In February, we at the McKinnon Institute of Massage were honored to provide massage for Alaska Airlines employees at the San Francisco and Oakland airports following the crash of Alaska Airlines Flight 261. With short notice, the McKinnon On-Site Team pulled together to organize the needed personnel. Alaska Airlines is a regional carrier, and many of the people on board were from the Bay area. For us this went beyond a sad story on the evening news: our friends and neighbors had died, more were in mourning, and we were directly affected. We so often feel at a loss when we are witnesses — however far removed — to tragedy, and the invitation to perform massage was a welcome way to contribute and also address our own sorrow.

The On-Site Team has benefited from the experiences of Mark Bitzer and Maureen Manley, both instructors at the institute. Bitzer performed massage on rescue workers directly following the Oklahoma City bombing, and Manley traveled repeatedly to Croatia in 1994, teaching massage and dance. Bringing together the lessons they have taught, and the team’s own experience with the Alaska Airlines tragedy, this article aims to highlight issues massage therapists may face when entering a trauma site, and also to address the appropriateness of massage therapy in these situations.

What Did We Learn in Oklahoma?

After the Oklahoma City bombing, volunteer therapists gave massages to exhausted rescue workers, numbed survivors and overworked pathologists. The state medical examiner observed that the massage therapists were “accomplishing more in 15 minutes than psychologists could in an hour or two” (Life, Aug. 8, 1997).

This is a strong statement that needs to be understood in context. Our perception is that touch may be the more immediate need for many people in moments of trauma. It can bring them into a greater sense of grounding which may better prepare them to receive the benefits of psychotherapy. We must remember that there are many avenues of healing, and no one approach or combination will work for every client all the time. When presented with particularly jarring, traumatic or overwhelming circumstances, our usual modes of healing may not be what we most need, and indeed we may not know what we most need to heal.

For this reason, we feel it is best to have a variety of modalities available at trauma sites. Psychotherapists, clergy, massage therapists, and others have complementary skills in dealing with people experiencing and recovering from trauma, and it is when working together within our scopes of practice that we are able to do the greatest good.

Physical Signs of Stress

When working with people who have been exposed to a disaster or significant trauma you will, of course, see people in great distress. How these people handle their stress, however, may vary greatly. Some may be quite composed, others may be visibly shaken and fragile. This initial presentation is an invaluable indicator in deciding whether and/or how to work with a particular client. It is by no means the only indicator. Especially in trauma situations, a client’s emotions may shift quickly during a session, and a massage practitioner must keep a close eye on client reactions. If a client appears to be overwhelmed, is shutting down, or has unusual responses to the work, it is completely appropriate to stop the session and explore the best avenues to address the client’s needs in the moment. As massage therapists, we must recognize that we are not rescue workers, psychotherapists or religious counselors. Sometimes the greatest good we will do for our client is to help him find the most appropriate practitioner for his immediate needs.

Today’s Tragedies

After the crash January 31, it was concerned employees at Southwest Airlines who suggested massage therapy be added as a service for their grieving Alaska Airlines colleagues. Therefore, when our on-site team arrived, we were not part of a coordinated effort with other grief workers. This limited the scope of our practice, as most of our clients were coming to us in the middle of their work shifts. When their 20-minute appointments were finished, they were returning directly to their posts. There was no counselor standing by to assist with emotions the massage may have brought up. And while we’re certain that any employee would have been given time off if he were to become markedly upset, all of our clients were very motivated to continue staffing their positions.

The employees at Alaska Airlines are a remarkably close-knit group, and the support they gave each other in this time was inspiring. We worked with a varied range of employees (gate and ticket-counter agents, luggage handlers, mechanics and supervisors) in all stages of grief. There were several clients who were very close to people on the flight, and several who had volunteered to work all their scheduled off-duty time since the crash. Some clients were working their regular shifts in Seattle, Anchorage and Portland, and then flying down to the Bay area to work weekends or swing shifts. They were all physically exhausted and emotionally strained and had hours or days to go before they would have time to relax and reflect on the past week’s events.

In this situation, we felt our mandate was to support our clients’ professionalism. Recognizing the strain they were under and the grief they must be feeling, while also appreciating their commitment to their jobs, went a long way toward this goal. We worked with each client to bring body and spirit to a place where the client felt alert, contained and able to perform his job without being overwhelmed. For some, that meant vigorous and superficial sports massage, for others slow deep tissue release or subtle energy work.

For many of our clients, this was their first massage, bringing the issue of informed consent into play. Of course, it’s always essential that a client give consent for our work. In this charged atmosphere, with people who had not experienced therapeutic touch, we were especially thorough in our explanations and checked in with our clients frequently.

Working in teams was invaluable. Not only were we able to see more clients than a practitioner working alone, we were able to support each other. This helped us maintain our professional boundaries so we were better able to assist our clients. Just as it took someone outside the Alaska Airlines organization to recognize the benefits massage could bring at this difficult time, our professional, compassionate distance allowed us to observe our clients more accurately, and treat them appropriately and effectively.

Working in teams also allowed us to take breaks. It was tempting to work straight through our shifts, but we all realized we were much more valuable to our clients when we took the time needed to nourish and refresh ourselves. There were strong emotions in the conference rooms where we worked. We expected to find and experience grief, but were also happily surprised by the joy we encountered. We took great comfort in seeing how the Alaska Airlines employees supported and cared for one another, and in our ability to help them. As we worked with our clients, our hearts were lightened as we began to work out our own sorrow.