Twenty months after COVID-19 emerged, massage clients are returning to therapists’ tables—so much so that some therapists are busier than ever—and clients are oftentimes presenting with heightened feelings of fear, grief, anxiety and touch deprivation.
“The State of Mental Health in America, 2021,” a report from Mental Health America, shows the number of people with moderate to severe symptoms of anxiety and depression remains higher than in 2019, with 8 in 10 people who took an anxiety screening showing such symptoms, and 70% of people reporting loneliness or isolation as the top contributing factor to their mental health issues.
We spoke with mental health experts to take a look at the profound effects of anxiety, fear, grief and touch deprivation; and with massage therapists around the U.S. on how they are responding to this new wave of clientele so in need of healthy touch.
Why Are We Stressed?
The reasons why clients might feel so stressed are many—the pandemic continuing with a more virulent Delta virus, deaths of loved ones to COVID-19, changes to workplace structure, political strife, personal reasons such as relationships and finances, fear about the future.
Anxiety is the brain’s attempt to anticipate and predict what is going to happen when there are threats coming from the world around us—and the brain kicks into high gear when there is no “all clear” signal that allows us to return to a more neutral emotional state, said psychotherapist Jude Treder-Wolff, LCSW. Many people are also worried about loved ones’ health and safety, while shouldering the effort to carry on with life, work, school and other responsibilities, she said. “This constant state of tension is exhausting,” said Treder-Wolff, “and the long-term nature of facing these threats has turned anxious thinking into mental habits.”
Constant feelings of worry, sadness, anger or despair can lead to a very bleak outlook on life, said clinical psychologist Brian Wind, PhD, and these emotions can manifest as physical symptoms like poor sleep quality and appetite, poor concentration, loss of interest in activities one used to enjoy, panic attacks, fatigue and headaches.
Massage therapist April Pilz, LMT, who practices in Bethlehem, Pennsylvania, said she has noticed that her clients are more stressed than they were pre-COVID-19. “Some are genuinely afraid for their health—I specialize in chronic pain, so a fair number of clients have underlying autoimmune disorders or are compromised in some way—or they are managing huge lifestyle changes that come from working from home or trying to help their kids with school,” she said.
In addition to her sanitation practices, Pilz is scheduling clients farther apart to properly ventilate the room in between sessions and to avoid any contact while they are coming or going.
“My goal is to make everyone feel safe and know that I am maintaining very high standards, for them and for myself,” she said.
Most of Kimberly Rogers’ clients in Weyauwega, Wisconson, are, she said, stressed out or burned out by politics, the pandemic, work (or lack of work), the closure of small local businesses, masks, vaccinations, being shut in, and life in general in the new normal. She’s had to set boundaries related to what she will and won’t discuss with clients in the session room.
Even then, she said, with all the cleaning and ventilating, self-care and boundaries, “stuff is trickling through. I can see one client and be exhausted afterwards. It’s not the occasional client. It’s all of them. They vent or remain silent and release their stuff during their sessions.”
What We Grieve
When this article was posted online in early October 2021, more than 700,000 people in the U.S. had died of COVID-19, leaving grieving family and friends behind. Yet, grief is related to loss in general, not just death, said family and psychiatric mental health nurse practitioner Kameko McGuire, DNP, PMHNP-BC, NP-C.
“There is also grief associated with longing for the past or the previous norm,” she said. “Some are grieving relationships, their jobs and previous security.” Something as simple as no longer being about to travel with fear can add to a person’s grief, she added.
As we see the world re-open, we further face grief that comes up with awareness of what has been lost from our social landscape, said Treder-Wolff. Businesses are closed, favorite restaurants are gone. “There can also be grief about a loss of the illusion that we could escape this kind of trauma in the modern world,” she said. In short, we grieve for the lives we left behind.
Just as humans need food to survive, we also need a steady influx of touch. What we’ve learned in years past about touch deprivation has tended toward the dramatic, from the infamous wire-monkey experiments of the 1960s to documented effects of touch deprivation in 20th-century Romanian orphanages. And then came COVID-19. Suddenly, most types of touch—handshakes, hugs, high-fives, pats on the back—were eliminated from our lives. Massage practices had to close. Remote work took the place of offices bustling with colleagues. We became a society living apart from one another—and while social distancing protects us from illness, it is two-sided in that it has increased negative feelings related to touch deprivation.
“As human beings, we have a natural desire for touch, for most of us, it signals that we are safe,” said Nicole Lacherza-Drew, PsyD. People are social creatures who need interaction with others, she said, and physical touch is also a way some people show affection—but that hasn’t been allowed to happen.
“Think about not being able to hug your 80-year-old grandmother for a year, or before she passes away,” Lacherza-Drew said. “These normal routines we had in place, many of us took for granted until we were told we couldn’t see certain individuals, couldn’t leave our homes, or if we could do both of those things, we had to have a buffer between us—a glass window or 6 feet. You cannot hug someone properly through a window or at 6 feet.”
Massage therapist Cariann Stafford, LPN, LMBT, who lives in Burlington, North Carolina, said she feels like some of her clients seem very eager to be touched. “Especially the clients that live alone,” she said. Stafford has also worked as a relief nurse for the state of North Carolina, and during those duties she encountered many residents who were feeling the effects of isolation and who responded greatly to simple touch, such as hand-holding.
Practicing in Pleasant View, Tennessee, massage therapist Susan “Kelly” Sanders, LMT, said, “More clients are getting massage because the power of touch and nurturing care is greater than any opioid, pill or prescription.”
And according to Jimmy Gialelis, LMT, BCTMB, a massage therapist and school owner in Phoenix, Arizona, “Touch is an innate and fundamental psychological need and massage therapy fulfills this need.” Gialelis said he had more clients as of August 2021 than at the same point in 2019 and has had to start a wait list for clientele. “I think many people in 2020 recognized, either consciously or subconsciously, their need for human interaction, including touch, during trying times.”
Massage to the Rescue
You feel how your massage helps clients. They relax, release and melt under your touch—and they, in turn, feel the nurturance, pain relief and respite from anxiety that massage gives them.
As for so many massage therapists, for Dallas, Texas, for massage therapist Rick Merriam, business is thriving. He attributes this his focus on studying marketing, developing a podcast, and filming videos to reach new clients—work he did during the time that COVID-19 orders kept him from practicing massage.
“In one of the first videos I uploaded, I showed how to palpate and address the obturator internus,” said Merriam. “In the first week, I had three new clients contact me. After doing a couple of paid consultations with one of those clients over Zoom, she flew to Dallas and did five sessions.”
St. Claire Shores, Michigan, massage therapist Jessica York, LMT, BCTMB, also has more clients than ever before. “I opened in July 2020, two weeks after being allowed to open in my state,” said York. “I did not anticipate the amount of business I had. I became busier than I had ever been in my entire career. Flash forward to today, and that never changed. I currently stay fully booked for about four-to-six weeks out at all times and expanded my business to accommodate the demand.”
Twenty months after COVID-19 emerged, massage therapists have learned how to work with such safety precautions as masks, air filters, more time between clients, ventilation and increased sanitation in place—precautions that are necessary as the Delta variant extends the pandemic—and are meeting clients’ need for stress relief, relaxation and, perhaps most important of all, human touch.
About the Author:
Karen Menehan is MASSAGE Magazine’s editor in chief, print and digital. Her recent articles include “This is How Diversity, Equity & Inclusion Practices Make Business Better” and “As Spa Industry Rebounds from COVID-19, Staffing Shortage Looms.”