The therapeutic relationship that occurs between a massage therapist and a massage client is one of the keys to being a successful massage therapist. The therapeutic relationship is what allows healing to happen for both the massage client and the massage therapist.
The therapeutic relationship is talked about by many authors in the massage profession.
Cidalia Paiva, PhD in her book “Keeping the Professional Promise” says this:
In the therapeutic relationship we are not simply serving the interests of persons: we are specifically serving the health care interests of vulnerable persons….
She goes on to say: 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. In order to be fully present in the therapeutic relationship, it is critical for the therapist to be self aware and personally responsible…. Therapeutic progress can be blocked when therapists use their patients, perhaps unconsciously, to fulfill their own needs: to caretake others, to boost weak self esteem and to feel capable and/or powerful.
Nina McIntosh in her book “The Educated Heart” says that “boundaries are like protective circles surrounding the professional relationship. Rather than being barriers that separate us from our clients, boundaries safe guard both practitioner and client.” The therapeutic relationship is focused on the well being of the massage client.
The dynamics of the client-practitioner relationship are complex and often subtle. Our clients automatically give us more power than they would for instance if they met us on the street. They are often looking for us to alleviate their physical, or emotional distress or discomfort which puts them in a vulnerable and dependent position…Our task is to meet our clients’ vulnerabilities with respect and kindness and we do that by maintaining secure boundaries.
Cherie Sohnen-Moe in her book “The Ethics of Touch” claims that ” practitioners must have a thorough understanding of the meaning of the therapeutic relationship; power differential, transference ; countertransference; projection; repression; and denial.”
Much of what is written for the massage profession does not do justice to the extent of the therapeutic relationship and how it can actually influence the success or failure of a massage business. It is also one of the hardest things to learn about just from a book or from massage school. Supervision is really the best forum for discussing the client-therapist interactions that you have with YOUR clients.
The therapeutic relationship begins the moment a potential client begins thinking that they want to find a massage therapist. The potential client is already thinking about seeking assistance for whatever issues they may be having – stress, physical pain or relaxation. They actually may or may not even know about you. They might just be looking online or just thinking about it at their desk or sitting on the sidelines of their soccer game. The act of seeking help often brings up past relationship dynamics with others of power in their lives such as parents, caretakers, teachers and religious educators. To put it simply and directly – people will often unconsciously think of you as their parent (person of power) and the dynamics of the relationship between client – massage therapist will be challenged by them (transference). Unresolved needs and feelings and issues are ‘transferred’ onto the person of power – in this case the massage therapist. The massage therapist will also have their own issues arise during the course of a massage which requires attention (countertransference). In real life regular friendships and romantic relationships also start in transference.
Transference is normal and will happen whether you are aware of it or not or whether you want it or not. It isn’t a bad thing like many massage therapists may start to think because of the small amount of time that is given to the topic in massage school. Massage clients also have special vulnerabilities because of the fact that they also end up on the massage table in some state of undress and are not feeling well or are injured. There are many signs of transference but often you will not really know if it is a case of transference. Creating boundaries for yourself as a massage therapist is what allows someone who is in a state of transference to have a chance to see their own issues and is a major part of the healing process.
As a massage therapist, you will also have your own issues that come up when working so closely with people. Countertransferrence is when your own unmet needs, feelings and issues come into the client/therapist relationship. It is basically unconsciously thinking that the client resembles a parent figure and we look to them to get our needs for recognition, appreciation and to be heard. Since it is an unconscious process most of the time, it is important to work with a Supervisor to get your needs met outside of the client/massage therapist relationship.
The more you know your own values, needs and feelings and the clearer your boundaries are for yourself – the greater the chances of you attracting your “Ideal Massage Client” to your massage business. Some examples of simple boundaries you can create are those around things like cancellation policies and fees, hours of operation, creating dual relationships with clients (becoming friends with them or even dating clients), giving advice and sharing personal information. The clearer your boundaries , the easier you will be able to make decisions that will support your massage business. The more you let your boundaries slip like allowing clients to get away with not paying for missed appointments the higher your risk of Burnout and also failing in your career/business.
That last sentence above took me about 15 years to really understand and the process of creating and defining my boundaries took another 5 years or so and is actually an ongoing process. The more that I could stand strong in my vision of working with mainly my “Ideal Clients”, the more clients I got that respected my time and were willing to pay higher rates for my services. The clearer my values and boundaries, the more successful I became as a massage therapist.