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?

Choice A reason: Massage therapy enhances circulation and lymphatic flow, which relieves muscle tension and promotes a sense of physical and mental relaxation, explaining the reduction in anxiety and improved well-being. Choice B reason: This describes mechanisms more consistent with acupuncture or acupressure rather than massage. Choice C reason: Reflexology or alternative energy-based modalities, not massage, are described by this explanation. Choice D reason: Physiologic relaxation responses, such as heart rate and alpha wave changes, are associated with meditation or biofeedback rather than massage, though massage indirectly promotes relaxation.