http://collegeofmassage.com/toronto/2013/06/emotional-boundaries-of-massage-therapy/
We are vigilant (and rightfully so) when it comes to physical boundaries in massage therapy. We learn about how to work with patients, make them feel comfortable, drape the sheets and position various parts of the body. We know the importance of informed consent. We know that strict adherence to our professional guidelines protects our practice.
But what about emotional boundaries? Lee Kalpin gives us a useful reminder when she argues for the importance of emotional boundary considerations in any massage therapy practice. We’re in a highly compassionate profession that requires person-to-person touch therapy every day. Massage therapy is intimate. As such, it demands our attention to our own emotional investments. This may not be a black-and-white area in your practice, so here are some helpful guidelines for how to maintain an appropriate emotional relationship with your clients.
Deal with chatty clients wisely
Kalpin is right to remind us that the therapy session is all about the client, so any conversation that takes place should have the client’s interests at heart. If your client wants to chat, listen and respond politely without over-sharing. If a client is nervous, take the time to answer his or her questions, and offer some explanations about your techniques. Many clients feel more relaxed after some initial conversation and will lapse into a peaceful silence –which you should obviously avoid interrupting. For those that are talkative, react accordingly, but always consider the client’s motivation for conversation. Be friendly, be courteous and be comforting –don’t be overbearing, overly social, or overly intimate.
Don’t give out too much personal informationKeep friendly talk that centres on you polite but concise. Clients will ask you about yourself, so provide them with information they have a right to know- where you went to massage school, how long you’ve been in practice, how you’re doing today, etc. Offer other personal details at your own discretion –but exercise caution. Your focus should be on your work. Creating an overly personal atmosphere with clients can change the entire dynamic of your relationship or distract you. It’s best that clients see you as a friendly and trusted professional.
Kalpin is right to remind us that the therapy session is all about the client, so any conversation that takes place should have the client’s interests at heart. If your client wants to chat, listen and respond politely without over-sharing. If a client is nervous, take the time to answer his or her questions, and offer some explanations about your techniques. Many clients feel more relaxed after some initial conversation and will lapse into a peaceful silence –which you should obviously avoid interrupting. For those that are talkative, react accordingly, but always consider the client’s motivation for conversation. Be friendly, be courteous and be comforting –don’t be overbearing, overly social, or overly intimate.
Don’t give out too much personal informationKeep friendly talk that centres on you polite but concise. Clients will ask you about yourself, so provide them with information they have a right to know- where you went to massage school, how long you’ve been in practice, how you’re doing today, etc. Offer other personal details at your own discretion –but exercise caution. Your focus should be on your work. Creating an overly personal atmosphere with clients can change the entire dynamic of your relationship or distract you. It’s best that clients see you as a friendly and trusted professional.
Let your clients have an emotional release without joining in
We like Kaplin’s point that many clients will find it cathartic to verbally express their stresses. This sometimes occurs naturally during the process of relaxing and releasing tension. Respond accordingly-show empathy rather than identifying personally with your client’s problems. If you feel the conversation is getting too personal, try to redirect the client’s expressions back to the treatment. “I’m sorry you’ve had to deal with all of that –do you feel more relaxed now? How’s the pressure?”
We like Kaplin’s point that many clients will find it cathartic to verbally express their stresses. This sometimes occurs naturally during the process of relaxing and releasing tension. Respond accordingly-show empathy rather than identifying personally with your client’s problems. If you feel the conversation is getting too personal, try to redirect the client’s expressions back to the treatment. “I’m sorry you’ve had to deal with all of that –do you feel more relaxed now? How’s the pressure?”
Leave your life behind during a massageAs with any profession, take a moment before each appointment to focus and clear your head. Leave your personal life behind you or compartmentalize everything so that you can centre your thoughts entirely on treatment. The last thing you want is for your own emotions to be communicated disproportionately in your conversation or your actual massage. For example if you’re feeling aggressive, you may still have a client that needs you to be extremely sympathetic, patient, and gentle.
Prepare yourself for the emotional investment of being a RMTDon’t underestimate how intuitively emotional the job is. Seeing clients in pain, hearing their stories, learning their health histories, and working to improve their quality of life can take you on a roller coaster of compassion, worry, determination, triumph and pride. Having an emotional response to the work you do is a good thing –you want to take meaning, passion and rewards from your profession. The key is to maintain professionalism, protect your business identity, and ensure that emotional connectivity doesn’t compromise your own wellbeing or client relationships.
Prepare yourself for the emotional investment of being a RMTDon’t underestimate how intuitively emotional the job is. Seeing clients in pain, hearing their stories, learning their health histories, and working to improve their quality of life can take you on a roller coaster of compassion, worry, determination, triumph and pride. Having an emotional response to the work you do is a good thing –you want to take meaning, passion and rewards from your profession. The key is to maintain professionalism, protect your business identity, and ensure that emotional connectivity doesn’t compromise your own wellbeing or client relationships.
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https://www.amtamassage.org/articles/3/MTJ/detail/2493
Physical Boundaries, for example, might include anything from the set up of your practice to proper draping to understanding a client’s preferences and any contraindications that might exist.
Emotional Boundaries speak to a therapist’s awareness of both themselves and their client. “You need to be willing to refer out if you notice a client may need psychological support you can’t (and shouldn't) provide,” Nelson explains. “Likewise, you need to know whenyou’re facing emotional challenges that require you to distance yourself from a situation.”
Professional Boundaries address a vast array of areas, Nelson suggests. “Proper representation of your abilities, financial propriety, appropriate advertising, as well as observing jurisdictional law and regulations, to name a few,” Nelson says. “Professional boundaries also include what you consider proper attire, your communication skills, record keeping, hygiene and cleanliness.”
Social Boundaries generally address issues regarding are going to preclude having social relationships with clients,” Nelson explains. “For therapists in small communities, however, where social relationships may exist, being very clear about your professional versus personal role is important.”
Boundary Issues Online: A plea to all Massage Therapy Professionals to step up our game.
10MondayNov 2014
Posted Tidbits from the Massage Mamma
in
https://bodywork-art.com/.../boundary-issues-online-a-plea-to-all-massage-therapy-pr...
I 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
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