Self-development can provoke change in your community
Right now, this world, is crazy. With the current events unfolding around us on a daily basis we are all working to thrive in a state of crises. Whether you know it or not, we are all coping in one way or another to deal with the surrounding chaos. No one is exempt. One way or another, everyone who is a human being and who is alive in this time is having to DEAL with the madness around us.
Helpers are needed more than ever. Helpers are the courageous people who are coping and dealing, by trying to help others cope and deal. This is a healthy and conscious way to manage what is going on. Helpers choose to be part of the solution, rather than focus on the negatively and the problems. Helpers bolster the survivors of these times.
Massage Therapists and Bodyworkers are Helpers. We work to make an immediate positive impact on the quality of people’s’ lives by providing rest and nurturing in a safe place to simply BE. We offer comfort and therapeutic touch. Some of our clients simply need to breathe, rest and receive a nurturing and relaxing massage. Others can benefit from a deeper treatment approach for musculoskeletal pain and discomfort. We adapt to the full spectrum of people and we are here to help. Massage Therapy is holistic healthcare, meaning, the benefits of receiving massage therapy are emotional, psychological and physical. We are not just here to help our clients, but to help ourselves by giving our lives meaning and purpose in this wild world we call home.
Massage Therapists are wave makers. Our work has repercussions. We offer valid and skilled therapy for our clients and we make a positive impact immediately on their lives. After receiving massage therapy, our clients can’t help but be more present, and thus more consciously aware of their actions and reactions. They leave their massage with a heightened sense of themselves and can be more in control of how they respond to the world around them. A client may be kinder to their employee, or their partner or their child after a receiving a massage because they are more connected to themselves. They have received comfort, nurturing and therapeutic attention from a massage therapist who has offered them unconditional positive regard, and time to just simply be taken care of.
If you are considering a career in massage therapy. Please find the school that is best for you and sign up right now and become a helper.
If you are a person who is suffering from the unreal stresses of your life, please make receiving massage therapy a NORMAL part of your life and watch how things get better.
If you are in the massage profession or industry, please take responsibility to support the profession by educating the public about the benefits of this career, and help bring the right people to this profession.
Jill Kristin Berkana LMT BCTMB
“Medicine is like the Tai Ji. There are two theories of thought. But truly one does not exist without the existence of the other. They are intertwined as people try to make them a dichotomy.” ~Brent Jackson
The intent of this blog post is to address and plead with the small and shrinking group of holistic health care practitioners, specifically massage therapists, who have a tendency to say negative things about western or traditional medicine to their clients, step out of scope with diagnoses and prescribing, and they do this all day long. I know this group well because 20 years ago, I was a full-fledged member.
This morning as I stand in my kitchen making breakfast, breathing and hungry, I’m reflecting on how many times traditional/western medicine has saved my life and the lives of my loved ones. My father, grandmother and brother have all suffered from serious bouts with Diverticulitis. My brother endured a temporary colostomy bag while his large intestine healed, and my dad had surgery to remove two thirds of his large intestine after years of suffering with chronic pain and acute flair ups of the disease. I recall his discomfort from time to time as a child, and watched him peel the sesame seeds off the top of his hamburger buns.
I’ve been a holistic health care professional for 27 years and counting, and a nutrition/natural medicine passionista for over 30, therefore, when I first started to have intestinal pain 22 years ago I decided to take matters into my own hands. This was also convenient because I did not have health insurance at the time. I did my research in naturopathic journals, read books on cleansing and fasting, talked with the experts at the health food stores and started a disciplined practice. I have since done annual fasts coupled with intestinal cleansing for a week every year since I was 30. I have not had any significant problems, until now. This year the disease caught me. Seeing as I had done a short fast and cleanse 3 days prior to my attack it is possible that the cleanse itself is what exasperated and/or revealed my condition. I will never know. I will also never know if my lifestyle choices kept the disease at bay until now. What I do know now is I have it, I am fragile, and my life has been saved once again by western/traditional medicine.
While I was in the hospital I really wanted a massage. I was having horrible headaches due to the IV drugs saving my large intestine from rupturing, but no, sadly, there was no massage. While I was suffering an incredible wave of nausea with a completely empty stomach due to doctor prescribed bowel rest the nurse DID swirl her warm hand on my back which felt wonderful and comforting. She put lavender aromatherapy in the room, and cold washcloths on my forehead. They did allow my husband to come in and spoon me for an afternoon nap. This all was VERY powerful medicine, however, there was no massage therapist there to give me a much-needed neck and head massage. Why is that?
Some hospitals are finally providing massage therapy which is paid for by patient insurance and prescribed by the physician! With all my heart I thank the AMTA, the Massage Therapy Foundation, pioneers such as Ruth Werner, Xerlan Deery, Susan Salvo, Carole Osborne, Brent Jackson and too many others to mention for the progress massage therapy has made in the hospitals. Still, massage therapy is not fully integrated. Why is that?
Here is one prominent obstacle. There are still too many massage therapists practicing some form a shamanism, (for lack of a better word) making false claims about healing, telling clients to eat toxic essential oils, encouraging clients to forego doctor’s orders, diagnosing, and demonstrating to the greater medical community our profession’s inability to stay within its scope of practice and collaborate with consistent integrity and ethics. Sad.
Sadder still is most of the massage therapists doing this have positive intent and really think they are helping their clients! This is what they were taught in school by their beloved mentors, and now… some 20 -30 years later… they are telling the same very old story. Some of these folks are teachers and continuing to propagate the mythology and lack of professional boundaries.
Massage Therapists in every single inch of the United States should be required to take a certain amount of continuing education to renew their license including at the very least professional ethics and research competancy. Additionally, the Continuing Education providers absolutely should comply at a higher level so we know the people who are getting massage therapists up to speed, are up to speed. Last I heard, continuing education is only required for licensure renewal in 35-37 states.
If you are a massage therapist and you are not taking continuing education courses I hope this article will inspire you to pursue it for yourself and for your clients. If you don’t like my message, please just take a moment to reflect on how many times traditional/westernized medicine has saved your life or the lives of your loved ones. Alternative Medicine is OUT and Integrative Health Care is IN! It should not be us OR them but us AND them!
By no means am I saying that western/traditional medicine is perfect. Obvious to all of us paying attention, pharmaceuticals are completely out of control, along with health care costs. If massage therapy can get it together and collaborate with a high level of professional integrity we can position to replace at least some of the pills and surgery.
You should powerfully advocate for yourself and your body whenever you are submitting to healthcare of ANY kind. For example, the doctor wanted to give me one more bag of antibiotics and I told him, “too much medicine, not enough nutrition” and so, he put me on soft food before I took the next bag.
My journey with Traditional/Western Medicine:
- In 1977 I had pneumonia and was saved by medical intervention
- In 1988 my son was born via emergency C-Section after a 40-hour labor at home with midwives. The medical intervention saved both of our lives.
- In 1995 I was in a horrific car accident and medicine did not keep me alive but kept me out of unbearable pain.
- Medical Intervention repaired both my right big toe which I crushed under 300 pounds of wood in Costa Rica, and my thumb which was damaged in two car accidents. I am walking/running and doing powerful massage today.
- 2017 – Doctors and medicine kept my large intestine from exploding.
Let’s face it, if you crush your leg, do you really want a shaman to chant over it and apply some tree sap? If you are a massage therapist, please do get up to speed and keep up. It’s not hard to do! Our profession is investing considerably in research and many new valid discoveries have been made! This is terrific news!
And if you have not yet got the memos:
- Massage Therapy is fine for healthy moms-to-be in the first trimester.
- Massage Therapy does NOT remove toxins.
- A new muscle has been discovered. See if you can find it.
- The parasympathetic nervous system may not govern the Sacral Plexus.
- Massage Therapy does NOT spread cancer.
- There is MORE! FIND IT!
Back in the day I would read a rune to each and every client at the end of their massage. I calculated their astrological charts to better understand how I could help them. I had crystals in my massage room and I still do because they are pretty. Today I believe in magic. I like to do ceremonies under the full moon, and I’m known by family and friends (not clients) for my special “white witch flu brew” around cold and flu season. I cut my teeth on the mystical, and I also know it’s high time massage therapy really honor the boundaries of our profession so we can work with and support the healing of those who need it the most.
Here is some powerful work all massage therapists should read:
Here are easy ways to stay connected to what is new:
I am writing this article because I am regularly hearing from my beloved Alumni, family and friends that they have had accidents; or their friends, family and clients have suffered accidents. I have some advice to share because the trend seems to be to give these events little attention (if that is at all possible) and just carry on. This can be a big mistake.
If you have:
- fallen down stairs
- been in any kind of a car accident
- run into a tree skiing
- fallen down on your roller blades
- slipped on the ice
YOU have had an accident. For the sake of this article, let’s assume these things:
- Every event that involves you at a higher speed running into something, or a thing running into you as it was rapidly flying through space is an accident. In other words, either you ran into it, or it ran into you, and the “its” could be just about anything.
- If you are air lifted or carried to a hospital in anyway with bleeding, serious trauma, unconsciousness etc., obviously seeing a Doctor is your first defense!
- My main motivation for this article is the myriad of whiplash victims I have encountered or heard about who are in a mild fender bender and go about their lives, when debilitating pain presents 6 months or later after the event. Often when this happens, the potential coverage for treatment is no longer available.
Normally when you are in an accident, you are in shock. The level and intensity of that shock will be determined by the event, the damages, the injuries, and by who you are constitutionally. When you are in shock, the natural thing for you to do is to begin to cope as best as you can with the situation. You will start processing the event in the realm of “how can I make sure everything is ok”. You will look at the property involved, the people involved, start to negotiate the planned events that are getting derailed, (if you are able to) and try to shape the event in such a way so it will drop conveniently into your reality in a way that it will fit, and everything will be just fine.
Within that negotiating process, you will be forced to pay attention to pain in your body. This is not a time to be a tough guy or girl… this is the time to listen to the feedback your body is giving you. Your body is going to have endorphins coming to the rescue to help you cope with the scene, so you will not have a real accurate assessment of the feedback your body is giving you. You are not going to feel the pain that truly represents the physical damage….yet.
You will naturally try to diminish the extent of things to help you cope. This can be a real big problem because you must advocate for yourself, and/or have someone else advocate for you if you are not able to. It’s way too easy to say “oh I’m fine… I just feel a little soreness there, it will be fine tomorrow… I’ll just take an Advil and put some ice on it”. In this day and age and culture we are all conditioned to say “it’s no big deal… I’m fine”, and tough it out. You may not BE fine, and if you say you are fine, and convince yourself you ARE fine, and convince your advocate that you are fine, you could miss out on opportunities to receive treatment, AND THE COVERAGE OF TREATMENT YOU ARE ENTITLED TO, that may have a phenomenal impact on the immediate and long term outcome of your recovery.
If your accident is anything beyond a minor incident you should see a doctor. Not being a doctor, you are not qualified to diagnose anything at this point so you need to go to a doctor to figure out what damage you have truly sustained. Do you have a concussion, do you have bruises and contusions, is anything broken, is anything ruptured, is anything bleeding that you can see or can’t see? These are the issues the DOCTOR is going to check for you and make sure you are cleared or treated for. The DOCTOR is the one to help you make sure there are no hidden problems that could potentially be REALLY bad right now or later.
What the doctor may not see and may not consider, or may not consider a problem for you later is SOFT TISSUE DAMAGE AND THE LONG TERM CONSEQUENCE OF THOSE.
You may not fully realize the long term effects of the soft tissue damage (muscle, tendon, ligament and the nerves that work with these structures) until several months, if not years after the accident.
Depending on the musculoskeletal damages you have sustained in the accident, the support you receive in the early stages of your healing could greatly influence the long term impact of the accident on your life.
If any of your injuries involve a sprain, strain, broken bones, soft tissue injury, whiplash, or surgery, Massage Therapy can be very supportive to your healing process and have a powerful and positive influence over the final result. Depending on the nature of your accident and the injuries, you most likely will not be able to receive massage therapy until the chronic stage of your healing. If you are working with a doctor, neurologist, chiropractor or an osteopath, you can ask them about working with a massage therapist, and see if they are open to writing you a prescription. It’s possible that your insurance plan will cover massage therapy for you.
Throughout your healing process, massage therapy can greatly support you in coming back to yourself as much as you can in the face of the trauma you have experienced. Physical Therapy, Chiropractic, Strength Training and Emotional/Mental Healthcare professionals may also be part of your recovery team.
If what has happened to you is the fault of another party, it is important that you receive all the care you need, keep solid records, and if necessary get an attorney to represent you. Don’t settle for as long as it takes to finally understand the long term damages you have sustained. This can take months to years. I recommend you keep a daily journal to record what you are feeling from day to day.
I hope that none of us are in any accidents! In the event you are I wish you a swift and complete recovery! Hopefully at least one piece of this advice will come in handy. No matter what, do not try to sweep what is happening under the rug and tough things out. You must pay attention to your body and what is going on as the healing process unfolds or you could miss a great opportunity to receive support and save yourself from bigger problems down the road. Specifically, pain resulting from musculoskeletal dysfunction.
If you do not have any injuries from your accident, please do take time to rest and find ways to nurture yourself before you go back to your normal day to day activities. Even a minor accident is a trauma that you will need to recover from.
Why am I qualified to give you advice? I have been in the field of Massage Therapy for 26 years as an educator, school founder, curriculum architect and a practitioner. I have had hundreds if not thousands of client’s who present with chronic injuries from accidents in the past that impact their lives later on. I have been in accidents myself. I have been in 2 major and 3 minor car accidents, I have fallen off horses, bikes, skateboards, and had a stint as a Karate enthusiast where I was falling hard, being punched and fighting. If you want to know more about me you can read my bio here.
If you are considering embarking on an education and career in Massage Therapy, there has NEVER been a better time to do this! I would like to share with you my perspective and hopefully encourage you to move forward in your research and also to consider if the Berkana Institute is a potential fit for you.
As an educator who strives to be on the cutting edge and provide the most current and up to date professional education that we can for our students, my team and I have been extremely challenged in the last 2-3 years. The reason we have had this experience is tremendously exciting and that is what I wish to share with you.
The American Massage Therapy Association has supported the Massage Therapy Foundation which creates and facilitates Massage Therapy Research. The result is valid research which strongly indicates that Massage Therapy is much more valuable than previously known to the health and welfare of people; and specifically supportive to those who are suffering and in pain.
The days of Massage Therapy being considered a spa type luxury item are OVER. Massage Therapy is HEALTHCARE and preventative WELL-CARE. Additionally, we are learning what we as a profession have been doing (or not doing) that has been damaging to our professional reputation, and to our clients. The profession is re-evaluating those outdated methods and ideas so we can better serve the best interest of the people we serve, and do no harm.
There has been a profound and accelerated evolution in the practice and profession of massage therapy and it’s on RIGHT NOW! RIGHT NOW massage therapy is being accepted and recognized as legitimate health care and as an alternative to pharmaceuticals for pain management. With the growing epidemic of opioid addiction this is a very big deal. Jobs for Massage Therapists in and out of the hospital setting are on the rise and this will continue. As an educator, I am on the fast track with my expert colleagues to create and implement education that will prepare our graduates for what is happening now and what is coming for this profession.
If you are considering a career in Massage Therapy don’t stop looking. Look at all of the schools and look at what is currently happening in this profession. The profession of Massage Therapy needs caring, ethical and intelligent practitioners more than ever and RIGHT NOW!
Here are some links that you can use to explore what I’m referring to in this article.
About me and my program…
Let me share with you who I am and why my opinion might be worth your consideration. I have been in this profession for 26 years. I was very lucky to attend what I believed to be the best school in the nation at the time, and had the great fortune to study with some amazing pioneers in this field who all had connections to the HUMAN POTENTIAL MOVEMENT. The school I attended was HOLISTIC, which means I was not only learning massage and bodywork technique and science, I was also studying the basics of psychological phenomena, and was encouraged to participate in careful self-inventory and self-development to ensure I would be prepared to work with the complexity of clients at their most vulnerable state.
I then went on to have 16 years of full practice work in eclectic environments and cultures, with opportunities to serve an extremely wide variety of clients. I provided about 20,000 hours of massage therapy and peaked in my practice in 2005. I decided it was time to share what I had learned so I could indirectly reach a larger audience. I needed more hands! Having been an international explorer, and having a brief education in international business I decided to create the first international/residential massage school. I chose Costa Rica. I trained 180 amazing massage therapists in the 7 years I lived there…there were monkeys, and it nearly killed me… enough said.
Fast forward, I returned to beautiful Colorado in 2012 where I have founded the Berkana Institute of Massage Therapy in the heart of Denver, Colorado. I have facilitated my original entry level massage therapy certification program in Costa Rica and Colorado 29 times and have signed 300+ diplomas.
This unique apprenticeship style program is refined with every term and it has been touched by over 2 dozen experts. Graduates have a 100% first attempt success rate on National Board Examinations and are holistic entrepreneurs who diversify Massage Therapy in practice as independent massage therapists in private practice, as employees and independent contractors.
The Berkana Institute is designed to be a charming and small, professional boot camp which provides a seriously accelerated, high caliber education. We only accept 32 students per year in 2 classes of 16. We teach our students to provide exceptional massage therapy and bodywork, that is highly ethical and professional, and is provided from a compassionate and mindful place. Excellence is our guide and we work very hard. This program is not a good fit for everyone, and perfect for a certain type of person.
If you would like to speak with me directly, please call me at 303-377-3111 ext. 3, or feel free to write me at firstname.lastname@example.org. Here is the Berkana Institute website: www.berkanainstitute.com
I was thinking about this today when it came out of my mouth with my step kids. The two girls have birthdays right next to each other and when the first birthday comes, the second kiddo is always sure to say things like “are you going to remember pizza for MY birthday TOO?” or “ Daddy, don’t forget when MY Birthday comes I want the PURPLE dinosaur” etc.
The second child will even try to wrangle the attention of the party goers and take control of the scene. Here is when I say. “Hey, don’t steel your sister’s thunder. Your birthday is right around the corner and that day will be all about you. Let her have THIS day!”
This behavior is a classic power/attention struggle. I see it play out at my Institute with my students and my Instructors, on social media, as well as in the Massage Therapy Profession. I see it in myself too. This is actually one of my great lessons still to learn. As a child, I would literally stand up in front of the television and act out and sing the entire Gilligan’s Island theme song while the family yelled at me to move out of the way. As you can see, I want you the reader’s attention RIGHT NOW, and that is probably why I am I writing this blog.
WHY does one feel the need to be sarcastic, make passive aggressive remarks or step on someone else’s toes for their own immediate ego gratification? What is it about needing attention that leads us to unsavory and selfish behavior?
These moments can play out in group settings in some of the following ways:
- Interrupting to tell the punch line, or the ending of a movie, or sharing the information that someone else is clearly supposed to be delivering.
- Making snarky or sarcastic remarks that you think are funny and cleaver, but are actually hurtful. These remarks are usually subtle enough that you get away with it. Kind of like passing gas while walking.
- Trying to make a group laugh at the expense of the leader, and/or derailing the leader’s train of thought.
- One upping in any way. Name dropping. Monopolizing a mentors time when there are others that may be shy to ask questions. Asking questions when REALLY what you want to do is prove that you know something.
- Just being a total jerk. Amazing how many people get away with this on Facebook every day with people they should treat with common courtesy and respect.
The very basic practice of mindfulness and being aware of how you respond, (or better yet noticing how you WANT to respond prior to responding) in a group or team setting will help you uncover why you feel the need to grab some power from the moment. It is okay to grab some power from the moment, but it’s not okay to do that in such a way that is hurtful or demeaning to others. This negative expression of power tripping, however subtly done, happens a lot and serves no one.
I don’t claim to know what motivates anyone other than myself. I want to feel important. I want to feel special. I want to feel like my contribution matters. I want to feel love and appreciation. I’m guessing this, at the bottom of the barrel, is what motivates most of us to vie for some type of recognition.
Noticing this behavior in others, and being annoyed by it, I’m going to turn my attention to where I can create change. I’m going to look at me. I’m going to breathe, watch my thoughts, and when I’m having an especially MINDFUL moment, bite my tongue when I want to add something to the conversation that really does NOT help, can hurt, and only serves to bring attention to myself.
In a world where no one is free from dysfunction, all we can do is try.
On a walk one day in the jungle several years ago, one of my beloved students shared this quote with me: “Before you speak, ask yourself: is it kind, is it necessary, is it true, does it improve on the silence?” – Sai Baba
May we all take this brilliant advice to heart, shower love and attention on ourselves and those around us so all may feel satisfied and filled up enough to enjoy a moment of just being in the silence, or letting someone else be in the spotlight sharing without our input.
Recently an article came out on Facebook that went semi-viral in the massage circles that was titled “20 Secrets Massage Therapists know about your Body!” While the article had a few reasonable tidbits of valid information, for the most part it was packaged, or should I say, TWISTED into an article that will do nothing good for our profession. It could prevent first time clients from seeking massage therapy, and it supports stereotypes that are not serving our profession.
Additionally, it has proven to provide some form of validation to some massage therapists who are making false and unethical claims, and/or support working out of scope. I want to be clear to state that I don’t blame those who contributed to the article for the end result.
The article is not so much the problem itself, but how many in the massage therapist community have responded to it. The article has been shared between thousands of massage therapists accompanied by dozens of comments that I find truly shocking. Comments like “yep, I’m psychic”, “well don’t let this scare you we are only trying to help. We know even more if we are psychic which many of us are” and “My clients usually get readings when they come to visit me”, and many more disturbing comments like this.
For the few very confused Massage Therapists, Listen up! You do not have magical special powers. Hopefully, you DO have a solid education, knowledge, and experience that would lead you to being able to professionally assess that your clients have certain conditions or have had certain life experiences, but you are no more psychic or magical than any other person on this planet. If you FEEL things it is simply because you are a MASSAGE THERAPIST, and your job is to touch a person for an hour or more in a focused and therapeutic way. You would have to be completely disassociated from your body not to FEEL things, and connect the dots with your knowledge and experience. Of course there will be indicators that your clients might need another pillow, or have had children, or are stressed out. DUH! It does not take a rocket scientist to figure out someone’s bra is too tight if they present with strap marks around their torso and have shallow breathing.
For those massage therapists who think you have some magic or extra special abilities with your clients I would highly recommend that you get your ego in check right away because that approach is dangerous and will hurt people. You may have natural abilities with providing quality of touch and a heightened intuitive sense, but that does not mean you have special magical powers! I know a lot of people who are naturally gifted in the kitchen! I know many people who are naturally good with mechanical things! I know lots of people who are naturally great with kids… this does not mean they have special or magical powers or are better than anyone else.
For those massage therapists who are also providing psychic readings for their clients or are in anyway telling clients what is going on in their lives beyond structural kinesiology issues, musculoskeletal anatomical dysfunction issues, and simple self care advice you may be completely out of scope. That is, unless you have on your business card “psychic and massage therapist” and you have license to practice both diciplines, and your clients are there because they have consented to receiving the services of both of your practices. This goes the same for massage therapists who dabble with crystal healing, aromatherapy, herbology, astrology, homeopathy, nutrition etc.
As for anything in the spiritual realm, there are priests, clergy, shamans, etc. who are professionals in the field of spiritual guidance and counseling. For mental/emotional support there is an entire mental/emotional health care field who we should refer to when our work ends and our clients need assistance. It is in your scope if you are a trained professional. If it is out of your scope, don’t go there! Reading a couple Eckhart Tolle books does not count for being a spiritual professional, and your personal spiritual belief system is none of your clients’ business.
Your job is to provide professional massage therapy and bodywork. Your job is to listen, and be compassionate. Your job is to be empathetic. It is completely unethical to get your ego stroked by having blurry boundaries with your clients. Furthermore, if you approach your massage therapy clients with an agenda to heal them, chances are you are going to do harm because YOU have an agenda and a plan to fix them. That is their job, not yours. Mindfulness, respect, gratitude, and humility will serve you and your clients better than any power trip. Please reel it in folks.
I have come to realize through recent interactions with my fellow educators and many Massage Therapists that not all massage therapy schools teach the management of dual roles or dual relationships. Hopefully this article will get into the hands of someone who has not been introduced to these important concepts, and it can help them avoid unnecessary and painful ethical dilemmas. In the end, this is ONLY an article, and if you know nothing of these concepts or wish to know more it’s time to grab some books and take some classes.
First let me start by clarifying that I am not a psychology expert. I am a massage therapy expert. I know enough about dual roles, boundaries, and the management of those to keep my clients, my students, and myself clear (most of the time) of the emotional and mental confusion, pain and destruction that can arise from unconscious engagement in multidimensional relationships.
For this article to work, I think it best to review or introduce many of the terms I will be using:
Boundaries – An emotional and/or physical limit in a relationship. Establishing healthy boundaries is a key skill in the helping professions and serve as good protection against problematic dual relationships.
Counter-transference – The feelings that a therapist develops toward one’s client, and which may be similar to or parallel the relationship patterns experienced by the client or therapist with other people and in other settings. When these feelings are especially strong, misunderstood, or ignored, they may lead to problems in the professional and therapeutic relationship. .
Dual Relationship – When you have more than one type of relationship with the same individual. This could be a professional relationship (the person is your client) and a personal relationship (the person is a friend whom you like to meet for coffee), could be multiple professional relationships (the person is a client, and is a building contractor who did painting and repairs on your office). Though not all dual relationships are automatically a problem, managing dual relationships is a professional skill and responsibility.
Ethics – The study of moral principles and appropriate conduct that may be applied to individuals, professions, or groups.
Ethical Dilemma – Occurs when two or more principles are in conflict, and regardless of your choice, something of value is compromised. Dilemmas can arise from a conflict between duties and rights.
Multidimensional relationships – Overlapping relationships in which therapist and client share an alliance, in addition to the therapeutic relationship. Multidimensional relationships suggest a more complex interweaving of roles.
Power Differential: The role difference between expert and client that results in a vulnerability on the part of the client.
Scope of Practice – Procedures, rules, regulations, and processes that are defined by a state or federal governing or licensing board for certain professions in order to ensure that those professionals are operating ethically, competently, legally, and with proper education, training, and certifications.
Transference – The feelings that a client develops toward one’s therapist, and which may be similar to or parallel the relationship patterns experienced by the client or therapist with other people and in other settings. When these feelings are especially strong, misunderstood, or ignored, they may lead to problems in the professional and therapeutic relationship
Now that we have covered that, let’s further explore DUAL ROLE, also known as “dual relationships”, “multidimensional relationships” or “multiple roles”. It’s all basically the same thing, the only thing that changes the term is the number of hats you are wearing in ONE relationship with ONE person. In other words, you would be in a dual or multiple relationship/role if you are in more than one relationship/role with the same person. Here are some examples:
- You have a Sister. You start to massage her as a professional massage therapist.
- You have a housekeeper. You start to massage him as a professional massage therapist.
- You have a massage therapy client. You decide to watch football games with him as a friend.
- You have a student. They become your accountant, and then start to date your son.
- You have a massage therapy client. You go to church with him. You start to date.
Hopefully from my examples, you can imagine how easy and natural it is to enter into dual relationships or dual roles with others, and how as human beings it only makes sense that as we get to know someone, we see the benefits in the exploration of how we can serve each other’s needs in multiple ways. Right?
Not so fast…YOU decided to become a professional Massage Therapist, and now everything changes for you if you want to be an ethical and professional one.
It has been proven time and time again by health care and non-health care professionals outside of Massage Therapy that these multi-relationships can and do lead to major strife as well as business sabotage. Massage Therapists and Bodyworkers have figured this out too, and I have personally had a lot of difficulty managing dual roles as a professional massage therapist and massage therapy educator. I strongly suggest that if you are a sensible massage therapist you too will struggle with the management of dual roles. Managing dual roles should be something that becomes reflex for Massage Therapists. Not that we should do it unconsciously, but it should be something that we focus on the management of similarly to the way we make sure that our linens are clean, and our nails are filed. It is a professional courtesy and, as far as I’m concerned, a professional responsibility.
WHY IT GETS MESSY? There are a multitude of reasons dual roles can and do go wrong, and many I don’t claim to understand so I will just point to the reason that is most obvious to me. Confusion with boundaries and power differentials. Every role we are in with the people in our lives often contain an unspoken but usually known collection of complex cultural boundaries and power differentials. When you have multiple roles happening simultaneously the boundaries and power agreements between the two people in the original relationship become overlapped and blurry. Confusion, miscommunication, and assumption can often lead to someone feeling hurt or angry and overall damage to the relationship. There is also the potential to have your business reputation negatively impacted by a dual role gone bad.
HOW TO MANAGE? The best way I have found to manage dual roles is to first stay mindful so I am aware when it is happening. Once I realize I am on the threshold of a dual role I will strongly consider the pros and cons of the dual role. If I decide to enter into, or to reject the dual role, I will thoughtfully communicate with the other person as authentically and clearly as I can about what we are going to change, or are not going to change with our already established relationship. Finally, if I have decided to enter into the dual role, I will get consent from the other party, move forward, and I will continue to be as mindful as possible and be careful not to step into any of the blurry problems inherent in dual role management. Here is an example of how that can play out.
- My sister wants a massage.
- I consider if I want to massage my sister, and if I think I can hold the space necessary to provide a professional session for her.
- I decide to give my sister the massage.
- At the intake interview, I clearly let my sister know that we are entering into a dual role, and for the next hour I will be her massage therapist and that I am there to serve her as if she were any other client.
- I receive her consent.
- If I don’t feel I can serve my sister’s best interest, I will let her know that I would feel more comfortable with her receiving from my colleague and refer her. I would take the time to educate and explain to my sister so she does not feel rejected by me.
TYPES OF DUAL ROLES: I always tell my students that they WILL manage dual-roles and the FEWER they have to manage the better. Figuring out the type of dual role you are considering the management of is the first step.
Yellow Flag: I explain to my students that the only dual roles you want to manage are those occurring with the people you are in some kind of personal or professional relationship with prior to providing massage therapy. In other words, they are in your life in a significant role before you became their massage therapist. These are easier to manage when the role they were in with you was in the past, such as they WERE your realtor, or they WERE your daughter’s soccer coach in high school. Still, the therapist must strongly consider is it worth the risk of damage to the pre-existing relationship to work with this person? It may simply be a better idea to refer them to another excellent massage therapist.
Red Flag: The dual relationships to avoid at all costs are those that start to develop with someone who is your client. For those people who end up in your life because they came to you from the beginning for massage therapy I recommend you do everything you can to keep them in that role only, and forever. Will there be exceptions to the rule? Of course, but these exceptions should be incredibly rare and thoughtfully entered into for the health of both of you. This might be a good time to bring in a Mentor help you figure it all out.
Random Flags: Things are not always black and white. One day you may be at work and your boss gets on the table. One day your mother in law wants a session. One day you go to a birthday party and realize your best friend’s brother is your client. One day (hopefully once out of the 20,000 massages you give in your career) the love of your life shows up in your practice. One day you are teaching a class and one of your new students was at a party you were at last week. Always have positive intent, be professional, do what you know is right and call your mentor for advice. If you don’t have a mentor, get one.
PROFESSIONAL REPRESENTATION AND SELF SABOTAGE: If your client invites you to their Holiday party, go as their Massage Therapist, do not “let your hair down” and do take your business cards. Be introduced as their Massage Therapist, do not obnoxiously market yourself, keep your visit brief and stay in your professional integrity the entire time. DO avoid entering into personalized relationships with the people intimately involved in any way with your clients. You do not want to drink or smoke a joint or sexy dance with your client or have your client witness any of these behaviors at their party. You can still be your authentic self, but be your PROFESSIONAL, authentic self.
Consider this; How much time, money, and energy directly and indirectly have you invested in finding and retaining this client? If you want to throw all of that away, go ahead and get your unprofessional sexy dance on down at the Christmas party.
There are enough people on this planet for you to have plenty of friends, and plenty of clients, and not blend them. Compartmentalize your personal people and your professional people. This is a lot harder to do when you live in a very small town. You have an ethical responsibility to do so. If you did not know this and don’t agree to this you may want to do a bit of soul searching on this one.
PEOPLE GET HURT. REMEMBER…DO NO HARM: There are plenty of people in this world to be your friends. I highly recommend you don’t feed off of your clients to meet your emotional, mental and physical needs. If you are doing that, it’s time to take a big step back, do a personal inventory and figure out why you became a massage therapist to begin with. Some sort of professional mental/emotional support is always recommended to navigate these confusing and psychologically challenging situations. We are human. We all want community, camaraderie and love, however for us to serve our clients’ needs we must have iron clad boundaries as massage therapists, honor the vulnerability our clients bring to us and practice professional skills at all times. If you have not been ethically managing dual roles professionally, now is the time to put that tool in your tool belt and use it as often as the need arises.
MANAGING DUAL ROLES WITH TRADES: Many massage therapists enjoy the great benefit of trading services for other professional services. These dual roles are usually easier to manage than dual roles that have the element of a personalized relationship. These are relatively easy to manage because the relationship will not normally bleed over into your personal life. Here are some trades that are usually pretty easy to negotiate the professional dual roles
- Massage Therapist and Accountant
- Massage Therapist and Dentist
- Massage Therapist and Hairdresser
- Massage Therapist and Tree Trimmer
- Massage Therapist and Massage Therapist
These professional trades are more difficult to manage because there is either a power differential, or the professional is serving you in your personal life and home.
- Massage Therapist and House sitter
- Massage Therapist and Babysitter
- Massage Therapist and Pet Sitter
- Massage Therapist and Tenant
Be super creative with this trade:
- Massage Therapist and Psychotherapist or mental health care worker.
This trade must be managed in a way that continues to honor the power differential, the boundaries and the professional roles involved. I recommend you provide your mental/emotional health care provider with gift certificates they can share with a completely neutral party.
MANAGING CLIENTS CONFUSION AND TRANSFERENCE – Let’s say your client is experiencing transference with you. They see you as a person they want to have as a friend. They ask you to go to the movies with them and then dinner on Friday. How do you honor this person, retain them as a client, have them not feel rejected and avoid entering into the dual role? Authentic, compassionate, professional, and courageous communication! However you would sincerely let them know, and in a forth coming way that you do not socialize with your clients as it has a negative impact on the therapeutic relationship. That’s how! If you need more tips on how to have these difficult conversations you may want to role play with a colleague, talk to a mentor, or read more about this very normal professional action that massage therapists have to engage in often.
ENDING A THERAPEUTIC RELATIONSHIP IN ORDER TO TRANSITION INTO A PERSONALIZED RELATIONSHIP What if you determine for whatever reason that the professional relationship you have with your client would better serve your life personally. You WANT that client to be your friend. You WANT to date that client, and you feel STRONGLY that this is where the relationship must naturally evolve. The most ethical thing for you to do is to communicate in an authentic and honest manner with the client and let them know that you need to end the therapeutic relationship. Once you have done that it is strongly encouraged that there be a “cool down” period. For romantic interests the cool down period is at least 6 months. This is to insure that the power differential is not a predetermining factor of the personalized relationship and that this attraction is not based solely on unhealthy transference/counter-transference or the client/therapists power differential. If you ever decide to make this move, I certainly hope you were not delusional. Please note: There are some state laws which have a longer “cool down” period with up to two years being reported as the longest limitation.
IDEAS FOR EDUCATORS AND MENTORS: If you have been a mentor or an instructor of a massage therapy student and wish to personalize that relationship, my advice is DON’T do it. EVEN after the educational commitment is over. Many will not agree with me on this and that is fine. This has been my choice and I’ve learned from my own mistakes after years of being an educator and trying to be friends with former students. It was confusing for everyone and so now and for many years I have decided to hold space for my students into the future in the event they need further mentorship or continuing education with me. Is this difficult? Of course it is! Is it worth it? YES! Are there exceptions to the rule? Indeed, but again, I think it should be an extremely rare exception and not a regular practice to engage in a personal relationship with someone who has counted on you to hold a professional boundary for them. In these rare circumstances, if the connection desired is that of a romantic nature, it is my strong opinion that there should be an extensive cooling off period that meets and far exceeds the 6 month rule between a therapist and a client.
IN CLOSING Nothing and nobody is perfect but we have to do our best. We are Massage Therapists, and we either did or did not receive an education on the psychological, mental, emotional ramifications of our work. Even if we did, it was scant to none so for the best of our clients and for ourselves let’s continue to study and learn more about these subtle yet powerful aspects of our work so that we can serve the public to the best of our abilities. Let’s all be absolutely sure to know that critical boundary which defines where our work ends when it comes to our scope of practice. In the end, your best tool to turn to time and again is the cultivation of mindfulness in your practice! This will insure you are aware of, and thoughtfully processing challenging events as they present themselves to you.
I highly recommend that every massage therapist and massage therapy educator be familiar with the content of these two books.
- The Ethics of Touch by Cherie M. Sohnen-Moe, Ben E. Benjamin
- The Educated Heart by Nina McIntosh
I have more or less, been on my own since I was 16. I was working full time and supporting myself entirely by the time I was 17. I did not graduate from high school, and ended up getting my GED. I was living in the mountains in a little A-Frame with half a dozen chickens and 3 stoner brothers; cooking and cleaning for that very messy crew, and working full time. I was not good at it, but I did it. I recall sculpting a pile of laundry into a chair shape, and throwing a blanket over it to camouflage the mess when “guests” were coming over. There was music and drugs, and people and parties and macaroni and cheese which I dressed up with the addition of peas. I stepped into adulthood and the responsibilities of being an adult prematurely. This was anything but a traditional way to grow up, and it was my journey and I walked each step of that path and fell down and got up, and fell down… and got up.
By the time I was 23 and my son was born, I was completely immersed in my independence to the point that I could not ask for help. I had this deep shame associated with the need to receive support or assistance, as if needing help somehow meant I was weak or a failure. The baby was born, and I was working full time and going to school part time and there was no other way. I was forced to reconcile my refusal to ask for, and receive help. It was painful. I felt horrible about myself. I needed help. I asked for help, and I received help. I asked for money so I could pay my tuition. I received it. I signed up for food stamps so I could feed myself and the baby. I received them and I shopped at midnight so I would not have to see people. I asked my friends, family, and co-workers to help me with my son and they all did. I felt awful about myself.
As time went on, I asked for help, received help and I started to become more comfortable with receiving. Started to realize, this was normal. Soon, that period of being the person in need faded and I got on top of my life. Eventually, every now and again, someone would ask me for help, and I was able to help them. More and more the exchange of help and the giving and receiving in my life increased and I saw and felt the balance, and the guilt and shame I felt when receiving diminished.
Now, I fully understand and appreciate the inherent human need to give and receive, to share and to exchange and to work together so that we all can succeed. This increases intimacy and a sense of purpose and belonging. I borrowed every penny to open my schools, and as of this year I will have paid it all back. I did not borrow the money from a bank, but from my friends and my family. I’m eternally grateful and I know they all feel incredibly good about their investment in this project which has created ripples of loving peace all over the world.
I’m writing this today, because there have been a few younger people who have come my way who have wished to attend my school. They can see themselves doing this work and need a break to help launch themselves. They do not have the funding, and feel inhibited in asking for support. There have been a few I have coached over the edge of that belief, and they have broken through. I have encouraged them that if they ask for and receive help now, they will be able to serve this world at a much higher level with their new skills. Ultimately, that is what happens. Still, there are those who won’t ask for help and they don’t come. It makes me so sad when this happens because I know there is a deep cultural shame or embarrassment if not pride that prevents them from asking for assistance from the people in their lives who could help.
As a middle aged person who has needed help and had to come face to face with the fear of asking, I want to let anyone who needs help to hear this message. When you have a need, and you ask others for help, you create an amazing opportunity for someone who has the need to give and to share. It’s reciprocal. The joy and healing that can happen for a person who has received at some point in their life, to GIVE is a full circle blessing.
Ask for the help you need. Visualize what you want to create and don’t let the fact that you need help stop you from moving forward. Ask for help. Receive help. Keep your commitments to pay all debts back and be sure to give when it comes time and you are being asked for support.
We are all in a position to give to and care for others in so many ways. Especially those of us who have been lucky enough to be born with the privilege of freedom. I want to be sure to state that just because one lives in a free country does not mean they are free. There are many MANY seriously oppressed people who the lucky few can give to. The list of those in need is crushing and heavy, and we need to take care of our brothers and sisters and the animals. I’m going to try to dig deeper and give more this time…
Since it is the holiday, I will just add that GIVING should come from one’s heart, and my message to my step-daughters this time of year is this: There comes a time when you realize that the gift is in the giving not the receiving, and when you give… don’t expect reciprocation, you already receive by giving alone.