Massage & Bodywork


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The Downside of Good Intentions As caring, committed massage therapists, we focus a lot of attention on what we do during a massage. We study the body, we learn new techniques and cutting-edge modalities, and we try to make each stroke meaningful. But there is another element of our work we largely ignore—what we say to our clients, both during the session as well as before and after. These moments can have a larger impact than we realize; the things we say can either enhance—or limit—the effectiveness of our hands. Your relationship with each new client almost never begins with touch, but rather, with talk: the questions you ask and things you say, the comments you do or don't make, both when you first meet or book the client, and then in your treatment room prior to their session. Depending on where you work and the kind of work you do, you may have an elaborate discussion with each client during their health intake, or you might barely have time for more than a question or two as you whisk them from the spa's waiting area to your treatment room. Then, during the session, you might tell your client what you are feeling in their musculature, or (more often than we care to admit) other random thoughts and observations that come to mind. And then after the session—again depending on the "what" and "where" of your work—you might push a cup of water into their hands and rush to change your table, or you might sit and chat. At each of these junctures, you decide what to say, or not. Those possibilities hold true for every subsequent session with that client as well. Except for a few brief hours during massage school and the occasional continuing education course, we don't explore these crucial moments all that often. After all, who wants to spend time on this stuff when we could be learning cool new techniques! I want to change that. We all know massage therapists aren't allowed to diagnose. There is some variety from state to state, but for the most part, we are allowed to "assess" but not to "diagnose." 1 Yet I believe diagnosis is more of a gray area than we would like to think. You've probably never declared to a client that they have a brain tumor or irritable bowel syndrome. Those are obvious instances where it would be not just unethical, but impossible, for us to test for and thus make a diagnosis. But beyond these obvious medical conditions, this is a slippery slope—one of the many parts of our profession where our best intentions get us into trouble. Maybe you've never told a client you are positive they have carpal tunnel syndrome. But has a client ever self-diagnosed something—carpal tunnel or something else—and you have agreed? You are on that slippery slope. And chances are you have definitely told a client—if not most clients— they have "really tight" muscles, or some other similar observation. Again, you are on that slippery slope. Rest assured, you are in good company. You and I and every other massage therapist who cares about their clients—we all live on this slippery slope. Sharing our thoughts is a natural impulse. After all, we want to help! And the rationale is pretty simple: Who else is going to give them this information? You can barely talk to your doctor for 15 minutes before they run to their next appointment. And besides: We feel a lot of muscles. We know about posture. We can tell when the body isn't working right. Right? Unfortunately, no. The longer I work, the less sure I am about how sure we can be about the declarations we are fond of making. And just as important, I'm not convinced that telling your client they are really tight actually does any good. I suspect that, at least some of the time, such words confirm some of the same problems that are baked into diagnosis itself—it confirms not just a temporary medical condition, but something essential about who that person is. I think we as a profession do too much defining and declaring, and not enough exploring and allowing. I believe when we tell a client we "know" what is wrong with them, we are not only violating our ethical boundaries, but more importantly, we are foregoing one of our greatest assets as therapists: the ability to be present with our client—to not tell them what is happening in their own bodies, but to encourage them toward a greater understanding of their own bodies. The consequences are not obvious, 50 m a s s a g e & b o d y wo r k j a n u a r y/ fe b r u a r y 2 0 2 2 There is another element of our work that we largely ignore— what we say to our clients, both during the session as well as before and after. It is these moments that I think can have a larger impact than we realize.

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