Anxiety – “Distress or uneasiness of mind caused by fear of danger or misfortune.” (1)
“A feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” (2)
Everyone feels anxious or stressed at one time or another. When our minds are in an anxious state, our bodies go into a sympathetic or “fight or flight” state. When the sympathetic nervous system is active, the pupils of our eyes dilate, our hearts beat faster, and our blood pressure goes up. These are all physiological mechanisms by which our nervous system prepares the body to respond to potential danger. Sympathetic responses are valuable when we are confronted by an immediate danger, where we need to respond quickly. However, when we are in an anxious state, these sympathetic responses persist and can cause damage to our bodies. (3)
Massage therapy has been shown to activate the parasympathetic nervous system (our “rest and digest” state), resulting in decreased sympathetic activity. This decreased sympathetic state can also allow the mind to relax and reduce the anxious feelings. (4) Scientific studies have found massage therapy to be effective in reducing pain and anxiety in hospitalized patients before and after surgery, in children being treated for burns, and in women who are experiencing labor. Massage therapy has also been shown to reduce anxiety and pain in military veterans with advanced illnesses. (5, 6) Studies on healthy individuals have also demonstrated that the use of massage therapy resulted in reductions in anxiety and physiological parameters associated with stress, such and blood pressure and heart rate.
Best massage techniques and bodywork for anxiety
Many health care practitioners and researchers believe that complementary therapies such as massage have great potential for reducing stress and anxiety, as well as having positive effects on the general welfare and health of healthy individuals.
Massagetherapy.com lists more than 250 types of massage and bodywork modalities. Many of these techniques have the potential for helping with relaxation and reducing anxiety.
1. Swedish massage
In the United States, Swedish massage is most typically used for relaxation. Techniques that are included in Swedish massage are effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (tapping or percussive movements), and vibration (shaking or vibrating specific muscles or body segments).
Textbooks on massage application report that the most relaxing strokes in Swedish massage are long, gliding effleurage strokes. These are most effective in producing relaxation when they are performed slowly, gently, and rhythmically. In addition, gentle, rhythmic rocking (a type of vibration) can have a significant relaxing effect. (4, 7, 8).
Studies on patients receiving Swedish massage techniques have demonstrated reductions in anxiety, although there are still research questions as to the most advantageous frequency, duration, and timing. For clients who are not in an acute state of anxiety due to hospitalization or surgery, research and clinical experience indicate that regular massage over a period of weeks or months is most effective for continued effects and longer-term improvements.
One interesting note about Swedish techniques: although the most relaxing techniques do not use extremely deep pressure, extremely light touch has been found to be less effective that moderate pressure. This may be due to the “tickling” sensation experienced during very light touch. (13)
2. Reflexology massage treatments on hands and/or feet
In addition to Swedish massage, another frequently used technique to product relaxation and reduce anxiety is massage and/or reflexology treatments on the hands and feet. Our hands are used constantly, in nearly every daily activity and a great deal of tension can result. In addition, standing, walking and other daily activities put stress and tension on our feet. Add in the effects of high heels, dress shoes, and poorly-fitting flip-flops, and the feet can hold a lot of tension and stress.
Because of the constant stress on the hands and feet, as well as because the hands and feet have areas that reflect back to the rest of the body, massage or reflexology on hands and/or feet can result in deep relaxation of the entire body. (4, 11) A study done in Japan on healthy individuals in the community, found that regular foot massage combined with aromatherapy resulted in a significant reduction in self-reported anxiety, as well as physiological measures of blood pressure. In this study, the participants did a self-massage on their legs and feet using a massage oil containing relaxing aromatherapy oils, such as lavender, chamomile, sandalwood, ylang-ylang, and marjoram. They also worked acupressure points in their feet and finished the treatment with a rest period before returning to daily activities. (9)
Aromatherapy added to massage therapy can add to the relaxation value. A frequently used aromatherapy essential oil is lavender. Other oils that have calming properties include orange, lemon, rose, clary sage, chamomile, cedarwood, frankincense, geranium, jasmine, neroli, marjoram, patchouli, rosewood, sandalwood, and ylang-ylang. (4,8) Before using any aromatherapy essential oil, it is important to be sure that there are no allergy issues with any of the oils, and that the person receiving the massage is receptive to the particular smell of the oil. There are also conditions, such as pregnancy and epilepsy that may contraindicate the use of certain essential oils.
Any massage or bodywork technique that utilizes slow, gentle, moderate pressure strokes is likely to aid in reduction of anxiety and stress. Other factors in a technique reducing anxiety are its use of specific areas that aid in relaxation, and the client’s level of comfort with the treatment. Some additional massage and bodywork modalities that may help to reduce anxiety include:
4. The M-Technique
Described as “physical hypnotherapy,” the M-technique was developed by Jane Buckle, RN to work on critically ill patients. The technique is a structured series of touch suitable for use on the critically ill, medically fragile, or dying patients. It is a series of stroking movements performed in a set sequence, repeated a set number of times. The pressure used is a constant light level, rather than increasing and decreasing throughout the treatment. Massage therapists using these techniques have reported that their clients relax more quickly and more deeply than with only regular Swedish techniques. (10)
Reiki is an energy/bodywork technique developed by Mikao Usui of Japan in the early 20th century. In a Reiki session the practitioner acts as a conduit for healing energy to the recipient, moving their hands to 12 different locations on the body. Reiki can also be learned and done as a self-healing technique. It is a way to improve the body’s energy flow, resulting in better physical, mental, and spiritual balance. (4, 11)
6. The Feldenkrais Method
Developed by Moshe Feldenkrais, this bodywork modality is a movement practice, where you learn how to observe and reduce patterns of tension in your body. It is based on the theory that the body and brain are connected, and that by retraining the body’s movement pattern responses you can also retrain the central nervous system, to improve your physical, mental and emotional functioning. Clients who have experienced this method have found that as their physical reflection of anxiety (such as shortening of the flexors in the front of body and rounding of the shoulders) was reduced, their emotional experience of anxiety was also reduced. (11, 12)
7. Craniosacral Therapy
Developed by John Upledger, DO, OMM, this type of bodywork is designed to assist the fluid movement within the membranes and cerebrospinal fluid that surrounds the brain and spinal cord. Using light pressure, the practitioner tests for restrictions in the fluid flow and to assist the natural movement of the fluid. By eliminating restrictions in the craniosacral system, this type of therapy helps encourage the natural healing mechanisms of the body, dissipating the negative effects of stress and enhancing health. (11)
In addition to using techniques specific to aiding relaxation, the environment in which the treatment takes place can aid in eliciting a relaxation response. Massages become more relaxing when the massage area is optimized for relaxation. This can include low lighting, a comfortable temperature, relaxing music, and minimal clutter. (8) In addition, the choice of colors for the room and the linens on the massage table can help reduce anxiety. Reds and yellows tend to increase energy and stress, while blues tend to be more calming. (4)
- Dictionary.com ;
- Barton, Boitano, and Brooks. Ganong’s Review of Medical Physiology. McGraw-Hill, 2016.
- Rowan, B. Massage. Barnes & Noble Books. 2003.
- Fields, T. Massage Therapy Research Review. Complement Ther Clin Pract. 2016 August ; 24: 19–31
- Boyd, C.; Crawford, C.; Charmagne, F.; Price, A.; Xenakis, L.; Zhang, W. and the Evidence for Massage Therapy Working Group. The Impact of Massage Therapy on Function in Pain Populations—A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part III, Surgical Pain Populations. Pain Medicine 2016; 17: 1757–1772.
- Mumford, S. Healing Massage: A Practical Guide to Relaxation and Well-Being. Hamlyn, 1997.
- Costa, L. Massage – Mind and Body. Metro Books, New York. 2009.
- Eguchi E, Funakubo N, Tomooka K, Ohira T, Ogino K, Tanigawa T. The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women:A Crossover Randomized Controlled Trial. PloSONE 2016 11(3):e0151712.doi:10.1371/journal.pone.0151712.
- Buckle, J. The M Technique – Physical Hypnotherapy for the Critically Ill. Massage & Bodywork, Feb/Mar 2002.
Glossary of Massage and Bodywork Techniques
- McCullough, L. The Feldenkrais Method. Massage & Bodywork, Nov/Dec 2011.
- Vanderbilt, S. Moderate vs Light Pressure in Massage. Massage & Bodywork, Apr/May 2005.