Massage Theory: How Therapeutic Massage Contributes to Long Term Mental Health


There are many theories on massage. The standard Massage Theory a student learns in massage school focuses on the physiological effects of therapeutic massage, and aims to explain why and how healing takes place. It is widely known that Therapeutic Massage helps remove stress, aid in depression, improves sleep, decreases anxiety and nervousness along with associated physical symptoms. Yet, little has been written about why it helps in many psychological conditions. Because the body and mind are inseparably linked, it is essential to understand therapeutic massage from both perspectives; the physiological and psychological. While massage is an active physical process, the extent of its benefits is deeply tied with the patient’s psychological state. When a person has a healthy mind, he is much more likely to have a healthy body as well. Likewise, as in a placebo effect, when a patient expects change to occur, it is more likely to occur. Understanding why and how massage helps from a psychological perspective will help both therapist and patient take advantage of the powers of the mind to create long lasting healing results rather then a temporary relief.

Most massage therapist today encourages relaxation to the point of sleep. This allows the therapist to calmly and quietly work through the session producing a certain intended therapeutic effect. Yet, one of the focuses of this article describes how additional psychological therapeutic benefits can be achieved by encouraging the patient to remain awake and conscious throughout the entire massage séance.
Massage is so frequently described in the context of “spiritual well being” that tag lines such as “Heal you body and mind” have become cliché and patients usually ignore them as sales jargon. Fortunately it is not just sales jargon and there is much truth in it. The source of massage’s effects on the mind is the touch. The moment of physical contact is a very important moment. At this very instant the patients awareness travels to the location of contact, and from that moment on, the patient and the therapist are linked on a psycho-physiological level. And the therapist has the potential to manipulate the patient’s awareness to create psychologically assisted healing.


Long term psychological benefits can be achieved through therapeutic massage. The therapist has the potential to influence the patient’s mental states through the physical points of contact during massage session. Every point of contact is a gate into the conscious and subconscious mind of the patient. There are two types of therapeutic results, those which are produced through subconscious actions, and those which are produced by conscious actions. Subconscious therapy is dependent on the automatic response system of the mind/body and does not assist in gaining insight into the workings of mind/body system.  Conscious therapy produces immediate therapeutic results while simultaneously developing insight into the workings of the mind/body system, thus giving fruit to long term psychological benefits. Alert and conscious massage is required in order to achieve maximum mental therapeutic results. Sleep massage decreases insight based therapeutic effect because both therapist and patient lose control of the patient’s mental processes. Therapeutic effect is achieved through a balanced and equanimous mind. The therapist has the responsibility to provide a balanced massage which is neither painful nor pleasing so as not to arise aversion or desire in the mind of the patient which would imbalance the mind.

Massage Meditation Analogy

Even if you have never tried meditation, when describing long term psychological benefits of Therapeutic Massage, various forms of meditation can be used for comparison in order to deepen our understanding of the healing effects.
Vipassana (Insight Meditation) is one of the forms of meditation taught by Goutama the Buddha, and is an essential practice in most Buddhist traditions today. The Buddha taught that through Vipassana meditation complete enlightenment is possible. The technique of Vipassana consists of continuously scanning the body for physical sensations while maintaining an equanimous observant mind, over time deepening concentration and penetrating deeper and deeper into the essence of body and mind.

During Therapeutic Massage a similar state of mind naturally arises if the patient mentally and equanimously watches the physical sensations produced by the therapists touch. At the point of contact a very important bond occurs between the therapist and the patient. Through this bond, the therapist has the potential to manipulate the inner condition of the patients mind. It can be said that therapeutic massage is a meditative experience if performed consciously and skillfully.

Two Types of Healing

There are two basic types of healing, one which happens subconsciously (automatically) and one which happens naturally as a side effect of becoming increasingly conscious while maintaining a balanced mind.

Automatic healing relies on the subconscious system which must be manually triggered in order to take effect. Subconsious healing is your body’s automatic immune system response. It happens when your body fights off diseases, and when drugs do what they are designed to do without the patients knowledge. Massage can also be a triggering mechanism for automatic healing.

Conscious healing relies on discovering natural self healing potential which has a quality of self control through free will. Once conscious of this self healing potential, a person gains insight and a long term psychological healing asset. Massage is also an excellent means to develop conscious healing ability.  

The Point of Contact

If you think of the mind as being composed of a conscious level and a subconscious level, then the conscious level is simply the point of awareness which is subject to your free will, while the subconscious point of awareness is almost completely automatic and is subject to your habitual or instinctual mental responses. For example: If you consciously use your freewill to put your attention on your hand, then the hand becomes the point of awareness, and thus enters into your conscious mind, while at that same moment all the other points on your body are on the subconscious level of your mind. So by moving your attention you are constantly converting different regions of the body/mind from a subconscious to a conscious state. This is the first example of the connection between mind and body which is very important to understand in order to skillfully take advantage of massage’s potential in healing the patient on a psychological level. Perform this experiment on yourself to understand it and to see that it is indeed true.

When the therapist touches the patient the door to the subconscious unlocks, but whether or not it remains open will depend on the skill of the therapist and on the compliance of the patient. Together, this will determine the extent to which a patient will have long term psychological benefits. The mental activity of a person is dependent on his habitual patterns as well as physical condition. When a patient anticipates the touch of the therapist to occur, his point of awareness travels to the anticipated location. This point can be large or small. There can also be multiple points of awareness simultaneously. At the moment of contact the point of awareness becomes concentrated. But after this moment, the patient has the choice to either maintain concentration on that point of contact or to allow the mind to scatter and travel away from the point of contact. When the mind scatters then the therapist loses mental control of the patient, but if the therapist maintains control over the patient’s point of awareness then mental healing is possible. There are many techniques to control the patients point of awareness, such as intensifying the pressure or minimizing the point of contact to just a small area of the body. This is a very complex topic and many books can be written on this aspect of touch therapy only.

The point of awareness has various qualities. First, the point of awareness serves as a gateway to the subconscious mind. This point is the vehicle of the mind. It is a neutral point of observation. It can firstly experience the sensations on the body and secondly it can act as an anchoring point for the transmission of mental content. The patient has the option to watch the sensations or to watch the content which is transmitted through it. This is a very subtle activity which is very hard to control without prior experience.

Although dependant on the modality of massage, normally when a masseuse begins a massage séance the patient is conscious of the point of contact only during the first 5 minutes or until the body is warmed up. Following this, the patient enters into a semiconscious state where he allows his attention to pass through “the gate” of point of contact. In other words, the mind begins to drift in and out of consciousness, automatically switching attention from the sensations to the mental content which is anchored to them. This is similar to entering a very relaxed state where there is no particular intended focus.

This semiconscious state is excellent for immediate short term therapeutic results. But it has very little potential to create any long term psychological health improvement based on insight. On the other hand, if the patient intends to, and thus remains conscious of the sensations of the point of contact, then insight based healing is taking place. For the masseuse, it is important to understand what types of movements and techniques encourage consciousness and what encourages sleepiness. There are no black and white rules of what always works and what never works. The efficacy of the séance depends on how well the masseuse is able to concentrate on the patient’s responses to touch.  It also greatly helps if the patient himself understands the technique and has the intention to maintain awareness on the sensation of the point of contact instead of the content which becomes anchored to it. When awareness passes through to the subconscious level, the mental content and the sensations become inseparably linked and the mind cannot distinguish between the two. This is experienced as drowsiness or light sleep.

The Mind During Massage

The roles which the mind plays in therapeutic treatment is essential for success. We can understand the role of the mind by examining it within the context of Relaxation Massage versus Therapeutic Massage. Relaxation massage techniques encourage sleepiness while therapeutic massage techniques encourage consciousness. Among many therapeutic massage techniques three examples are deep tissue, pressure point, and Thai Yoga.

As a result of mental distress, usually the patient is unaware of the process when physical tension happens and muscular knots form. When the mind is in stress, the body is in stress. Frequently people who are depressed or stressed unconsciously tense up their body and develop unhealthy physical behaviors. Over time the body feels the toll of accumulated tension and pain is experienced in the body.

During a therapeutic massage treatment, the patient experiences the release of this tension as a sensation of pain. It is important to understand the duel quality of a sensation - it is both mental and physical. When muscular tension is relieved, simultaneously the subconscious content which caused and maintained this tension also becomes relieved. Thus, therapeutic effects are occurring on both physiological and psychological level concurrently.

The next level of psychological healing is dependant on the patient’s own reaction to the sensations. This is based on the principle of balance. A balanced mind is an equanimous, unbiased mind. If the patient experiences pleasure during massage and develops an attachment to this sensation then equanimity is lost and the therapeutic effect is lessened. Likewise, if the patient creates aversion to pain or discomfort during massage, then the therapeutic effect is also lessened because the equanimity is lost. An equanimous state of mind has the greatest ability to release old trauma and tension. While all states of craving and aversion hinder mental ability to release old psychological imbalances and only have a negative impact on health.

Based on this principle of balance, the therapist must understand that an entire massage séance must be balanced and performed skillfully. The therapist must in tuned with the patient and be extremely attentive and intuitive. Depending on the patient, the masseur must manipulate the techniques accordingly. A therapeutic session must not allow the patient to drift off into semi-consciousness or sleep and he must not create so much pain that the patient creates aversion to it. A balanced massage promotes a balanced mind.

Frequently patients come to receive massage in order to relieve stress. What is this stress? Stress is simply too much investment into mental content. It is like a bottleneck of mental content pressuring to get through the point of awareness all at once. Therapeutic massage is extremely effective in relieving stress because of the dual nature of mind body system. When the patient experiences the sensations of the point of contact, the attention travels away from this mental content and to immediate sensations. This allows for the bottle neck of mental content to dissolve. Maintaining balanced equanimous awareness of present sensational phenomena causes all forms of stress to disappear very quickly. This is a highly therapeutic aspect of massage.

On the other hand, if the patient falls asleep the therapeutic effect drastically diminishes, because during sleep the mind enters into the realm of subconscious mental activity, or in other words, the other side of the gate of awareness. Lasting effects of psychological benefits are much more easily achieved through the conscious mind then through the subconscious. 

Therapeutic Massage or Pleasure Massage

The main difference between therapeutic massage and pleasure massage is that there is an intention to heal in the former and not in the latter. Any massage modality can be therapeutic. If healing is the intension then from the beginning, and both therapist and the patient are mentally prepared for healing to take place, then the minimum effect guaranteed from a therapeutic session is a placebo effect. But, additional consistent concentration on sensations by the patient adds an additional psychological healing effect.

Pleasure massage is dependent on sensually indulgent tendencies. All sensual pleasure derived from massage is stimulated by an unbalanced psychological state. Additionally, during pleasure massage the patient often drifts into sleep, diminishing the potential for long term mental healing to take place. As far as short term results are concerned, pleasure massage is very effective at quickly relieving stress because the mind concentrates on physical sensations thus maintaining a conscious point of awareness. Indulgence during pleasure massage unbalances the mind and creates an associative attachment to the experience, causing stress to return soon after the associated sensations are gone. Thus, to maximize therapeutic effect, it is always better to observe all massage sensations objectively - with a balanced mind.

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