One of the least talked about concepts in massage school is the therapeutic relationship that occurs between the massage therapist and the client. Cidalia Paivia in her book “Keeping the Professional Promise” says:
When a massage therapist and a patient come together, the therapist and patient enter into a therapeutic relationship. What distinguishes the therapeutic relationship from other relationships is its very special purpose and goal, which is to serve the needs and interests of our patients.
The Therapeutic relationship’s primary function is to facilitate the health and well-being of our patients, ensuring that we bring our full presence and commitment to this experience.”
When people come to us seeking help with their condition or distress, what happens is that a power differential is created. People come to us thinking we can ‘fix’ or help them. They think that we hold the answers to relief from their symptoms. They are vulnerable because they are in pain or under stress. The act of seeking help recreates an old pattern of relating to someone in power which is based on our early relationship with our parents or major caregiver. Since no caregiver is perfect and able to provide for all of our needs we are left with holes in our essence and we seek to fill these in most relationships especially one where a person is actually seeking help.
On the other hand the “helpers” have their own issues and reasons why they feel compelled to be the helper. While on the surface many help because it brings more meaning to the helpers lives, helping is also a great way to really learn more about oneself. Rachel Remen in her article “in the Service of Life” talks about helping in this way:
Serving is different from helping. Helping is based on inequality; it is not a relationship between equals. When you help you use your own strength to help those of lesser strength. If I’m attentive to what’s going on inside of me when I’m helping, I find that I’m always helping someone who’s not as strong as I am, who is needier than I am. People feel this inequality. When we help we may inadvertently take away from people more than we could ever give them; we may diminish their self-esteem, their sense of worth, integrity and wholeness.
Because the nature of touch can bring up so many deep and unconscious feelings and emotions in clients and the massage therapist, it is important that a massage therapist have an understanding of what happens in a therapeutic relationship and understand how what they do and say can influence the relationship.
The therapeutic relationship is based on the massage therapists ability to stay present with a client and not judge, fix or otherwise hinder the client’s process of healing. It requires that the massage therapist have a clear idea of what their own needs are and learn to get their own personal needs for appreciation, validation and to be needed met in other areas of their lives so that they can become and stay more present with the client for the clients healing process. Working within the therapeutic relationship requires that you be able to give empathy for the client. To be able to give empathy, one needs to have met their own needs for empathy first by doing the grief work that is related to not getting your needs met and working with a skilled peer supervisor or mental health counselor to rewire the brain and body for empathy.
Since so many of our needs are really unconscious, it is important to begin to become aware of our own needs and learn to take care of them outside of the therapeutic relationship so that we can become more present to witness the healing process in clients.
So often massage therapists find themselves crossing the boundaries between friendship and clients, wanting to fix a client, wanting to give more, getting paid less, giving advice and acting in other ways that will actually foster a client’s dependence on the massage therapist. The massage therapist will often start sacrificing their time and energy in order to help a client or so they think. There is such a fine line between helping and when helping is actually hurting that it is near impossible to distinguish until it is too late. The massage therapist will end up feeling resentful, burned out, facing physical injuries/illness which may lead to career ending events.
The presence of a massage therapist depends on their own awareness of themselves and the reasons why they feel compelled to help. Our early childhood is where it all starts. Our self esteem is developed at an early age. We begin projecting our unrecognized feelings on others shortly after birth. When our early needs for nurturing, appreciation and acceptance were not met, we see ourselves as less than worthy and it is reflected in all of our actions and reactions. When our own needs for empathy and mirroring are left unmet from early childhood, they often get in the way when we try to help others. We can learn to be of service more when we take the time to receive the empathy that we need for ourselves.
As a massage therapist, we owe it to our clients to do our own personal growth work and fill in the holes left by the wounds of our past. Learning about ourselves and setting clear boundaries in a massage practice can take you much farther in building your practice than any marketing plan. The clearer you get about who you are, what you are doing and why, the clearer your relationships with your clients and potential clients.
I wrote a page on my website a long time ago (2001 or so) on erections that occur in men when getting a massage. It always seems to cause quite a reaction particularly in men who routinely site all of the physiological reasons that erections occur.
Being a heterosexual woman of course, I only know about erections second hand, but do know that anything that is occurring physiologically has it’s root in our thoughts - most of what are unconscious thoughts. The way to become aware of your thoughts is to pay attention to what your body and feelings are telling you. What are men who get erections on the massage table unconsciously thinking? That is the real issue where healing can begin.
If the issue were a total physiological one- then why don’t all men get one at the time of a massage? Why don’t men who are stressed out or have something else on their mind that is bothering them automatically get one? Why do men who are with a loving partner that they trust have issues with erections when they are under stress? If the issue was just physiological it would be able to be controlled by changing the physiology. Erectile dysfunction could be remedied by massage then instead of the many drugs that are out there today. (Yes and maybe it can help in reducing the stress that is a part of ED.)
If erections were just a result of being touched then do heterosexual men get erections when they are massaged by males?
So what does it mean when a man gets an erection while getting a massage from a woman who is a total stranger in most cases? What must a man be unconsciously believing about himself or the act of getting a massage or even touched by anyone?
So often men seem to have a fear of getting a massage because of the fear of getting an erection during the massage. Doesn’t that actually set men up for getting an erection during massage - since what we think will become a reality. If men are concerned about getting an erection during a massage do they actually get one or are they less likely to get one because they are aware of their fears about it?
My writings in the article noted above are influence by a local psychologist -Anne Stirling Hastings who wrote a book called “Body and Soul: Sexuality on the Brink of Change”. In it she talks about just how much our society is influenced by the media and shame. Here are a few quotes to explain more about where I am coming from on this:
“The more ashamed and controlled a person or a culture, the more reactive he or she becomes to sexual stimuli to make sure this energy is not eliminated. The current cultural definition of sexual freedom is to be able to react to any kind and amount of stimuli we choose. Real freedom will come when we don’t have to react to stimuli, when we are able to allow our sexuality to emerge when it is right to do so. As sexuality is repressed, reactivity increases, and as reactivity becomes more intense, the cultural desire to control it increases.”
“Cross wiring, as I have defined it (the author of the book is saying this) reflects the incorrect associations between sexuality and anything else that is not inherently sexual”….she goes on to list categories of sexually cross-wired behaviors one of which is this category -Feelings that produce arousal and lists wondering if the person will arouse you or not during a massage.
Getting an erection during massage is not normal (as in it doesn’t happen every time) but it does happen. I have given massage for 20 years full time (probably around 20,000 massages) and I have only had one male get a full on erection. I know there are probably more who have had feeling stimulated or had the massage feel sensual. Touch is sensual as in appealing to the senses. Professional Massage isn’t sexual.
It is OK if it happens. A skilled massage therapist will be able to address the issue comfortably. If the line is crossed where the man is wanting something to relieve the erection that is a different story and it is called prostitution. It does not have any place on a massage table or massage practice. Males getting erections on the massage table is really a great indicator of where healing needs to occur for men and the massage therapist doing the massage too.
Why the massage therapist? Could there be some unconscious intention being played out? Most likely there is - but what is left to each individual massage therapist to discover.
So I hope this can be the beginning of a very important discussion for the massage profession.
Dating massage clients has in the past been seen as acceptable and almost a way of life when I went to massage school 20 years ago. Teachers dated students. Students dated each other. So it wasn’t anything to think that dating a client would not be acceptable.
As massage becomes more accepted as a profession it is important to start understanding the issues that come up around dating clients. Massage schools are starting to mention it in their classes and some states like here in WA are starting to make it illegal to date clients. In 2006 it was made into a law that massage therapists can not date a client within 2 years of seeing that client. The specifics are outlined in the WAC 246-16-100
The thing is that there are still so many massage therapists out there that don’t think it is a problem to date a client. What happens is that clients come to us for help. That act of seeking help often creates a reenactment of our early relationships with caregivers. They think that they will be taken care of like their parent (s) did or should have. Clients come to us in a vulnerable state and the act of getting a massage which requires that massage clients take their clothes off and let a stranger touch them also creates more vulnerability. To put it simply, clients can easily think and act like we are their parents and they want to recreate that early merging and bonding energy that occurs that makes them feel safe. It happens in other personal relationships in fact all most all relationships. I can’t actually think of an instance where it doesn’t happen.
What happens is that the early feelings are also ‘remembered’ through the touch that is given in a massage which complicates the matter even more. Touch elicits the bodies feelings.
The therapeutic relationship is created where the client can come in and project their early feelings onto the massage therapist. Some of the ways that it is shown is when clients bring you gifts, offer to do things for you, or think that YOU are the cause of their healing. These are what is called signs of transference.
Article: Did you make enough this year? (And how do you feel about it?)
How do you feel about the money you earned this year? Is it more than you thought it would be? Is it less then you thought? Do you know?
It’s important to take the time to figure out exactly what you earned this year. If you use accounting software, what is your total revenue? Perhaps you can look back at your deposits and other statements. Maybe you are salaried and you know exactly what you earned. But you simply must be clear on the number.
Once you know your 2007 income total, take a moment and reflect on how you feel about it. Given how much you worked this year, does it feel like a good payoff for all your life energy? Did you get ahead this year or does it feel like you are simply treading water?
Remember that “underearning” is the pattern of earning below your potential. When you look at your 2007 income total, does it feel like underearning or are you earning at your potential? When people underearn, they begin to resent their work. It’s important to get in touch with your “resentment number” —how much money do you need to earn in order to not resent doing your work?
Do you know what “enough” would be for you? Knowing what you need to earn in the first place goes a long ways towards hitting that number! It’s very frustrating to walk around simply saying, “I need to make more money!” How much more? Be exact. Give your creative mind a specific number to work towards.
If you are frustrated with your earnings, take heart. When you take the time to really look at your earnings, it is a huge step. Frankly, many people are unclear as to how much they make. They simply go month to month, doing the best they can. Clarity is the first step. You can’t change what you don’t know.
If you earned less then you thought, or you are unhappy with your earnings, answer this: what is one thing you could do to increase the amount of money you make? Quick! What is the very first thing that came to mind? Is it time to ask for more? Are you in the wrong career? Do you need to raise your fees or start working with a different type of client who will pay more money?
Some of these answers feel harder then others, and that is why people often don’t ask the question to begin with. Sit with this question over the next few weeks. A new year is coming. And with it comes new possibilities. It is possible to earn more money.
Mikelann Valterra may be available to speak to your group/ organization. As a specialist in earning issues, she speaks and consults widely on how to earn at your potential and overcome self-sabotaging beliefs about money. Mikelann@womenearning.com.
How often do we look at pain and try to get rid of it. Most of our lives we spend trying to get away from pain.
In our work as massage therapists we are faced with so many people in pain - back pain, neck pain, injuries, car accidents, foot pain, hip pain, pain from inflamed muscles and joints, pain from arthritis, headaches…we don’t usually think of the gift of pain.
Insurance companies make the client focus on the pain by making them report it constantly to us and other health care providers.
We try to deal with the pain by fixing it for the client when maybe fixing it isn’t really the best answer. Do we try to fix the pain because we can’t bear the pain that it brings up in us to see someone in pain? Do we keep the client focused on getting rid of the pain by chasing it around the body? If we ‘fix’ the pain do we miss the message?
What if pain were just the messenger. Like the old saying - “Don’t shoot the messenger”.
Pain is different from suffering. You can have pain and live with pain but it is the suffering from the pain - wanting or expecting things to be different causes the suffering. We keep focusing on the pain and getting rid of it causing suffering. We can get easily hooked into fixing pain and trying to ease other pains instead of looking at what is coming up for us in relation to seeing others in pain.
How can we accompany clients in turning toward their pain?
Learning to address our own pain first before being able to go there with others is needed to be able to be present with others in pain.
I actually think this is one of the main reasons for massage therapists having such a hard time building a massage practice. They want to leave when the work becomes to difficult or demanding and can’t bear the pain of others. They end up always trying to fix clients which leaves people feeling like massage is not valuable to them. We look for new techniques or research that will make us better fixers when we already have all of the tools needed to witness others healing process. Our hands are what help the client connect or reconnect with their bodies which are the messengers. Our hands help people interpret what the pain is to them. Our hands support the client in seeing themselves clearer. The best massage therapists see themselves as guides and fellow travelers- not experts on another’s situation.
When we are reacting emotionally to a client in pain with giving advice, trying to rationalize and explain, we are usually trying to provide solutions that are really for us and not the client -not physically for us necessarily - but what makes us feel the best- like we did everything we could do to help this person in pain. It is often confusing to decipher whose needs are whose.
This role of fixing is really the shadow side of helping. The thing is that when we help others it reveals the parts of ourselves that really need healing (or help.) We hide behind masks as our role of a massage therapist - the healer, the pain fixer, the one who the client can’t live without, the one who can give the client relief when no one else or no medication could - the all knowing “Oz”. A mask actually produces the exact opposite that it is intended to create. As we tend to our own pain and dis-ease, we can begin to be present for others and witness their pain. Much of presence is about listening. We listen with our hands, our heart and our ears.
The more we can become aware of our own pain and attend to our own suffering, we become more available at deeper levels and we are less likely to project suffering on others.
Part of the problem is that we are taught to ‘fix’ pain in massage school. We keep seeking more knowledge and training and diplomas and it makes it harder to keep things in perspective. With our new knowledge we often develop a vested interest in being right. It takes us farther away from our precious essence or true self. We create more separateness with our institutions and will find ourself in ‘prison’.
We seek to get our own needs for acceptance and acknowledgment from our clients when they are not really in a position to give it or we lose patience or get bored and move farther away from our own pain and end up burned out or leaving the massage profession for something more exciting.
It is pain that allows one to change and grow. I can’t say I ever really grew or expanded from feeling joy or happiness. So why do we work so hard to get rid of pain? What if pain could be eliminated by facing it and going through it? How can we be more present for those who come to us in pain? How can we learn about our own pain from working with clients in pain?
