I’ll never forget one colleague who, while working on a client’s feet, would crouch down on his knees and rest his head on the table. The result was an odd, contortionist-like posture that couldn’t have been very comfortable for him and a disconnected few minutes of work that couldn’t have felt very good for the client. More than one colleague stopped without warning, stepped away from the client, and sipped a cup of coffee. Others hawkishly watched the clock, then ended the session at 60 minutes on the dot in midstroke, stood up, and barely uttered a thank-you or goodbye as they left the room. 

I mention these anecdotes not to pass judgment. We all have our off days, and we all have sessions where the clock, the cup of coffee, or the door seems infinitely preferable to the task at hand. And yes, such breaches of professionalism make me concerned that many people out there may have a negative impression of massage therapy. But more importantly, watching my colleagues has made me concerned about our capacity as massage therapists to take care of ourselves. 

 

Beyond Burnout

Working alongside my colleagues in those days also prompted me to think about burnout. This nebulous concept was mentioned often while I was in massage school, and then rarely discussed among my colleagues at different spas. In both circumstances, burnout remained a foreboding concept, a shadow lurking in wait, rather than something that was really analyzed and understood. 

The statistic I remember from way back during my student days was that, at least in New York State, only half of all massage therapists renewed their licenses. After four years, when the state required us to recertify, a full 50 percent of therapists chose to let their licenses expire, meaning either they are working without a license (always a possibility), or they stopped working as massage therapists. While the statistic seems like an exaggeration—a shocking fact that’s quite effective for teachers trying to convince eager, green students that good body mechanics really are important—it is clear to me that the careers of too many massage therapists are shorter than they could be, and all too often end badly.
Sometimes that end comes when a repetitive-stress injury cannot be ignored any longer, but sometimes it is because therapists get so sick and tired they can’t face a day chock full of clients. 

It seems to me that these ends of the spectrum are more closely linked than we think. I believe we massage therapists can’t talk about our physical ailments without talking about our mental ailments as well. And ultimately, I think that we would better understand burnout, and would be better able to avoid it, if we reconsidered the matter altogether. 

Finding Balance

The problem with burnout is that it only has negative connotations. But such a simple, one-sided concept ignores the complex blend of emotions and merger of the physical and the mental self that a massage career is built up on. It is also far too easy to ignore. Usually, we only see it in the past tense, when we are already burned out. At that point, the term offers us nothing except a look back at a derailed career. Instead, we need to clearly recognize this problem when we can actually do something about it. So to move forward, let’s move past the idea of burnout altogether and instead address the concept of focus. 

After a decade of learning and teaching and working, it seems to me that the key to being a happy massage therapist is not merely avoiding burnout, but cultivating a healthy focus—what I call a freed focus. I think that the problem for the many massage therapists who are flailing in their careers is that they swing back and forth between two extremes. Sometimes they care too much about their work; other times, they don’t care enough. None of us are immune to this pendulum. It is as inherent to the human condition as the perpetual movement of the breath—from the fullness of the inhale to the emptiness of the exhale, and back again. I believe we all swing between a focus that is frayed and a focus that is faulty. Once we acknowledge that swing between extremes, and see that each side has both deficits and benefits, we can move toward the center, toward a focus that is freed. 

Maximum-Effort Massage

The contorting and coffee-drinking may be my most cringe-worthy anecdotes, but they are far from the only ones. Other colleagues I worked alongside were, for lack of a better term, too good at what they were doing. They were so eager to take care of the client’s every ache, every pain, every whim, that they forgot themselves in the work. They pushed their bodies way too hard, often going way over the client’s allotted time. They were so convinced that they had the key to all that ailed their client—that they could “fix” the person on the table—that they worked deeper or harder or longer than the client even wanted. In other words, they were too focused. 

All of these things stem from good intentions. And yet eventually, too much of a good thing is just as bad as not enough of a good thing. One of my colleagues was particularly passionate about his work—so passionate that after each session he dripped with sweat. (He tied a bandanna around his head at the beginning of each session to avoid dripping on a client. With the strap of dark cloth encircling his head, he looked a bit like Rambo, a comparison that, unfortunately, was all too appropriate.) He was adamant that he knew how to make his clients feel better and believed that the best way to do so was to push as hard as he could, hour after hour. 

His degree of focus was commendable. And yet the spa manager got repeated complaints about him, and finally he had to meet with our lead massage therapist to figure out why clients were unhappy. But the problem was clear, even though our manager never phrased it this way: that therapist cared too much. He was so determined to help his clients that he was convinced he knew the best way. The result was that he wasn’t really connecting with those clients—responding to their bodies and engaging in that subtle connection between the practitioner’s musculature and the client’s that can elevate the work to an art form. Instead, he was just pushing his clients into submission, daring their tight spots to resist his will. 

Sure, some clients loved him because his pedal-to-the-metal approach to massage matched theirs. But the larger problem remained: he wasn’t actually listening to his clients’ bodies and adapting his work to fit their needs. And seeing him slumped in the employee room after his fifth session of the day, I would say that he wasn’t actually listening to his own body, either. I lost touch with him after I left the spa world to start my private practice, but I can’t imagine that he is still practicing anymore; or rather, I can’t imagine that he is still practicing happily.

Frayed vs. Faulty

Burnout implies a reductive image of our careers: a straight line, always slanting slightly downward. You start out with passion and enthusiasm, and then, as the years go on, you gradually descend toward clock watching, frustration, and injury. The other possibility is that our bodies are only capable of doing a certain number of sessions, and that after that number—which varies widely—our bodies give out, give up, or go kaput.

What a depressing vision of a career that we love and—at the very least—paid a lot of money to be a part of! Why would we want to think about massage that way? 

The notion of focus, by contrast, allows us to see our careers in all their complexity, to acknowledge the joys of our work alongside the frustrations. While burnout, by definition, is negative, focus is both good and bad, positive and negative, productive and counterproductive. When we take a coffee break in midstroke, it is easy to see that we have too little focus, that our focus is frayed. 

But it is just as important to acknowledge those moments when we have too much focus—like my Rambo colleague—when we are so convinced that we know what to do to help that we stop listening to clients. We stop listening to what they tell us verbally, or what changes in their breathing patterns tell us, or what their body language tells us, or what the musculature response to our touch tells us. In these moments, our focus is faulty, creating an illusion that we know what’s best and an illusion that a good massage means giving of ourselves completely. 

While too much focus is a less obvious problem than too little, both extremes often lead to the same negative conclusion.  

Learning to Exhale

No one starts massage school feeling unfocused, detached, or disenchanted with the profession. With our first job, too, we are excited and full of focus. We rush to get the client a glass of water after the session. We dutifully write SOAP notes. (How many of us today write as much about our clients as we did when we first started?) We really, really, really want to help our clients. That passion is inspiring, and a wonderful aspect of working with new students and new practitioners, but it carries hidden challenges. 

Many of my best students literally throw themselves into the work. So eager to do good, they don’t cultivate that crucial boundary between themselves and their clients. With their laser-like focus, they don’t hold anything back. Such dedication is at first beautiful to see; teachers (me included) and peers rightly praise these efforts. But we must also counsel these wonderful students on skills that are equally difficult: how to hold back, how not to become enmeshed in your client’s pain, how to commit to the body on your table, and how to let go of that client afterward. 

I was one of these students—eager to work as deep as possible and thrilled by the praise I received. But what I see now is that my careful massage strokes were also a means of stroking my own ego. My desire to help was sincere, but distracting. I saw clients in terms of how I could reshape them, like stunning, shimmering possibilities rather than people who had their own needs. Such vanity would carry me away, down paths of my own devising, and I would ignore the much simpler needs of the body in front of me.

After graduating from massage school, I was hired by a wonderful wellness center. I was thrilled to start working. My first day, I calmed my zeal enough to introduce myself to my client and get his intake information. I came into the room and began to apply oil to his back. About two minutes later, my low back was burning with pain. It ached so much that I seriously considered stopping the session. I thought about the loans I had to pay off. I wondered if I would ever be able to do this for a living. I winced and kept on going. Finally, about midway through the session, I realized that I was the source of my pain. I was so eager for my career to begin, so determined to push my way into this (poor, unsuspecting) client, that my whole body was rigid and tense. I was barely breathing. I gradually coaxed my paraspinal muscles out of their taut, hyperaware state of attention and allowed myself to exhale. The pain began to dissipate.

Slowing the swing

When we know how to fix our clients, as I thought I did, we typically force our way into their body. Our mental hubris becomes physical exertion. We expend more effort than we should and that excess tension, that “too-muchness,” builds up within us. We start to ache. It was only by loosening up, by not being as focused, that I was able to complete that first massage. If I had continued in that hyperalert state, desperate to do a great job, then I would not still be practicing today. 

That intense desire—what I have called a faulty, or excessive, focus—can mar our careers. The coupling of passion and ego can become counterproductive. Once we believe we know best, our clients suffer. And gradually, so do we. We think of being stuck in a rut as part of getting burned out, as what happens when we stop caring. But I think we can also get stuck in a rut of focus. We can get stuck trying to do too much, trying to be too good.

An impassioned desire to help can lead to self-righteousness when clients don’t respond as we think they should. “I want to help so badly,” we think to ourselves, and then ponder, “why isn’t my client amazed by my work?” After a while, we start to pay less attention. We feel unappreciated. From there, it is a short distance to dreading our shifts at the spa or feeling annoyed rather than elated when we book a full day of private clients. Our focus shifts from faulty to frayed.

But that shift is not final. Our stereotypical image—that slow, steady, inevitable decline toward burnout—is not an accurate representation of our careers. There is no identifiable moment when you stop being an engaged, happy therapist and become an unengaged, unhappy therapist. 

Instead, the more complicated reality is that both of these capacities are always present within us. Too much focus and too little focus exist as two sides of the same coin. They are counterproductive in their extreme forms, but in proper proportion they are both essential. 

My favorite photographs are a balance between great clarity and a bit of blurriness. Those parts of an image that are out of focus make the image as a whole more alluring. So, too, our work is more potent—more useful for the client, and more satisfying for us if we are not completely focused, if a part of our consciousness is a little bit blurred. 

Another way to say it: it does us no good to be focused on our own body, stuck in our own thoughts. Nor is it ideal to be focused entirely, slavishly, on our client. Our talent emerges when we spread our focus, when our work encompasses both therapist and client. In between a focus that is frayed and a focus that is faulty, we can find a focus that is freed. In that serene center, you are aware of your own breath and also of your client’s breath. You are aware of the sensations in your skin and your musculature, and also the information that your client’s skin and musculature offer you. With that dual awareness, that freed focus, the massage becomes an active, reciprocal engagement between you and the client—an experience you have with the client, rather than something you do to the client. 

If we can let go of our ego (our ideas about what the client needs), and if we can let go of our tension (our desire to force the client to feel better), then we can engage more fully and more honestly with the client, wherever he is, whatever he wants. We will be better attuned to his needs, without the distractions of our own ego, without the interference of our own muscular tension. 

Similarly, if we can let go of the clock and let go of the unending distractions beyond the treatment room (the to-do lists and the family obligations and the financial worries), we can be absorbed by what is happening right at our fingertips. 

If we slow that swing between extremes, we can appreciate the necessity of both—the joy of giving of ourselves and of holding ourselves back. As we let go of that too-much focus, or bolster that too-little focus, we find both in proper proportion, and we come to that calm confidence in between: that soul-satisfying, body-nourishing moment of engagement; that focus that is freeing, where we are helping another being and being nourished at the same time. 

That effort is a perpetual process. It is impossible to find a perfect balance and stay there, as if frozen in place. Nor would we want to. Rather, if we acknowledge that we are navigating between these extremes, we can lengthen our longevity, abandoning the harmful concept of our careers as a slow, irrevocable decline toward burnout. And we can also temper our eager ego and our need to fix, instead inhabiting the supple, serene center and discovering a more potent capacity for healing.  

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Adjust your table up or down a notch in order to challenge your body mechanics and remind yourself that subtle shifts can have a big impact.

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Choose one client each day and begin working in a different position than you usually do.

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Choose one client each day to spend four extra minutes on an area you usually ignore (anterior legs, for example, or posterior arms).

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At the end of a shift, see if you can remember the name of each client you worked on. Offer a mental thank-you to each of them.

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Brush your teeth with your nondominant hand in order to cultivate a new dexterity.

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Volunteer—not getting paid can make your work feel more worthwhile.

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Become aware of your breath. Practice lengthening your exhalation as a way to slow down your body and slow down your work. Focusing on the passive exhalation, rather than the active inhalation, will remind you to focus on doing less and feeling more. 

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Become aware of your client’s breath. Let the breath shape the speed and pressure of your strokes. 

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Work without a goal. 

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Think of yourself as a facilitator. You are not healing your clients—rather, you are facilitating their ability to heal themselves.

To read this article in our digital issue, click here.