is very small and usually not different from zero, so it cannot explain the larger effects on anxiety and mood.

Practical points

• The whole experience matters: welcome, room set-up (see Draping and room set-up), clear communication and consent all contribute to the client feeling safe.
• Massage can support wellbeing, but it is not a treatment for anxiety disorders or depression. If a client discloses mental-health concerns, listen, stay within your scope and encourage them to see their GP or a mental-health professional. The unit Work with people with mental health issues covers working with people with mental-health issues.
• Say: “Many people find massage helps them feel calmer.” Avoid: “This will treat your anxiety.”