A 42-year-old man presents to the PMHNP for a follow-up appointment to re-evaluate his symptoms of generalized anxiety disorder. He says, "I have been getting weekly massages and they have helped so much! Why are massages so relaxing?" What is the appropriate response?

"Massages are believed to affect anxiety and tension by increasing lymph flow and blood circulation, thus improving muscle tone and relaxation of the mind."

"Massages are believed to reduce anxiety because they increase the activity of endorphins by manipulating points of energy flow in the body."

"Massage alleviates tension by cleaning crystalline deposits under the skin that may interfere with the natural flow of the body’s energy."

"Massage produces physiologic effects such as decreased heart rate, blood pressure, and respiratory rate; decreased anxiety; and increased alpha brain waves."