Although it may be hard to believe after reading this, I have never been tossed out of the profession or reprimanded by a state board. But in 17 years of practicing massage therapy, I have made some whopping errors. The following are absolutely true stories in which I goofed. Big time. As you start shaking your head and thinking you’d never make mistakes like this, understand that I’m a textbook author, I have a thriving private medical massage practice, and I have spoken nationwide on lymphatic, medical, and oncology massage. If I can make these mistakes, perhaps you can use the following as a road map to keep yourself out of trouble.

Start at the Bottom
An elderly gentleman was suffering from severe sciatica. This necessitated my having to work on his lumbar spine and gluteal regions. During our intake, I asked permission to work on his glutes. He nodded, eager to get on the table. After having completed the detailed work on his lumbar spine, I placed my hands on his glutes. He immediately arched into a perfect yoga cobra position, pushing himself off the table with his arms, looked back at me, and said, “Why are you touching me there?!” He obviously had no idea where his glutes were.

Another client, with severe shoulder girdle pain and abundant breast tissue, told me after she got off the table, “Well, no one ever massaged my breasts before, but I feel better.” I had not in fact massaged her breasts; I had performed detailed subclavicular work with one hand while gently holding her breast tissue out of the way with the other. To her, I had massaged her breasts.

Lessons Learned
Don’t use anatomical terms if there is even the slightest possibility the client doesn’t understand; indicate with your hands where you intend to work. After years of working with bodies, we can get too comfortable with moving tissue around and out of the way, even in private areas. Stay keenly aware of body parts traditionally viewed as private and always ask permission—and explain why you are trespassing—before starting the work.

Falling in Love
We are told from the very beginning of massage therapy school, “Don’t date your clients. No emotional involvements. It’s unethical and compromising.” But, of course, I had to be the exception. I met a client at a chair massage event. We both felt the chemistry. He had severe scoliosis and extreme hypertonicity, and asked if he could get a full treatment on his back. “Sure,” I said, thrilled I’d see him again, and gave him my card.

You know the rest. One thing led to another. I tried to keep our personal relationship separate from our professional one, but it was impossible. When the inevitable breakup occurred, I lost my heart and he lost the opportunity for the corrective bodywork he truly needed.

Lesson Learned
I don’t really have to spell this one out, do I?

Dropped Stones
I wish I could say most of my errors occurred when I first started out, but this one happened less than a year ago. I had just completed a lovely two-day hot stone continuing education class and was eager to try out my new skills on one of my favorite clients. If you accidentally heat the stones beyond what would be safe to apply to the skin, you have to give them time to cool off. I found myself tossing a stone back and forth in my hands until it cooled. Great idea—until the darn thing slipped out of my hands and plunked onto the client’s back. So much for relaxation. I’m fortunate it occurred with a client who was also a long-time friend. We laughed, and I apologized profusely as I regained both the rock and my composure.

Lesson Learned
Stay clear of your client’s body while shifting equipment, shaking stuck lotion out of the bottom of a tube—or throwing rocks. If a hot towel or hot stone needs to cool, put it down somewhere safe and leave it to cool on its own.

Watch the Humor
One of my pet peeves is being called a masseuse. Most therapists consider it a derogatory term that smacks of prostitution, so when it’s used, I always take the moment to educate. At a church gathering once, the minister, a well-intentioned fellow who I knew pretty well, said, “Charlotte, tell us about your work as a masseuse.” My standard response—which I had always thought was pretty funny—was, “I prefer to be called a massage therapist. In my mind, masseuse means prostitute, and I don’t have that much fun.” Yep, I dropped that line in the middle of a church gathering. You would think all the oxygen had been sucked out of the room. The minister turned six shades of red, cleared his throat, and immediately changed the subject.

Lesson Learned
Some of us are better at reading a social group than others, but my ineptitude made it clear I had a lot to learn about reading a group before using even the slightest bit of off-color humor.

Cultural Insensitivity
While working in a hospital as the lead medical massage therapist, I was often overworked, stressed, and moving way too quickly. Once I was called to the room of a young Middle Eastern boy who had abdominal pain. The physician asked me to do something to help the boy, as narcotics weren’t working.

When I arrived at the patient’s room, I nodded to the mother, sat on the bed, soothingly talked to the boy, lifted his hospital gown, and began massaging his abdomen. Suddenly, I heard and felt the rush of someone coming at me, shouting something. I looked up to see the boy’s mother physically restraining a man who must have been the father. His eyes were wild and he clearly wanted me to get away from his son. The mother ushered him out of the room while signaling to me to continue my work. I did so. It took about 20 minutes, but I did manage to ease the boy’s pain and put him to sleep.

Lesson Learned
Although my intentions were good, my myopia caused me to trample all over cultural norms. Non-family, cross-gender touch without permission was a big no-no in this family’s culture—and beyond that, not asking parental permission before touching a child is a mistake in any culture. I was fortunate a loving mother intercepted what could have been a physical confrontation.

She’s a Witch
One evening in the same hospital, I was working on the hospice floor. Usually, hospice patients are so frail that a foot, hand, or head rub is enough to settle them into sleep. One patient, however, was very visibly agitated and the nurses hadn’t been able to calm him all day. I thought that since everything else had failed, I’d try reiki (energy work) to calm him. I lowered the lights and began the reiki session, closing my eyes and running my hands above his body. The session helped the patient settle and I left the room quite satisfied with myself.

Outside the room, I found a very irate-looking younger woman with the charge nurse. I could tell I was in trouble. The patient’s daughter had come into the room during the session, misunderstood what I was doing, and flew down the hall to tell the nurse, “Someone is in my father’s room doing witchcraft!” No amount of explaining could convince her I was not “of the devil.”

Lesson Learned
As convinced as you may be about the efficacy of your techniques, remember they may be out of the ordinary to others. Always honor those in the room by explaining what you are doing and getting permission to proceed.

CE Snob
Many of my clients had asked if I offered hot stone massage. For 15 years I had avoided taking a hot stone class, thinking it was “fluffy stuff,” and there was no need to add it to my toolkit. However, after enough clients asked, I decided to succumb and take a two-day course. I went into the class with an attitude, thinking it was silly, it couldn’t possibly feel as good as everyone said—just wanting to get the dumb thing over with. The absolutely excellent instructor was smart enough to know several of us had reservations, so her tactic was to put us on the table immediately to receive the experience of hot, oiled stones being rubbed slowly over our bodies.

I thought, “Yeah, right.” But as my partner started moving the rocks over my back, I began to relax deeply—which surprised me because I rarely relax during these public teaching sessions. After only a few minutes, I fell asleep! Never in my life have I fallen asleep on the massage table. I was totally wowed by the experience and came to understand the deep benefits of hot stone therapy.

Lesson Learned
Keep an open mind when choosing CEs and take a class outside your normal comfort range. You might be pleasantly surprised.

A Damaged Reputation
Fibromyalgia is a tough condition to treat—the patients are often very demanding and it can be difficult to realize any improvement. I had worked with one woman for a few weeks who had a reputation as a “doctor hopper”; she had gone to a dozen physicians and health-care providers and said during her intake, “No one can help me.” I love a challenge and gave her my best for several weeks before realizing we weren’t making any progress. But it was not all due to my techniques: she refused to perform the homework exercises I knew would help her, she was a constant complainer, and there seemed to be a deeper psychological issue related to her fibro that was beyond my scope of practice to approach. She stopped calling to rebook, and frankly, I was relieved.   
 
Months later, I heard from one of her distant acquaintances that she was telling people she had stopped coming to me because I couldn’t help her, so I obviously didn’t know what I was doing. This truly stung for several reasons. I had given her my best, and she did nothing to help herself.

Lesson Learned
I should have addressed this client’s lack of compliance and discontinued our sessions rather than just allowing her to drift away. When you can’t help a client, for whatever reason, diplomatically end the professional relationship. I’ve learned to refer to colleagues in these situations. By being proactive, you save your reputation, and there is a good chance your client might receive help elsewhere.

The biggest and worst
I have never told anyone this, let alone write it for a national publication. But it was so deeply embarrassing to both me and the client, and I was so naive about the whole situation, I figure if I tell you about it, it may save some real heartache.

About six months out of massage therapy school, I was working on a young gentleman who had a severe knot in his glutes. I did not yet know to work on surrounding tissue before attacking the point of difficulty. Instead, I spent nearly the entire 60 minutes working on this poor guy’s glutes. Digging in with my elbow, using my forearm, digital kneading—oh, I pulled out all the stops. But the kicker was that I finished the session with about five minutes of very deep, very rhythmic fist-kneading to both glutes. At one point, I thought I felt his glutes stiffen and I heard a sigh, but I was too wrapped up in my fine therapy to think much about it. When he got off the table, I noticed his face was red and he was sweating. He very shyly said, “I’m sorry, I think you’ll find a wet spot on your table,” before he hurriedly left.

My overly localized and rhythmic work had been sexually stimulating to the poor soul, and I had caused an ejaculation. I remember at that point realizing in a flash what I had done, and swearing to myself to leave the profession. Of course, I did not, but …

Lesson Learned
Think beyond the therapeutic effects of your work, and if there’s any chance it can be taken sexually or create a sexual response, stop immediately. (For more on this sensitive topic, see “Let’s Talk About … Um … Erections,” Massage & Bodywork, March/April 2013, page 64.)

Falling Asleep
Finally (can you believe I’m still practicing after all this?!), I was doing massage rounds in a pediatric intensive care unit in the hospital I mentioned previously. It was the end of a very long week and a tough day, but I wanted to see if any children needed help getting to sleep. One of our favorite kids was a little 7-year-old who had been in a near-fatal car accident. My team had been visiting and massaging her every day. I quietly tiptoed into her room. For once, she was asleep and her parents weren’t around, which was unusual because they always kept a 24-hour vigil. I pulled up a chair, sat down next to her bed, and just stroked her little back for a while, intending to leave in a few minutes. I must have laid my head down because the next thing I knew, her mother was stroking my back soothingly and saying, “Charlotte, Charlotte, how long have you been here?” I had been asleep for an hour. The mother said she found it “quite sweet,” but it was extraordinarily unprofessional of me.

Lesson Learned
Know when it’s time to quit work and go home before putting yourself in a compromising position. I have heard of massage therapists falling asleep standing while giving a massage; I can understand how it happens.

Full Disclosure
Well, now you know. I’ve dropped things on a client. I’ve fallen asleep on duty. I compromised my professional ethics by falling in love with a client. I was a hot stone snob. I crossed cultural barriers with absolutely no sensitivity. I embarrassed the bejeebers out of some very nice people. And I can promise you, these are not all the mistakes I’ve made.

The point is not, “Wow, how can I have misjudged so badly?” The point is that our profession has built-in land mines that any of us can step on. To maintain our professional standards and those of our chosen career, we’ve got to be alert, culturally sensitive, emotionally responsible, able to sense confusion, and open-minded from the day we graduate to the day we hang up our lotion bottles.

 May your mistakes be few and far between. May my errors lead you away from similar mistakes. May you continue to do good and help heal. We are in a wonderful profession.

Charlotte Michael Versagi is a national presenter and the author of Step-by-Step Massage Therapy Protocols for Common Conditions (Lippincott Williams & Wilkins, 2011). Contact her at charlotteversagi@gmail.com.

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