The therapeutic relationship is a very complex relationship that requires that we become more aware of the dynamics of relating to each other. One of the ways is by studying and learning about the Drama Triangle. I wrote about it initially on my website www.thebodyworker.com
It is really the underlying dynamic in most relationships but because of the power differential that occurs in the therapeutic relationship, the drama triangle can be more evident in a client/massage therapist relationship. There are three positions of the drama triangle -the rescuer, the victim and the persecutor. There is usually a combination of them at work in a therapeutic relationship or any relationship for that matter. One position leads to the next. The rescuer can become the persecutor or victim and any combination of roles.
As massage therapists we are often taught to ‘fix’ a clients pain and injuries. Many massage therapists come to the profession wanting to ‘help’ others. Clients come to us looking to be fixed and taken care of. One of the roles on the drams triangle is the rescuer. We think we need to get the client out of pain.
People who are in pain or sick or injured quickly take on the role of the victim -wanting someone to fix the condition for them. This is the basis for modern medicine. Needing to be fixed they will find a rescuer to help them. As massage therapists we often take on the role of rescuer but we can also move into any of the other roles with clients and also within ourselves. Becoming aware of how we rescue (help, fix) is not an easy process. It doesn’t just stop overnight. When the process occurs internally taking on various roles at different times, it is usually can lead to feeling stuck in building a practice or finding a massage job. We blame the economy or bad spa owners for our lack of success.
Rescuers need to rescue to feel good about themselves. They need victims to be successful. A rescuer thinks everyone needs their help even those who are not directly asking for it. Rescuers don’t know how to take care of themselves so they focus on others. Rescuers usually have deep unconscious beliefs about themselves that they are not good enough so they rescue to feel good about themselves. Rescuers see others pain so clearly because they are filled with pain of their own. It easier to help others with their pain instead of addressing their own pain. Rescuers are not usually aware of their own pain or even think that they have any issues to work through. They are so busy helping they can’t see their own pain. They say things like “I just want to fix this psoas” or “if only I knew more anatomy, I could fix this”. It is a very unconscious process meaning that most are not even aware of the dynamics and their own part in each interaction. Rescuing others tells the other person that they are not good enough or smart enough to help themselves. Rescuers often end up underming others and reinforcing the victim stance. It is hurting more than helping. Rachel Remen MD explains this beautifully in her article “In the Service of Life”.
The early child/parent relationship sets us up for the drama triangle with parents often taking on the role of rescuer. The child isn’t old enough, smart enough and needs to be protected from the world. When are early childhood needs aren’t met ( which they rarely are ever totally met even with the best of parenting) we often are left waiting to be rescued. We fear asking for help because we may be further abandoned and hurt. We begin helping others so that they will become dependent on us and not leave us.
The thing is that every person has within themselves the power to find the answers to their health problems, business building problems or whatever they are faced with. You and you alone are your best source of advice if you can only begin to access your true self and listen to yourself. As a massage therapist our role is to be present for others as they uncover their own answers and true self. The thing is that you have to know your own self first before you can do this with a client.
People don’t even become aware of their rescuing habits until it becomes too painful to bear anymore. This is usually when a career in massage comes to an end but it doesn’t have to end if one can find the courage to begin to get off of the triangle.
The way off of the triangle is to start learning to feel the pain of abandonment and/or the pain of not getting one’s early needs met. It means learning to take care of yourself in every aspect of your life from being financially sound, healthy, eating the right things, exercising and taking car of your internal needs for acceptance, love, appreciation and recognition. It is about becoming more aware of what you are feeling when a client arrives at your door wanting to be fixed. Staying present with the feeling means that you can have the feeling and not act on it but use it to become aware of what you are thinking or what belief you have about yourself that is creating this need to rescue.
Changing doesn’t happen overnight. It is a process and it can be supported by getting regular peer supervision sessions with an experience peer.
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.
ABMP reports in their 2007 member survey report that Close to 83 percent are women. AMTA report that their members are 85% female and 15% are male. Male’s entering the massage profession find themselves in the minority which is a very unusual place for men to be.
One of the most FAQ’s on my website -www.massagetherapycareers.com is about the demand for men in the massage profession. FAQ- Is the massage profession for men?
Women have played the role of nurturing for so long that many are drawn to the massage profession to continue their work of helping others. I actually just had the thought that maybe it is also the reason why so many people struggle as a massage therapist. Through my own process of learning and discovering the hidden side of helping (see the code of the caretaker category) and seeing it in the massage therapists that I work with and interact with online and in person, I have seen that so many massage therapists confuse helping with running a business. (This is a whole other post for later!)
So what are the challenges for men in the massage profession?
Women clients find themselves uncomfortable being touched my men in some situations. The abuse of women by men sets up the bad image that males are faced with as a massage therapist. Men are skeptical of getting massage by men as they may also feel threatened sexually or they just prefer to have the nurturing of a woman.
Whatever the reasons many men are left out in the cold when looking for a job because men do not seem to be in demand in the massage profession. But how much of that is actually create by the massage profession itself?
In about 2002, I asked a male massage therapist, Ryan Hoyme (who went on to create www.massagenerd.com) to write an article on my website -www.thebodyworker.com about what issues males are faced with and how he overcame those issues.
Through the years he has also gotten many inquiries and replies to his article and he has posted them on his website at www.massagenerd.com.
The thing is that there are many successful men in the massage profession. Many have gone on to become teachers and develop their own methods of massage and bodywork. Many have written books.
Keith Grant- Massage School teacher and writer who is very informed about the politics in the massage profession and is working to create standards for the massage profession. His website is www.ramblemuse.com
Joseph Heller -Studied with Ida Rolf and created his own version of Structural Integration called Hellerwork.
Milton Trager- Tragerwork and Mentastics.
These are just a few of the many males in the profession who have created a name for themselves. They all have done it by working on many people and studying the body.
I also wonder if part of the problem is that men are not used to being discriminated against. It is a new feeling for them to be faced with. Massage schools are also telling them they will have difficulties and so when they are faced with hiring challenges they may take it personally.
The thing is that if whether you think you will or will not have issues or challenges as a male in the massage profession - you are right.
Focusing on the problem will keep you stuck on the problem. Focusing on the solution will keep you focused on creating what you want for yourself.
If you find that you are always finding the spa or job that is against hiring males, it is just a good opportunity to look at your own resistance and fear of working in the massage profession as a male. Most of the time it is some unconscious thought process that is keeping you from finding your ideal job.
One of the things you can do is to join or start your own peer supervision group that can be men only or a mixed group. Talking about these issues is one of the most important things we can do as a profession. Being able to share your concerns and yes- feelings is how the images of males as being a minority in the massage profession can begin to be changed.
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.
There are not any clear statistics of how long a massage therapist lasts in this profession and there aren’t any studies on the reasons why people leave the massage profession, but burnout is definitely one of them.
Burnout can show up in many different ways. You may feel drained after working with clients. You may feel stressed when you don’t have enough clients to make ends meet. You feel fatigued and may develop physical injuries or other conditions that prohibit you from practicing massage. You think that your work is not valuable and you don’t charge enough so you end up feeling resentful. You never seem to get enough clients to make ends meet. You never quite get the hang of marketing your practice and asking for what you want - clients.
No matter what the cause or the issues around burnout - isn’t it ironic that massage therapists whose role is usually to assist in helping others to avoid burnout in their own profession are plagued by it themselves?
So many massage therapists come into the massage profession thinking that it will make them happier to be ‘helping’ others. They think that in doing so they will feel better about themselves and have more meaningful work. While massage can do that in some ways, it is more about the massage therapists perspective on their work and how the massage therapist takes care of themselves so that they can work with others.
The thing is why don’t massage therapists do what they need to do for themselves? Most massage therapists are taught to get massage themselves and to eat right and to exercise. They are taught to tell clients that and to support clients on their path to being healthy. The problem really lies in the basic core beliefs of the person. ( It is really not just about massage therapists but anyone who is not getting what they want in their lives.)
Your actions (or lack of actions in this case) reflect your basic beliefs about yourself that were created in your early childhood and infancy in your family of origins. When you know you should be taking care of yourself but are not there is usually something more going on there. Most massage therapists know what they need to be doing - eating right, exercising, getting regular massage, getting your needs met outside your practice, taking vacations, etc.
Are you rebelling and trying to control at least one thing in your life? Are you wanting someone else to do it for you (on a conscious or unconscious level)? Are you eating the wrong foods and not exercising because you are seeking comfort and not wanting to do things that are difficult?
Whatever the reason for not taking care of yourself, you can begin to become aware of the way you take care of yourself by participating in peer supervision groups and sharing your stories and histories to learn more about the shadow side of helping.
