Mindful Massage

Working in the Present Moment

By David M. Lobenstine

As massage therapists, we are supposed to be graceful, kind, and warm. We are supposed to abound with healing love. We are supposed to wake up each day eager to share our unique gifts with the world. Yet, the reality of our work is often quite different. The laundry service hasn’t delivered clean sheets. Your spa manager is disorganized. That song you hate is playing again. Your hands are aching, and the client keeps asking for more pressureWe all know what happens next—our work suffers. We are not fully engaged in the session; our mind spins with resentment or distraction or whatever else. As a result, our client suffers. And though we often don’t acknowledge it, eventually, we suffer, too.
There is, however, an alternative.
We can massage mindfully.
Mindfulness—an ancient practice of self-awareness, with roots in Buddhism, among other religions—is a hot topic.1 No surprise: who doesn’t want to exude that enlightened air of calm serenity; who doesn’t want to live in the present moment?
Using it as a self-care tool is critical, but I don’t think mindfulness has to stop there. I believe we can, and should, be mindful in session as well.
The practice of mindfulness is a powerful way to deepen and clarify our work—from the moment we meet a client to the moment she leaves our office, session after session, day after day. It's a way to help ourselves and our clients at the same time.

The Application of Awareness
Jon Kabat-Zinn, one of the leading teachers of mindfulness in the United States, offers a simple definition: “Mindfulness is awareness, cultivated by paying attention in a sustained and particular way: on purpose, in the present moment, and nonjudgmentally.”2 As we have all experienced, daily life is often the opposite: we worry about things that have already happened, we anticipate things that haven’t happened yet, we distract ourselves from the one thing we are actually doing right now with thoughts of all that we could or should be doing. That default setting—of mindless flitting rather than mindful focus—too often becomes the norm in our treatment room as well. But, by adapting the principle of mindfulness into our work, we can transform the endless hours we spend with oiled hands.
So what does a “mindful massage” look like? To be honest, it’s not much different than a normal one. I am still compressing and effleuraging and petrissaging and frictioning. I can work fast or I can work slow. If you were watching me, you might not be able to tell any difference, but I assure you, the client knows.
The reason is that what our teachers told us from the very first semester of massage school is true: intention is everything. And my intention, my aim, is not to accomplish anything. For us therapists, with our desire to help and heal, this not doing is extremely difficult. As Kabat-Zinn says, “The challenge of mindfulness is to be present for your experience as it is, rather than immediately jumping in to change it or try to force it to be different.”3 In other words, with mindful massage, I am not trying to fix my client.
Mindfulness is typically practiced via meditation. You do nothing but sit with yourself, observing the movement of your breath in and out. When thoughts and distractions arise, as they are guaranteed to do, you don’t judge yourself or try to push them away; you just acknowledge them and return your attention to the breath. The aim is to “experience our experience” as it is, rather than trying to change it.
With mindful massage, we expand this principle of observation to encompass both ourselves and our clients. Compared to many jobs, ours seems to beg for the application of mindfulness: how many other professions are built on large, uninterrupted chunks of time? The phone doesn’t ring, there are no emails to answer, no annoying coworkers stopping by your desk (and even those chatty clients, as we’ll see, are less likely to babble when you work mindfully). We have only our client’s body before us, and only our own mind to reckon with. Though we are moving rather than sitting, the meditative principle is just as applicable: we anchor ourselves with our breath, acknowledge mental distractions when they arise, and return our awareness to the inhale and the exhale. The difference, of course, is that there is another person in the room. So we expand this awareness to encompass the client: we attend to our own breath, as well as our client’s breath; we observe our client’s body as we observe our own—without judgment.
Now, it is easy to imagine meditation as something monks do on mountaintops—as abstract and disembodied. But working mindfully is not a polite way to say “working lightly.” Unless the client wants otherwise, I am working quite deep. In fact, we can often apply more pressure—we can more effectively put the “deep” in a deep-tissue massage—when we massage mindfully.  

A Mindful Massage
So, how can I help my client if I am not trying to accomplish anything? Here is the key: I recognize that my client is already complete. Yes, she has aches and pains, and yes, there is that recurring spasm in her right gluteus medius, and yes, she gets that piercing headache behind the eyes when she sits at the computer for too long. All of these problems—all of the specific reasons why a client seeks massage—are real, and I take all of them seriously. It’s just that these problems are ultimately just a part—and I would argue, a very small part—of who we are.
Just as the vast expanse of our mental life is often hijacked by fears and frustrations, our particular ailments distort our own awareness of our bodies. We become the sum of our issues. As therapists, we unintentionally encourage this problem-centered story. In our effort to ascertain the necessary medical details (and in the inevitable rush to get the client on the table), our intake questions focus on the problems. How often do we ask our clients to describe the parts of their body that feel good, as opposed to the parts that are in pain?
Pain is real. Everything our clients tell us is important. And yet, there is always more to the story. Mindfulness reveals the gap between the story we create about our reality and the much larger reality of life itself. When we massage mindfully, we are expanding the boundaries of that narrative—both physically and mentally, both for ourselves and our clients. The flutter of thoughts and hopes and worries don’t disappear, but when we simply acknowledge them, without judgment, and return our focus to our breath, the flutter of our mind loses its disruptive power. Our mindful capacity blooms beyond our mindless tendencies. Similarly, we are reminding our clients (and ourselves) that we don’t need to be held hostage by our aches and pains and worries. We are enhancing an awareness of the whole body, from head to toe, from muscles to mind, from body to breath.
The irony is that such expansion is only possible when we don’t force it. Just as a muscle fiber will involuntarily contract if it is stretched too far or too fast, I find that the greatest change only comes when I don’t try to make that change happen. By not trying to accomplish anything, I am avoiding the trap we therapists too often fall into: believing we can fix our clients; believing if we just push hard enough, we can force the aches and pains into submission. The more clients I see, the less I believe we can fix anything. The less I believe we can heal our clients, the more I believe our clients can heal themselves. The greatest gift we have to offer, I believe, is not fixing, but facilitating.     

Breathing Back the Body
Massage with mindfulness may seem like a contradiction. How can you care about your work without being attached to the outcome? How is a focused detachment possible? Via the breath.
In mindfulness meditation, the breath anchors our awareness of ourselves. When applied to massage, our breath anchors us both to ourselves and to our clients. As I become more cognizant of the rise and fall of my own breath (and my own thoughts) while I work, I also become more receptive to what is happening in the client’s body. The result is a curious kind of reciprocity, a feedback loop: as I become more aware of myself, I become more aware of my client.
Usually, the client feels this shift, too. She becomes more aware that she is an active participant in the session, even though she is not doing anything; she realizes she can communicate with me even though she is not talking. She, in short, becomes more aware of her awareness. As a result, I am facilitating the session, but her engagement is just as important.
Of course, it doesn’t always happen this way. Some clients want the massage to help them forget about their body, rather than become more aware. With these clients, I try not to judge. I resist my urge to engage and I let the client zone out. These rare sessions are a good reminder of the importance of detachment. Ironically, it is when the client is not interested in mindfulness that I must be the most vigilantly mindful, in order to avoid forcing my own attention onto her.
But for the vast majority of clients, my own expanded awareness is almost immediately (if unconsciously) mirrored by their own. We have all felt that moment in a massage—when we realize, say, that we only have eight minutes left, and still have to work on both arms and the neck—that we push into the client too quickly, too deeply. The client’s body instantly tenses up and she inhales sharply, readying herself for the next assault. That protective response can ruin a massage, yet it is vital—our unconscious body guarding against invasive contact. We can also utilize that instinctive response productively.
If we contact the client’s body slowly—if we sink into her tissues, rather than push—then we work with the power of the breath rather than against it. Try this: at the start of your next session, with the client prone, place your palms between her shoulder blades. Then—and for us good-intentioned helpers, here is the tricky part—do nothing. Feel just the weight of your hands on her back. Don’t push or press or change. Just observe. Become aware of your own breath; how it fills and empties. My experience with most clients is that after a few breaths, with just the weight of my hands on their back, they start to inhale more deeply. Your client is probably not consciously aware of why her breath is deepening; it just happens. The presence of your hands is like an invitation.
That expansion is the opposite of what happens when we push too deep, or too fast. Instead of causing the client to anticipate the next attack, to guard against whatever might cause pain, she is doing the opposite: she is opening herself, expanding herself. As she deepens her breath, she becomes more aware of the extent of herself. She finds she can breathe more fully—even if her shoulders hurt, even if she is worried about her ailing mother.
As Kabat-Zinn explains, “Whatever the quality of your experience in a particular moment, what is most important is your awareness of it. Can you make room for awareness of what is unfolding, whether you like what is happening or not, or whether it is pleasant or not? Can you rest in this awareness, even for one breath, or even one in-breath, before reacting to try to escape or make things different?”4 When we “rest in this awareness,” our pain does not magically go away, but rather, we feel how much bigger we are than our pain. My client realizes that even if she is in pain, that pain is not the sum total of her life.
On your next exhale, imagine you are pouring some of your body weight into your hands. Feel the client’s breath deepen further as you sink into her tissue. You are now working with an awareness of your own breath—how you can sink your body weight into the client as you exhale—which in turn is instigating your client’s awareness of her own breath.
With both client and therapist inhabiting the breath, the possibilities only grow. Let’s say, for example, that because of how this client has described her headaches, I spend 15 minutes doing myofascial and deep-tissue work around her shoulder blades and up the lateral neck. Though I am focused, I am not fixing. There are many ways I could make her feel better, but I don’t want to make her do anything. Whatever techniques I use will be more powerful if they don’t overwhelm her musculature, but rather enhance her own engagement with her body.
As I am frictioning the distal attachment of the levator scapula, or as I am scooping underneath the lateral edge of the shoulder blade to access the subscapularis, the specificity of each technique is in the service of a larger aim. She has been getting headaches for as long as she can remember; she feels that vise of tension clamping across her shoulders as soon as she gets out of bed in the morning. I am not going to be able to make that tension disappear with a few minutes of work. But, as I sink in, as I invite her own breath, perhaps she will feel her own capacity to breathe into this area. Perhaps she feels how, even in the midst of the pain, there is still the possibility for expansion on the inhalation and melting on the exhalation. As our breath expands, so, too, does our consciousness.
Though I am knuckle-deep in her subscapularis, very little has changed. Some of her muscle tension, inevitably, is still there, not to mention any of the other things our clients carry onto our table, like concerns over money or relationships. What can change in this moment is perspective. We can see that this great churning cauldron of sensations and thoughts and feelings is real and true, and yet is only one small piece of our life. Kabat-Zinn asks us: “Can you see that if you can accept how things are now, the very next moment is already different? Can you see that it is instantly liberated from all the narratives we constantly saddle ourselves with that aren’t the full story? The practice can bring us back to how it is in the body right now.”5

The Perpetual Present
Mindful massage, I believe, is just such a practice—one that enables us and our clients to feel “how it is in the body right now.” It is here where lasting change is possible; not the mindless, short-lived relaxation of 60 minutes in which you are exempted from the rest of life, but change that enables us to embrace the rest of our lives, change that enables us to inhabit our bodies anew.
When we, as therapists, commit ourselves to simply observing—rather than judging—our thoughts and emotions while we work, we can acknowledge the endless distractions around us without disrupting the calm focus we need to be effective therapists. We remind ourselves, with each breath, of the profound importance of this present moment. Each time we choose focus over distraction, we “sustain our awareness and come to know it better and live inside its larger, never-diminished wholeness.”6
And, as we manifest that wholeness in our work—by observing rather than judging, by pouring rather than pushing, by facilitating rather than fixing—we model for the client how she can be conscious of what is happening in her own body just at that moment. Not the story she tells about her body, not her fears about the future and disappointments about the past, but just what is happening right now, in this breath, in the spacious now. And just as we find that our thoughts and emotions are fleeting, malleable, and only one tiny part of our huge self, so, too, can the client gain a clearer perspective on her physical and mental self. With mindful massage, each session is a reminder, both to our client and ourselves, of the expansive opportunity contained within the perpetual present.

Integrating Mindfulness

Notice Yourself
Pause before you enter the treatment room. Breathe. Feel the inhalation filling your body; on the exhale, feel the breath sliding from you. Notice your feet, solid on the floor.
Begin by Doing Nothing
Your first contact with the client’s body establishes the tone of the entire session. Place the weight of your hands on the client wherever you intend to start. Focus on your breathing. Don’t push, don’t force, don’t do anything at all. You are offering a nonverbal demonstration that you are not going to force your client to change; rather, you are going to help her facilitate whatever change she is ready for.
Pour, Don’t Push
The quality of your strokes reveals your intention. As you continue the session, think of using your body weight to pour your point of contact into the client’s tissues, rather than using your muscles to push into the client. When we push, we are trying to fix. When we pour, we are facilitating.
Often, our urge is to rush, to move faster, to push through the tissues in order to get everything accomplished in the time available. Do the opposite: slow your breath, slow your strokes. A smaller number of attentive strokes are far more satisfying than a greater number of rushed strokes.
End by Doing Nothing
End the session as you began. Just the weight of your hands on the client’s body. Just your breath in and out. No goal. Then, slowly lift your hands. You are showing your client you are focused on her, not on the idea of fixing her.
In talking with your client before, during, and after the session, offer compassionate detachment. Use her own descriptions of her problems when asking her additional questions, which shows you are listening attentively. Make it clear that this work is collaborative—you can’t fix her, but you can help her inhabit her body more fully.
Feel Gratitude
Though the uncertainties of our career are many, and though there are always distractions and frustrations, let’s be grateful our job provides long chunks of time when we can do nothing but focus on ourselves and one other person!

1. Each of the three national massage magazines have had at least one recent article on the benefits of mindfulness as a self-care technique: David M. Lobenstine, “Mindfulness: Breath, Thoughts, Feelings, Sensations,” Massage (September 2013): 66–68; Clare La Plante, “Present & Accounted For: A Mindfulness Practice Can Help Prevent Fatigue, Stress and Burnout in Massage Therapists,” Massage Therapy Journal (Winter 2013): 34–40; Mary Beth Braun, “The Power of Presence: Mindfulness for Your Life and Practice,” Massage & Bodywork (November/December 2012): 66–69.
2. Jon Kabat-Zinn, Mindfulness For Beginners: Reclaiming the Present Moment—and Your Life (Boulder, Colorado: Sounds True, Inc., 2012), 1.
3. Kabat-Zinn, Mindfulness For Beginners, 26.
4. Ibid.
5. Kabat-Zinn, Mindfulness For Beginners, 130–131.
6. Jon Kabat-Zinn, keynote speech, 2011, Creating a Mindful Society conference, accessed November 2014, www.mindful.org/in-body-and-mind/mindfulness-based-stress-reduction/meeting-pain-with-awareness.

David M. Lobenstine, LMT, is a massage therapist, writer, and teacher of continuing education courses in New York City. Combining deep tissue and myofascial work with an attention to the breath, his aim is to help both his clients and fellow massage therapists to figure out how to inhabit their bodies with greater ease and effectiveness. Find him at davidlobenstine@gmail.com and www.fullbreathmassage.com.