6 Tips for Massage Therapy with Highly Sensitive People

By Pacific College - March 17, 2020

6 Suggestions for Massage Therapy with Highly Sensitive People

By Bracha K. Sharp

Until I came to massage therapy school and found out that there were at least three or four other HSPs in the world, and in just one school, no less, I had thought that they were thin on the ground. But then more and more of them started popping out of the woodwork, and it reminded me that HSPs—or Highly Sensitive People—don’t just do sensitivity when they want to. They simply are inherently sensitive, and it is, according to Elaine N. Aron, who coined the term “sensory processing sensitivity” as its scientific name, an innate and genetic trait. It occurred to me that massage therapy with highly sensitive people needed to be examined a bit more.

Aron estimates that about 15-20% of the population are HSPs. Therefore, if you’re a student in a healing profession, such as massage therapy or if you are already a practitioner, you might be quite likely to encounter an HSP. In fact, chances are good that you already have.

While the unique natures of their sensitivities may present more challenges to you as a student or as a practitioner, the rewards of learning how best to work with such a population can challenge you to grow more deeply in your client-centered approach. Moreover, it can increase the depth, breadth, and scope of your work, allowing both the client and practitioner to continue to cultivate an upwardly-moving growth mindset. The suggestions within this article may also be applied to introverts, those with sensory integration, and people with processing challenges and learning disabilities. While these challenges are not all necessarily comorbid, many of them do exist on a continuum. However, these suggestions may be applied to most of your clients and fellow students, as almost anyone can benefit! Presented are six ways to best work with the HSP personalities who may just be your fellow classmates or your clients:


  • Communication is Key

As with all clients, one should communicate, so that both parties are in agreement regarding the work. A good way to begin this opening dialogue might be to include a question on your new client intake form such as: “Do you have any bodily or environmental sensitivities that the practitioner should be aware of, in order to make you more comfortable during?” An HSP client may be less apt to speak up, with regards to his or her various sensitivities and needs, than would a non-HSP client. Whether this is the case because they have been told that their sensitivities are too much to handle, unrealistic, or because they are trying to please you and not cause any distress, it is important to gauge their tolerance levels and gain their feedback, particularly at the outset. If you have not checked in with them and your massage therapy treatment has resulted in an uncomfortable hypervigilance or in an uncomfortably wired-up nervous system, then the bodywork session has most likely backfired, and they will not be back to see you. Of course, for those HSP clients who can, it is important that they learn to communicate their preferences to the practitioner. Similarly, it is the practitioner’s job to do the best that he or she can, to ensure the safety and comfort of his or her clients—and this can often start just after the first greetings.

  • Respect Their Space Considerations

Again, this is likely already an aspect of regular bodywork that is incorporated into the treatment, but for the HSP client, it may be even more of a factor. It is important to consider that an HSP’s nervous system is already processing myriad sensations, interactions, and thoughts on a (usually) deeper level than may generally be true for the general populace, and while high sensitivity of course exists on a spectrum, it is worthwhile for the fellow student or practitioner to come into their client’s space and lay their hands on them in a slower, more unfolding way—at least at first. It is likely that the HSP’s space and center of self (both energetically and otherwise) has already been impinged upon, and sometimes severely, by the time they reach your table.

Furthermore, because HSPs might also be introverts, empaths, or the like—often highly comorbid with the trait of higher sensitivity—the potential discomfort evoked by unclear communication may be higher. In addition, the broaching of energetic space without permission may ensure that your client is not a repeat customer. Communication thus extends not only to the client’s physical and emotional space, but also his or her psychic space. Thus respect for the client’s space of all kinds helps promote a unified triptych of healing measures that enable higher growth and healing. How can you best communicate about spatial boundaries in an encouraging way? “I’m going to move to your other side,” you might say, at least at the outset. Later on, the same needs may still prevail, although the relaxed HSP client may let you in on a deeper, more profound level if their sensitivities are not overstrained and their minds are calm. Managing the conversation for massage therapy with highly sensitive people is a significant aspect of the treatment.


  • Touch, Depth and Pressure Considerations

Building upon the last suggestion: it is always a good idea to consider how touch might both favorably and, by turns, unfavorably affect the HSP client and his or her time on your table. As we might have inferred by now, the regulatory functions of the HSP’s nervous system are often greatly amplified. Thus it is necessary that the practitioner take time at the outset to verify what depth and pressure are most amenable. In turn, it is helpful when the HSP clients themselves come prepared to discuss the variances in touch that they prefer. Too often, your idea of a gentle pressure may be more akin to a vortex of squeezing pain for this client. Also, because they are often more thin-skinned in the literal sense, hyperemia may set in at a much earlier juncture and that might be a signal that it is time to move on to a different area of the body—at least for now. While everyone has densely-packed nerves in certain portions of the musculature, making a slow and steady approach more welcoming at the beginning of a session, this is even more important for HSPs. That prior discussion, as well as regular check-ins during the session, can increase their receptiveness of the healing process.

  • Ask About Scents, Perfumes, Lotions, and Textures Before You Begin a Treatment

Once again, it is likely a good idea to ask all fellow students and/or clients about this type of sensitivity, but for the HSP client, it is of critical importance. How can you tell that there’s nothing strange going on in the surrounding physical environment? Unless you yourself are an HSP, you can’t, but the four people in the room who are coughing, sneezing, and kindly offering each other tissues are HSPs, and some of them can smell the cleaning spray that you used two days ago, to wipe down your table. Of course, you can’t not clean your tables or the room, but HSPs will be grateful if you use a more natural cleaning solution or air out the room beforehand. The HSP client should understand, however, that rooms must still be cleaned, lotions may be used, and people must wash their hands with soap; but just as you would try to refrain from using scents, lotions, or perfumes that might make an asthmatic ill, it’s a good idea to be a little bit more familiar with the HSP client’s sensitivity. Because such sensory sensitivities may affect this population more drastically than the rest of the populace, a little scent—or nothing scented at all—goes a long way. While this may not always be an option, a less-is-more approach may be warranted, at least for the first time that a lotion or an oil is used. It’s important to note that, as in other areas of life, not all HSPs may be sensitive to too much lotion or even to a lightly-scented lotion, but it is much better to find this out beforehand. Your client does not want a severe rash—and you don’t want him or her to get one.

  • Temperature for Massage Therapy with Highly Sensitive People

The HSP fellow student and/or client may be more highly attuned to varied and subtle environmental and temperature variances. Since his or her nervous system tends towards a higher level of depth of integration, the temperature in the room may be a determining factor as to whether or not he or she will benefit, overall, from a bodywork session. Sometimes, the temperature may even hurt his or her skin and make it harder to settle the nervous system. Because overstimulation occurs more easily in their general systemic functioning, it is a good idea to ask if they tend towards feeling either cooler or warmer—or sometimes both. You may inquire about this not only before but also during a session. The HSP client may feel differently throughout different portions or segments of the treatment, or even on different days. It is wise to have a backup plan, perhaps in the form of extra blankets or sheets, if they are too cold, or the use of a fan if they tend to be too warm. Certain lotions or oils may also grant a cooling or warming sensation, so a patch test on a small portion of skin may be advisable before beginning the bodywork session. Since these clients’ bodies process and interpret temperature and weather-related changes more acutely than much of the population, the client and practitioner may be able to come up with some clever or newly-imagined compromises. Environmental factors such as these may prove somewhat trickier to resolve, which is why, as in other cases, it is still a good idea to ask, at the outset, if this might be pertinent.

  • The Lighting in the Environmental Space

Along with some of the other sensory challenges that the HSP client may face, lighting is a particularly important variable to address if possible. Just as touch, smell, and temperature may impact the HSP client’s ability to settle down and let their nervous system begin to relax, so too may a light burning a touch too brightly impede the resulting bodywork session. For instance, some people may find that lighting can trigger headaches, migraines, anxiety, and dizziness. While lighting is not always so easily adjustable, there are many ways that you can accommodate this sensitivity, such as dimming the lights, using a lamp or two, using a small salt lamp that emits a pleasant glow, or allowing your client to use a facemask or a rolled-up washcloth over their eyes. While not all of these resources may be available to you, even one is better than none—and if you ask your HSP client directly for some of their suggestions, many of them will be more than happy to suggest a way forward. Particularly in the case of lighting, many of your HSP clients will thank you for your care and concern.

You may now have at your disposal many new ideas to help your HSP client, as well as others of a similar nature or disposition, on the road to relaxation and comfort. The unusual chance to work with such clients may be a tricky endeavor at first, but when approached with care, concern, and kindness, they may become the happiest of all your clients. Taking an understanding approach to their specific needs and their various sensitivities may pose some interesting challenges, but the opportunity for both student, practitioner, and client to grow can encourage a beautiful growth mindset. All of your clients could benefit from this and will appreciate such sensitivity, care, and concern.

Happy massaging and bodyworking to all!


BRACHA K. SHARP is a writer, author, and poet. She draws particular inspiration from her background in English literature and psychology. She graduated with a BA, summa cum laude, from the Lander College for Women (Touro College) in New York. She is currently attending the AOS degree program at the Pacific College of Health and Science’s New York campus.

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