Mary Ann Foster: A few years back, I fell down a flight of stairs and injured my neck and head, so I went to a massage therapist for relief from the pain and trauma. The therapist began with a warm-up massage on my back and then had me turn over. When she looked at my face, she exclaimed, “You have a lot of trauma!” to which I replied, “I know. I just had a serious accident.” She then clarified that she was referring to my childhood trauma, and she offered to help me work on it.

Mary Kathleen Rose: What did your childhood have to do with your current problem?

MAF: I’m not sure. I hadn’t mentioned anything about my childhood. I thought I was clear about what I needed when I set up the appointment.

MKR: I think this is a common problem. A friend called me recently to process her difficulties with a massage therapist who kept asking questions of a psychological nature. This friend felt like she had to convince the massage therapist to give her a massage, and then she had to be vigilant against the therapist’s probing questions during the session.

MAF: In my case, the therapist’s comment about my face put me on guard. It made me feel like a freak, especially since my reality was already altered from the pain and injury. As I walked out the door, my head was not only spinning with pain from my accident, but also with confusion about our session.

MKR: My friend said her massage experience felt like an invasion of privacy.

MAF: The massage therapist’s comment about my trauma not only felt invasive and judgmental, it totally shook my confidence in her as a professional. It was hard to relax with someone who had a different agenda about what she thought I needed.

I’ve found that clients sometimes want me to work with body patterns that develop around psychological issues and expect me to be their personal counselor. A man came to me once for massage, then called three times to ask for advice about personal issues. I suggested he find a mental health professional to get help.

MKR: Truthfully, we can’t really separate people’s physical and emotional needs. They often come for massage when they are feeling emotionally stressed or vulnerable. Sometimes, even just the relief and comfort they feel with skillful touch can bring emotional release. One client of mine started crying during the session, saying, “Nobody has ever touched me like this, with such unconditional care.”

MAF: In that situation, the emotional release happens naturally; all we need to do is validate the person and support him or her in the process. On the other hand, probing for psychological content can be like picking a scab: it can tear open a lot of emotional pain.

I am glad to see that the Massage Therapy Body of Knowledge (MTBOK) document (available at www.mtbok.org) excludes psychological counseling from the massage and bodywork scope of practice. Section 140 of Version 1.0 further bans the “intentional use of techniques to evoke an emotional response in the client.”

MKR: I trust in my clients’ abilities to deal with their own issues. I don’t need to probe, analyze, or fix anything, and I certainly don’t need to inject my opinion into their process.

MAF: When clients have emotional releases, I celebrate the connection they show between the body and mind. Too often people berate themselves for showing emotions. To validate their internal resources, I might say, “You’re OK, really. Look at the fact that you allow yourself to feel your emotions.”

MKR: I have more than once quoted to a client the words of one of my favorite children’s songs sung by Marlo Thomas: “It’s alright to cry. Crying gets the sad out of you.” It’s like taking a shower from the inside out.

MAF: Well put! We can’t help but touch a client’s whole reality with massage, emotions included. Yet, our role as bodyworkers does have boundaries. We can remain client-centered and within our scope of practice, while still respecting the privacy of the individual’s thoughts and feelings.