Living with a Traumatic Brain Injury – my personal journey


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shatteredI wanted to share something that is significant for me, which is my relationship to the world and how a Traumatic Brain Injury (TBI) shifted everything. I hope this offering will provide some insight for someone who lives with TBI, or has someone with TBI in their lives.

In 1995 I was in a serious car accident. I had been a busy and successful practicing massage therapist with a private practice in Boulder Colorado for 5 years. I was on the edge of burning out and a single mom. I went to my dad’s home in North Carolina for the holidays, and was driving home. I was rear ended on the highway heading West in Alabama by a brand new, shiny blue 18 wheeler carrying fuel with a Christmas wreath on the grill. The driver was going about 73mph when he tried to pass me. I was going 68mph. He clipped me. I spun out of control, jumped the median, flew through the air and landed. My son was in the back. He was 6 years old. Upon impact to the driver’s side front corner of the car, my neck was completely rotated to the right as I had my arm over the front seats to try to secure and watch my child in the back seat as we were spinning. When we hit, I  suffered a whiplash in a strained neck rotation to the right with my left ear practically hitting my chest. My son was in shock, and after tests at the hospital he was released at 100%. I was seemingly fine. I had no broken bones, no blood loss, yet something dramatic had shifted. I felt as if I had walked through the looking glass.

What I ultimately learned after all of the tests was that my brain was more or less slammed against the inside of my skull. It was also suggested that some issues in my neck were responsible for the symptoms. The initial stages of my injury and the recovery pulled the rug out from beneath every aspect of my life for a period of 2 years before I stabilized. I suffered a lot of musculoskeletal trauma with constant pain, and I eventually recovered about 70% from that. I have a great deal of scar tissue.  I was told by my health care team that I had suffered a traumatic brain injury specific to my frontal lobe, and the goal was to become functional in life with it. For a period of time, I slept about 12 hours a night, could not remember beyond the normal things we forget and I was a disaster. Losing my keys, not being able to drive, forgetting to turn off the oven, losing my car, missing appointments, forgetting names of people etc. I lost 40% of my vocabulary. The greatest rip off is I feel that I missed my son’s 2nd and 3rd grade years. They are a blur. I can’t remember anything but the struggle of survival during that time. No one understood what I was going through.  I was suffering from PTSD, was dealing with lawyers, insurance companies, in a brutal battle with the trucking company, and was in various recovery treatment 25 hours a week. There was every type of therapy and tons of it. I had become left side dominant, and there were some difficult symptoms that required a lot of new life skills. I have never fully recovered, but with the help of my doctors, specifically the neurologist and neuropsychologist I had learned how to cope with my new brain. Some of my greatest breakthroughs were getting filtered ear plugs to help with focus issues, doing crossword puzzles daily, drinking coffee, and using a computer to hold the memories and important information I could not. Photographs became very important to me.

I also had a lot of musculoskeletal dysfunction and pain from the trauma and I got a lot of bodywork and massage which I could not have made it without. That is another story, the brain injury is what I’d like to focus on for this essay. Many people live with varying degrees of this condition. How your brain is damaged will determine who you are. I have a list of symptoms. I have a short term memory which can be embarrassing and give the impression that I don’t care to remember or that what others shared with me was not important to me. This is completely untrue. I do care. My perception of reality is different. I feel like I’m always half way between a dream state and an awake state. This has never changed since the accident. There was “reality” before the accident, and “reality” after the accident, and my perception of these two realities were vastly different. My sense of smell and hearing is so strong that what these senses are picking up can be completely distracting and maddening. People don’t understand. I can hear everything and it annoys the hell out of me. If I am trying to focus, and I feel bombarded by the hum of my computer, the refrigerator making ice, animals breathing, people clicking pens, etc. It can be crazy making and my anxiety rises. If I am not being mindful of my reactivity, I could be short with one of my kids or husband. I can become extremely agitated if I am interrupted because I’m sure to completely forget what I was talking about.  If I am in a room where someone is wearing oils or perfumes or hairspray it can distract me to the point that I can’t keep my thoughts straight. I FEEL a lot. My list of “A LOT” goes on and on. The reason for this is I have lost some gate keeping. This is not easy to deal with. I feel that I live in the now more than I did before the accident, and I don’t hold back like most people do. This has been a great gift and a great curse. I feel I lack normal self-restraint at times, so I will often take on things reasonable people would not. This has resulted in great accomplishment… and big mistakes. I found my brain was working in different ways. I was using a computer a great deal and I could learn to use programs with ease. I could see, understand, and write HTML. I was able to accomplish sick amounts of work in a very short amount of time, still do. I could see things in life that were normally flat, in dimensional layers, for example, music. When I hear music now, I’m not just hearing the music, I’m hearing the 8 or 9 or 12 layers of the music. My massage therapy palpation perception was suddenly worlds beyond what I had ever experienced before which greatly improved my ability to serve my clients. If it were not for my TBI, I would not have the same accomplishments that I have now. I forgot a lot too, and some of the memories I forgot were those that resulted in victim identification from events in my young life. I had identified completely with self-pity from troubled events in my childhood, and that was suddenly not an issue anymore. I was forced to reinvent myself, and even though I had to repair and rebuild which was painful and difficult, I do feel that my TBI was one of the greatest things that has ever happened to me.

It does not always go that way for people, however. Do you know the many ways a traumatic head injury can affect a person? Have you or your loved one been hit in the head at some point in life? When people begin to explore TBI, it is shocking to consider how many people could be living with a TBI and don’t even know it! Especially children. That issue you have with your child could simply be a misinterpretation of their perception of reality. People with TBI are trying to make it work here in the face of life’s normal expectations, and are often misunderstood. It can be really hard just to feed and shelter yourself.  We don’t have a big bandage on our heads, and so when we don’t meet the normal expectations of others, we can be thought to be self-absorbed, or uncaring.

Everyone with a TBI operates at different levels of functionality. Coping can turn into the opening up of a different kind of brainpower, hence the gift/cursed new reality, and some people hurt badly for the rest of their lives and will need complete support. Consider our homeless veterans. How many of them are suffering from PTSD and possible TBI?

I am lucky. My noodle was twisted just right. I know that if it were not for my TBI I would not have been able to accomplish the work I am today, and I’m grateful for the change that has occurred in me. I hope by sharing my personal experience with TBI someone will be better supported in their journey toward healing and functioning. Here are some other resources if you would like to explore further.

Jill Kristin Berkana

Jill Berkana LMT Founder/Director Berkana Institute of Massage Therapy and Bodywork Passionista

The Ethics of Claims: I wish I knew how to fix this.


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hercules-hydraMassage Therapy in the United States, is in a state of accelerated change, conflict and chaos. Up until 2008 I had been living in a vacuum having a very definitive idea of what massage therapy was, and assumed everyone, for the most part, was approaching it the same way I was taught to, and had been. In the last few years, I’ve been blessed to share with high level massage therapy professionals from all over the United States and beyond… and I would like to share the information I have assimilated, along with my unique historical perspective, and my opinion.

Where I am coming from: I went to Massage Therapy School at the “Harvard of Massage Schools” the Boulder School of Massage Therapy in 1990. I studied there for 2 years. While I was there, I was taught a great deal of science, ethics, bodywork, theory and holistic principles. The school had an emphasis on holism, and taught us that what we were thinking or feeling as we touched our clients would impact the quality of our touch, and what our clients would feel. For example, if I was thinking of the meatloaf I was going to make for dinner during my session, the client would feel I was not present. If I was thinking that my client had cellulite, the client would pick up on my judgmental energy. If I was thinking my client was attractive and I wanted to date him, my client may have a feeling of being violated or aroused. Made sense to me so I became vigilant over my thoughts when I worked, and did my best to stay present.

I had some instructors who were wild dreamers. I had instructors who had trained with the source of traditional modalities. I was taught ancient ideas and concepts that had no scientific evidence, but had been practiced and been helping people deal with the many different types of pain in life for over 5000 years. I learned a bit about Ayurveda, Shiatsu, quite a bit about Neuromuscular Therapy, MyoFascial Release, Swedish, and Integrative Massage Therapy. We learned about Rolfing, Structural Integration, Trager, Feldenkrais, Alexander Technique, Bindesewebsmassage, etc. We learned about transference, counter-transference, projection, and coping. We learned communication skills, body centered therapy, and talked about sexuality. We learned about the human potential movement and our lineage to that group of visionaries. We learned about human disease, how to run our business, how to communicate, and how to move our bodies when we worked. We learned about honor and we learned that since we wanted to touch people for a living, we had to be extremely careful with our boundaries and our own emotional/mental/physical health.

I had instructors who trained me to “ground” myself so I would not pick up my clients energy. I had instructors who told us not to massage pregnant mothers in the first trimester of their pregnancy. I had instructors teach me that massage released toxins and the drinking water after the massage would help flush those toxins out of the body. I had an instructor teach me that sound carries energy and events leave energetic residue that can be diffused by sound. The same therapist used to “sing” the spine, whereas she would make the sounds she could hear in her head when she touched the spine in order to diffuse and open up the energy in that area and create change.

Many of my fellow students were choosing to specialize in energy work. That work was so intense it spooked the hell out of me, so I focused on the body. It was not ALL mystical and magical, there was a ton of college level science too and I carved my path. I was fortunate to train with people I would not hesitate to call Masters. School was exciting, challenging and fun and I bought it all, as did the other 300 or so international graduates per year coming out of that system for 30 years. Naropa University was right down the street teaching Transpersonal Psychology, so we all had access to mental/emotional processing. We were all processing our baggage all the time, and using new and alternative methods to achieve a greater sense of holistic health and wellness.

During this time, my mom owned a new age book store in Boulder Colorado. Her store was an iconic new age hub of information where people could find books on anything and everything from Aliens to Astrology to Crop Circles. There was always a psychic of some kind sitting in the corner ready to tell you the mysteries of yourself. Boulder was extra special in these days. Not unusual to go to a hear a trance channeler speak, and follow that up with a community hot tub experience to watch the aliens land behind the mountains on a first date. It was an era, and I was young and quite gullible. I WANTED and NEEDED there to be magic in the universe because life had been pretty tough. I was not in this desire alone. Many need life to have something MORE…to give us hope. We craved ceremony and community ritual. We craved spirituality and answers to the deep mysteries of life, and we found them. It was an era… and times change.

Flash forward into reality: My dad is a physician. He triggered my desire to help others and to explore the human body. I LOVE science. My DAD helped me latch onto that which is real and can be proven. I went into massage practice and the years went by. I ended up doing an enormous amount of massage therapy and my client’s needs and pain dictated that I became a deep bodyworker. In 1995 I was in a car accident and found that the work I needed to receive was of a core or deeper nature and I sought out therapists who had the ability to touch and manipulate the holding in my deeper core tissues. This continued to develop my propensity toward core tissue manipulation as a therapist.

I have gone on to massage all types of people for 25 years. I have not just touched their body, I have touched their lives. I have listened to them. I have been compassionate. I have seen clients through the death of their grandparents, the birth of their babies, graduate school, their divorce, their second marriage, the birth of their first grandchild and breast cancer. I have been a massage therapist, a loving, compassionate, listening, caring, person who supports my client’s journey into a greater awareness of their relationship to their body and lives by providing touch, unconditional listening and care. I have supported them in finding relief from pain, by helping them discover what conditions are in effect that are leading to musculoskeletal dysfunction = pain, and helped them find ways to change behaviors that are putting those conditions into effect. For whatever reason, the manipulation of their muscular system using my approach provided relief and restoration for them. I have had a deeply rich therapeutic practice, and the work I have done with my clients has taught me 10,000% more than I learned at massage therapy school.

I have grown into a passionate massage therapy educator. Beyond the education I always provided for my clients, I have been training Massage Therapists for 10 years now. Massage Therapy is evolving so fast I’m trying to keep up for the benefit of my students. If I don’t keep up with the evolution and progression of massage therapy I am doing a disservice to my students and I should leave my career. I have tried to stay on top of things, and through the technology of the internet, I’ve been able to communicate with Massage Therapy professionals and experts across the globe. It’s been a real blessing. In the midst of running my school, I’m doing my best to pay close attention to the movement in the profession, and found myself exposed to some interesting dynamics in the U.S Massage Therapy Scene. Here is what I believe I have witnessed.

  1. Canada is, and has been approaching massage therapy as a health care profession. They have high standards for education and competencies for massage therapists. Canadian Massage Therapists are respected by the collective health care community, are reasonably compensated, and are able to serve patients with massage therapy similar to the way nurses and physical therapists are able to serve patients. We can learn a lot from the Canadians.
  1. Due to the sluggish regulation of massage therapy at the state level in the U.S. the varied educational approaches to massage therapy, and the lack of organization by our leadership organizations, Massage Therapy in the United States has evolved into a multi – headed monster. Those practicing come from MANY different schools of thought, MANY different qualities of education, and MANY massage therapists should not be practicing at all. Many who should not be practicing at all have been in practice for decades and are teaching a new generation of massage therapists who should not be practicing at all. From what I have witnessed online, we have 9 distinct groups of therapists. Here is my attempt to categorize and describe my impressions of the groups:
  1. The Incompetents: This is a group of massage therapists who took a 100 – 250 hour course. They did not learn anything about ethics, know nothing about pathology, anatomy or physiology, learned a few Swedish strokes and somehow fell through the cracks of the regulatory system and are in full blown practice making huge errors with their clients every single day. Many in this group have great intentions, but don’t know the first thing about universal precautions or hygiene etc. because they were never taught.
  1. The All Powerful Healers: These are those who claim to be doing some form of magical special healing that is associated with massage therapy or bodywork with the agenda to heal, and a claim that they can.  They have major ego issues, and a story. They have told the story about their magical special powers so many times that they believe it. They may have a certification or training. This usually involves the manipulation of what they call energy. They claim they can feel your energy from a distance and have the nerve to diagnose you from afar. They have beliefs that I would classify as religious or spiritual, but they have no boundaries with their clients and actually use their spiritual or religious beliefs to work with and manipulate clients. These people are dangerous. Clients who benefit from this type of work are probably benefiting from the placebo effect. They believe it and so on some level it works for them.
  1. The Scientists: This is a small but growing group of great minds that have good intentions to abandon the dark ages of bogus claims and woo woo in Massage Therapy. It is my impression that if you do not subscribe to exactly what they are declaring, you should be exiled from the world of Massage Therapy. I believe the Science group feels that if you are not of the science group you are a FREAK (see above). From what I gather (and I may be wrong) these folks want more of what Canada has. The science group believes nothing should be taught or practiced that has no bases in solid scientific evidence. Here is what I have gathered (from minimal exposure) are some of the reasons behind their goals.
  1. Indigent people cannot receive massage therapy through socialized programs, and they should have access.
  2. Many “therapists” are being unethical by making false claims.
  3. The public is hurt by the false claims.
  4. We (massage therapists) look ridiculous when associated with sooth sayers and snake oil salesmen.
  5. Other members of the health care profession do not take us seriously, and this prevents massage therapy from getting to those who need it the most.

My impression is also that they want Massage therapy to be a globally defined, standardized and consistent as a health care profession.

This is an extreme group, and they are making people aware of things that must change. Unfortunately, in the process, they are wanting to eradicate anything and everything that is not scientifically proven. This threatens a great percentage of the massage therapists who are practicing ethically and effectively today. I would love to see the science group build a remedial education bridge to ethical massage therapists who are making a positive impact on their client’s lives without trying to eliminate them completely. I believe that some of the massage therapists making false claims are doing so not because they are bad therapists, but because that is how they were taught. These people deserve patience and re-education.

When myths are debunked, and new evidence becomes available the masses of massage therapists in the US need to be reached and educated. I would like to think our leadership organizations would be able to pull that off. Schools need to be absolutely clear to teach the Ethics of False Claims, the importance of staying up to date, and Ethical Codes need to include some language stressing the importance of this. I hope the science group will realize that you can’t dig a big hole and throw everyone in it that is not 100% with them. As far as I’m concerned this is an Ethics, Scope and Boundary Issue. Some people need to be brought up to speed. Many others are doing incredible work right now that is not all based in evidence, but does not promote false claims.

  1. The Cogs: These are the massage therapists who were recruited off of their couches by a television commercial at 3:00am to go to X, Y, or Z Corporate Massage School/Diploma Mill, got a huge student loan, made it through massage school, and got a job at a franchise. This “chew them up and spit em out” branch of massage therapy is all about the franchise and many of these therapists will have a shelf life of 3 years. It’s a sad state of affairs for this group. Luckily there are exceptions to the rule. Some of these MTs will escape the franchise and discover something deeper within themselves, connect with an amazing mentor or continuing education and jump the exploitation track to get a job that is worthy of them. Most of these graduates are not qualified at entry level to work with all demographics.
  1. The Ethical Linear Massage Therapists: This group of massage therapists were not taught about holistic principles, power of intention, bodywork as art, psychology, and seem to do beautiful work providing massage therapy without that knowledge. From my perspective, they simply come from a different school of thought, and help a lot of people by providing ethical and professional massage therapy. They do not make false claims. They are compassionate, supportive, knowledgeable and professional massage therapists. Holistic Massage Therapists and Linear Massage Therapists have difficulty collaborating and/or in peer review because their foundation, and what is critically important to them philosophically is completely different.
  1. The Ethical Holistic Massage Therapists: These are the massage therapists, like myself, most of my colleagues, and all of my students, who do not make false claims, and approach massage therapy as a holistic healing art. We integrate traditional and modern techniques to serve our clients ever changing needs. We would not have the audacity to assume or claim we understand the magnitude of what is happening when we touch another human being, nor would we limit it by trying to define it. WE understand that our intent is extremely important because we are interacting with human beings who have feelings, and who will be able to be more vulnerable when with someone they trust, and who they know cares for them. We know we must be knowledgeable and stay appraised of, and integrate new scientific evidence that is being introduced, and drop what we learned decades ago that has been proven to be mythological. We follow ethical codes at a high level, continue to learn, and study the human body, somantics, psycho/emotional phenomena, and we practice self-care to the point that we work with our own issues so they we don’t project those onto our clients experience. We honor a strict set of hygienic and record keeping practices. We represent the profession at an extremely high level whether we are in the treatment room or not. We are authentic in our compassion for the human condition. Emotional, psychological, mental and physical boundaries are honored at all times. We can adapt to practice work, spa work and a medical environment. Partnerships with mental/emotional health care teams are especially positive and productive.
  1. The Ethical Energy Workers and/or traditionalists: These are the energy workers who do not make false claims. They are using traditional or modern methods of energy focused bodywork and they inform their clients of the rich history, limitations, and unproven nature of the method. They often will share the benefits clients have experienced from receiving the work. They would never recommend treatment in lieu of medical treatment for medium to high risk conditions. There have been many scientific studies done on the manipulation of electromagnetic energy which are worthy of exploring. As far as I’m concerned, the jury is still out.
  1. The Medical Massage Therapists: These are our new cutting edge progressive pioneers who are carving our path to the medical environment. They are setting new standards for performing massage therapy in hospitals and other treatment facilities. They are helping us learn how to adapt our approach so that we can serve the patient population who can greatly benefit from massage therapy when their health requires medical intervention.
  1. The Revolutionary Inventors: These are the educators who have invented or developed something new that is going to change the face of bodywork and massage therapy forever. This is nothing new. We have a new 3 letter acronym titled modality and methodology show up every month or so for the last several years. I even have my own method that I teach to my students who want to know more about my approach. Students will gravitate toward the mentor and method that resonates with them the best, and specialize in it. They will attract clients and help them or not. The method works or it does not. In the end, it’s not likely that any one method is going to save or change the entire massage therapy world.

Regardless of what I think or how I am categorizing the groups I have encountered to try to make sense of it all, and regardless of how you feel about my opinionated opinion, one thing stands absolutely clear. If you are a massage therapist or bodyworker who is making false claims, YOU are the problem, and you will be the catalyst of a great transition that passionate stakeholders will continue to demand, that Massage Therapy in the United States is a respected health care profession that everyone has access to. Why would any of us who really care about people and know the benefits of massage therapy dare to stand in the way of that?

I know that as an educator, I am rapidly revamping my program to align with this new culture so that my students will be ready to serve at a level that I never have before.

If you are operating from an agenda to heal your clients with your magical special powers it is time that you do a personal and professional inventory, redo your literature, your website, even your business name and start to be vigilant over the claims you are making, and the words coming out of your mouth that can do incredible harm to your clients and to the profession of Massage Therapy. Time to get with the program, or get out.

Jill Kristin Berkana

Jill Kristin Berkana LMT Founder/Director Berkana Institute of Massage Therapy and Bodywork Passionista

Boundary Issues Online: A plea to all Massage Therapy Professionals to step up our game.


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a_line_in_the_sand_by_raindropsonthewindow-d2ye4keI have spent quite a bit of time on the Massage Therapy Boards on Facebook in order to share, gather, and exchange information. It’s been incredible and awful. Before I dig into the “awful” which is what this blog post is about, I just want to take a moment to celebrate the good stuff.

I have learned so much about the massage therapy myths that I was taught, and continued to propagate with my students. I have been able to correct my own belief system, and share the new ideas with my current students and Alumni. I want to stay on the cutting edge as we evolve.  I’d like to call that a huge win!

I have been able to connect with other massage therapy school owners about the content of our programs, our challenges and victories with our schools. We have created a supportive network. I call that a HUGE win!

I have been able to have daily conversations with mentors I never dreamed I would ever meet. win, Win, WIN!

I’ve been able to stay on top of the many shifts and changes going on at the massage therapy organization/political level, and I’ve been able to call out injustices that I feel are hurting our profession. Working towards a WIN.

I have shared my opinions extensively which are based on my personal/professional experiences, and I hope I have been a positive influence in someone’s life. I call things as I see them, and sometimes I’m right, and sometimes I’m wrong. If I find out I’m wrong I’m willing to look at myself and try to grow. I’m also willing to say “I’m sorry”. Growth is not always an easy task… but in the end, why else are we here?

As I have been cruising and participating on the massage therapy interweb, I’ve come across a basic negative theme that I’d like to bring to light now. I’d like to talk about professional boundaries, or the lack thereof, online. What I’m going to share with you I’m not 100% clean with, myself. I have participated in some of the Boundary Infractions I am listing, and hope to be a better example starting now. Social Media is a new world, and we are learning.

When I went to massage school in 1990, on the first day of class we started to explore the world of boundaries. Since then, boundaries have been a huge part of my life. I try to understand where boundaries are… mine and others, and I try to honor other’s boundaries and have my boundaries respected. Teaching Boundaries at my school begins on day one and is a constant thread through the entire education.

Being able to perceive and understand (mindfulness) boundaries, and respecting them is the most basic form of actively practicing ethical behavior that we have. Frankly, if a massage therapist has not cultivated the critical skill of determining, understanding and honoring boundaries, they missed a vitally important developmental milestone.

So what is a Boundary? Merriam Webster defines a boundary in this way:

a line that marks the limits of an area; a dividing line.

a limit of a subject or sphere of activity.

synonyms: dividing line, divide, division, borderline, cutoff point

We start to learn about boundaries as toddlers, and we learn about boundaries in kindergarten. Our education in boundaries continues as we become adolescents and adults. Once we arrived at Massage Therapy School, BOUNDARIES should have become a critical topic from the beginning. From what I have experienced in the massage therapy community here online, I have grave concerns that many MANY massage therapists did NOT learn the basics of professional boundaries, and we may have a need for remedial training as our profession strives to improve.

Here are some boundary infractions that I have repeatedly witnessed online:

  • Massage Therapist’s public profile does not support the professional massage therapy image.
  • Massage Therapists treat each other with disrespect.
  • Massage Therapists make false claims.
  • Massage Therapists pushing products.
  • Massage Therapists breaking client confidentiality.
  • Massage Therapists diagnosing.
  • Massage Therapists judging and being cruel to one another.
  • Massage Therapists and other holistic health care professionals being passive aggressive with manipulative self-promotion.
  • Massage Therapists projecting.
  • Massage Therapists sharing stories describing that they were clearly out of scope of practice.
  • Massage Therapists sharing stories where they are clearly involved in counter-transference.
  • Massage Therapists sharing stories about their clients which demonstrate they are working with clients who they resent.
  • Massage Therapists and other health care professionals slandering other professional individuals.
  • Massage Therapists projecting their agenda and limited belief system about our profession onto everyone else in the profession.

In the broad examples I have stated above, not only are massage therapists crossing boundaries, but they are frequently breaking professional ethics. Here are some examples of the aforementioned boundary infractions and the potential damage caused to the public professional image of Massage Therapy, and the Public in general.

BOUNDARY INFRACTION: Massage Therapist’s public profile does not support the professional massage therapy image.

EXAMPLE: The massage therapist has not figured out how to separate professional from public communities on their Facebook page. They have friend, family, colleagues and clients all pooled into one friend list. They are making it known they are a Licensed Massage Therapist on their profile and have some professional posts and photos, right next to the photos of them pole dancing in Aruba wearing a bikini and having tequila sucked out of their belly buttons by ½ a dozen busboys.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: This therapists is sending the wrong message to the public about how massage therapists behave. Clients will become confused and you may be spreading the sex/massage connection myth. If you wish to have content on your Facebook page that could be perceived as sexual, PLEASE do us all a favor and learn how to use your restricted list and share your Aruba photos only with your friends and family. As a side benefit, you will probably find that those clients that keep on trying to cross YOUR boundaries in practice will start to fade out.

BOUNDARY INFRACTION: Massage therapists treating each other with disrespect.

EXAMPLE: A Massage Therapist questions the integrity of another massage therapist publicly online.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: The public is watching. The public will not trust us or feel safe with us if we are publicly abusive to one another.

BOUNDARY INFRACTION: Massage therapists making false claims.

EXAMPLE: A Massage Therapist claims that if you eat essential oils you will be protected from Ebola.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: This is extremely dangerous and unethical. You make the rest of us look like reckless idiots, and you are doing harm to anyone who takes your unsubstantiated advice.

BOUNDARY INFRACTION: Massage therapists pushing products.

EXAMPLE: A Massage Therapist spams their entire friend list to sell blue-green algae AND they are making false claims about the benefit.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: The public gets the idea that we are snake oil salesmen.

BOUNDARY INFRACTION: Massage therapist breaks client confidentiality.

EXAMPLE: The Therapist posts about their client who was just in a car accident, or their celebrity client.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: Even if you have permission from the client or the client’s family to post such things, other massage therapists see this behavior and think it’s okay to brag or make drama at their clients expense. This also can have the effect of challenging the public’s impression of how we manage confidentiality. We lose respect as a profession from other health care providers. Please place your testimonials where they belong.

BOUNDARY INFRACTION: Massage therapists diagnosing and prescribing.

EXAMPLE: Telling another person that you can feel their energy and you think they are operating from a place of victimization and fear. You recommend Bach Flower Remedies.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: Breaking our professional rules of engagement make massage therapy professionals appear to be flaky, unprofessional and unethical, as well as reckless with the public well-being. The public and other health care professionals are seeing this and deciding where Massage Therapy stands in the grand scheme of things.

This Massage Therapist is completely out of scope and can put individuals with particular pathological signs and symptoms at risk for believing the MT knows what they are talking about, and may follow their advice. Additionally, one can send someone who is more fragile into an emotional/psychological tailspin all for the therapists temporary and ungrounded power trip.

BOUNDARY INFRACTION: Massage therapists judging and being cruel to one another.

EXAMPLE: Massage Therapists don’t agree on the point, they take it personal and publicly argue.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: The public is watching. This lack of self-control and inability to have civilized and respectful conversations reflects poorly on our profession.

BOUNDARY INFRACTION: Massage therapists and other holistic health care professionals being passive aggressive with self-promotion.

EXAMPLE: A Massage Therapy professional tries to make their interaction on the boards appear to be neutral, but their agenda is to sell a book, a workshop, a class, or a product.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: This is manipulation, and it just makes massage therapy professionals look tacky. It’s fairly easy for anyone but the manipulator to see through the thin veil of ulterior motive. If you want to sell something, find the appropriate marketplace and be honest and direct about your intention. If you have to trick someone to buy your product, your product is probably is not worth buying.

BOUNDARY INFRACTION: Massage Therapists projecting.

EXAMPLE: A Massage Therapist has not worked through their own issues with their own body and refuses to massage the abdomen of clients. Therapist makes a statement online that it is her prerogative not to address the abdomen and if her clients don’t like it they can find another therapist.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: This just makes us look like a bunch of incompetent idiots in the face of the public, and other health care professionals. How this Therapist graduated from massage school… I’ll never know. This type of post propagates self-loathing and body issues, and fear of judgment with potential clients. This therapist needs to stop massaging and get into therapy to resolve this issue.

BOUNDARY INFRACTION: Massage Therapists sharing stories where they are clearly out of scope of practice.

EXAMPLE: The Therapist makes a diagnoses on-line of a sprained ankle.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: The person reading the post may not seek a physician’s diagnoses, and thus receive the care needed to heal properly. Additionally, the public receives a confusing message regarding our scope of practice, and we as professionals appear to be unethical and flaky in the eyes of other health care professionals.

BOUNDARY INFRACTION: Massage Therapists sharing stories where they are clearly involved in Counter-transference.

EXAMPLE: The Massage Therapists posts how angry they are that their client is late again.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: Personalizing the Therapeutic Relationship is always bad for the client. If you allow your client to cross your boundaries to the point of having anger and hurt feelings then the therapy should not continue. You should have professionally addressed the issue the first time and either have the behavior stop, or end the therapeutic relationship if the behavior continued. This post can confuse other therapists regarding their feelings for their clients, and the public can be exposed to a very unprofessional image of the profession.

BOUNDARY INFRACTION: Massage Therapists sharing stories about their clients which demonstrate they are working with clients who they resent.

EXAMPLE: Massage Therapist repeatedly posts how unhappy they are at work.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: The public is exposed to the possibility that their massage therapist hates what they are doing when they massage them. This reflects poorly on all of us.

BOUNDARY INFRACTION: Massage Therapists and other health care professionals slandering other individuals.

EXAMPLE: Massage Therapist or other Health Care Professional names an individual in a post, stating a behavior that is negative and untrue.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: This hurts the public perception of Massage Therapy as a peaceful and helpful profession, and makes us look like we are at odds, and aggressive toward one another. This is also potentially illegal and the Therapist could be found to be libel.

BOUNDARY INFRACTION: Massage Therapists projecting their agenda and limited belief system about our profession onto everyone else in the profession.

EXAMPLE: Educators treating each other with disrespect and lack of esteem, preaching their way is the ONLY way when their background is limited to their experience, region and education; and neither can fully comprehend the road the other educator has traveled or the depth and breadth of their experience, region, and education. There is a great deal of assumption going on here, and a power struggle ensues.

HOW THIS HURTS OUR PROFESSION AND THE PUBLIC: Educators arguing and debating on Facebook is just an embarrassment for all of us. This should not be a competition, but a respectful meeting of the minds with an honorable approach to accepting and sharing our differences with curiosity and appreciation. We should all be open to growing and learning from one another for the betterment of our profession.

In the end I want to encourage all of us to do our best to BRING our best. We need to be mindful of who we are as a collective profession, and step with care each and every time we post. We need to consider, WHO is reading this and how will this impact that individual. The moment we all became Massage Therapy Professionals is the moment we started to represent the profession.

If you got into this profession because you wanted the freedom to express yourself without reservation or limitations, I’m sorry to say you were wrong. If you wish to stand with pride next to all of the other amazing massage therapists in the world, you must walk your talk and mind the rules… inside the treatment room, outside the treatment room, and ONLINE!

Please, let’s all try to do better. I will! ❤

Jill Kristin Berkana LMT

Jill Kristin Berkana

Founder/Director Berkana Institute of Massage Therapy and Bodywork Passionista




The Cultivation of a Therapeutic Voice


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soundWaveHave you ever known someone whose voice irritates you to your core? Have you heard a voice that was so suggestive you felt sexually stimulated? Can you recall when you heard a voice that was so soothing, it put you to sleep, or alternatively one that startled you to a state of attentiveness?

Human beings who have the ability to hear have heard and reacted to all types of voices and voice inflections. This article hopes to inspire you to consider how your own voice and voice inflection, including tonal quality and volume might be impacting your massage practice. If you have not considered this, now is the time. Your voice alone can sabotage or support your success in this profession, especially since our client’s senses are all heightened when they are receiving massage therapy.


You have a different voice you use with your mother, your child your employer and your lover. You have a different voice you use when you are yelling at the dog and lulling a baby to sleep. As a massage therapist, you must also use a correct voice for your massage therapy clients. This is another mindfulness practice. Here is a list of should-nots to help you find your way:

  • Your voice should not be irritating.
  • Your voice should not be too “breathy”, for lack of a better word.
  • Your voice should not be too loud.
  • Your voice should not be too soft.
  • Your voice should not be too sexual or sensual.
  • Your voice should not be coming out of your nose. Work with bringing your voice into your chest and engaging your diaphragm. If you need support with this, see a voice coach.
  • Avoid repeating trendy words or phrases like “gotcha”, “for sure”, “absolutely”, “totally” and “awesome”. This really belongs in an article on communication skills. I’ll leave it in nonetheless, because this can be a pet peeve for certain clients.

Work with the cultivation of your professional therapeutic voice and be sure to use that voice on your voice mail recording as well.


At the Berkana Institute of Massage Therapy, I have included a great deal of student presentation in our classes. When the students present, the information presented is always educational for the audience, however, the real goal is for the presenter to have the opportunity to fine hone their presentation and public speaking skills.

I have repeatedly stated in my blog that as a massage therapist you are not just going to have clients magically appear on your massage table. YOU have to get them there. You will do this by either convincing someone to give you a job or a contract, or by recruiting clients to your very own practice. How is this done? We must present our story to our public. The “story” includes:

  • who I am
  • what I do
  • why you want what I do
  • how to get it from me

We must be adept, warm and friendly, confident and authentic in our presentation style. Here is a list of regular feedback I always give to my students when they speak publically.

  1. Do not read off of your notes.
  2. Make eye contact with your audience.
  3. Project your voice.
  4. Dress for success.
  5. Smile and have a relaxed but healthy posture.
  6. Do not fill every single moment of silence with Um, Uh or AND. The silent moments will keep your audience engaged, and remember this, music is beautiful because there are pauses between the notes.

These points of advice are standard in public speaking education.


There is one very big problem that I think many are not aware of. It is a use of rising intonation in speech that makes a person sound as if they lack intelligence and have no idea what they are talking about. It’s extremely common with young adults, and more so with women than with men. I call it “speaking in questions”.

I’m not quite sure where speaking in questions was born, but I suspect it came from the 80’s and from somewhere in California. Speaking in questions looks like this.

When one makes a factual statement such as “my name is Jill”, they make that statement with a question inflection. When one speaks in questions, their voice inflection will go up a few curved notes upon the end of the statement so it sounds like they are asking “my name is Jill?”

When this voice inflection is used at the end of a statement, it sounds like the person does not know what they are talking about.

Everyone has heard this before. Here is another example. “Hi? I charge $80 per hour? My office is at the corner of Vine and 17th? I’d really love to see you and give you a massage? I specialize in Trigger Point Therapy?”

Hmmm. I think I’ll find another therapist.

Please listen to yourself speak, and if you find you’re speaking in questions, please stop. I know this is hard, really I do. My 7 and 10 year old are working it out and you can too. It will be to your benefit to start to speak like you know what you are talking about.

I hope this advice helps you! May your voice be music to your client’s ever relaxing ears, and a great tool to add to your marketing toolbox!

OH! You SAY you are a Massage Therapist, EH?


I live to serve.Anyone who is a massage therapist knows this. There are times when you introduce yourself, or are introduced as a massage therapist, and the person’s reaction is to literally turn their back to you and in one way or another, lean into you and directly or indirectly indicate that you are going to work with them right there in that moment.

I’m not sure how other massage therapists respond to this, but my reaction is to have an internal secret moment of “HA HA HA HA HA! ummmm no.”  I then compose my internal dialogue with a deep breath and politely inform the person, “I can’t work with (not to be confused with on) you right now, however, if you would like to receive a professional massage therapy session with me you can call and we can schedule a session. I’d love to hear from you.” If you feel like it, you can go into “my specialty is _______ and my office is only a mile from here. If you have specific complaints we can address those when we meet for your appointment” I would say this while handing them my card. Now, in this modern day of smartphones, you could schedule them on the spot. Not my style, but may be yours.

If this is at a bar, and this does seem to be a potential client, I will most likely change my location to distance myself from them so they are not witness to any of my personal activities, or at least behave with a higher level of awareness of my professional representation.

Massage Therapists who will give a spontaneous massage at a party, or at a bar, or a neck rub at the beach etc. to strangers and potential REAL clients are doing a disservice to our profession. It may seem counter-intuitive to the massage therapist, but they are also sabotaging their own client recruitment. It’s one thing to work with your friend at the beach, or help your relative or close friend out in any location when they are in need, giving 5 or so minutes of specific treatment. That’s different.

When a massage therapist provides treatment for strangers in a non-professional environment, it hurts the profession. The therapist is indicating that we do this for free any chance we get, and whenever some-body turns their back to us we are ready to serve their needs. You don’t see dental hygienists pulling out their dental scaler, dental floss and a spit bowl at a bar, do you? Mortgage Brokers don’t whip out documents to be filled out and signed at the bar, beach or a concert or anywhere other than their desk. They don’t do this because they are professionals, and it would be a completely ridiculous thing to do.

We too are professionals, and when professional massage therapists demean our profession by performing massage therapy in a non-professional public place on the spot with potential clients it sends the wrong message to everyone about who we are, what we do, and how we value it. Furthermore, it is totally unethical because you do not do a thorough intake and you don’t know what contraindications, or medications the client presents with or are taking. If this is in a resort of bar setting we must avoid working with people who are intoxicated in any way, and chances are something has been ingested or smoked.

In closing, I will just add something completely random that unfortunately I feel compelled to say.  If you are at the Phish Show, one burrito is NOT a decent trade for a massage, however, if you have your massage chair at the phish show, and you receive 5 burritos, and the person trading the burritos is not tripping on psychedelics this may appear to be a decent trade for a 10 minute massage. I highly recommend before you enter negotiations on this barter situation, consider this:

  1. You are there to provide massage therapy and market yourself.
  2. Burrito guy is NOT regulated by the health department.
  3. You are going to eat onions and garlic.
  4. You might have to use the porta potty.

Please help keep Massage Therapy Professional! Seriously.

“Let me look at your shoes” a super easy MT hack for basic gait and postural assessment.



7357582_f520As massage therapists part of our job is to help our clients become aware of, take responsibility for, and change behaviors that interfere with their ability to have a healthy relationship to their bodies. Many of our clients come to us because they have musculoskeletal pain, and often that pain is a result of unhealthy movement and postural patterns.

Unhealthy movement and postural patterns are a result of LIFE, specifically trauma and conditioning.

Trauma: We are born through trauma, and for the entirety of our lives we experience different forms of emotional, mental, and physical trauma. Every type of trauma can lead to physical compensation patterns.

Other Stuff: Trauma is not the only thing that can lead to postural or movement dysfunction. We also have cultural modeling, and overuse due to occupation or lifestyle to point to.

Whether it is overuse from lifestyle, occupation, cultural modeling or trauma the result is that everyone on the planet has some type of postural and movement dysfunction which can ultimately lead to pain in the musculoskeletal system. I like to call this job security.

When a client presents with a complaint of musculoskeletal pain we can sooth and support by providing the basic massage therapy manipulation we massage therapists provide in a session, but there is oh so much more we can do to support our clients in changing behavior that leads to pain from movement and postural dysfunction.

Truly, if we do not empower our clients with some form of awareness and self-care to move them into a healthier relationship with their own body and life, we are missing a huge opportunity to serve them. We are here to help long-term, not just apply lotion, rub, collect fee and reschedule.

We can interview, assess gait, do ergonomic assessments, assess posture, etc. and that’s all wonderful. The intent of this article is to share a very simple assessment hack that can provide a ton of feedback and support the fascinating and unfolding story of what is going on with your client, and how we can help them.

Look at their shoes!

  • Ask your client if you can look at their shoes. If yes…
  • Pick them up and look at the soles.
  • Compare one sole to the other. Is one more worn out than the other? What does THIS tell you?
  • Are the soles worn evenly, or is there some type of deviation?
  • Look closer…
  1. Are the shoes worn on the inside edge bilaterally or not?
  2. Are the shoes worn on the outside edge bilaterally or not?
  3. Are the shoes worn under the big toe bilaterally or not?
  4. Are the shoes worn at the inside of the heel bilaterally or not?
  5. Are the shoes worn at the outside of the heel, bilaterally or not?
  6. Are the shoes worn down in the middle of the arch, bilaterally or not?
  7. Are the shoes worn down evenly on the entire shoe, bilaterally or not?

Here is where things get interesting and your curiosity and that of your client’s should be stirred.

What I have found to be consistent imbalances over the span of my practice:

  • If one sole is worn out more than the other we have a pretty big indicator of favoritism of sides here. At this point I would ask my client, are you right or left side dominant. Counter-intuitively, often the side that is not dominant is the one that is carrying the weight. Being a mom I know that I did the heavy lifting with my left side (kid on hip) while my right dominant side had to manage details (putting the key in the front door). I will then explore with them if they have ever injured the side that the sole is not worn on. Sometimes, information comes up that is very helpful in determining a treatment plan.
  • Are the shoes worn on the outside edge bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as lateral muscular aspects of the lower body in a state of hyper-tonicity with ischemia, and weak medial muscles including the adductors. This is a good time to explore the knee stabilizers and maybe check the tracking of the knee.
  • Are the shoes worn on the inside edge bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as medial muscular aspects of the lower body in a state of hyper-tonicity with ischemia including the adductors, and weak lateral muscles including the abductors. This is a good time to explore the knee stabilizers and maybe check the tracking of the knee.
  • Are the shoes worn under the big toe bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as medial and anterior muscular aspects of at least the lower body in a state of hyper-tonicity with ischemia including the quadriceps, and weak posterior muscles including the hamstrings. This is a good time to explore the hip flexors, abs, check for forward head posture, TMJ and especially the illiopsoas for issues.
  • Are the shoes worn at the inside of the heel bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as medial and posterior muscular aspects of at least the lower body in a state of hyper-tonicity with ischemia including the soleus, gastrocs, hyperextention and medial rotation of the knee, short internal hip rotators, and tight hamstrings.
  • Are the shoes worn at the outside of the heel, bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as lateral and anterior muscular aspects of at least the lower body in a state of hyper-tonicity with ischemia including the peroneals, and lateral rotation of the knee, short external hip rotators, specifically piriformis may be an issue.
  • Are the shoes worn out on the entire sole bilaterally? This indicator will often show up as the need to get new shoes! 🙂

You can always attempt to replicate where they are favoring the weight on their feet to give you clues of where holding might be. In the end it seems whatever point that is being favored on the foot sends a line of tension through the body with corresponding tightness, and weakness in the antagonistic muscle groups.

An amazing instructor of mine once told me that whatever is going on in the feet will always send repercussions throughout the entire body. Having recently experienced my own foot surgery which resulted in false sciatica pain syndrome due to my protective and compensatory gait, I really get it. I can’t stress how interested you should be as an Massage Therapist in your client’s shoes…and the older the shoes the better!

Finally, you can help encourage your client to become more aware of their movement patterns and work towards balance in their body through stretching, strengthening, and receiving consistent awesome bodywork and massage therapy from YOU! As always, a mindful, and compassionate approach will support the highest level of success for you and your client.

Jill Kristin Berkana

Jill Kristin Berkana Founder/Director Berkana Institute of Massage Therapy and Bodywork Passionista



Dear Massage Therapy Clients

594990Dear Massage Therapy Clients,

Many of you are being played. Here is the game.

  1. Some Massage Therapy Schools require Federal Financial Aid in order to entice students to attend and thus have the tuition income needed to survive.
  2. In order for a school to qualify to offer Federal Financial Aid, the school must demonstrate that a certain percentage of their graduates will have job placement.
  3. Many of these Schools will partner with huge chains of Massage Franchises to fulfill this job placement requirement.
  4. Those Franchises then hire the graduates and pay the therapists substandard wages, claiming they are “green” and need experience.
  5. The Franchises pay their therapists $12-$17 per hour (plus tips) to provide YOUR MASSAGE. The rest of the money you paid goes to “overhead” which includes large executive salaries, big parties, huge conferences, and massive advertising campaigns that have little to no benefit to the therapist who gave you YOUR MASSAGE.
  6. You pay about $50 for the massage, but you are getting a $12-$17 massage value.
  7. The massage therapists can be overworked in order to make ends meet working for these substandard wages, can burn out and this can have a negative impact on the quality of the massage you receive.
  8. If you are lucky enough to work with someone at one of these places who HAS gone to a school that cares, and who HAS been in practice for a while, you are still getting a$12-$17 massage.
  9. If it makes you feel better about the arrangement, you can add on the $10-$20 tip you are paying. So… you are paying $60 – $70 per hour for a $22- $37 massage.

Your massage therapist is ONLY going to give you what they earn. They have to pace themselves. They might have to do 6 massages a day working in this atmosphere just to start to pay the rent, AND many must have another job.

Be a Discriminating Massage Therapy Client! You are paying for a service, you are making yourself vulnerable and you have options!

  • Work with Amazing Independent Massage Therapists! If you are looking for one in your region, let me know!
  • If you DO prefer the spa environment, please avoid the HUGE Corporate McMassage Chains that are notorious for exploiting massage therapists, and have incalculable client complaints. There are many wonderful locally owned Spas that will take care of you AND their Therapists!

As for the Groupons, Specials, and Contract Arrangements…when it comes to giving someone permission to touch your body and your whole life do you REALLY want a bargain?

And one final thought… Until you have the opportunity to build a long term relationship with a Therapist who you have seen over and over again, you really have not experienced the true benefit of this amazing therapeutic relationship and the work that can only happen once that deeper rapport has been established.

Receive the unlimited benefits of Massage Therapy, and… Don’t be a chump!

What you COULD earn as a Massage Therapist. Another perspective…


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New-PerspectiveSince I’m a massage therapy educator I try to keep my finger on the pulse of trends, reports, and articles that come out regarding the profession of massage therapy and bodywork. One thing I’ve been paying attention to are the polls that report the state of our industry, such as employment rates, how long someone stays in the industry and how much they are earning. Just recently I have seen some numbers come across that literally made my stomach hurt.

When I enter into a commitment with a student to provide an excellent training that will enhance the quality of their life, I take that to heart. I enter into an agreement with each and every one of my students to teach them to succeed. I am completely invested and attached to their success. My entire team is.

Recently,  some polls revealed that massage therapists were not making enough money to survive. I have also come in contact on Facebook with many massage therapists who are complaining about how little they are earning.  This has deeply troubled me, because I am trying to live with integrity. I could not stop thinking about the “fact” that I was selling this education with the promise of a dream that, according to these polls, was not going to come true. What was the most upsetting to me was the hourly wage the massage therapists were reportedly earning. This is not only having a negative impact on the Massage Therapist, but also on the public. If a Massage Therapist is earning sub-standard wages, the client is receiving sub-standard bodywork.

Here are some of those numbers that have crossed my desk:

The other day I had the realization that these polls did not represent my students and my program. None of my students had been surveyed. These surveys represented other school’s graduates, not mine. I considered the value of doing my own survey of my graduates, and that is what I’ve done.

Once the results were in, not only did I feel blameless, and validated, I also felt inspired to continuing doing exactly what I’m doing. Through this process, I have learned a lot about surveys and statistics. I’ve always been pretty good with numbers, but the science of statistics is a big world. While statistics are fascinating, it’s very difficult to get to what is real or “the truth”. I have found that in the case of my survey, there is no black and white, however, there is enough information to make an assessment. I have consulted with a brilliant advisor of mine, (I’m terrific at having plenty of those around) and I also spoke with a Statistical Consultant for half an hour. That is the extent of it.  I have put in this additional bit of effort because I know this survey is going to blow some minds. The numbers are looking fantastic from my perspective, especially compared to what has been reported recently thus far.

This is a simple survey and I have gotten out of it what I wanted to get out of it. If you want to look at it, please be my guest and you can make up your own mind what you think. Hopefully you will get some value out of it too. This survey is not intended to be an official anything. I don’t have time for that. It is a simple survey of my graduate’s experience. The most important information I received from them is that 100% of them are happy being a massage therapist. I am a very lucky woman to have been a part of their journey.

If you do want to look it over, please consider these precept or assumptions.

  1. Because some massage therapist will report tips and some will not, we are not adding tips to any of the numbers to inflate the hourly rate. Just know that the number may or may not include tips. This will keep the survey numbers on the conservative end, so we can have an “at least and maybe more” number.
  1. When they reported a range, for example they are doing 10-20 massages per week, we went exactly with the middle unless the middle was odd then we rounded down.
  1. We are assuming no overhead or taxes have been taken out, so these numbers are GROSS, and we assume that most Sole Proprietors, or Self-Employed Massage Therapists have overhead. (est. max 25% before taxes) You can probably pick out who the Sole Proprietors are just by looking at their earnings.
  1. We are going to assume that many participants will slightly exaggerate, because that has been proven to be a perpetual human condition in survey taking.
  1. We are going to assume that the people who are earning best are going be more willing to participate in a survey, and those who are not, will not be as enthusiastic to participate.
  1. The sample survey population is 83 of 213 or 38.5% of MY GRADUATES. I’m pretty happy about that. Thank you all for participating! I’m not including my current students because they are not in the field.
  1. Many of these massage therapists are working part time, with full time being considered to be 18-25 hours of hands on massage time, and many are part time which would be anything from 1-17. Several are raising a family, and/or have other career endeavors.
  1. Every price on this survey is PER HOUR OF MASSAGE WHAT THE THERAPIST SAID THEY ARE EARNING, (not charging) INCLUDING AVERAGE TIPS AND BEFORE TAXES AND OVERHEAD. We are posting EXACTLY what they said since many have a sliding scale and work in up to 3 different environments. (self employed, independent contractor, employee)
  1. Some massage therapists do a different amount of massage each month. For these numbers we have used an average.

With that, Here is the link to my survey: Berkana Alumni Survey


I believe our graduates are succeeding at a high level for these reasons:

  1. We teach and stress self-care. “If you don’t care for yourself, you can’t care for others”.
  2. We teach them about “burn out”.
  3. The Program we offer is an Elite Apprenticeship Style Comprehensive Education. Tons of one on one time with some of the best instructors in the industry.
  4. The students are extremely serious and committed. They have to self fund because we don’t offer financial aid.
  5. We have a solid business program which teaches them to be entrepreneurs and provides a lot of strategy.
  6. We teach the value of massage.
  7. We don’t have job placement with an unethical under payer, and we screen potential employers for substandard wages. If they are offering substandard wages…they get a piece of my mind.
  8. We instill confidence!
  9. We make sure they are doing outstanding bodywork and massage so they will retain clients.
  10. We teach an extremely high level of professionalism, and they prove that during their time at the Institute.
  11. We teach them to make a living by diversification. Mix it up with other things!
  12. We teach them to have integrity with the profession by never ever accepting substandard wages for their work, thus driving the value of massage therapy down.
  13. We screen them for business aptitude and we equip them with reasonable expectations prior to enrollment.
  14. We teach them how to avoid being exploited.


So what ARE standard or reasonable wages for a massage therapist to earn per hour for massage? Considering a variable cost of living index, I will use a percentage that is reasonable:

  1. SOLE PROPRIETOR WORKING FOR SELF WITH OVERHEAD: Find out what the high end is charging, and what the low end is charging and come in at the middle. Do NOT include special offers, Groupon on or LivingSocial prices in your determining calculations. Use THOSE numbers when you are going to launch your own sale event. Add on 15-20% for delivery (dependent on how far you travel). Most Sole Proprietors do not accept tips but charge what they intend to earn. Great idea to give Student, Senior Citizen, and Veteran standard discounts. Sell packages and build in a loyalty discount. If you want this to work, you must dig in roots, network, be assertive, do educational events and be patient. There are discerning clients who want to work with you. Don’t let the competition get you down. Focus on YOU!
  1. INDEPENDENT CONTRACTOR WITH ESTABLISHMENT PAYING ALL OVERHEAD: If you are an independent contractor and the establishment is providing all equipment, marketing, materials, billing, and clients, you should earn 40% at a minimum, receive 100% tips allocated to you, and their price per hour of massage must start out reasonable ($60+). If they are doing some huge Groupon or LivingSocial thing to bring in clients, negotiate carefully and do NOT be a chump. You should not have to wait around for clients which drives your hourly income when you are actually doing massage way way down. READ YOUR CONTRACT, and be careful with Non-compete clauses and get advice from a mentor if you need some.
  1. EMPLOYEE: If you are an employee and the establishment is providing all equipment, marketing, materials, billing, and clients, you should earn 35% at a minimum, receive 100% tips allocated to you, and their price per hour of massage must start out in the mid-range of local prices. I would not factor in the prices the franchises are charging for massage because for the most part they are not reasonable. If they are doing some huge Groupon or LivingSocial thing to bring in clients, negotiate carefully and do NOT be a chump. You should not have to wait around for clients which drives your hourly income when you are actually doing massage way way down. Consider benefits carefully! Are the benefits for you? Or the company? If they intend for you to do more than 5 hours of massage a day, 5 days a week…walk out of the door. Your best bet is to work for a company that is owned by a massage therapist. They will be more understanding and appreciative of you from the start.

 However you end up earning as a massage therapist, expect business to be hard, even brutal at times. You will learn what works and what does not and it will become easier as you persevere. Being successful takes courage and risk. Why do you think so many executives read “The Art of War”? You can’t just sit there like a cream puff and expect to be served. Go Get Yours! If it was easy, everyone would do it.


  1. As soon as you graduate you will earn your entire living as a massage therapist and job placement will be your answer to this. This idea right here is how the Mcfranchise is surviving, and burning out thousands of massage therapists a year. We tell our students this, “when you graduate, clients are not going to fall into your lap, and you may not find a decent job or contract right away”. Everyone needs a safety net. A safety net is something else you can do to make money while you hold out for a decent offer, and/or build your own practice. It could be the thing you did before you did massage therapy such as:
  1. Cleaning houses
  2. Bar-tending
  3. Child care
  4. Accounting
  5. Being a coach
  6. Being a yoga instructor
  7. Food Server
  8. Website design

Get your hands on as many people as you can to demonstrate the quality of your work. Always give your best and you will get there!

  1. Overhead is 50%: If you are paying 50% for overhead, you have not been very creative…at all. Here is what we tell our students about overhead. Start out with mobile massage if you have no start up capital. Rent a space and share it with others. Why not get the lease yourself and rent it out to two others so that the 3 of you can carry the burden. If you’re really cleaver, the others can pay the entire rent since you are the one carrying the responsibility of the lease and the cleaning. Plan to buy new linens once a year. Even if you are doing 20 massages a week, you only need the space for 30 hours a week with your set up and cleaning times. I have never paid more than 25% for overhead, and none of my colleagues have ever paid more than that. For example; If you are earning a minimum of $50 per hour for 20 sessions, that is $1000 per week and $4000 per month. Who spends $2000 a month on linens, cream, hand sanitizer, utilities, rent, insurance and marketing? (Please note: Overhead does reasonably include taxes in other conversations. I’m not including those here, since an IC or an Employee with no overhead expenses as a massage therapist also has to pay taxes and “before taxes’’ is the constant for my survey. We need to remove the taxes from this discussion on overhead in order to be able to make a reasonable comparison to massage therapists earning as employees and Independent contractors.
  1. Some people just don’t have what it takes run their own business. This may be true, but one should still respect our profession by having reasonable boundaries, and massage schools need to teach this. If you are going to be a cog in someone’s machine, and you accept substandard wages then you are not honoring our profession and you are doing damage.


If you want to hurt yourself and give up longevity in this profession, do 4-hour long massages for $15 or less each, and keep doing that! If you want to support our industry, and have the respect you deserve for this amazing work you do, do a 1-hour long massage for $60. It would be better for YOU and everyone who is a massage therapist if you had a part time job doing something else for $15 per hour, and had boundaries around what YOU earn when you do the skilful and specialized work of massage therapy. Your $60 massage, is going to be 4X better than your $15 massage. The customer does NOT get what they pay for when it comes to massage therapy, they GET what the therapist EARNS. I know this because I’ve given 18,000 massages. Quality VS quantity!

Your $60 massage CAN be an amazing marketing event (word of mouth) and those 3 hours you save are time for your marketing efforts. Would you rather do 5 massages for $60 per hour per week and 10 or so hours of marketing? Or would you rather do 20 massages for $15 per week? You are still going to earn $300 per week.

Personally, as a client, I don’t want your $15 massage. Whether you are an IC or Employee or Self Employed, I want your $60 massage, especially if I’m paying $60 either way.

You will see from my poll that this “LESS IS MORE” philosophy and approach is the one my graduates are using.

We are not a masseuses! We are a Massage Therapists, not technicians. We are providing therapy and we deserve to earn a decent living for our investment in learning this art/science, our skill, and our courage to compassionately and professionally touch people’s lives.


Jill Kristin Berkana, LMT

Jill Kristin Berkana

Founder/Director Berkana Institute of Massage Therapy and Bodywork Passionista

WHO opens the door?


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LA7328-001The way the public perceives you will, without a doubt, impact your massage therapy career. We want to explore and maximize every possible angle we can as we are trying to attract clients, hoping to be offered an awesome independent contract or applying for the great job. The intention of this post is to encourage you to explore if you are utilizing every bit of your number one marketing tool, which I believe is your appearance and charisma. Once you get your client on the table, you can wow them with your mad massage therapy skills. This is about how to get them there.

Of course, if you have been doing consistently beautiful work, your reputation will precede you, and positive word of mouth is extremely powerful. Still, we must consider how we represent as professional massage therapists.

I’m not a superficial and judgmental person. Of course I struggle with those human shortcomings as we all do, but this is not about that. This post is intended to provide tools for greater professional prosperity. Over the 24 years I have been an industry professional and educator, I’ve connected with many massage therapists who complain about their lack of business or how hard the business is for them. Many also demonstrate some type of professional self sabotaging behavior.  Often there is something about their appearance, (which could easily be improved) and/or lack of business charisma that is getting in their way.

Now, let me be clear. I am not implying that you have to be some classic beauty, be perfectly symmetrical or completely lean and toned to be a successful massage therapist. How boring anyway, right? People want massages from human beings, and if you had that magazine cover, photo shopped, unrealistic “perfect” shape and face, many people would not feel comfortable getting under your hands. Everyone has potential untapped beauty that comes from inner confidence, kindness, warmth, humility, a dash of humor and compassion. I’ve always told my students this, “Guess what, your clients have to like you!”

If you feel stifled in the area of personal confidence and expressing yourself, you might want to look into a public speaking class. If you lack personal confidence at a deeper level, you might consider working through things with a life coach or therapist. There is no shame in this. I believe we ALL should spend some time in introspective self discovery with a professional neutral party if we want to touch people for a living. Massage Therapists must have a strong personal constitution to work with the vulnerability our clients show up with.

Now let’s examine your number ONE marketing tool from the external perspective. Consider this scenario:

You have been given a massage therapy gift certificate for your birthday. You have called and made the appointment, you walk up to the door and ring the doorbell.

WHO opens the door? What qualities do they possess that make you feel comfortable enough to give them permission to touch you for an hour or more?

Of course, the actual gift certificate was their first professional impression of you, and the way you managed the phone call was their second impression, but what happens now?

Here are some qualities that id like to experience: warmth, smile, welcoming, friendly…but let’s face it, the massage therapist is going to be judged at the superficial level as well.

We can enjoy more success attracting and retaining awesome clients by paying attention to and working with the following details:

  • Being yourself with all types of clients: Lucky massage therapists! We get to be ourselves and express our individuality in so many ways! Authenticity is a very attractive quality and Independent Massage Therapists have this special freedom to explore the full spectrum of style from freaky to conservative. My advice to you is this, if you want to be on the funky end of the spectrum, go with clean, cool, artistic, bohemian and ditch smelly un-kept hippy with holey clothes. The more you can adapt your style to create rapport with all types of clients, the more success you will have making a living.
  • Hair: Your hair must be clean and you will want to pull it back if it is getting on your clients.  Please do have a trade with a hairdresser for color (if you do that) and cuts so you look professional. If you are a man and you want to have facial hair, don’t look like you just came out of the forest. Please carve that into something more along the lines of a renaissance man.
  • Teeth: There are many people out there in the world who are going to judge you by the health of your teeth. If you need some cosmetic work done, find a dentist to trade with you! If you need a lot done, take my advice and go to Thailand! I had about $15,000 worth of work done in Thailand for $1,700. They did a perfect job…and I got to go to Thailand!
  • Breath: If you want to never see a client again, have foul breath. If you want to keep your clients floss and brush your teeth, have your teeth cleaned regularly. Why not do a trade? Brush and scrape your tongue, and if you are a mouth breather, look into why that is going on. It could be that you have an allergy to dairy, or a deviated septum. Either way, breathing out of your mouth can make pervy sounds when you are working and forces your breath on the client’s body in unacceptable ways that cross the comfort zone. Also, avoid onions and garlic for the several hours prior to your appointments, and use breath spray. Don’t use mints or gum during a session. This will bother a client with a gum smacking pet peeve.
  • Skin: If you have skin issues, you might want to see a dermatologist, esthetician or a nutritionist. So much of this challenge is genetic disposition, but you may be able to improve the quality of your skin with the assistance of a skin care professional. Why not do a trade!
  • Eyes: Your eyes should be clear and sparkly! Make sure you are getting enough sleep.
  • Voice: We all have the voice that we have, but it is changeable! For example, the voice you use in the bedroom with your lover is not the same voice you use to talk to your Great Aunt. Explore and cultivate your therapeutic voice. This should not be too sensual, sexual, too soft or too loud, don’t whisper, and avoid using the voice up in your head that has a nasally high pitched tone. Speak more from your throat and chest. If this is confusing or an issue for you, take a class with a voice teacher. Why not do a trade!
  • Posture: Who wants to get a massage from a massage therapist with crappy posture? C’mon…really? Start with postural awareness and police yourself! You may find it helpful to have a mirror in the massage room so you can watch yourself while you work. Please don’t have that at the foot or the head of the table. If posture continues to be an issue, find an Alexander Technique Teacher. Why not do a trade!
  • Wardrobe: The clothes you choose to wear should be non-revealing, non-wrinkled, fit correctly, be clean, and not have holes in them, or any offensive symbols or language. Your wardrobe should be stylish and not cross the comfort zone. Your clothes should also be free of the smell of detergent. Make sure when you lean over your blouse does not reveal your breasts or cleavage, and wear a bra or a camisole under your shirt. Also avoid jingling jewelry. If you dress provocatively expect to have aroused clients, and attract clients with sexual intentions. If this happens to you regularly, I highly recomend that you do a personal inventory and explore everything about how you are holding yourself, dressing, speaking, your intake procedure and policies, marketing etc. and CHANGE whatever you suspect might be sending your clients the wrong message. That’s NOT supposed to be happening.
  • Nails and cuticles: I’m sure you learned this in massage school, however being scratched is one of the number one client complaints.  Don’t fool yourself, you may NOT have a French manicure, and you must cut those nails off and file them each and every day. Make hard fists in each of your hands. If you are leaving fingernail marks in your palms, your nails are too long. If you ever leave a scratch on a client, this should be a big wake-up call for you. Keep trying till you get that manicure right! It’s better to err on the side of caution. We all cut our nails too short at some point. This is especially important if you do deeper work or any work under the body. If your cuticles are dry and cracking, use cuticle cream to improve the texture.
  • Odors: Please avoid all neurotoxins! Many clients are allergic to them and will get an instant headache and/or be nauseous by being in a small room with you. Some neurotoxins are found in hair spray, chemical colognes, perfumes, some deodorants, and body creams. They are also found in memory foam. Please use natural products and ones that have very little smell if any at all. You want to avoid aphrodisiacs such as rose, sandalwood, patchouli, and vanilla, and really keep things as neutral as possible especially if you are working with someone who has asthma as strong smells can trigger an attack. If you are providing aroma therapy, be sure this is what your client wants, and make sure you have cross ventilation so you can clear the space in between your clients. Aromatherapy should not be assumed.
  • Smoking: If you are a smoker and a massage therapist, this most likely is impacting your practice. For me, going to a massage therapist who smokes is like going to a dentist with rotten teeth. As a former smoker, I know how hard it is to quit. It’s horrid, but if you want to be a health mentor for your clients (which is essentially what a massage therapist SHOULD be) please walk your talk and give up the cancer sticks. There are ways this can be done. Try switching to Organic American Spirit brand cigarettes which will initially get you off of the addiction to all of the additives, then you might try going to the e cigarettes as a bridge to your freedom.
  • Fitness level: The size and shape of your body or body type does not matter unless you are obese. If that is the case you are certainly aware that this is not good for you, and if you want to live, and live without pain, you must seek change.  If you are a personal trainer or a nutritionist, your fitness level might be more important to attracting clients. Regardless, there are many people who will judge a massage therapist for their body shape and level of fitness. There are people who will judge a massage therapist’s ability to give depth if they are petite or assume depth from a stronger looking therapist. However we are built, we can all improve our fitness level by drinking plenty of water, eating normal quantities of healthy food, getting plenty of rest, being outside and doing at least one half hour of exercise every day. Continue to reach for health and you will have it! You can always trade with a personal trainer, and/or nutritionist if you need support to get things on track.

I hope this post provides some ideas for you. One of my favorite business role models Madonna reinvented herself a couple of hundred times. We can do it too, and as you revamp yourself you will see improvement in the cultivation of your practice.



Mindful Hugging


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meerkat-huggingHugging is good medicine, and like all medicine it needs to be taken in doses and not assumed to be good for everyone all the time.

A hug. Such a nice thing. We wrap our arms around one another, and squeeze. Informing the relationship that we both care and want to be close. So nice. Who wouldn’t want a hug? This blog post is going to be about boundaries with hugging. This should is especially relevant for Massage Therapists.

Are you a Hug Person? A person who likes to hug anyone and everyone because you feel free with your ability to hug the whole world? That’s great! Not everyone is on board with you. Different cultures, life history, the way the person feels for you and the way the person is feeling in general is going to determine how comfortable one is with being hugged or hugging.

I’m a Mindful Hugger and I’m sure I still get it wrong on occasion. Hugging is a risk that not many people consider. I like to hug some people at some times.  I may want to hug Person A, and I may NOT want to hug Person B. I may not want to hug Person B for a variety of reasons such as:

  • They are wearing a bunch of AXE, or hairspray, or patchouli or amber oil or some other neurotoxin or natural smell including body odor and once I hug them I’m going to smell like them all day. I don’t want to hug them let alone stand next to them because I’m going to get a migraine.
  • Maybe I just don’t feel like being that close to Person B due to the level of intimacy we have shared to date, or the role they are playing in my life.
  • The timing is bad because my bladder is full, I have a sunburn, I just got a parking ticket, or someone is going to witness the hug that I don’t want to witness the hug. Perhaps a later time for the hug is better for me.
  • I’ve got a feeling that Person B has sexual or needy energy and I’m not willing to feed that.
  • Perhaps I want a professional relationship with Person B and that much physical intimacy is not working for the relationship that I want to have and the boundaries that describe that type of relationship for me.
  • Maybe I hugged Person B before, and they held on too long, or pressed their crotch against me.
  • I’m pissed off at Person B for some reason.
  • I don’t have a reason, I just don’t want to.

As you can see there can be a multitude of reasons that I don’t want to hug Person B. I hope that person B does not judge me for not wanting this exchange, but chances are if they came in for the hug, and I somehow managed to refuse it, confusion and judgement is going to happen. Too bad. This is a good reason to look into MINDFUL HUGGING.

What about Person A? I WANT to hug Person A, and I don’t see any obstacles to hugging Person A, but does Person A want to hug me? This is where Mindfulness comes in. Does Person A have a multitude of reasons NOT to want to hug me? Maybe! Who am I to assume Person A wants to hug me back? I’m not in Person A’s head.

I’m not trying to be a wet diaper here and squash your desire to hug and show affection to the people that you care about. I am suggesting a more mindful approach. If you want to be a Mindful Hugger, this deserves some thought, awareness, and requires on the spot adaptability to the present opportunity for the hug.

Have you ever received a hug that you did not want to receive before? There is not much worse than an unwanted hug. It’s icky. It can even feel violating. As children, many of us were taught that we have to hug people our parents want us to, such as a Great Aunt who you had never met before.  We were told to do it so, we grit our teeth, turned our heads and gave the reluctant hug. I’m here to tell you that you don’t have to hug anyone you don’t want to ever again.

I believe a hug should really include 2 consenting huggers. If you determine that a hug is appropriate and wanted from both of the people, then bring on the hugging bliss!

How do you know if the other person is wanting the hug? If you have never hugged the person before, you may want to say “ are you comfortable with a hug”? I know that sounds weird, so come up with your own way of communicating and getting consent. If you are open for the hug and the person initiates the hug…awesome! Hugging is ON! Read body language and facial expression. If you are paying attention at all (being mindful), you are going to get the signal that the hug is ON or the hug is not on. I just caution you that if you are the hugging, touchy feely type, you can become numb to the subtle signals due to your hugging agenda and hugging lifestyle. Pay attention, and try not to assume.

The not let go: This hug is icky. It’s the one where you have the two consenting huggers, and then one does not let go. LET GO ALREADY!

The pat pat pat: The pat pat pat on the back is a great way to indicate that the hug is over. Be sure this does not turn into a slap slap slap.

The long never ending sway: This is for lovers my friends. If you hold on and sway this is not a hug. It’s a dance.

The crotch rub or press hug: This is such a drag. Someone comes in for the hug and they press their crotch against you. This is now a sexual exchange, and if both people are into it…yay you! If both people are not into it and you do it, you have just alienated a person from your life.  Please control your “stuff”.

Should Massage Therapists Hug Clients, and if so HOW?

Massage Therapists will often hug their clients. We are sharing a very special professional intimacy that often warrants a hug. Here are the guidelines that we teach at my school The Berkana Institute of Massage Therapy that you are welcome to consider, as follows:

  1. A hug at the initial meeting prior to bodywork is rarely appropriate. If the client initiates it and you are okay with it, a brief professional type hug is okay.
  2. Never Never NEVER hug the client when they are on the table, and they are not wearing clothes.
  3. Once the client is dressed, standing up, and they initiate the hug, this would be an appropriate time to exchange a professional type of hug.
  4. When you hug, turn your pelvis to the side and do not engage in any long swaying, never let go hugs. Brief with the pat pat on the back is appropriate.

I hope you have enjoyed my opinion on hugging. Remember, everyone is coming from a different history and culture, even if they come from the same home town, were born the same year as you, and went to the same church. We all should be vigilant in our efforts to avoid assumption and be respectful at all times with all people. Mindfulness is the key.