Client-Centered Massage

By Mary Kathleen Rose and Mary Ann Foster
[Talk About Touch]

Mary Kathleen Rose: “Do you know what your body needs?” the massage therapist asked me, after grabbing and pressing the tops of my shoulders. I sensed he was expecting me to say, “Tell me: what does my body need?” But instead I said, “Yes, I do know what my body needs.” Then, I explained to him where I felt the pain in my shoulders and the kind of contact and pressure I knew would help relieve it.

Mary Ann Foster: Where was this? 

MKR: I was at an airport, getting a seated massage after a long and tiring trip. I just wanted some nice work on my aching shoulders. 

MAF: Did you ever get the shoulder massage you wanted?

MKR: He had an agenda about what he thought I needed. He started doing cross-fiber friction on my pecs. It felt like he was tearing my skin, and my tactile defenses went on alert. When I asked him to stop, he claimed chest work would help my shoulders. Then, he launched into a lecture about my need to stretch, drink more water, and take calcium supplements.  

MAF: This sounds like problem-centered massage instead of client-centered massage. I heard a similar story from a woman seated next to me on an airplane. She had received a gift certificate for massage and was looking forward to a relaxing experience. Unfortunately, the massage therapist insisted that she needed deep-tissue work on her arthritic neck and wouldn’t stop when she asked him repeatedly. She said that as a result of that session, eight years later she is still taking pain medication and deathly afraid of massage.

MKR: Her story is a reminder to bodyworkers of the importance of focusing on the needs and goals of the client. I might have my own ideas or beliefs, but I don’t need to impose them on the client. It is imperative to ask clients, “How are you?” and “What do you need today?” before we begin to touch them.

MAF: After all, we are in a people-centered business. People need to come first, no matter what we think they need. We should always respect them by listening to what they ask for and responding appropriately. As I told the woman on the airplane, “When you say stop, a professional will stop.”

MKR: During my seated massage experience, I had to wonder what motivated the therapist to be so insistent on using an approach that didn’t feel comfortable to me. He was obviously enthusiastic to use all the great techniques he had learned recently in school.

MAF: I’ve found that a massage therapist’s enthusiasm to help people with the many treatment techniques now available in the profession can get in the way of actually focusing on the client.

MKR: Yes, the human body is so complex, and there are so many possibilities when it comes to techniques to address a client’s concerns. When you get lost in the possibilities, it helps to pause a moment and refocus on the person living inside the body you are touching. Remember that your intention is to help your clients, always treating them with respect.

MAF: Respect is a fundamental precept for a client-centered approach to massage and bodywork. Another key component involves professional communication—really listening to what the client says. Observe how the client responds to your touch and adjust your approach to what works best for each individual.

MKR: Sometimes I can be working along, thinking I am doing the appropriate technique in a session, only to realize that the client’s verbal or nonverbal feedback is telling me something different. It can be humbling to let go of the seemingly effective track I’m on and reconnect with the client’s experience in the moment.

MAF: Massage is an interpersonal relationship that requires moment-to-moment attention. We bring our skills, good intentions, and personal styles to our work, but our primary focus really needs to be on the client. This builds rapport and trust.

MKR: Rapport and trust alleviate tactile defensiveness and make relaxation possible.

MAF: The connection with the client is so important in massage; technique is secondary. How could therapeutic massage be anything but client-centered?

  Mary Kathleen Rose, BA, CMT, practices shiatsu and integrative massage and is a consultant for massage training in medical settings. She is the author of Comfort Touch: Massage for the Elderly and the Ill (Lippincott Williams & Wilkins, 2009).

 Mary Ann Foster, BA, CMT, specializes in movement education in massage and is the author of Somatic Patterning: How to Improve Posture and Movement and Ease Pain (Educational Movement Systems Press, 2004).