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Massage Therapy And The Placebo Effect

placebo effect in massage

Massage therapy and placebo – what’s the connection?

Officially massage therapists, at least in the US and in several European countries, cannot claim that massage therapy heals anything.

However most of us who have been in this profession for a while have seen with our own eyes that our clients can and do get better, sometimes dramatically so.

This does not happen all the time which is not too surprising since there is not a single healing or medical modality that has a 100% success rate.

For the purposes of this article I will use the word ‘healing’ across the board for all therapeutic systems, from the jungle shaman to the heart surgeon.

How to define ‘healing’

What I mean with ‘healing’ is a substantial improvement of a condition. There is no 100% healing – the human condition is terminal for all of us, and all bodies are slowly breaking down over our life time.

Defining ‘healing’ as an absence of physical symptoms neglects the fact that we are more than physical machines.

We have minds, emotions, feelings, passions, opinions, attractions and aversions, good and bad habits, and constructive or destructive thought patterns.

We live in environments which can be helpful or destructive to our well-being, and we ingest food which supports or destroys our health. So we can safely rule out any kind of absolute definition for ‘healing’.

Clearly no massage therapist can claim to achieve a complete cure. But healing, defined as a substantial improvement of a condition, is definitely within our reach.

What accounts for such healing? What causes it? What is the mechanism?

Healing and the placebo effect in massage therapy

In our drug obsessed world, many people assume that any change in the body has to be caused by a chemical agent, a pill which alters the functioning of our body in some way. How can pressing on a muscle, just touching someone, result in any kind of healing?

Let’s stay on the scientific side for now. There have been numerous studies that demonstrate very convincingly that it is not just the pills by themselves that cause an improvement – a major factor is our belief that the pills will cause an improvement.

This is called the “placebo effect“. If you give one group of people the real pills, and you give another group fake pills, in many cases both groups will show a similar effect, as long as they believe that the pills will help them.

This does not only work with pills, it can even work with operations. In one case a patient underwent a knee operation. The surgeon cut the knee open and sewed it back together, but did not change anything in the knee. The patient reported substantial improvement in the condition, although there had been no real surgery.

It is not only possible, but desirable that our clients imagine that our touch and our manipulations will improve their condition. There are statistics that a high percentage of patients who visit a doctor get better just by seeing him or her.

Why? Because that is what they expect to happen. The same thing can and should happen with our massage clients.

Is the placebo effect fake or real?

Now the question is: Should the healing which resulted from taking the fake pills or fake operations be written off as fake, as a trick? Or should we accept that healing is always good, no matter how it came about?

We know that placebo results can sometimes be almost as good as ‘real’ results. We also know that if you tell the placebo patient that he had only taken a sugar pill, the symptoms will come right back.

But it works both ways. We also know that if you tell a patient who took the real pill that he actually only took a sugar pill, the symptoms will come right back as well.

All this has been tested many times. There is no question that the mind plays an important role in the healing process.

In regards to the placebo effect the argument goes that you have to tell the patient that the pill was not real, since the effect might not last and then you can get sued for malpractice.

To be balanced we have to acknowledge that the effect of the real pill might not last either, or it might not work at all. There might even be dangerous side effects, especially with long term usage.

Two ways to get results in massage therapy

So is the placebo effect inferior to the ‘real’ therapy? Or is getting results the only thing that matters? Let’s translate this into our massage therapy practice.

When we work on a client, there are two ways to produce results. One is a scientifically measurable result, like improved circulation, better lymph flow, or increased production of certain chemicals in the body, etc.

The second result is not as easily measurable and is not part of the scientific realm. It comes from factors such as the following:

  • The trust of the patient in you
  • Your ability to communicate effectively with the client
  • The willingness of the client to get better
  • Your ability to connect with the client on an emotional and energetic level
  • The quality of your touch (which is not the same as your knowledge of the techniques)
  • Your ability to move energy in your clients

Some of these factors might well induce a kind of placebo effect. In other words the client might experience a degree of healing or improvement which goes beyond the effect that your massage could generate.

This can range from a substantial improvement to miraculous and unexplainable results.

Redefining the placebo effect in a positive way

At this point we need to redefine the term ‘placebo effect’. Should you go up to your client and say: “Hey, in the interest of science and transparency I should tell you that your amazing improvement is probably a result of your mind, or your imagination, a mere placebo effect. Your symptoms will probably come back again.”

This would clearly be counterproductive and cruel to say the least. However if you stop equating the placebo effect with “fake”, and redefine it as as “constructive engagement of the client’s mind to aid in the healing process“, then you are dealing with an essential tool to produce results in your massage therapy sessions.

The difference between scientific placebo studies and massage therapy placebo effects is this: In scientific studies the subjects do not know that they are taking a sugar pill. However in your massage practice you can elevate the placebo effect to a conscious process.

Using the power of the mind in massage therapy

On your side you can improve your communication skills, the quality of your touch, your ability to move energy instead of just physical body parts.

On the client’s side you can educate the client about working with you in a constructive way. When I have clients with serious issues, I often get them involved in the session by having them direct their breath and their intentions to a trouble spot.

I help them become aware of their restricting patterns and in some cases even guide them in a visualization process to accelerate healing.

“Placebo effect” could be just as easily redefined as a way to engage the immense power of our minds to affect change, improvement and healing.

Instead of using the placebo effect in a clandestine way, you can use it in a conscious, constructive way to get better results in your massage practice and accelerate the healing process in your clients.

You can be proud of the ‘placebo power’ of our minds

Instead of writing off the placebo effect as a way to trick our belief system, we can use it to engage our client’s mind in a constructive way and accelerate healing significantly. I have read comments by sceptics who proclaim that good results in massage therapy are just a placebo effect.

They are not “just” a placebo effect. By introducing the power of the mind, of suggestion, of positive expectation, of focused energy and a conducive environment into your work, your results will dramatically improve.

It can be a very useful part of our job to help our clients make the power of their minds work for them, not against them.

We should be proud of the “placebo” effect, not ashamed of it. If you succeed in engaging a massage client’s subconscious to aid the healing process, what could be wrong with that?

If you don’t use those methods and only use a clinical approach in a clinical environment, you are withholding a lot of healing potential from your clients.

The power of the mind in your massage profession

This is not something that only a few talented healers are gifted with. It is a learnable skill that you can acquire with practice.

Thai Healing Massage Academy has produced many massage video training courses which are based on the principle that massage therapy can be much more than just the manipulation of someone’s anatomy.

If the placebo effect can get results almost as good as the actual therapy, imagine what the conscious application of this scientifically documented principle can do.

Click Here to learn the art of Thai Massage through our proven and effective online training course.

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The author, Shama KernThe author, Shama Kern, is the founder and director of Thai Healing Massage Academy and the creator of 20 online training courses for Thai Massage. You can reach him at shama@thaihealingmassage.com

 

5 thoughts on “Massage Therapy And The Placebo Effect

  1. Thanks for another good article, Shama. Certainly got my juices going 🙂
    Personally I don’t like to think that many (if any) of my clients are expecting to be “healed” of anything. I am providing and teaching people to provide a service to their clients and acquaintances that “makes them feel better”. And if we are successful and make them “feel better” to the extent that they want more and keep coming back… then we are satisfied and very happy.
    Of course there are some that come to get their aches and pains relieved and their stress-levels reduced through relaxation and thus put in a place of “preventing” more serious problems down the road. Some come for the “complementary” benefits of Thai Massage, which usually manifest as their ‘other’ treatments, such as chiropractic, acupuncture, and even chemo and pharmaceutical courses, proving to be more effective.
    So I try to stay away from “healing”. It helps to keep the ego out of the way when I think of it as the client being the “healer” who’s doing all the “healing” and us, the practitioners, being the “facilitators” who create an environment (within and without the client/organism) more conducive to that “healing”.
    Placebo and Nocebo, both very important and effective concepts in helping people to get better (or worse, if that should be our objective, God forbid). Everyone, whether they are doing conventional bio-medical/pharmacological or traditional/alternative medicine, would do well to understand these things and make them an important part of their practice.

    • Thanks for your elaborate comment, Deon. I totally understand where you are coming from. In the US ‘healing’ in massage therapy is a no-no.

      However where I live, in Thailand, Thai massage really has been used as one of the main ways to heal people of their problems for the last 2000 years. Nowadays with the advent of modern medicine, Thai Massage has taken a backseat, but still many people here do go to therapists with the expectation to get better or get healed of an affliction. So here there is no negative connotation between ‘healing’ and ‘massage therapy’.

      Also in my personal practice I worked on quite a few clients who had serious immune system diseases like multiple sclerosis and Parkinsons. They did expect to improve their condition when getting massage therapy. After all, their alternative was to die an early and unpleasant death since the doctors had written them off.

      I remember one client of mine with MS whose doctor told her that he could help her manage the disease and when the time came, he would help her pick out a wheel chair. Not very encouraging, to say the least.

      As of this day, I am still regularly working on a client with Parkinsons. He gets massage therapy regularly from several therapists, and he swears that without the massage he would have been in a wheelchair a long time ago. Instead his condition is improving steadily.

      I do see the connection between healing and massage therapy, partly because of the cultural environment I live in and because of experiences I had in my practice. Luckily I don’t have to be afraid to use the word ‘healing’ in Thailand since nobody would ever get sued for that here. Also it is not an ego trigger here. People in Thailand expect to relax, and/or get better through massage in minor or major ways, and the job of the therapist is to facilitate this process and create a conducive environment for accelerated healing to take place.

      I remember when I went to massage school a long time ago, the entire school went to a Thai village one weekend and set up a free one day clinic there. The villagers came in droves all day long to get massage and herbal remedies. I am pretty sure none of them came to get relaxed. They had real physical issues and they wanted help.

      It is a different world here in Thailand compared to the US, and my articles reflect the fact that I have spent most of my massage therapy career here and not in the western world.

  2. Hi Shama,

    I think we’re “on the same page” with this. But just for some further clarification of where I was going with this discussion – and it has mostly to do with semantics and the choice of words (which is always tricky).

    If “healing” means alleviating the clients pain and discomfort (in addition to relaxation), then I am all for it and consider myself to be in the “healing” business, just as you do and all the other practitioners of Traditional Thai Medicine.

    But I, personally, prefer to stay away from using the term “healing” in the context of say “Healing them from MS or from Parkinsons”. To me using healing in that way, when you name specific diagnoses, is similar to saying you are “providing a ‘cure’ for those conditions”, which could be very problematic.

    I prefer keeping things in a “Traditional” context where I can tell people that their “symptoms can be alleviated” and “their experience improved”, rather than indicating that we are going to try to heal/cure their “condition” (as labelled by Western Medicine).

    I also prefer to work and think in terms of the Sen and conditions relating to Sen Line issues, such as “This looks like a Kalatharee situation” or “this looks more like a Sahatsarangsi issue” etc. And then tailoring my treatment that way.

    I guess I’ve never been a fan of “labeling” the problems the way Western Bio-medicine does. Yet, I do realize that most clients think in those terms and we as practitioners need to try to relate with them in language they understand.

    I hope I’m making sense!?

    • You are making perfect sense. As you say, choosing words can be tricky because they don’t have the same meaning to everyone. For me ‘healing’ does not mean curing someone of a disease as in eliminating all symptoms and causes. Healing is not something that I do – it is a result of what can happen when I help someone unblock their energy flow.

      If even the two of us who are in the same profession, in the same niche, have to discuss the meaning of the word, one can only imagine how difficult it is to convey such a concept to others who have no clearly defined concept of it at all.

      And then you have the legal types who insist that they know what we mean when we use this word, since clearly only their definition is the correct one…

      That’s why I totally understand that you shy away from the term ‘healing’. The problem is that it is not so easy to replace it with a simple concise word that has the same beautiful ring to it. I like the word, and I have the big advantage of being in Thailand where nobody is trying to get me into trouble for using it. If I were in the US, I would probably lean more towards your way of dealing with this.

      I would certainly never tell a client that I will heal them or cure them. I communicate the concept by explaining that I facilitate an acceleration of the healing process in their own bodies. I also make it clear to them that their own bodies and minds have immense healing powers, and that Thai Massage is one way among many to stimulate this.

      I know that you and I are on the same page with this. Sometimes language is an insufficient tool to express certain concepts clearly. We just have to live with this I guess.

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