Key Point

• Research has proven that bodyworkers and massage therapists can share their clients’ emotional and/or physical symptoms.

Uncanny experiences are more common during bodywork than you might think. The ability to seemingly share our clients’ physical, emotional, and mental conditions isn’t weird; rather, it’s the natural aspect of social perception. Consider that talk therapists are familiar with what they call somatic countertransference, when they share some emotional and/or physical symptom with their client. And emotional contagion between people is well documented: anxiety, crying, and laughing spread rapidly between us. 

Pain is also a sensation that can be shared. Neuroscientists studying when and how pain spreads from one person to another are finding it can happen from images, sounds, and even thoughts. If people are shown a photograph of someone in the act of breaking a leg, one-third of them feel pain in their own leg and find the image unpleasant.

Sometimes caregivers, through their touch, can feel pain in their own left hip if the client has a painful left hip because the caregiver is more sensitive to that pain. Detectable activity in pain regions of the brain correlate with the pain being experienced by the other person. Wives who think their husbands have been hurt show brain activity of their own pain regions. Some schools of nursing refer to “compathy” (suffering with others) as an occupational hazard of nursing that needs to be minimized.

Unwittingly, our heart rate, breathing, sweating, blood pressure, skin conductance, and pupil dilation adjust to align with those of other people during certain social conditions, and not just between partners—sometimes even more so between strangers. This phenomenon, known as interpersonal physiological synchrony, is thought to be an important way we predict how others will behave.

Until recently, the complexity of the human brain restricted neuroscientists to only study brains in isolation, one at a time. But technological advances enable brain activity to be recorded while two or more people interact socially. It turns out that brains link up to form a kind of network and that “brain coupling” enhances comprehension and cooperation between us. When you feel connected to someone, you may well have your brains “coupled” and your bodies in sync even if only temporarily.

Of key importance to bodyworkers is that skin contact enhances interpersonal physiological synchrony; hands-on bodyworkers are therefore in a prime position to take on the conditions of their clients. 

What Shall We Call It?

Experience suggests that sharing how others feel helps us to better understand them. Structural integrationist Dr. Jeffrey Maitland writes in his book Embodied Being, “When you can feel aspects as well as see them, your ability to read your client’s emotional and psychobiological orientation is much more accurate than when you deduce them from visual patterns displayed by your client’s body.”¹ 

Similarly, craniosacral therapist Maria Esposito writes in The Fulcrum magazine,  “I often saw images, for example, a femur or tibia or fibula, in an incorrect position, and sometimes I would feel pain in my own leg knowing that it was not mine. This would lead me to ask if there was a problem with the limb that presented to me, and I found that the answer was always ‘yes’ when I worked in this way.”²

Experimental research supports this observation. Studies find that interpersonal physiological synchrony stems from our attempts to comprehend another person when we are engaged, focused, and attentive. The word we use to describe understanding other people is empathy, which is loosely defined as “understanding and sharing the feelings of others”; it is the sharing part that is of interest. Those two components—understanding and sharing—are described as cognitive empathy and somatic empathy because although they overlap and integrate, they have different neurological pathways and processes. If you tell me of your recent bereavement, cognitive empathy allows me to deduce how that might feel if I were you. But somatic empathy enables me to share your experience of that loss with you to feel grief. 

How Does Somatic Empathy Happen? 

Does something pass between us—a smell, pheromone, or vibratory resonance? Are we simply mirroring what we see using specialized mirror neurons in our brain? Is our shared experience with others just our imagination? 

Although mirror neurons were once thought to be a sufficient explanation of somatic empathy, scientists now propose a range of perception-action mechanisms (PAMs) that translate sensory perceptions into embodied experience. These PAMs include the possibility of specialized mirror neurons but are now thought most likely to result from everyday motor neurons activating vicariously. Simulation theory proposes that we form “another self” inside our own body to comprehend what it feels like to be this other person. In this way, we can rapidly predict their intentions—good or bad. Biologists think this is how humans understood each other before language, how we understand others as infants, and how animals understand each other. Feeling with others is a rapid and reliable means of predicting what others are going to do. Because survival relies on effective mind-reading, natural selection has produced sophisticated mind-reading skills.

When our attention is on a client and we want to comprehend them, we have multiple sensory inputs triggering PAMs, which produce embodiment of their condition, or, more accurately, our perception of their condition. Crucially, somatic empathy is a subjective perception of our client—an inference predicated on our life experience. But the fact it is subjective should not detract from its value. With skilled guidance or practice, such intuitive insights can be incredibly useful. Because bodyworkers work in an environment that is particularly conducive to somatic empathy, we should be thoughtful about incorporating it into our professional toolkit.

“Being embodied is how we experience, what we experience, and whom we experience,” says Christopher Eccleston, professor of pain science at the University of Bath (United Kingdom).³

Applications

Somatic empathy is an amalgamation of numerous felt sensations that are difficult to articulate, so it can provide information that is not accessible verbally. We can feel things about a client they can’t express. Somatic empathy also bypasses a great deal of social “presentation,” accessing deeper, more fundamental intentions, drives, and dysregulations. As we are unaware of unconscious processes, when practitioners share and recognize what could not be articulated, it can provide the client with a profound sense of being heard. We also can monitor somatic empathy during a treatment to assess whether change has occurred. 

Health and Safety Warnings

Taking on others’ emotions, aches, pains, and mental states can cause problems for therapists. It is well-known that psychotherapists and counselors can suffer from secondary trauma after simply talking with certain clients. A study in The Journal of Advanced Nursing warns that “pain contagion” is a serious problem for nurses: “There is emerging evidence that some elements of empathetic arousal are autonomic and therefore unable to be fully controlled; this may have important implications for nurses’ vulnerability.”⁴

Establishing boundaries is a vital skill for all therapists, but when delving hands deep onto other people, bodyworkers need to address this phenomenon systematically. 

The key to self-protection is knowing how it works. Understanding the psychology and biology of somatic empathy enables better self-regulation of our natural tendency to feel with our clients. 

Scientific research shows you are unconsciously generating the internal conditions of your client yourself. This means you are not being “taken over” by someone; you are giving them your attention and thereby embodying how they are. It is helpful to know this information should you start to have unusual mental imagery or unfamiliar sensations. Somatic empathy is normal. And it’s good to know you aren’t being “infected” with a contagious bad energy, although it may often feel like that. You are simulating other selves all the time, trying them on like a pair of new shoes to see how they feel, feeling what they are likely to do next. Because this is a fundamental aspect of intelligence, it is unavoidable. We therefore need to learn how to modulate the process.

Individual Variation

Some of us are habitually more somatic than others, more inclined to feel with others. But it’s a spectrum rather than an all-or-nothing trait; I don’t believe you are either an empath or not an empath. Research points to somatic empathy being innate in everyone (as well as many other species) but that there is a large variation between individuals. In tests, people show a degree of trait differences that last throughout a lifetime, but the ability to read others via embodied empathy can be modulated to a degree through teaching and practice. 

Control Dial

We can modulate how much somatic empathy we feel by adjusting our attention and curiosity. Because even a tiny amount of unconscious curiosity (say, in a passing stranger) will trigger somatic empathy, mindfulness is key. What or whom are you focused on now? Are you interested in their health and well-being? Training and practice help with mindfulness.

Interpretation of somatic empathy also requires a mindful approach. The tendency to overinterpret is common. Try to avoid putting too much of your own stuff into your interpretations of somatic empathy. It can get messy. If you feel nothing, it’s fine to say so. I have spent decades checking and double-checking my somatic sensations to familiarize myself with how my “minded body” works. I know of no shortcuts to such experiential learning about oneself.  

Self-Protection

Since we can’t completely avoid somatic empathy, we need to extend self-regulation practices into our free time so we don’t become overwhelmed by relentlessly taking on other selves. As our minded body simulates whatever we focus attention on, let us find healthy objects or situations to simulate. I take regular walks or bike rides in nature because nature is person-neutral. 

Mindful movement is another effective means of self-regulation because it changes somatic patterns that may remain from your work. Mindful movement such as qigong, tai chi, or yoga are better than competitive sports in which you are shifting your somatic empathy to your team members or opponents as you try to predict their intentions. (Brain coupling is enhanced between members of the same team to help them coordinate and cooperate.)

Somatic empathy is a strategy of bringing the outside in, rolling it around, and identifying its patterns and associations. Making use of somatic empathy as bodywork therapists requires good interoceptive awareness, a database of somatosensory life experience, and competent self-other discernment.

As evidence-based theories emerge for what somatic empathy is, how it works, and how we can modulate it, bodyworkers are working in a fascinating new area of research into human intelligence. 

Notes

1. Jeffrey Maitland, Embodied Being: The Philosophical Roots of Manual Therapy (North Atlantic Press, 2016).

2. Maria Esposito, “Transformation,” The Fulcrum 82 (January 2021), www.craniosacral.co.uk/blog/transformation.

3. Christopher Eccleston, Embodied: The Psychology of Physical Sensation (Oxford University Press, 2016).

4. Marsha Campbell-Yeo, Margot Latimer, and Cèleste Johnston, “The Empathetic Responses in Nurses Who Treat Pain: Concept Analysis,” Journal of Advanced Nursing 61, no. 6 (March 2008): 711–9, https://pubmed.ncbi.nlm.nih.gov/18302611.

Resources

Engel, C. Another Self: How Your Body Helps You Understand Others (Independent Publishing Network, 2024). 

Keysers, C., and V. Gazzola. “Expanding the Mirror: Vicarious Activity for Actions, Emotions, and Sensations.” Current Opinions in Neurobiology 19, no. 6 (December 2009): 666–71. https://pubmed.ncbi.nlm.nih.gov/19880311.

Keysers C., and V. Gazzola. “The Vicarious Brain.” In Mechanisms of Social Connection: From Brain to Group. M. Mikulincer and P. R. Shaver, eds. American Psychological Association, 2014, 71–88.

Maffessoni. F., and M. Lachmann. “The Complexity of Understanding Others as the Evolutionary Origin of Empathy and Emotional Contagion.” Scientific Reports 9, no. 1 (April 2019): 5794. www.ncbi.nlm.nih.gov/pmc/articles/PMC6453980. 

Marsh, A. A. “The Neuroscience of Empathy.” Current Opinion in Behavioral Sciences 19 (February 2018): 110–5. www.sciencedirect.com/science/article/abs/pii/S2352154617301031.

Preston, S., and F. de Waal. “Only the PAM Explains the Personalized Nature of Empathy.” Nature Reviews Neuroscience 18, no. 769 (December 2017). www.nature.com/articles/nrn.2017.140.