Domestic Violence: How Massage Therapy May Help

The first article I ever wrote on domestic violence was in 1982. I had gone back to school after getting out of the Navy and was doing an internship on a local daily paper. My assignment turned into several pieces and ended up on the front page of the features section. I naïvely thought that by bringing awareness to the issue, people might be enlightened and it would result in more awareness and less violence. Now, here I am, 30 years later, still writing on the same topic, still trying to bring awareness, one voice among many, in a seemingly endless crusade to help stop it and help victims get much needed support and assistance.

30 Years Later – Have Things Improved?

In the 10 years following that first series of articles appeared, reports of domestic violence increased at a rate of 117 percent. According to the Rape, Abuse, Incest National Network (RAIIN), recent statistics have shown that overall sexual assault has actually decreased, by about 60% since 1993. Often when there is a downturn in the economy, job loss, and increased debt, there is also an increase in domestic violence, which accounts for the up and down statistics. When things get better, domestic abuse often declines.

Some Statistics

One in every four women will experience some form of domestic violence during her life. That translates to about 1.3 million women who are assaulted by an intimate partner every year. Most victims are women, accounting for about 85 percent. Domestic violence is one of the most under-reported crimes with only about 25 percent of physical assaults, 20 percent of all rapes and half of stalkings being officially reported to the police.

The U.S. Department of Justice offers a wide range of estimated incidences of partner abuse – from 960,000 to 3 million – the disparity being caused by the lack of official reporting by victims.

Women and men of all ages are affected, but the ones at greatest risk are women between 20-24. Domestic violence crosses all boundaries. It pays no attention to race, ethnicity, income bracket, social structure or geographic location. It can happen in all types of relationships – heterosexual, homosexual, or transgender. It can happen between married partners, individuals living together or those dating. Percentages are higher in lower income brackets and in urban areas, but only by about 20 percentage points. Anyone can be a victim. It has nothing to do with the characteristics of the victim – it is solely because of the actions and behavior of the abuser.

In a national poll on domestic violence, three out of four individuals admitted to personally knowing someone who is or had been a victim of domestic violence, and 30 percent know someone who had been physically abused by a domestic partner in the past 12 months.

The combined annual cost of domestic violence in the U.S is estimated at close to $6 billion. More than $4 billion is for direct medical costs and mental healthcare; the rest is for the indirect costs of lost wages and productivity. Yet, it is thought that less than one-fifth of domestic violence victims sought any medical treatment following an injury.

Perhaps the worst statistic of all is that children who witness domestic violence, especially boys, are twice as likely to abuse both their own partners and children when they become adults – thus perpetuating the abuse and violence onto yet another generation.

Massage Therapists as Confidant

Most of the victims of domestic violence are women. Women make up most of the clients for massage therapists and most massage therapists are women. What this means is that there is probably a strong likelihood that, as a massage therapist, you may be highly likely to encounter signs of domestic violence in your clients, your peers or even be a victim – past or present – yourself.

When a client is on the massage table and relaxed during a session, she will often start talking about things in her life that she might not otherwise discuss. Some things may be trivial, but others may be important clues regarding possible domestic violence. Your client may tell you her partner is very jealous or gets angry easily. She may tell you over several visits about the partner getting drunk of abusing drugs.

Other statements* could include your client saying that her partner:

teases her in a hurtful way
calls her names like “stupid,” “bitch,” or “crazy”
gets angry about the clothing she wears
blames her for his problems
reads her mail or goes through personal things
keeps her from getting a job, or causes problems at work
keeps money from her, keeps her in debt or has “money secrets”
sold her car or other mode of transportation (or won’t allow it to be repaired)
threatens to hurt the children, pets, friends or family members
threatens suicide
forces her to have sex
isolates them from family and/or friends

As a massage therapist you may notice bruises that might otherwise be covered by clothing or makeup. Bruises on the face, back, arms or wrists are often indications of hitting or grabbing harshly. A one time bruise or injury may truly be an accident, but if the client comes in week after week with new bruises, or if there is an incremental increase in marks over time, these may be signs of abuse.

Asking someone if they are in an abusive relationship can result in denial or a series of excuses about being clumsy. These statements could be true, but patterns of injury often are signs of something more serious. At the very least you might encourage your client to see a physician.

A partner does not have to be physically abusive to be, well, abusive. Mental abuse can be just a crippling as any physical action. The partner who received physical abuse may choose to end the relationship, because the abuse is more visible, more tangible. The partner who is the recipient of verbal and mental abuse may choose to stay because the wounds are invisible and easier to justify.

Can Massage Therapy Help?

For someone experiencing domestic violence, massage can be a big help. That hour of massage, at the very least, can be a time of refuge, peace and healing with someone they trust. For some it can be a passive form of asking for help, of showing someone they trust the bruises on their soul and body.

If You Suspect Domestic Violence

If you suspect a client is a victim of domestic violence there are some things you can do. First, you need to be aware of your professional boundaries and be careful not to act out of your scope of practice. Although clients often discuss things of a personal nature, most massage therapists are not trained psychologists or medical doctors. There are some ways you can be helpful

Educate yourself. Research what you can about domestic abuse and trauma. Take classes in the subject. Your local college may have classes on domestic violence. You may also find that there are continuing education courses available on massage and domestic violence.
Be observant. This should be true for all your clients as a part of both your intake and your assessment while the client is receiving massage. If you notice unexplainable bruising, cuts or lacerations, ask your client about them. As a part of your routine intake you may even have a question about trauma or abuse, past or present. During a massage session it is possible for a person to have flashbacks of past trauma or abuse.
Listen to what your client has to say. Don’t be afraid to ask questions. Even if someone does not admit outright to abuse, there are often clues in the answers – or lack of answers. The client may complain of chronic fatigue, joint or muscle pain, insomnia or a weakened immune system. They may experience nightmares or re-experience intense memories. They may tell you of them or you may see evidence of it on the table as the client relaxes.
Be supportive. It may be beyond your scope of practice to offer specific advice, but you can be there to listen and ask questions. Keep contact numbers on file for safe house organizations as well as domestic abuse hotlines in your area. Put out brochures with information on domestic abuse and where a person may go to for help. Even if your client does not speak with you directly about it, she may pick up a brochure and make the first step herself toward getting help.

Precautions with Massage

A person who has been abused or traumatized in some way is often unable to communicate their needs adequately. The client may also have problems defining boundaries, so it is up to you as the professional to help with this. Take care to follow proper procedures especially when it comes to things like draping and where you place your hands and body during a massage session.

If you suspect or know definitively that a client has been abused or traumatized in some way, avoid using deep tissue techniques. This may be perceived as unsafe or can bring up unpleasant memories related to the abuse.

Massage therapy can be used as a part of an integrated recovery program. Massage can offer a way for the abused person to reconnect in a healthy way with their body. The massage office can be seen as a safe place with healthy boundaries as well. A compassionate and skilled therapy team can help the client to rebuild trust. Massage, used together with psychotherapy, can help a person be present in his or her body, allowing them to function in present time, rather than dissociating, which they may have been doing to protect themselves from fully experiencing the abuse. As time and therapy goes on the individual regains control of his or her body as well as becomes more grounded.

* To get help or more information on Domestic Violence:

Get the facts about domestic abuse at https://www.thehotline.org/is-this-abuse/ (The National Domestic Violence Hotline)
Free informational brochure on Domestic Violence can be found at: http://www.ncdsv.org/images/TakeStandAgainstDVBrochure.pdf

Editor’s Note: If you or someone you know is a victim of domestic violence or abuse contact: The National Domestic Violence Hotline at 1-800-799-SAFE (7233) 1-800-787-3224 (TTY) or go online: www.thehotline.org. If you are in immediate danger call 911.