Massage Therapy Provides Real Relief to Grieving Clients

 by Jennica Klemann, May 1, 2026

What is the first thing you think of when you hear that someone is grieving?

Most people think of big, tragic events like the loss of a loved one or a chronic or terminal diagnosis, a wanted pregnancy cut short by miscarriage, or a friend or loved one navigating infertility. They think of something that is often beyond the person’s control, or at least not completely within their control, that is often also long-term, life changing and almost always devastating. Many people who encounter someone grieving have an almost automatic sympathy for and empathy with them.

Of course, there are many other life events that can cause grief, too, like divorce, retirement, financial difficulties and family estrangement, all examples that a person might actually choose or need but still bring feelings of immense sadness and loss.

No matter the source, all grief has one thing in common, at least in the U.S.: A culture that doesn’t promote a healthy grieving process. We don’t talk about grief because it’s uncomfortable, and many of us stay stuck in the grief process because we don’t know how to “fix” it.

As a massage therapist, you may be feeling apprehensive or even fearful if a client gets emotional during a session. You may be afraid to say the wrong thing or worry you’ll make your client feel worse. Of course, you also have ethical boundaries you’re constantly reinforcing so want to ensure you’re not providing a grieving client any therapy that bleeds outside your scope of practice.

Understanding grief for yourself, however, will help you feel more confident and capable of helping your clients understand what massage therapy can offer and the profound difference massage can have in easing emotional pain, as well as when you’ll need to refer out to another health care provider.

We already know that grief hurts, but physical pain is also part of the healing process and one area where massage therapy can really shine.

So, let’s break it down and talk about it.

What is Grief?

According to the American Psychological Association’s (APA) Dictionary of Psychology: “Grief is the anguish experienced after significant loss, usually the death of a beloved person. Grief often includes physiological distress, separation anxiety, confusion, yearning, obsessive dwelling on the past and apprehension about the future. Intense grief can become life-threatening through disruption of the immune system, self-neglect and suicidal thoughts. Grief may also take the form of regret for something lost, remorse for something done or sorrow for a mishap to oneself.”

Even more simply, The Cleveland Clinic suggests grief can “accompany any event that disrupts or challenges our sense of normalcy or ourselves.”

Everyone will experience grief differently. We must remember that although we can lean into broad definitions and the outdated and often inaccurate “stages of grief,” grief is not a one-size-fits-all experience and will show up in people differently because everyone will process grief in a unique way.

The Physiology of Grief

Notice the APA definition of grief above mentions “physiological distress,” “anxiety” and “disruption of the immune system,” which begs the question: What does grief do to our body exactly?

Experiencing grief is one of the most intense stress responses our bodies can endure, and not only impacts our brain, but every system in our body through neurotransmitters (stress hormones).

When you’re in a stressful situation, your body is flooded with adrenaline, norepinephrine/noradrenaline, and cortisol, triggering what is commonly known as the “flight, fight or freeze” response. Serotonin and dopamine are suppressed because your brain thinks you’re in imminent danger.

These stress hormones increase the force of skeletal muscle contractions, redistribute blood to the muscles and alter metabolism; regulate visceral functions, increase heart rate and blood pressure, and expand the lungs. Cortisol alone can contribute to high blood pressure, muscle weakness, changes in mood, tiredness and impaired brain function, and increases the risk of infection.

But we’re not running from a bear. Instead, our bodies are reacting to a significant life-changing event we are trying to process while also managing our usual—and sometimes stressful—day-to-day routines.

So, what might a grieving client be experiencing? Some examples include:

• Poor Sleep
  
  
• Abdominal Pain/Digestive Disruptions
  
  
• Brain Fog/Cognitive & Functional Impairment
  
  
• Headaches/Muscle & Joint Pain
  
  
• Anxiety/Depressed Mood
  
  
• Colds/Flu
  
  
• Infections
  
  
• Increase in accidents & injuries

Identifying Some of Your Clients Potential Coping Behaviors

People who are grieving can be at risk for isolating themselves or engaging in coping or avoidance behaviors.

Statistically, the most common coping mechanisms are drugs and alcohol, including mixing medication with alcohol, and abusing prescription medications.

Cell phones, too, provide an easy avenue to distraction and allow people to sometimes rationalize avoidant behaviors, like staying in bed, not engaging with friends or family, and losing interest in their own health and well-being regimens.

To be clear, there is nothing wrong with having or using a cell phone—even when sometimes you are indulging in avoidant behaviors—but especially for people who are processing grief, being careful they aren’t endlessly scrolling on social media, becoming dependent on virtual relationships, gaming, gambling, shopping—any number of things—is essential.

Massage therapists must also be aware of “decision fatigue,” a term coined by social psychologist Roy F. Baumeister, and used to describe the emotional and mental strain resulting from a burden of choices. “When humans are overstressed, we become hasty or shut down altogether, and that stress plays a huge role in our behaviors,” says Tonya Hansel, Ph.D., Associate Dean of Research at the University of Texas, Arlington. This type of fatigue typically leads to one of two outcomes, she adds—risky decision-making or decision avoidance.

People who experience despair or whose lives are complicated by loss are especially vulnerable to mental health issues, including addiction disorders.

How Can Massage Therapy Help People Manage Grief?

Massage therapy alone will not fully relieve a client’s grief, but as with so many other client populations, massage can be an integral part of a person’s overall approach to managing feelings around grief, both physical and emotional, like anxiety and stress, as well as pain.

What makes a grief-centered massage different? Clients who are suffering from loss are already in pain. So, we need to be sure we’re not using techniques that might compound their discomfort, like deep tissue, myofascial or trigger point work. Our intention is to calm an overstimulated nervous system while maintaining heart-centered contact throughout the session.

Many times, someone who is actively grieving is more than likely disconnected from their body in order to process their loss. They could be caring for others and putting themselves last, or they might be organizing funeral arrangements, managing legalities, going through belongings, or navigating numerous health care appointments.

As best we can, we want to “defragment” them and facilitate their need to release physical and emotional tension while they are on our tables because that may be the only place they will allow themselves to let go.

What makes holding space different for grievers? You’re allowing them space for what’s said and what is unsaid. Going back to the “decision fatigue” mentioned earlier, our clients may become apathetic or frustrated if we ask too many questions or give them too many options during intake.

If that happens during a session, please don’t take offense or question your ability. Grievers don’t always have the mental capacity to articulate what they’re feeling or what they need verbally. It’s ok to “take the reins,” so to speak, and guide them through the session.

For example, during intake, you might remind them that they can talk or stay quiet during the session, whichever is more comfortable for them (and you should take your cue from them in knowing if they want you to talk during the session, beyond the needed check-ins around pressure and other information you need).

Also, they aren’t obligated to share any details of their loss; the “what” isn’t relevant, but how they’re feeling is important. Direct your clients out of their heads and into their hearts as much as possible.

Tears may or may not happen, and either is OK. But if they do feel emotional during the session, let them know they’re in a safe space where tears are welcome and encouraged. Let them know where to find the tissues (keep them within reach next to the table). They can also direct you to stop the session, or pause and keep contact at any time—whatever is the most comfortable for them.

If you’re already in a regular session and a client discloses a loss or a tragic life event, you can check in and ask them if they would like to continue with their regular session or try work that is more focused on connection, then honor whatever they request.

How the end of massage sessions may differ for grieving clients. Following the session, give the client time to get dressed and compose themselves, then communicate the importance of doing more grief-specific work. Nurturing a broken heart is just as important as healing a physical injury.

The appropriate treatment plan would be the same as you would recommend for acute pain (about twice a month). The goal is to help them feel better without having to lean on coping mechanisms that might not be as healthy or provide as much relief as massage therapy.

Facing Your Own Fears and Feelings Around Loss and Grief

The biggest fear massage therapists face is usually saying the wrong thing, and that’s valid. In fact, certain cliches or figures of speech can make someone feel misunderstood and guarded. Being considerate and aware, especially if you don’t know the circumstances around why someone is grieving, should be your primary concern.

It’s also important not to assume loss is always bad. Sometimes, a loss is a relief, such as a complicated or abusive familial dynamic, or a divorce.

Avoid saying common phrases like:

• Give it time (time is different for everyone and each loss is unique)
  
  
• Keep busy (this can encourage avoidance behavior)
  
  
• Referring to “stages” of grief/loss (grief isn’t linear and can’t be compartmentalized; sometimes, people feel like they are grieving wrong if they aren’t following a process in order)
  
  
• Any religious or spirit/spiritual existence (you may not know their belief system or their current relationship with their faith)
  
  
• Saying “I know how you feel” or talking about your own losses. You can’t know how someone feels, and making a client’s loss about you can be off-putting. You don’t want to put a client in a position where they feel compelled to offer you comfort or support during their massage session. If you feel the need to say something, try to be comforting, like: “I can’t imagine how you must be feeling right now, but I’m here for you and you’re not alone.” Simply be a heart with ears and listen.

Taking Care of Yourself While Taking Care of Others

Caring for people who are grieving is sacred work; you’re engaging with someone at a very vulnerable time in their life, and that can be very emotional and energetically intense for you.

If you have unresolved grief yourself, you may not be equipped to hold space for someone else who is actively processing a loss, and it’s OK to own our limitations. This work isn’t for everyone, and it’s also not for everyone at all times. Know when you need to step away.

We have our own personal losses, plus client losses, peer losses, and even location or financial changes. Finding healthy outlets for yourself is imperative for you to care for others in a meaningful way.

You can try:

• Meditation/mantra with balancing and “clearing” essential oils as well as gemstones
  
  
• Take a walk outside, plant your bare feet on the ground
  
  
• Take a salt bath; burn sage, use sound therapy
  
  
• Journal—write affirmations/gratitudes/lessons for yourself
  
  
• Connect with your pets, kids, partner and friends
  
  
• Seek peer support and receive your own bodywork

When I first started my career as a massage therapist, many of my clients were retirees. I realized that they were experiencing the loss of their parents, spouses and friends. They were struggling with retirement, health issues and transitioning into assisted living.

Through this work, I began feeling like these clients might benefit from a unique treatment plan that would help them give themselves permission to feel their way through their loss. So, in 2004, I added a “Grief Massage” to my menu options.

I was afraid of grief pain myself, but I jumped in and embraced it. That one shift in my practice changed everything for me. I became a grief coach and educator in 2019, and now I enjoy empowering others to grieve mindfully.

So here is my final piece of encouragement: When you can’t find the words, your hands and your heart will know what to do.

The Ethics of Working with Clients Who Are Grieving

Massage therapist who work with clients experiencing grief need to always maintain their scope of practice and healthy boundaries.

We do not give personal or professional advice or counsel, but we can offer resources for clients and help them find self-care strategies they can do between sessions that might help extend the benefits of the massage session and give them a way of relieving stress on their own.

The SAMHSA.gov website provides a variety of 988 crisis materials for free. You should also consider having an emergency contact on file for clients, as well as a list of professional therapists you might refer out to when needed.