go to circuses; we tramp through jungles; we listen to loud music; we

purchase exotic fragrances; we pay hugely for culinary novelties; and are even willing to risk our lives to sample a new taste.

In Japan, chefs offer the flesh of the puffer fish, or fugu, which is highly poisonous unless prepared with exquisite care. The most distinguished chefs leave just enough of the poison in the flesh to make the diners lips tingle, so that they know how close they are coming to their mortality. Sometimes, of course, a diner comes too close, and each year a certain number of fugu-lovers die in midmeal.

How we delight our senses varies greatly from culture to culture (Masai women, who use excrement as a hair dressing, would find American womens wishing to scent their breath with peppermint equally bizarre), yet the way in which we use those senses is exactly the same. What is most amazing is not how our senses span distance or cultures, but how they span time. Our senses connect us intimately to the past, connect us in ways that most of our cherished ideas never could. For example, when I read the poems of the ancient Roman poet Propertius (who wrote in great detail about the sexual response of his ladyfriend Hostia, with whom he liked to make love by the banks of the Arno) Im amazed how little dalliance has changed since 20 B.C. Love hasn't changed much either: Propertius pledges and yearns as lovers always have. More remarkable is that her body is exactly the same as the body of a woman living in St. Louis right now. Thousands of years haven't changed that. All her delicate and quaint little places are as attractive and responsive as a modern womans. Hostia may have interpreted the sensations differently, but the information sent to her senses, and sent by them, was the same.

If we were to go to Africa, where the bones of the petite mother of us all, Lucy, lie, just where she fell millennia ago, and look out across the valley, we would recognize in the distance the same mountains she knew. Indeed, they may well have been the last thing Lucy saw before she died. Many features of her physical world have changed: The constellations have shifted position a little, the landscape and weather have changed some but the outlines of that mountain still look much the same as when she stood there. She would have seen them as we do.

Now leap for a moment to 1940 in Rio de Janeiro, to an elegant home owned by the Brazilian composer Heitor Villa-Lobos, whose music, both rigorous and lavish, begins with the tidy forms of European convention and then explodes into the hooting, panting, fidgeting, tinkling sounds of the Amazon rain forest. VillaLobos used to compose at the piano in his salonhe would open the windows onto the mountains surrounding Rio, choose a vista for the day, draw the outline of the mountains on his music paper, then use that drawing as his melodic line. Two million years lie between those two observers in Africa and Braziltheir eyes making sense of the outline of a mountainand yet the process is identical.

The senses don't just make sense of life in bold or subtle acts of clarity, they tear reality apart into vibrant morsels and reassemble them into a meaningful pattern. They take a contingency sample. They allow an instance to stand for a mob. They negotiate and settle for a reasonable version and make small, delicate transactions. Life showers over everything, radiant, gushing.

Excerpted from Diane Ackerman's introduction to A Natural History of the Senses (New York: Vintage Books, 1991). Copyright ©1990 Diane Ackerman. Reprinted by permission of Random House, Inc.

Dianne Ackerman has published poetry in literary journals and authored several nonfiction works, including A Natural History Of Love. She also was the recipient of the Academy of American Poets Lavan Award.

Desexualizing The Massage Experience

Even the upright massage therapist and client are accompanied in the session by human sexuality. The massage therapist must deal with this ethically and safely.

By Dianne Polseno

Much more must be said about the correlation between sex and massage besides, Don't do anything sexual with a client. Actually, the connections between sex and massage extend far past the outdated, nagging reputation of their foremothers and forefathers. This article is an attempt to identify those connections and discover ways to desexualize massage in a culture that sexualizes almost everything.

Ethically Safe Massage

It is the responsibility of the massage professional to create and maintain a safe environment for clients and themselves. In the process of learning how to carry this out, therapists undergo extensive training in the physical and emotional effects and ramifications of touch and massage. They are often painstaking in their efforts to cultivate and enrich the physical and emotional well-being of their clients, being ever mindful of the indications, precautions and contraindications for massage. They are conscientious about their clients physical status, emotional condition and spiritual well-being. Yet this strategy, while entirely appropriate and necessary, is shortsighted. Although these measures may help to keep massage physically and emotionally safe, they do not address ethical safety.

An ethically safe massage environment provides much more than the assurance that a massage therapist will not flirt with, fondle, attempt to date, or seek to sleep with a client, and vice versa. If the massage therapist and the client are to be completely safe in all regards, these professionals must ensure that the massage experience is not sexualized. If, despite all cautions and proper behavior in the massage room, the therapist and the client fall in love and move into a romantic relationship, then their professional roles as therapist and client must cease. Then who massages whom becomes a private matter apart from the massage room. Dr. Pat Feinstein, psychiatrist and avid proponent of massage therapy, introduced the concept of desexualizing the massage experience in her interview on breast massage for the Massage Therapy Journal article, Why DonÕt They Do Breast Massage? (MTJ, Winter 1998). She said both the client and the therapist must be capable of desexualizing the massage experience. This can be a challenging task indeed. The factors that contribute to this challenge are numerous and deserve individual attention.

Sexuality And Massage

It is not possible to entirely keep sexuality out of the massage treatment room, since humans are, by nature, sexual beings. Just as we are intellectual beings, emotional beings, spiritual beings and physical beings, our biology equips us with a sexual nature, the primary purpose of which is to help preserve and propagate our species. This means that every client and every massage therapist bring their sexual nature with them into the massage setting. The ultimate ethical challenge is this: Both client and therapist must allow the presence of sexuality in a milieu where sex is absolutely inappropriate. In other words, both must allow sexuality, and at the same time, desexualize the experiences of both giving and receiving massage.

Typically, the sexual nature of the client or therapist is not regarded unless something sexually inappropriate happens that requires ethical intervention. This reactive stance does not work. To be diligent in their ethical efforts, massage therapists must proactively consider human sexuality, both their own and that of their clients. To do this, they must always appreciate the impact that massage can have on the sexual response, take full responsibility for how they are affected when they perform massage, and remain keenly aware of the potential effects of massage on their clients.

Terminology

Attention must be given now to the clarification of terminology.

Sex refers to sexual relations, sexual acts, sexual activities, sexual pleasures, sexual intercourse, or being any way involved in a sexual manner involving the genitals and/or secondary sexual organs such as breasts and erogenous zones such as the groin.

Sexuality, a much more complex issue, is about our nature, character, and makeup as sexual beings. It encompasses all of who we are as men and women. The Sexual Health Network says, Sexuality spans the biological, psychological, social, emotional and spiritual dimensions of their lives. [It] begins with us and our relationship with ourselves and extends to our relationships with others. Our relationship with ourselves includes how we feel about ourselves as a person, as sexual beings, as men and women, and how we feel about our body and how we feel about sexual activities and behaviors.1

The ways in which we channel and express our sexual nature are as different as the number of human beings on this planet, since we express each and every aspect of our nature uniquely. How we integrate our sexual nature into our personality is greatly influenced by genetics, upbringing, health status, and cultural, social, and religious influences, and while we do not have control over having a sexual nature, we do have control over when and how we express it. The term desexualize is best defined by examining its opposite, sexualize. Sexualizing means making an event, procedure, conversation or experience that is not implicitly sexual into something that is sexual or could be interpreted as sexual.2

Desexualizing, then, means ensuring that massage is not sexualized; that it is not in any way turned into a sexual experience, either overtly or covertly, for either the therapist or the client. While the terms sex and sexuality commingle and share aspects of their meanings, their differences can be significant in the massage setting.

SocietyÕs Role

In recent decades, society has witnessed a rampage of the exploitation of sexuality. Sex appeal is promoted, advocated and revered. We are literally bathed in sex, sexuality and sex appeal. Michael V. Reitano, M.D., editor in chief of Sexual Health Magazine, says, Virtually every advertisement, movie, television show, magazine or book has either at its core or as part of its appeal issues of sex: how to achieve it, maintain it, enjoy it, remain safe from it, embrace it, abolish it, prohibit it, exploit it.3

You donÕt have to look far to see the truth in this statement; even animated characters in childrenÕs movies have sex appeal. Current views on sexuality, so skewed, tend to perpetuate the association of sex and massage in the minds of the consumer, despite current appreciation for the holistic health benefits of massage. So, despite the respect and acceptance massage has gained in recent years, the word massage still summons erotic thoughts in the minds of many. The corporate workplace has, in recent years, found the need to prohibit the deleterious expressions of sexuality among its personnel. The creation of laws regarding sexual misconduct and harassment now prohibit what was, in the past, regarded a benign interaction (See Ethically Speaking, page 136). Like the corporate workplace, so must the massage workplace be desexualized. Therapists may be na•ve in thinking that if they have the correct intentions and act professionally enough, inappropriate expression of sexuality will be kept out of treatment sessions.

Sex Response Physiology

Because they are interdependent, it is difficult to separate the physiological, sociological and psychological aspects of human sexuality. Here, however, is an attempt to isolate the physiological-anatomical functioning aspect, in order to examine the physical associations of massage and the sexual response. There are three significant physiological connections, all of which stem from the bodyÕs nervous system: the senses, the parasympathetic nervous system, and the limbic system. First, letÕs examine the primary sensory aspect, or touch. The tactile stimulation produced by massage provides the central and peripheral areas of the nervous system with a tune-up of sorts, stimulating the clientÕs whole sensory mechanism. Sandy Fritz sums up this connection in MosbyÕs Fundamentals of Therapeutic Massage.

Massage to certain areas of the body can further complicate the matter, since they may actually induce a sexual response. Tactile stimulation of sensory nerve pathways in the area of the abdomen, lower extremities, and buttocks are carried over the same two nerve plexuses as the genitalsthe lumbar and sacral plexuses. Stimulation of these nerve plexuses, as would occur in massage to the abdominals, gluteals or thighs, would not be not confined to local perception, but instead would be diffused throughout the area and the nerve signals of the genitals would be affected.4

The parasympathetic nervous system provides the second vital link between massage and the sexual response. This aspect of the autonomic nervous system is responsible for the bodyÕs regulation of the rest and digest, the restorative responses, and counterbalances the effects of the sympathetic division, which regulates the fight or flight dynamic. Furthermore, parasympathetic influences regulate both the relaxation response induced by massage and the physiological changes that occur during sexual arousal. When massage methods such as slow, rhythmic, repetitive stroking; passive movement; slow, broad compressions; reflexology; and acupressure are used, the relaxation response, under parasympathetic control, is induced. The parasympathetic nervous system also controls the primary and secondary bodily responses that occur during sexual arousal. The common characteristics are vasocongestion, or the increase of blood supply to the genitals, and myotonia, which is the increase in muscle tension that is the result of sexual stimulation.5

Fritz tells us that, Therefore, each time a client relaxes out of the Ôfight or flightÕ responses of the sympathetic autonomic nervous system into a more relaxed response, the predisposing factors are present for sexual arousal. The reaction is not only possible for the client, but also for the practitioner as he or she begins to relax and flow with the massage.6

The third link is the limbic system, a group of structures that form a curved border around the brainÕs core. This complex aspect of the brain controls emotional and sexual experiences.7

Stimulation of the body by massage influences the limbic response. This not only serves to be another physiological connection between sex and massage, but may also explain why emotional responses occur in the client during or after massage therapy. These physiological influences, touch, the parasympathetic nervous system, and the limbic system, mandate the deliberate consideration of, and accountability for, human sexuality in the massage setting. Under most circumstances, a sexual response can be completely bypassed. Or, if a sexual response does occur, and the erotic energy is not directed, it is short-lived, and the massage can continue within ethical bounds. If sexual arousal does occur, however, on the part either of therapist or client, and regardless of the situation or circumstances, it is always the responsibility of the therapist to establish and maintain appropriate boundaries (see below). Sexual talk, sexual relations, sexual acts and activities, sexual pleasures, sexual intercourse, sexual touching, or being any way involved in a sexual manner is always unethical and must never occur in the professional massage setting.

Providing Safe Experiences

The ethically safe massage experience does not just happen; it must be created, structured and continually sustained. Structuring it means at all times proactively demonstrating absolute professionalism in all aspects of a massage therapy practice, particularly around the connections between sex and massage. It also means the therapist must be prepared to deal with physiological reactions of sexual arousal, if and when they do occur. The following suggestions are for therapists of both genders.

1) Observe and know yourself. Be aware of your own tendencies toward flirtation, and notice the times and places when and where you sexualize an event or conversation. Consider how you may come across and the messages you may be transmitting to others, especially to your clients. Take time to think about your work environment and your approach with clients. Ask yourself, Is there anything about me or my workspace or what I say or do, that is likely to be sexualized? Ernie Ezersky, licensed massage therapist, teacher and student-clinic supervisor in Massachusetts, instructs students, In this business, you must be Ôsqueaky clean.Õ Remember that your good intentions are not enough; you are also responsible for how you may be perceived.

2) Be clear about your intentions toward your clients. Clients are not candidates for romantic interest or sexual pursuits. Every therapist must be steadfast in this rule. It is never appropriate to date and/or sleep with a client. To date a client, even when the feeling is mutual, is a very precarious situation. Do so and you invite potential problems into your practice. The very least of these is unethical patterns in your client interactions. Always seek guidance for these issues with a mentor, supervisor or professional consultant, so that you can make decisions responsibly and fully cognizant of possible ramifications. Never be in the position of being a clientÕs massage therapist and suitor. Being clear about, and adhering to, your own boundaries in this regard will set limits for your clients and will help to diffuse aroused erotic energy.

3) Establish ethical safety at the initial contact. Do not wait until the new client arrives for her appointment to discern whether or not your communications are ethically appropriate. In other words, whether interviewing on the phone or in person, determine your intentions and goals for the massage when you first talk with the client to set up the appointment. Assess her demeanor, language and approach as to whether or not she is seeking nonsexual massage. Ask questions such as, Why are you seeking massage at this time? and What are your goals for this session? If she remains vague and obscure, inform her directly that the massage you offer is therapeutic and nonsexual. This is especially important when doing out-call or residential massage for a new, unknown client, either at hotel or clientÕs home. Beyond determining that he is not seeking sexual massage, it may be wise to ensure your own ethical and physical safety by developing a policy where you require that another adult be at home at the same time. Also, if possible, avoid setting up your massage table in a bedroom. These actions may be easier to accomplish at a clientÕs residence than at a hotel. In discussing what you will need when arranging the appointment, inform the client that you prefer that someone else is home and that the table be set up in a space other than a bedroom.

4) Maintain a professional appearance and demeanor. Dress appropriately when you massage, avoiding provocative or revealing attire. Realize that when and where you represent yourself as a massage therapist, you represent the entire profession. For example, do not hand out your massage therapy business cards when you are out dancing, or while you are working as a waitress or bartender at a part-time job.

5) Establish a professional, healing space. Sight, sound, smell, touch and imagination all have the potential to arouse. Desexualize the workspace by providing a professional atmosphere that communicates clear boundaries in all regards. If the area you use to massage happens to be in a spare bedroom in your home, remove the furniture that makes it a bedroom. Declare your massage table a sacred healing space and do not pursue sexual interests with anyone, even your mate, on your table. Being clear about your role during a massage, regardless of who is the recipient of your work, allows you to secure your professional boundaries, making you less likely to give mixed signals to clients. This also fosters trust, as well as appreciation of the professional nature of your work, by your mate.

6) Provide informed consent. Before the massage begins, always inform the client about what you intend to do for the treatment protocol, so he knows what to expect. Take him into the treatment space and run through the session scenario verbally. Explain whether you will begin with him in the prone or supine position, the anticipated sequence of where you will work, how he will be draped, and any other pertinent details. For instance, if the client is to receive a full-hour relaxation massage, inquire before the massage begins as to whether or not he wants his abdomen massaged. If it is a female client in this case, describe how you will employ the breast-draping linen.

7) Allow privacy. Regardless of how well you know the person to be massaged, always allow her complete privacy while she undresses and redresses. Some clients will begin undressing before you have a chance to leave the room. In these instances, ask them to wait, then leave promptly. Remember, the client is not the one responsible for setting professional boundaries. You are.

8) Choose appropriate music. If the client wants music, offer the soothing but not the sensual or romantic kind. Songs containing lyrics about lovemaking or instrumental music that sounds seductive will give mixed messages about the intention of your massage session, and about massage, in general.

9) Speak clean language. Strive for more professional ways to communicate about massage. Be aware that what you say may be interpreted differently from what you mean. Avoid language that might be sexualized. Instead of using misleading and suggestive terms such as full-body massage, describe it as a full-hour relaxation treatment, or use other terminology which accurately and neutrally explains what you do. Consider using the phrase residential massage when referring to house calls. When referring to certain anatomical parts, be careful to use terms that are not suggestive. More obvious examples are terms such as gluteal area versus butt, and inguinal area or groin instead of crotch. Less obvious, though, are phrases that can be suggestive. For example, direct clients to move your feet apart, versus move your legs apart, or open your legs. When making comments to the client about the body, avoid statements that refer to anything other than what is related to the massage. While it is essential to report objective findings that are related to her physical well-being, refrain from commenting about matters such as weight gain or loss, attractiveness, beauty, and other appearance issues, especially when the client is on the table. For one thing, when you make such comments, it fosters the notion that you are observing his body in a judgmental way. This can make a client feel like a bug under a microscope. Secondly, comments that sound like compliments may be interpreted as flirtation. If a client thinks you may be flirting with him, he may become sexually aroused during the treatment. Confused about the intentions of the therapist, he may be inclined to pursue his sexual interest.

10) Always use proper draping techniques. While the client has a clear choice about many aspects of the massage, such as what to wear under the draping linen, proper draping should not be optional. Modest draping is recommended. A sheet or large bath towel is used to cover the body areas that are not being massaged. If a client insists on forgoing the draping linen, explain that you are more comfortable when modest draping is used, that, in the interest of your professionalism, modest draping techniques are used with all clients. Offer to adjust the room temperature, turn on a fan, or uncover her feet if she claims to be too warm. If and when the client does wear underwear during the massage, recognize it as a boundary and do not move the underwear to apply massage techniques to that area. Massage therapists need to remember that effective techniques, such as compression, can be applied to clothed or draped areas, in the event that the client feels uncomfortable disrobing. Ensure that all draping is secure and does not allow drafts or partial exposure of areas intended to be draped.

11) Be mindful of body contact during the massage. Beyond using proper body mechanics, be attentive to how you brace, support and lean. Mind where your body may contact the clientÕs body during your strokes, stretches and techniques, and avoid contacting the client with body areas other than your extremities. Maintain a professional posture and stance throughout the session.

12) Prevent straying strokes. When working areas such as the medial thigh, gluteal tuberosity, the sacrum, or the subclavicular area, strokes must not stray, even accidentally. The slightest slip in these areas would be invasive and inappropriate, and they could give the client the wrong message about your intentions.

13) Be prepared. When working with a male client who has never received massage in the past, or is a new client, request that he keep his undershorts on during the massage. Make it a matter-of-fact direction when you are explaining the procedure, as in, Disrobe, keeping your undershorts on, then lie on this table under the draping linen. In some instances, beginning the massage on the dorsal body, with the male client lying prone, may allow him to become accustomed to touch and the parasympathetic response before being massaged supine, which hazards higher-risk areas for arousal. The arousal response for a male is less likely to occur as he becomes more accustomed to the massage experience, so this may not be a necessary step for the client who receives massage more often.

14) Diffuse any hints or signs of sexual arousal immediately. You should know what to do if you find yourself, as the therapist administering the massage, becoming sexually stimulated when a client is on your table. Charles Wiltsie IIIÕs article, Uniquely Male, summarizes this issue. It quotes William Frick, a New York-licensed massage therapist: Dealing with erotic energy is one of the most challenging issues that face massage therapists. Erotic, sexual feelings periodically occur in the massage experience. These feelings cannot be eradicated by working only on members of the same sex, since homoerotic feelings may come up É What is one to do with erotic feelings? At least three possibilities exist: acting them out, repression and conscious sacrifice of the impulse to act out such feelings.8 Of course, the ethical massage therapist will choose not acting on the impulse. However, this must not be the result of repression. A stereotypical response is to ignore such feelings. But that will not make them go away. It will only remove the feelings from rational thought, which may actually increase the risk of unethical actions.9 Conscious sacrifice of the impulse to act out is necessary.

Be Aware And In Control

Honest awareness of the massage therapistÕs state is the first step in this process. Conscious recognition, along with an ethical self-pep talk, may be enough to distract the therapist and interrupt the response. Also the approach must be changed and work moved to a less risky body region. The therapist should direct thoughts to the clinical perspective of the work, as in trigger points, adhesions, origins, insertions and muscle actions. If sexual intentions arise with more than one client, or happen repeatedly with the same client, the therapist should seek support for the issue by consulting with a mentor, another massage therapist or a professional consultant. The therapist needs to remember that the solution to the problem is within the control of the therapist, who must be able to desexualize the massage experience in order to be an ethical professional. Even if the therapist does not act on her feelings, it is inappropriate to entertain sexual interests in her mind.

The arousal response of a client may or may not have any connection to an interest in having sex. As explained above, various aspects of the nervous system can generate this response automatically. Of course, there is a major difference between the sexesÕ responses to being aroused. The female can largely keep her feelings to herself. Unless her nipples are erect and noticed, the therapist would never know of the clientÕs arousal. The male also may keep his feelings to himself but his erection is a prominent sign that arousal has occurred. In either case, male or female, if behavior suggests that sexual arousal is occurring, the situation requires immediate intervention.

There is no cookbook method for dealing with the sexual arousal of a client. Intervention may mean different things, depending on the client and circumstances. In any situation where a client indicates, either overtly or covertly, that arousal has occurred, the therapist must determine, at that moment, the best way to handle the situation before it becomes an incident. When first aware of the situation, the therapist must change what he or she is doing. The antidote to the parasympathetic response is activation of the sympathetic response. Changing the tempo of the massage to a quicker pace and increasing the pressure and depth of the work will encourage sympathetic nervous system involvement. Moving to a less risky area of the body, such as the upper extremity or the face and head, helps, too. As long as the client does not in other ways indicate sexual interest, give the client a minute or two to pass through this phase, since it will likely subside. Then massage may be able to continue without further arousal. It is often appropriate to not discuss the situation at the time it occurs. Whether or not the therapist should discuss it after the session depends on the situation and a sense of whether or not it is fitting and necessary. Discussing it may simply mean informing the client that arousal can be a short-lived physiological response that may occur, and that while it would never be acceptable to act on it, the incident was not interpreted by you as improper or unethical.

A situation in which the client expresses sexual interest, whether or not actually in an aroused state, requires a clear, unequivocal response that this is an inappropriate interest. A statement an be used such as, This is inappropriate and unethical and it cannot continue. If the client persists past this set limit, it may be necessary to terminate the session by simply stating, Please get dressed; the session is over, and walk out of the room. Do not engage in discussion about the subject. Instead, state your directions simply and clearly. Regardless of the cause or intent, sexual arousal should not be allowed to continue under any circumstances. Even if the client does nothing else to follow it up, it is inappropriate to allow the client to remain aroused. Some therapists opt to pretend to ignore the signs of sexual arousal if the client does not act otherwise inappropriately. This is an incorrect stance. Remember, both the client and the therapist must be capable of desexualizing the massage experience if it is to be ethically safe and sound.

Summary

Connections between sex and massage exist. Human sexuality accompanies into the session even the client and the massage therapist with the most upright of intentions. This must be acknowledged and dealt with ethically and safely. In order to do this, the massage therapist must be aware of the many factors that make it necessary to provide an ethically safe massage experience and follow the steps that can be taken to carry that out.

¥¥¥

Dianne Polseno, former chair of the National Ethics subcommittee, is a practicing massage therapist, practical nurse, author and publisher of Comprehensive Review Manual For Massage Therapists. A teacher at Bancroft School of Massage Therapy, she receives mail at dipol@aol.com or 1 Raymond St., North Smithfield, RI 20896-8215.

References

1. Fritz, Sandy, MosbyÕs Fundamentals of Therapeutic Massage, St. Louis: Mosby-Year Book, Inc., 1995, p. 33.

2. Redleaf, Angelica, with Susan A.Baird, Behind Closed Doors: Gender, Sexuality and Touch in the Doctor-Patient Relationship, Westport, CT: Auburn House/Greenwood, 1998, p. 119.

3. Sexual Health Magazine, p. 1. [www.sexualhealth.com].

4. Ibid.

5 . Gotwald, William H. Jr., and Gale Holtz Golden, Sexuality: The Human Experience. New York: Macmillan Publishing Co., Inc., 1981, p. 295.

6. op cit., Fritz, p. 33.

7. op cit., Gotwald and Golden, p. 297-298.

8. Wiltsie, Charles III, Uniquely Male. Massage & Bodywork Magazine, April/May 1999, p. 47.

9. op cit., Redleaf, p. 171.

How To Avoid Grievances

Open communication is the key to best serving clients and most effectively preventing disciplinary actions.

By Paul Musser

The article that follows was written by Paul Musser. He joined AMTA in September, 1987, and immediately became an active member in California and an advocate for ethical practices. He was a therapist, teacher, mentor, friend and someone who cared for and about people. In 1991, Paul joined the newly enlarged AMTA Grievance Committee and was a strong voice on the team that wrote the new Grievance Procedures. Paul was always a strong advocate for clients. Paul wrote the accompanying article, based on his experiences as a therapist, for an open forum at the 1996 AMTA Convention, presented by the Grievance Committee, on How To Avoid Grievances. While the article speaks in generalities about grievances, the subject of sex lurks just below the surface. In 1996, Paul was diagnosed with amyotrophic lateral sclerosis (ALS), popularly known as Lou GehrigÕs disease. He died in July, 1997. I know he would have been anxious to share his knowledge gained through experience to enable massage therapists to better serve their clients.

William Greenberg, AMTA Board of Directors, former chair, AMTA Grievance Committee

One of the most significant dilemmas that we members of the AMTA Grievance Committee have with nearly every one of the complaints that we receive, is the lack of communication between the parties of the grievance. Many of the grievances begin because there was not clear communication between therapist and client. Others have developed because of lack of clear communication between massage school teachers and students. Yet others have come to us because of lack of clarity between licensing officials and therapy applicants.

Clear, concise communication is the basis for understanding. Without it, there is only separation, chaos, anger, conflict and pain. Often we hear of the breakdown in communication and would like to mediate between the two parties, only to learn that they have so completely alienated themselves that communication cannot take place.

A classic example of communication breakdown took place about a year ago, while I was coaching a pair of clients who have been married to each other for more than 30 years. They are each otherÕs best friend, as well as business partners. Even though they have been communicating all those years, they havenÕt been communicating clearly with each other.

A crisis arose when she said that she needed more passion in her life. He took this to mean that he was not enough for her any longer and that she was going to start looking for a replacement relationship. What she was saying was that she needed to attack her activities with more passion, giving 110 percent to her goals.

When I pointed out to them that they had been speaking in half sentences (only half of the thought), they were able to communicate to each other the reality of their thoughts. Now he is supportive of her needs to bring passion to her goals. She is also able to invite him to share her passions. They are communicating again. What at first looked like the end of the relationship is now a wonderful new commitment to clear communication, a continued growing together.

Thief Of Understanding

Poor communication creates misunderstanding. It robs us of our ability and power to hear what people are trying to tell us and it keeps us from being able to enroll others into our life.

Psychological studies indicate that as much as 94 percent of communication is nonverbal. So even if we are trying to speak distinctly and clearly to the other party, if our mannerisms, body language, or touch are not in communication with us, there is a breakdown in the message that we are trying to convey. The following are just a few of the situations that have been brought to the attention of the committee:

1) A therapist was negotiating for a position in a facility with a senior therapist. Based on a lack of clear communication, and the laying of ground rules, there developed a great misunderstanding, which ended the professional relationship, and brought a grievance to the committee.

2) When a therapist did not clearly discuss with her client the difference between adult entertainment and therapeutic touch, the client made an inappropriate pass. The therapist promptly ended the session 30 minutes early, and dismissed the client. The client filed a grievance based on the fact that he felt that he had been overcharged, and not given a full session.

3) A client did not tell her therapist about her history of sexual and physical abuse. The therapist did not see the nonverbal communication coming from the client and was very insensitive to the needs of the client at that time. This was perceived as another abusive encounter.

4) An officer/member was asked about the qualification of another member, by their local licensing board. The officer made a statement that sounded as if the member was unqualified, which placed the member in a very difficult position. It required a year of work and legal fees, to correct the misstatement.

5) A sports massage therapist treated a client, who was locked into the John Wayne Syndrome and did not communicate the fact that the treatment was very painful. Even though the client was grimacing and showing signs of bruising, the therapist remained insensitive to the clientÕs pain.

6) A therapist did not tell her staff that she believed the office mailing list to be her personal property. When one of the staff took a copy of the list, a grievance came to us.

7) A student in a massage school was afraid to tell the director that he was dyslexic. The director decided to make him a throwaway because of what she judged to be his poor comprehension skills. Before the final exam, several of the students asked if they would be marked down on spelling error. The director said, No, then changed her mind without telling the class. Even though the student was very intelligent, his dyslexia got in the way of his spelling, and the director failed him from the course. This lead to a lawsuit and the director was made to refund the studentÕs full tuition.

8) At a sporting event one day, a therapist volunteer came up to me, and said that another therapist at the event kept walking up behind volunteers and without asking, began to massage their necks and shoulders. The volunteer was a survivor of abuse, and said, If he touches me without my permission one more time, IÕm going to deck him! About that time the touch-deprived volunteer came up behind her and once again began to massage her neck. I intervened by taking the touching volunteer aside and explaining to him the need to ask permission, instead of sneaking up behind people. He finally got the message.

By now, you can begin to see that the lack of good, clean, clear communication caused all of these problems. Sensitivity training and the practice of developmental listening skills, could have prevented nearly all of them from taking place. The goal of the committee is to educate members and if at all possible, prevent these types of events from occurring. We prefer to see therapists and their clients, and the general public operate at a level of understanding and harmony. Our commitment is to have the therapeutic connection be truly therapeutic for all parties involved.