The woman introducing herself to me would never be blessed with laugh lines. She demanded, “What can you do for me?”
“I don’t know what the problem is yet.”

Impatient for me be omnipotent, she talked angrily about her -low-back pain. People in pain can be irritable, so I held on to my compassion. As I offered treatment options, she interrupted, “I don’t have time for massage therapy.”

How about remedial exercise then? I suggested a simple, 20-minute relaxation stretch. “I don’t have 20 minutes a day. I don’t have time to exercise at all,” she shouted. “I need drugs!”

Many therapists tell me it’s a waste of time to suggest stretches to complement massage. People often perceive them as passive treatment, but treatment can be more effective with the right exercise, and it’s our responsibility to try to optimize healing. It’s unethical to release trigger points and not suggest ways to keep the tight areas loose.

“The remedial exercises will consolidate the gains you get from massage,” I said to another client, as I demonstrated a stretch.

“I don’t have time for that,” he said.

“Okay,” I said, trying to be adaptable and relentlessly positive. “How about trying this stretch for a week? It would help with your neck pain. You can do it in the shower each morning.”

“I’m too rushed in the morning.”

“How about at work you try deep abdominal breathing for a few minutes a day?”

“I’m a government employee,” he said. “They don’t give us time for deep breathing.”

Message received. At least he was making time for massage. He knew I cared and accepted my encouragement with a smile.

There was a time I considered dumping any client who wasn’t with the program. However, blackmail doesn’t set an equitable tone for a therapeutic relationship. Lots of people are exercise-averse and you can’t force them to release tragic memories of a seventh grade gym class.

Instead of nagging another client who prefers not to rehabilitate intermittent pain, he and I joke occasionally about it. I’ve shown him simple stretches and strengthening exercises. If he ever reaches that point where exercise is preferable to pain, I’ll be glad to show him again.

People want massage, not a trip to the principal’s office. At least they can get temporary relief knowing that our therapeutic relationship is solid, no matter their choice. A good rule for all therapists is avoid being more invested in your clients’ healing than they are. It doesn’t mean you care less for others because you refuse to do their work for them.

The latest stage of my evolution began when a client asked me in a foreboding tone, “Are you suggesting I have to do these exercises for the rest of my life?”

My previous answers had been apologetic, even weasel-like, but this time my new answer bubbled up. Its inherent confidence prompted her to nod respectfully. “We all have to exercise for the rest of our lives,” I said.

Maybe someday I’ll have a better answer, but for now I’m doing what everyone is doing—the best I can with what I have now. I’m evolving.