As a therapist I see a number of reactions on the table. In this post I’m focusing on one of those – blissing out on the table – why it happens, and why it is a Very Good Thing.
From little noises of contentment, to long sighs, to deep snores, one common reaction to getting a massage is one of blissing out. After a massage clients will say things like: “What just happened?!” as they come back from wherever they went, and: “I forgot how good it feels to be touched”. This is completely normal, and a tremendously important part of the healing process. There are some clear scientific reasons for this, and some interpersonal ones (though as we’ll see, they go hand in hand).
Let’s start with the science. If you were to perform a search for the positive effects of massage, you’ll see many results all claiming that massage raises levels of these “feel good” chemicals in the blood: dopamine, oxytocin, serotonin, and endorphins. Furthermore, you’ll see it mentioned that one of the main stress hormones, cortisol, is reduced. I thought it would be interesting to dig a little deeper as these claims are rarely substantiated.
There are not actually that many studies out there, and as it turns out, some of them contradict each other (likely having to do with the differences in methodology and the types and duration of massages performed).
That said, one study shows an average increase of serotonin of 28%, an average increase of dopamine of 31%, and an average decrease of cortisol of 32%. (1) Why does this matter? Well, another study found that “the conjoint release [of serotonin and dopamine] is highly pleasurable” and “the additive effect of serotonin and dopamine conveys significant reward related information and is subjectively highly euphorizing.” (2) In other words, it feels really good.
Raised cortisol levels are indicative of chronic stress. Chronic stress can negatively affect our neural, cardiovascular, autonomic, immune and metabolic systems, and lead to behaviors such as smoking, eating too much, drinking, and poor quality sleep. Lower cortisol levels on the other hand are associated with higher parasympathetic nervous system activity (the rest and digest function that helps restore balance to our body.) (3)
(Speaking of the parasympathetic nervous system, there is evidence that massage stimulates the vagus nerve, which in turn activates the parasympathetic nervous system, promoting relaxation, relieving depression, reducing inflammation, and strengthening the immune system (4), but that is a story for another time.)
In terms of oxytocin (also sometimes referred to as the “love-hormone” or “cuddle-hormone”), one study found an average increase in oxytocin levels of 17%.(5) Oxytocin has a host of benefits, such as activation of the adaptive immune system, providing stress release, and mediating depression. (5) It helps you feel connected, loved, and happy, and is essential for creating and sustaining social bonds, the absence of which is severely detrimental to one’s health. (6)
Endorphins (more specifically, beta-endorphins) are sometimes called “nature’s pain killers” and can exert an analgesic effect that is more potent than morphine. (7) It’s a good thing then that one study found that massage can increase levels by 16% (8) (though, to be fair, there are other studies that report no increase, or even a decrease) (also, there are other pain reducing mechanisms that come into play during a massage therapy session, but that too is a story for another time.)
No wonder we zone out!
Science aside, there are some very important interpersonal aspects to receiving a massage. How special is it to find yourself in a safe, non-judgemental space, where you don’t need to do or worry about anything, while someone is giving you their undivided attention? A time where you can just be, where your body is taken care of, and you don’t need to make any decisions (other than perhaps whether the table temperature is right). That sounds like magic to me (granted, I’m biased).
Now why is this blissing out so important? Why do you owe it to yourself to try and stop thinking about your to-do list, to not feel like you have to make small talk with your therapist, and try and give in to the moment? The answer lies in the bi-directional link between body and mind. The mind influences the body, and conversely, the body influences the mind. (4) During the course of a massage therapy session it’s hard to say where this begins. It might be the mind, it might be the body (and as we’ve seen, the body has plenty of mechanisms to assist you with that.) It doesn’t really matter, as long as you reach that virtuous cycle where once one relaxes a little, so will the other, and thus the first relaxes a little more, followed by the second, etc. etc., until you are fully and completely at peace. This will then assist in the unwinding and healing of injuries, tension, and mental and emotional stress. (4) As an aside, as a therapist I can think of no greater accomplishment than getting you to that place, so you’d be doing me a favor :).
Ultimately though, does the science or the interpersonal stuff really matter when we can see and experience the restorative effects first hand? I’ll let you be the judge of that as you reclaim and reconnect with your body.
Sources:
(1) Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci. 2005 Oct;115(10):1397-413. doi: 10.1080/00207450590956459.
(2) Fischer Adrian G., Ullsperger Markus; An Update on the Role of Serotonin and its Interplay with Dopamine for Reward; Frontiers in Human Neuroscience 11/2017; DOI: 10.3389/fnhum.2017.00484
(3) McEwen B. S. (2008). Central effects of stress hormones in health and disease: Understanding the protective and damaging effects of stress and stress mediators. European journal of pharmacology, 583(2-3), 174–185. https://doi.org/10.1016/j.ejphar.2007.11.071
(4) Tarsha Mary S., Park Sohee, Tortora Suzi. Body-Centered Interventions for Psychopathological Conditions: A Review. Frontiers in Psychology, 10/2020. DOI: 10.3389/fpsyg.2019.02907
(5) Morhenn V, Beavin LE, Zak PJ. Massage increases oxytocin and reduces adrenocorticotropin hormone in humans. Altern Ther Health Med. 2012 Nov-Dec;18(6):11-8. PMID: 23251939.
(6) Magon, N., & Kalra, S. (2011). The orgasmic history of oxytocin: Love, lust, and labor. Indian journal of endocrinology and metabolism, 15 Suppl 3(Suppl3), S156–S161. https://doi.org/10.4103/2230-8210.84851
(7) Pilozzi, A.; Carro, C.; Huang, X. Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism. Int. J. Mol. Sci. 2021, 22, 338. https://doi.org/10.3390/ijms22010338
(8) Kaada B, Torsteinbø O. Increase of plasma beta-endorphins in connective tissue massage. General Pharmacology. 1989 ;20(4):487-489. DOI: 10.1016/0306-3623(89)90200-0. PMID: 2526775.