Misconception #1: “I just need to act naturally.”

“I recently graduated from a massage school that offered only a short course in ethics and professional boundaries, and I’m still finding my way in that area. A friend who has been a massage therapist for a couple of years says her philosophy is to be natural with her clients and to not act like she’s better than them. For instance, she talks to her clients the way she talks with her friends, even sharing problems in her personal life. Last week, she told me she asked a client to wait 10 minutes before starting the session while she had a snack. She said the client was fine with that. Although being natural sounds good to me, I don’t know where to draw the line. Is it okay to be so casual with clients?”

E.W., Trenton, New Jersey

I understand your confusion. Naturalness sounds like an appealing and positive quality. The problem is that there’s not much that’s natural about the circumstances of our work. Basically, we’re paid to put our hands on the naked bodies of strangers. Our sessions don’t occur naturally as spontaneous, organic events. People come to us at a pre-arranged time and place and pay us to focus on them for a certain amount of time. It’s an artificially intimate situation that is potentially awkward, embarrassing, and threatening, and we’re the ones responsible for helping make the other person feel comfortable and safe. Even if we’re working with someone with whom we’re already friends, it’s not the same as just hanging out with that person.

The desire to be natural is useful if it means being warm and unpretentious, not mystifying our work or being arrogant about what we do or how we do it. However, you’re right to be concerned about being too casual. “Being natural” can be self-indulgent when it means treating clients like buddies, expecting them to listen to our problems, or not to mind if we’re careless about the framework of a session, such as not starting or ending on time.

Some massage therapists might protest that their clients ask about what’s going on with them or that their clients wouldn’t complain about a little pre-session snack.  However, consider this: our clients are a captive audience who want us to help them and, therefore, don’t want to risk offending us. Rarely will they complain directly to us. Although some clients may want to hear a little about how we are, most are probably inquiring about us out of politeness. It’s more likely that clients who seem interested in our lives or tolerant of our laxness are just putting up with us, hoping that we’ll eventually get around to helping them feel better.

There’s another reason we may not want to follow our natural impulses when it comes to boundaries. If you didn’t grow up in a family that had perfect boundaries (and who did?), what feels familiar and natural to you may not be a reliable indicator of what’s appropriate.

A colleague reports: “I once worked with another massage therapist in one half of a duplex in which the two bedrooms were used as treatment rooms. I was surprised to see that the other therapist often left her door ajar while she was working. My clients and I could see in as we walked by, and although the client was draped and not exposed, it still seemed odd. Later, the massage therapist told me that when she was growing up, the children weren’t allowed to close their bedroom doors.”

That’s an unusual example of a therapist’s blind spot, but we all have them to some extent. To be careful that our experiences don’t blind us to clients’ needs, certain guidelines about dealing with clients, such as keeping the focus of our actions and words on the client, will help us stay professional.

Of course, boundaries can soften as we get to know a client. If we have clients we’ve been working with for years, we’ve likely learned when or if we can relax with them and be more personal or flexible. But even with long-time clients, respect for their time and maintaining a level of professionalism are still due.

If you’re wondering if you’ve been sharing too much with clients or if you’re being too “natural” or careless about other aspects of the session, you could practice turning the full attention back to your clients or tightening up other standards and then notice their responses. You probably won’t get any direct comments about the change, but you might just hear more compliments about what a relaxing massage that was.

Misconception #2: “The healing energy in my hands is enough.”

“I’ve been told that I have good energy in my hands and that the energetic connection with my clients is what matters most. How does that fit in with your emphasis on being professional with clients?”

B.S., Topeka, Kansas

That’s a great question. The energetic bond with our clients can be powerful and healing. And it’s possible that clients might overlook shortcomings in our professional presentation if they feel a special energy and sensitivity in our touch. However, clients deserve to be treated with care and respect and shouldn’t be asked to overlook flakiness.

A friend reports: “I once got several bodywork sessions from a woman who had ‘great hands.’ I could feel a warm, comforting energy coming through her hands. However, her professional behavior left much to be desired. She actually thought it was okay to watch television or talk on the phone while she worked on me. She’d been taught

that the energy came through no matter what else was going on. After a few sessions, my irritation with these many distractions overrode any benefits from her work and I quit seeing her.”

No matter what “healing energy” you project, you also need to create an atmosphere within which clients can be at ease. They need to trust you to attend to the details of their comfort and privacy. Wonderful energy in your hands combined with great professional care would be an unbeatable combination.

Misconception #3: “My clients should adjust to my needs.”

“Last week, I cancelled one of my regular clients at the last minute so that I could take care of some personal business. The business wasn’t urgent, but it made me feel better to get it out of the way. My client was really upset. How can I get her—and other clients—to see that I have needs too?”

F.V., Austin, Texas

Of course, you have needs, but you’re confused about who is supposed to take care of which needs. Clients don’t have to care about our personal needs—that’s not part of the deal. The agreement is that we’ll show up when we say we will and do our best to help them for an hour or so. Of course, personal situations may occasionally intrude into their time, but that should be a rarity.

Being professional means the show must go on—that we put aside our personal needs while we’re working. When we have to let our clients down, we try to make it up to them. For instance, if you require that your clients cancel 24 hours in advance of their scheduled session, you would want to apply the same rule (and courtesy) when you need to cancel on them. It would also be a good idea to offer this client a free or discounted session at her next scheduled time to let her know that you understand her disappointment.

If you’re feeling frustrated that your personal needs are taking second place, it may be because you’re not taking good care of your professional needs with your clients. It’s common for massage therapists to have a hard time setting limits. But you have a right to expect clients to treat you with respect and to honor your policies about time, fees, and cancellations, for instance. You can’t wait for clients to intuit what these are or to set limits on themselves. Spell your policies out clearly from the beginning and then follow through if a client makes a mistake. When you don’t feel taken advantage of by clients’ lateness or poor payment habits, for example, you might feel less like your needs and theirs compete for time.

You also want to make sure you’re giving enough time to your own self-care. That can be a hard one for massage therapists, but it’s essential to let yourself have enough free time to get your personal business taken care of, and to take vacations, have massages from other therapists, and do other things that restore you.

There’s no downside to being professional and having solid professional boundaries. In the end, professional boundaries work to the benefit of both the client and the massage therapist. With a solid focus on benefiting clients when you’re with them and yourself at other times, life should come more easily into balance.

 Nina McIntosh combines more than 20 years of experience as a bodyworker with her previous years as a psychiatric social worker. She is the author of The Educated Heart: Professional Boundaries for Massage Therapists, Bodyworkers, and Movement Teachers, now in its second edition. For more information, contact Lippincott Williams & Wilkins at 800-638-3030 or visit www.lww.com. To learn more about professional boundaries and ethics, visit www.educatedheart.com.

 To learn more about illustrator Mari Gayatri Stein, visit www.mariscardsandmore.com.