Karen Guzzo knew that first week. She watched the teary-eyed students describing their ordeal; she watched the shaken teachers react when they no longer had to be teachers; and she watched parents crumble in relief, exhaustion and thankfulness when they knew their child had survived. What she saw were bodies talking loudly - bodies full of fear and pain. She knew these survivors needed the healing power of touch.

Owner of Dancing Hands in Englewood, Colo., Guzzo was one of the first massage therapists to offer her services to the victims, families and survivors of the Columbine High School shooting last April. Working through the county's mental health services, Guzzo reminded the establishment that bodywork was indeed indicated for these battered bodies and souls. They agreed. It's hard to conceive how they wouldn't have.

Imagine being enclosed in a small, dark room for five hours. Imagine you are crammed together with whimpering, sobbing, panic-stricken teenagers. Imagine the fire alarm blaring incessantly the entire time. Imagine the sprinklers going off overhead. Imagine hearing screams and gunshots just outside the door. Imagine knowing the gunmen are looking for you. Now put it all together. This is what the majority of the high school students, faculty and staff went through that day.

With the red tape behind her, Guzzo has provided massage to more than 20 people directly involved in the bloody rampage; many are now on-going clients. "The majority of people have a lot going on in a physical level in the upper part of the body and legs. There are a lot of muscle spasms from crouching four to six hours that day." Guzzo said the chief complaint she hears is stress. "They are so stressed that they don't know what to do." She said Columbine staff personnel are feeling it more so now that school has let out for the summer. "They're able to let their guard down now," she said.

As a result the symptomatology is growing - chest pains, muscle spasms, headaches, migraines and neck aches. "They are now starting to feel what they had not allowed themselves to feel yet...they're starting to de-armor themselves." Guzzo said the students have been much better at de-armoring, because they are able to show their emotions and deal with them. Counselors, on the other hand, have not been able to do that at 100%. "They've cried with the kids, shared with the kids, but they've not cried for themselves." Guzzo said now comes the traumatic time when those involved are reliving what they heard, what they felt, what positions their bodies were in that day.

Guzzo encourages her clients to talk about the events if they choose to; the majority do. She said she's not able to refer out as much as she'd like as all health professionals are still in crisis mode, but she's comfortable the work she and her therapists are doing is not going outside their scope of practice.

Still, she recognizes that on an emotional level, this is a very different clientele than any she's worked with. "I've worked with rape victims, suicidal clients. But this is a different emotion because it's not understandable for them. If someone had been molested or abused, that's a physical thing, their physical bodies know that. This is on a different level. They're just coming into their awareness now of the impact it has had on them."

Knowing the high emotions of that first day causes Guzzo to ponder whether first-day response by massage therapists would have been helpful or harmful. "On that initial day, I can actually see some issues. The fear base and the trauma were too high at that point." She said it wouldn't work unless you had the time and space to create a safe environment.

So, are Guzzo's efforts working? "I'm seeing benefits for them and so do they. The most important thing is helping with high stress levels." She said she offers clients a variety of techniques, depending on what is found in the physical body and what she sees while doing her client intake. Largely she offers deep tissue, Swedish and basic relaxation. "I don't trigger point with these people right now, it's too deep for them. It could throw them over the edge. What I bring is a safe environment, a place where they can talk about whatever they want to without being judged; and most of all, just giving them a way to vent their stress and to physically get rid of it."

Guzzo recommends only seeing two to three clients a day when dealing with this level of trauma. "You need to spend more than an hour with these people, sometimes two hours." It's also for the sake of the therapist. "For me, I don't take this on as a personal issue. This is something that they went through and I'm just a facilitator. I'm affected when it happens, but when I come out of my massage room, I don't bring it out. I need to be in a space where I can separate myself from that - it's one of the most important things a therapist can do."

As she plans for her part in a Columbine community center, complete with massage tables, Guzzo offers this one last piece of advice: "This is an ongoing healing process for anybody who's been through this kind of trauma. As a therapist, you need to be well aware of what you're getting in to."