Understanding Your Stress Response

By Cindy Williams

Stress is a catalyst for nearly every massage you schedule, whether you know it or not. Physical pain and injury; emotional challenges of anxiety, depression, or sadness; and mental demands of a high-pressure job or an excessively busy life are all common stresses we bring to the massage table.
Yet, every one of us is different in how stress looks to us and feels to us. What works to reduce the effects of stress for one person may not work for another. A large part of the massage therapist’s job is figuring that puzzle out. A large part of your job as a client is understanding how the stress response affects you and being able to identify its effects.

The Stress Response in a Nutshell

The stress response begins when a real or perceived threat arises. Take a breath, and let’s walk through this. The hypothalamus, which controls the autonomic nervous system and the endocrine system, receives a neural signal from the amygdala that there is a threat. In response, it releases corticotrophin-releasing hormone (CRH), which stimulates the pituitary gland to release adrenocorticotrophic hormone (ACTH). The ACTH makes its way to the adrenal glands, causing them to release epinephrine (adrenaline) and cortisol into the blood stream. Simultaneously, the sympathetic nervous system, which originates in the spinal cord for quick response, is activated to release the neurotransmitter acetylcholine (Ach) that causes the release of norephinephrine (another form of adrenaline). The chain reaction of the release of these neurotransmitters and hormones creates responses throughout the body, such as:
• Increased heart rate and a rise in blood pressure, so plenty of blood is available for large muscle groups to take powerful action
• Tensed muscles ready to fight or flee
• Dilated pupils for clarity of vision to identify and respond to the threat
• Increased breath rate to feed oxygen to the lungs, brain, and muscles
• Breakdown of glycogen in the liver to fuel the body with glucose and increase energy
• Constriction of blood vessels to nonessential organs and systems that don’t need to be used in fight or flight, such as those of the digestive and immune systems
• Increased perspiration to cool the body during these high-level metabolic processes
Now that is a big domino effect! Once the danger has passed and the body is back in balance, the hypothalamus “turns off” the process, and the whole-body responses return to homeostasis.
At least that’s what the body is supposed to do.
When we are in a constant state of perceived or real danger, the process perpetuates. Something as typical as always driving in heavy traffic can fall into this category, and, in many people’s lives, this is a daily reality. A high-demand job. Raising children. Overscheduling. Unhealthy relationships. There are many life experiences that can cause a perpetual, imbalanced reaction that keeps homeostasis out of reach. Massage therapists and bodyworkers come into direct contact with the results.

What Might Your Massage Therapist See, Hear, and Feel?

By the time you get to your massage therapy treatment room, you are no longer in the heat of a real or perceived threatening situation. Yet, with chronic stress, the effects can remain and stress responses continue. These might include:
• Quick pulse
• Tensed muscles
• Dilated pupils
• Rapid, shallow breathing and/or quickened speech
• Chronic digestive issues or weak immune system (such as chronic cold and flu)
• Excessive sweating, even when inactive
When massage therapists see, feel, and hear these signs, we know our client’s stress response is in an ongoing, repetitive loop and not appropriately turning off.



Stress Defined

MedicineNet.com defines stress this way: “In a medical or biological context, stress is a physical, mental, or emotional factor that causes bodily or mental tension. Stresses can be external (from the environment, psychological, or social situations) or internal (illness or from a medical procedure). Stress can initiate the ‘fight or flight’ response, a complex reaction of neurologic and endocrinologic systems.”1


1. MedicineNet.com, “Medical Definition of Stress,” accessed February 2019, www.medicinenet.com/script/main/art.asp?articlekey=20104.

Keeping the Calm

Working to help clients reach homeostasis is an important goal for every therapist. Ideally, massage therapists also want to equip you with the knowledge of what is occurring in your own body during the stress response so you can understand, envision, and honor it too. Studies have shown that envisioning a process in healthful functioning will cause the system to regulate. You don’t need to know all the technical terms, although it’s great if you do. We just want you to have a basis of understanding. If you are willing to be open to the process, the effects of your massage therapist’s work will be cumulative and long-term.

Since 2000, Cindy Williams, LMT, has been actively involved in the massage profession as a practitioner, school administrator, instructor, curriculum developer, and mentor. She maintains a private practice as a massage and yoga instructor. Contact her at cynthialynn@massagetherapy.com.