Education Destinations

Why do I continually encounter people who don’t take my profession seriously? Or who like to make a joke of it?

• “Are you still doing that massage thing?” – like it’s a passing phase in our life.
• “Dude, check her out!” – conventioneers elbowing each other as my massage therapist is doing chair massage (and I’ve heard much worse).
• “Oh that’s nice…” – then the business person at the Chamber of Commerce event scans past me for a more “serious” business owner to talk with.
• “You need to click the link ‘Misc. Licenses’ (which includes dog licenses)” – when inquiring with a city clerk how to find massage licensing requirements in her city.

I had a conversation with a client recently about this. I told her that I often don’t mention that I’m a massage therapist when I meet new people, unless I have some reason to believe that I can really help the person, or feel comfortable that my occupation will be received seriously. She surprised me, saying that when she refers to me in conversation with new acquaintances, she now calls me her friend, not her massage therapist, to avoid raised eyebrows, innuendos or smirks. She does refer others to me but only if she thinks she’ll avoid those reactions.

I still hear occasional off-color jokes or inferences about massage from those who think of us as masseuses working in parlors, but I’ll save some space on a future blog for this topic. If they are a person I’m trying to build or maintain a relationship with, I’ll put on my serious face and give them a bit of an education. If they’re just a jerk, I just change the topic or excuse myself from the conversation.

Maybe I’m a little like the Budweiser delivery driver who told me he’s sick of hearing the same old line every day as he carts his cases into a store, “Hey buddy, you can drop one of those into my trunk here!” “Oh yeah! Maybe next time! Hahahaha!” he replies while inwardly cursing at having to respond to that tired joke day after day.

I should probably be an evangelist for massage 24/7. I really love giving and teaching massage. But I’m tired of these reactions I often get. Why? And how can I (and you) regain a little more of that “on-fire-for-massage” attitude that we had in our early years of massage?

• Perhaps some are uncomfortable with the thought of discussing such an “intimate” topic. Solution: keep the conversation professional, emphasizing the therapeutic benefits. Give real life examples of how you’ve helped people with back pain, headaches or other conditions.
• Massage may be perceived as a luxury, something only the wealthy or those who like to pamper themselves do. Solution: Site evidence of the benefits of massage and how it may reduce other health care expenses. I also tell people that my clients represent a wide cross section of local residents, and how some are able to use their HSA or insurance to cover the cost.
• The continued presence of illegitimate massage establishments linked with prostitution and human trafficking certainly doesn’t help our professional reputations. These make for easy lead-ins for jokes by those not educated about therapeutic massage. Solution: Agree that there are always a few establishments masquerading as “massage therapy”, but the clear majority of massage therapists take a lot of pride in providing therapeutic massage for people who are stressed out or in pain. Look them in the eye and make it clear that you’re proud of the benefits you provide and that you don’t appreciate being lumped in with a few bad characters.

We’re still a relatively new wellness profession in the US. While practitioners of various forms and applications of massage have existed since the 1800’s, it’s only been since the 1970’s and 80’s that massage for therapeutic and relaxation purposes has begun to gain acceptance with the broader public. Acceptance has still grown slowly, as only 18% of Americans had a massage at least once between July 2014 and July 2015, according to a recent AMTA consumer survey.

I think I’ll begin this week presenting myself as Dale Wheeler, massage therapist. Join me, and let’s see what happens!

I get bored with the four walls of my massage room. I love my clients and my workspace, but I welcome a change from the daily routine whenever I can get it. Taking my massage chair out to another workplace or event gives me the fresh air I crave.

Besides the need for variety in my massage practice, I’ve discovered several benefits of chair massage for myself and my clients:

Supplements your massage income: Frequently, I can schedule chair massage to fit my schedule, filling in my slow days or timeslots with chair massage events. Many of my corporate clients aren’t terribly picky about the time of day or day of week that I come in. I also keep my eyes open for large events requiring multiple massage therapists. I’ve coordinated many of these and they can be very financially rewarding. Finally, keep in mind that a massage chair and accessories are an inexpensive investment. 4 to 8 hours of chair massage will pay for your equipment.

Find new table massage clients: With chair massage I meet four clients per hour. Potential clients get to know me for a few minutes. I can demonstrate my quality of touch and personality, both big factors in a client’s decision to schedule table massage with me. I always bring a stack of business cards and sometimes discount cards for first time table massage. I have several regular table massage clients who have scheduled with me for over 10 years – all of whom I originally met through chair massage.

Touch people who are not likely a schedule traditional table massage: Chair massage is generally provided in a neutral, safe environment – their workplace, a mall or airport, a convention. People who might be squeamish about going to a massage clinic are more open to massage if they control the location. Chair massage alleviates concerns that they will have to disrobe, get oily skin, or mess up their hair. And people lead busy lives, unable to carve out time to squeeze in a one hour table massage. But most have time for a quick 15 minutes of chair massage.

I’ve become a better massage therapist: My body mechanics have dramatically improved – a must if you want to do chair massage for very long. I’ve learned to make better use of elbows, knuckles and sometimes tools, and reduced the amount of gripping, squeezing and thumb work.

Even with all these benefits to the client, not everyone will want a massage, even if it’s free. My experience with corporate location chair massage is this: If it’s offered for free to the employees, about 50% will try it. If the employees pay for their appointment, only about 25% will sit in the chair.

So pack your gear, put on your traveling music and enjoy some productive time outside you massage room!

I have many clients who enjoy chatting with me during their massage. One long-time client is particularly fun to visit with. She has an upbeat, fun personality, she enjoys cooking and dining out, movies, books and travel, and she has a great husband and family. All traits that I enjoy and value with my best friends. One day recently we visited on the topic of my relationships with my clients and I told her that I’ve always been a little squeamish about using the word “client”. “But, I don’t really feel comfortable using the word ‘friend’ either,” I told her, sort of thinking out loud. After a pause, I continued, working this idea out as I went, “You, for example, I would definitely think of you as a friend, but we don’t do the normal things that friends do, like going to events together or meeting at each other’s houses to grill out, because of our massage relationship.” And then I hit upon a phrase that perfectly described this relationship I enjoy with her and many other “clients”: “Friends with Boundaries!”

I think many of us tend to attract clients to our practice who are like us, or who are the types we enjoy spending time with. Aren’t we told to market towards the groups we know? That’s how I’ve built my practice. So what happens when some of these clients who also happen to share similar interests (just like our non-massage friends) step over into friendship territory beyond the massage table? How do we proceed when welcomed social invitations outside of the massage session arise?

Let’s define the term “friend”:
• a person attached to another by feelings of affection or personal regard. (Dictionary.com)
• one attached to another by affection or esteem. (merriam-webster.com)

Basically, someone to whom you form an affectionate attachment. We seem to be hard wired to want to form networks and social groups. So what’s the problem with mixing some friendly massage clients into our social scene?
That voice in my head from my first ethics teacher in school, for one. “Thou shall not cross the line from clients to personal relationship!” My early instructors carved those words into our brains as surely as they were carved into the “stone tablet” that was our Ethics textbook. “You’re not becoming a massage therapist to find a lover or new best friend, you’re doing this because you want to provide the best therapeutic massage you can give to each client. Period.”

As I researched the various Codes of Ethics and Standards of Practice that we have each have agreed to adhere to (if we’ve joined or been certified by one of our professional organizations), the words “friend” or “friendship” aren’t listed. But they have plenty to say about therapist/client relationships.

For instance, NCBTMB, in its Standards of Practice, warns against “Multidimensional Relationships: Overlapping relationships in which the therapist and client share an alliance, in addition to the therapeutic relationship,” and, “An alliance in addition to the client/therapist relationship, such as social, familial, business or any other relationship that is outside the therapeutic relationship.” These Standards recommend avoiding multidimensional and dual relationships, as do corresponding documents from many other massage organizations.
Other serious concerns that arise as we become social with our clients include:
• Client confidentiality during social interactions
• Sexualizing the relationship
• Development of transference and counter-transference issues
• Your ability to give unbiased care and advice, to name a few.

While we can rationally think of many solid reasons to strictly keep your therapist/client relationship as just that, we live in a world where we do seek and cherish connections and friendships in our everyday lives. I confess that I have a small handful of these overlapping relationships – not many – but they have seemed to work out about as well as relationships with any other new friends. I think it’s necessary to define for ourselves, each of us, what our boundaries are on this topic. Some things to consider:
• Does the boundary apply to each and every client equally, or are there some exceptions? What are the exceptions?
• If an opportunity comes up to move to a level of friendship, should we immediately accept, or take some time to consider how this may affect the professionals relationship?
• Might you or your client start to feel differently about the exchange of money for ongoing massage sessions?
• Will your friendship become awkward if your client chooses to discontinue massage with you or change to different massage therapist?
• Would you consider ending the professional massage relationship between the two of you in order to cultivate a social relationship?

It seems wise to discuss concerns such as these with your client early on in your social relationship. Always keep in mind how the relationship started and proceed with caution.

I know many massage therapists who have found wonderful friends that began as clients. But I’m also aware of relationships that have gone terribly wrong, from miscommunications and hurt feelings, to massage therapists being stalked or worse. So far with my few overlapping relationships, my friends beyond the massage session, I’ve had no disasters. But I have purposely put the brakes on many more opportunities, sacrificing the expansion of my network of friends and settling contentedly for the pleasant visits with clients during their appointments.

In my practice, I have always had a set routine.

When my client arrives, I have my clipboard and pen in hand with notes from previous sessions. I have a new SOAP chart and sometimes a body chart for my client and me to fill out.

And I’m ready to fire off my regular list of questions and actions:

• What can I help you with today?
• How is the hip/neck/foot/ (fill in the body part) doing today? Regarding your painful condition, how long have you had the pain, is the pain sporadic, what activities cause
• the pain, etc.
• Stand up and let me check or test your posture. Let me see you walk to that wall and back.

I have my clients well trained, and they dutifully describe this week’s history of their restricted movement, headache, back pain or latest sports injury. And then we move on to the massage and I work on the problems. It’s all about the specific, focusing mainly on the physical.

But I’m often left wondering, could I do more for my client? Did I really get to the source of the problem? Why do they keep coming back with the same complaint? How much does a client’s wellbeing or emotional stress affect the problem?

So I’ve recently changed my approach and started asking this first question: How do you want to feel today?

My clients give me quizzical looks, and are frequently stumped for an answer. But I keep pressing the question before asking anything else. How do you want to feel today? The question puts the client into a reflective, thinking mode, more in touch with what’s really going on inside them.

“Hmmm, how do I want to feel…?” I’m quiet after asking, not suggesting how I think they should feel, but giving them time to ponder. Often, with a burst of nervous laughter, they’ll say something like, “I want to feel like a million bucks!” or “Pain free!” But some responses are a little more introspective. “I just want to wake up in the morning and not dread the day again,” replied one longtime client with chronic left hip pain. Another client who is a runner with occasional minor injuries said, “I am just SO stressed with my situation at home. I just want to have that pressure taken away for a while.” Wow. I am almost always surprised by the response, and gain deeper insight into my client’s pain or inner turmoil.

Then based on their response, I ask the appropriate questions that will help me figure out how to treat them in a way to achieve that desire.

I’m sure I have many times treated a problem but not the person, a symptom but not the cause. I’ve discovered, or more accurately rediscovered, that focusing on the whole body first often goes far in resolving the specific complaint. Now, instead of diving in right away with deep tissue or trigger point techniques, I’m more likely to start slowly and generally with myofascial approaches, working from the core to peripheries, taking more time to “see with my hands”, following patterns of tension or referrals. I often end up applying deep tissue and trigger point work as needed, but I always begin with my focus on the whole physical and emotional client.

Most of my clients love the new approach, though some still want me just to work on a specific problem. As for me, I am more excited and energized about massage than ever, finally feeling like I’m giving my clients what they most desire.

Give it a try and ask your next clients, “How do you want to feel today?”

“The funniest thing happened during a massage today…” I’ve started several daily recaps with my wife with these words.

Maybe because I’m a “glass half full” kind of person, I seem to always find humor in my surroundings. Whether it’s an interaction with a client or one of the massage therapists in my office, I can’t seem to keep a lid on the funny stuff. Laughing with a client is part of giving them a relaxing, restorative experience. Sharing a chuckle helps relieve tension, takes the mind off stressful thoughts, provides better perspective, and strengthens connections with each other.

I think we massage therapists take ourselves too seriously sometimes, maybe as a result of trying hard to legitimize our profession or establish our expertise. Try meeting up with a colleague and share some amusing moments you’ve had giving massage. It’s usually when I meet informally with other massage therapists for coffee or an after work libation that the humorous work stories begin to flow. We seem to crave sharing these things with others who understand our lives with bodywork. Some things are just too funny to keep bottled up.

Here are a few of my special moments:
Clients say the darnedest things. I have a home office where I see some of my regular clients. Recently we’ve had workers in our home working on a major kitchen remodel. One day while our contractor was quietly working there, finishing some detail work, my long-time client (and even longer-time friend) Sherry comes by for her massage. After admiring our new kitchen, she suddenly shifts gears and with a big grin loudly states, “OK, I’m ready to get naked!” From the corner of my eye, I could see the contractor freeze for a moment, then resume his work. I showed Sherry to the massage room. Returning to the kitchen, I quickly explained that I’m a massage therapist and that my friend is a client and practical joker and I’m not having an extramarital affair. Big laughs, but I imagine I gave him a great story to share with his wife that night.

Believe it or not, wardrobe malfunctions can become part of the humorous landscape. One day about 10 minutes into a 90 minute massage, I felt something give at my waist line and was alarmed to see my pants button at my feet. The qualities of these particular slacks that I valued so highly for massage work – light weight, loose fitting, a little stretchy – immediately became liabilities. I was able to grab my waist band as the pants headed south to my ankles, and yanked them back up. I recall that for the remainder of the massage I focused on massage strokes requiring just one hand, or that allowed me to be seated. Thankfully I think the client never knew anything about it. Some combination of a stapler, rubber bands and masking tape held my pants secure about my hips for the remainder of my work day.

Sometimes we laugh because a situation could have been much worse but wasn’t. While giving a massage to one of my regulars, we both nearly jumped out of our skins when a bright flash and loud popping sound occurred under the massage table. He jumped up (fortunately wearing boxers) and I had to peel myself off the ceiling. A quick investigation revealed that a leg of the massage table crimped the electric table warmer cord, and one deep stroke too many caused the table leg to cut and short it out. Once the mystery was solved, we continued the massage with nervous laughter and the untherapeutic scent of ozone.

Is there an ethical boundary for humor? I steer away from humor with any sexual connotations, and avoid gossip, prejudices or anything that puts others down. Keep your comedic impulses positive, building up good energy. And remember that we’re not stand-up comics. We don’t need to entertain our clients for an hour with our wit.
“There is nothing in the world so irresistibly contagious as laughter and good humor.” – Charles Dickens