A recent discussion on Linkedin.com has inspired me to write an article about this exact thing. What happens when your massage clients don’t listen to you and they don’t do the things that you are telling them to do that might help them get better? It can be really frustrating to massage therapists when that happens but more importantly is why do massage therapists find that frustrating and what is the real issue?
It could be you are trying to fix your massage clients which means
Massage school teaches us to “fix” people-plain and simple. Learn this and that about anatomy and physiology and how massage works so that you can fix that pain, help soothe that stress and help make people feel better. When you work with insurance and injuries the goal is to ‘fix’ the problem. We work hours and hours, putting our heart and soul into helping and fixing. We love being the hero (or sometimes called rescuer!) We learn that applying massage in various ways will help tissue heal, will help reduce pain and tightness. So with all of our hard work and they go out and trash their bodies again and again. They don’t change their desk set ups like we said. They don’t rest, ice and stretch at home to continue on with all of our hard work and time. Yes….so frustrating!!!!!!
It just feeeeellllsss sooooo very, very great to help and fix! We need our fix of fixing and helping! It helps us feel good about ourselves. It helps build self esteem and self confidence. It is so powerful to be that good! It feels so good to be that good!
In massage school I was given this book called How Can I Help? Stories and Reflection on Service
I read it back then (circ 1987) and didn’t really think much of it. It didn’t really mean much. I wasn’t a helper. I just wanted to do massage. 10 years later, burned out, frustrated by so many client not getting better because I was telling them all of my best stuff and doing all of my best work. Fed up with clients not showing up and all of the other things that go on in the business of doing massage. It wasn’t feeling good anymore.
We gotta fix this up right away. We gotta call this person for advice. It’s tricky because this impulse may arise from genuine empathy, but the form of action is compulsive. Often what is happening is that ‘we gotta’ get rid of someone’s pain because it is hurting us too much.
I also received this article somewhere along the line – In the Service of Life by Dr. Rachel Remen.
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. When I help I am very aware of my own strength. But we don’t serve with our strength, we serve with ourselves.
Hmm…. I started getting it little by little.
When I have posted that article on Facebook though, some people get confused. They only know services as in restaurant service. Oh boy! How did this get lost in massage school?
Then I found a few articles (Go to the bottom and see Caretaking) by my now supervisor – Jack Blackburn. I needed to know more. I signed up for a class with him at the AMTA WA convention and the rest is history. 12 years later of regular supervision and peer group meetings and I am still getting it more and more everyday seeing in all of the great discussions online.
In all helping professions it is necessary to discern whose needs are being met; the practitioner or the client… this is a major reason for supervision.
Whose needs are being met when I tell someone what to do – for their own sake of course! (sarcasm!)
How do you tell when it is your needs being met at the time? How do you stay aware? There isn’t any one solution. There isn’t any one answer. It will be a process of learning and becoming more self aware.
I also remember a great line from Diana Thompson from a class on SOAP charting: “When you point a finger at the client saying, you should do this and this and this to get better, three fingers are pointing back at yourself!”
Giving advice and especially un-asked for advice is always more about the advice giver than the receiver. Always? Well I guess not when I tell someone to drop and roll because they are on fire! Is that advice?
Parker Palmer (A Hidden Wholeness: The Journey Toward an Undivided Life) also has a great quote on this: If you take my advice, you will surely solve your problem. If you take my advice but fail to solve your problem, you did not try hard enough. If you fail to take my advice, I did the best I could. So I am covered. No matter how things turn out, I no longer need to worry about you or your vexing problem.
He also has this great guideline: “No fixing, no saving, no setting each other straight. ” When massage therapists hear that their feeling of frustration show on their faces: What will we do then?
Why do people not listen and do what they are told? Being told what to do often brings up so many old issues of authority and fighting to be their own person, free from authority. People don’t want to be scolded or forced into doing things. People want to solve things for themselves. They want to feel heard and feel respected for who they are. When you give advice – it puts you up higher on the power differential making the possibilities for transference increase. In contrast, when you work together on achieving a goal – a pain free back/neck or whatever- you learn to set goals together. In listening to the client, you can also find out what they can and want to do. If you are telling them things to do and they aren’t doing it, you are most likely telling them what YOU alone think and not what the team of you and the client can make happen.
As a massage therapist, most of us probably got here because we just want to help others. Helping is the very first counter-transference issue that needs to be looked at when becoming a massage professional. Why do you want to help? In what ways do you help? How does it make you feel? I created this questionnaire (on my other site -www.massageschoolnotes.com) from all of my years of studying and reading on helping professions and what it means to help. Because many of the reasons why you help is to make yourself feel good and to feel valued and to feel important. Now there isn’t anything wrong with that but when you do it for that reason only, it often will get in the way of what the client needs most. It gets in the way of the therapeutic relationship that puts the client needs ahead of your own needs.
So how do we move toward being of service and away from fixing? How do we become more aware of our needs behind fixing and giving advice? It won’t happen overnight. It most likely will always be with you in your career in massage no matter how long it goes for. It is just something that needs extra compassion and acceptance and awareness.
There is one thing you can do to start understanding clients more and start working WITH them in setting the goals for treatments. It starts with doing a thorough intake interview and finding out about them. Learning to empower clients in their healing is a very different path. Instead of focusing on the dysfunction think of it as following the ‘path’ of the signs and symptoms into a deeper healing. Start working to figure out what your clients can do and help them achieve that! Start focusing on their strengths instead of their weaknesses. The clients are really the true experts in their health and healing. To really get to that, the therapist needs to set aside their own knowledge and start being curious. Listening is central to the process. When you listen you are not thinking about what you might say, you aren’t thinking about a story you might share on a similar topic – listening means not giving advice but really showing the person that you heard what they said. Often listening is really the first and possibly the only thing they really need! Can you set aside your agendas and assessments to really listen? (It won’t happen overnight! It is a process!) Can you really just be compassionate and share their pain with them – which is the true meaning of compassion?
The book Interviewing for Solutions (Psy 642 Introduction to Psychotherapy Practice)
is very helpful in giving new insights into the intake process and working with clients to get to solutions that clients can achieve.
Supervision and participating in peer groups can provide a place to get your own needs for being listened to yourself outside of your business. Having a good self care program that includes things like having the money you need to take care of your own needs, taking vacations, taking time to enjoy your own life – these are all good tips too.
So that’s my advice and I am sticking to it!
How can you work towards getting away from giving advice and letting go of having to fix clients?
How will it feel when you want to fix clients but also want to refrain from fixing?
See also: The Code of the Caretaker
Overcoming the need to fix from Coping.us