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Modesty, An Expose

Do modesty & massage go together?

After all, most massages are performed when clients are partially or completely naked, while you knead, apply pressure, pat or rub bare skin. Although the client is covered with a sheet or towels, those are folded back to display the part of the body being worked on. Where does modesty fit into this equation? One therapist put it well when she said, “When you’re working on naked bodies, there are some things you’d better consider!” Regardless of the modality you practice (and the state of undress of your clients), modesty brings up many important issues in massage therapy, all the way from setting boundaries in mind, body and professional life, to taking into account the emotional and cultural background of clien

A good starting place might be looking at our own biases about modesty. Do we wonder whether it’s just a little prudish to consider modesty? Is an impediment that needs to be removed in order for therapists to do good work? And with massage becoming more mainstream, and more people walking into your office with some idea of what will happen, isn’t it the client’s responsibility to bring up and stand up for his or her own definition of modesty? Or is it?

Framing the Discussion

A little walk through history might help us see why the link between modesty and massage isn’t always so obvious. Historically, the term has often been used to describe a woman’s sexual virtue. You may have heard of the “modesty piece”—a lace inset in a dress or blouse that covered a woman’s bosom. Some of the synonyms for modesty are virtues we don’t always embrace in our Western culture as positive, including shyness, propriety or being reserved in speech or manner.

When you connect that connotation and how far the industry has come in moving beyond the days where “massage parlors,” it’s easy to see how modesty can fall off the radar. Yet, there are many compelling reasons to revisit modesty and massage.

Living and working in a culturally diverse setting means that clients don’t always share the same perspective as therapists. And, working in what has been called a “sexually charged” society means that honoring another’s physical and emotional boundaries (and keeping your personal boundaries intact) takes thought and preparation.

Perhaps we can gain more clarity if we go all the way back to the Latin root of modesty, modestus, which means “keeping within measure.” Modestus hints at one of the most important issues in modesty and massage—setting proper boundaries.

To explore the interplay of boundaries, power and cultural sensitivity, let’s check in with a few therapists, teachers and consultants who have strong convictions about the continuing relevance of modesty.

Boundaries and Modesty

Wendy Stone, from the Cortiva Institute-Boston, believes that the issue of massage and modesty really boils down to having good boundaries.

“A client whose boundaries are crossed may never come back and you will never know why,” she says. Stone believes that a good starting point for honoring client boundaries is understanding the inherent power that you have in the client/therapist relationship. First and foremost, there is a power differential when it comes to information. Since the therapist is more knowledgeable, the client might hesitate to question the work being done. There is also a differential in position. For example, the therapist is standing and fully clothed, whereas the client is undressed and lying down.

When a client is prone, they can’t make eye contact, which inhibits communication. Stone believes it’s critical to look for ways to give clients power in the relationship. “We need to become good communicators and good readers of people,” Stone says. She believes that starts during intake—when you take the time to converse with clients before they are undressed and while they can still make eye contact. Stone says that this can be as simple as asking, “Are there any parts of your body you would prefer that I don’t touch?” and then keeping notes on their preferences.

She also employs her own body (rather than the client’s) to make sure they have a clear understanding. For instance, she’ll say, “I’d like to work this high up on your hips,” as she points at her own body. Or she’ll draw a line on her body showing them how far down she’ll fold the sheet, asking clients if they’re comfortable with those parameters.

When dealing with different generations (see sidebar, page 47), special populations or different cultures, Stone says you have to be particularly aware of power and boundary issues. To make sure she has a clear understanding with clients, Stone describes how she’ll proceed while getting informed consent. That may include language (depending on the client) such as: 

  • What brings you here today? What are you hoping to get from today’s session?
  • What type of massage have you had? What was your experience like?
  • Here’s how I proceed. Does that sound like what you’re used to?

Stone lets clients know early in the interview that she tailors each massage to the client’s individual needs and preferences. And, by finding out a client’s previous experience, she can avoid repeating a negative experience, and take positive steps to reassure clients that she will honor their boundaries or preferences.

Creating Safeguards for Modesty

Ben Benjamin, PhD, co-author of The Ethics of Touch, believes that communication is key to safeguarding modesty. He points to research saying that every third woman and every fifth man has had a sexually abusive experience.

Benjamin says, “This fact alone gives the therapist reason to pause.”

Part of establishing professional communication is setting good boundaries in the client-therapist relationship. For instance, if a client asks him out for coffee, Benjamin will reply, “I like to keep my personal life and my professional life separate. That’s a firm boundary in my practice.” If a client asks to be uncovered, he might say, “That’s not the way we work in our profession. Have you had experiences where that is different?”

Benjamin stresses that there is much to learn about setting proper boundaries in the client/therapist relationship. (See chart “Understanding Boundary Infringements,” page 49). He suggests a couple of starting guidelines that can make a big difference when it comes to modesty:

  • Ask clients to show you on a chart where they do or don’t want to be touched. Make sure you have a clear understanding before the massage.
  • Cover whatever part of the body you’re not working on and never reach beneath the sheet.
  • Don’t talk to your clients about personal matters or have a relationship outside of the professional one.

When you want to work on a sensitive area, raise the possibility for the next session, e.g., “If you’d like, next time we could consider working on this area. Please think about it, and let me know at the beginning of the next session.”

Then only pursue doing the work if the client brings it up again. In fact, Benjamin says that the amount of sexual impropriety in massage is incredibly lower than in the medical profession: “We have to deal with it, clearly since we touch people’s bodies in a private setting.” Benjamin says it’s important for all therapists to do some self-reflection. Some questions therapists to ask yourself may include:

  • Do I like to look at bodies and touch them?
  • Do I want to practice massage because I don't have intimacy in my own life?

"If you don’t have a healthy attitude toward sex and intimacy, it will come out,” Benjamin says. “Clients will sense it, and they won’t come back."

Modesty and Emotional Boundaries

Cherie Sohnen-Moe, co-author with Benjamin of The Ethics of Touch, believes that honoring a client’s modesty starts with understanding the inherent nature of massage. “When you are touching a body, whether for relaxation, rehabilitation work, sports massage, or whatever, you are touching them on a psychoemotional level,” she says. “You can’t touch someone and not know that there is an emotional response.”

But she says that some therapists are too quick to assume that they understand that response, or even that they can read the client’s body language. And she says that often these assumptions are “incredibly inaccurate,” leading to inadequate communication that can violate clients emotionally. Being “an ambassador for massage,” Sohnen-Moe recommended massage therapy for a friend who was rather modest. When her friend went, the therapist (who Sohnen-Moe says is a great therapist) asked, “Have you always been this overweight?”

What the therapist didn’t know is that this woman had just lost 100 pounds. The client barely made it through the massage, fighting back tears. If it weren’t for Sohnen-Moe’s intervention, she might have never had a massage again. “People have injuries, scars, weird body parts. We need to develop a reverence for the magnificence of the human form,” says Sohnen-Moe. She says she is appalled when she hears therapists talk disrespectfully about people’s bodies outside of the therapy room.

One of the most rewarding experiences of her career was working with an elderly client who had a double, radical mastectomy. The client was very uncomfortable with how she looked and was reluctant to get massage. Because the client knew Sohnen-Moe from a social setting, she was comfortable with her. As Sohnen-Moe worked on her, she explained what she was doing and why, saying, “OK, now we’re going to get a little more sensation in here.”

She also acknowledged the emotional connection, giving voice to the client’s experience by saying things like, “It’s really a shame that they had to do that to your body.” The massage ended up being a deeply moving experience for both of them. During the last few years of her life, the client benefited greatly from massage therapy. Sound can also be a part of emotional healing. Sohnen-Moe says it’s important to let the client know that this is normal and important. “Whether they moan, laugh, sigh or even pass gas, I want them to know that the different sounds they make are fine.”   

Modesty and Cultural Sensitivity

Felicia Brown, spa consultant and owner of Spalutions!, sees a large overlap between boundaries, ethics and cultural sensitivity. She believes that cultural insensitivity starts with the assumption that everybody is just like us. “We have to be aware that just because something feels good to you, or fits with your value system, does not mean that it feels good to someone else,” she says.

Language is a powerful part of the therapist-client relationship. But it also bears the capacity for misunderstanding. “There are so many slang terms that have become part of our language, which means people can say things without realizing they are being potentially disrespectful,” Brown says. Likewise, Brown cautions therapists about using industry lingo that others may not understand, such as “intention,” “palpate,” and “insertion.”

Although it could be overwhelming to try to understand all the nuances of different cultures, she says you can go a long way toward cultural sensitivity by asking yourself a simple question: “How would I feel if this comment was made to my mother, sister or child?” Brown says that when clients know what to expect, they can relax and be more comfortable. Knowing that their one-hour session is truly 60 minutes, that a full-body session consists of work on these specific areas, and that the therapist will communicate any changes in the schedule, technique or areas to be touched, all help them be at ease, as much as knowing the sheet is a boundary that protects their modesty.

Group practices and spas can start by teaching staff members to be more sensitive to each other. In her continuing education classes on cultural sensitivity, Brown helps staff learn about each other’s backgrounds and experiences through games, partner exercises and group discussions. These exercises help them understand that everyone’s perspectives and boundaries are different.

By acknowledging their differences and similarities, they begin to lay the foundation for a deeper acceptance and respect for their clients’ different value systems. This also holds true for preventing sexual harassment. In Brown’s seminar entitled “When Intention Doesn’t Matter,” she helps therapists protect themselves by first implementing good boundaries in the workplace. Some of her suggestions include:

  1. Ask everyone in the workplace permission to touch them. “As touch providers, we tend to think that everyone loves massage, especially if they work in the environment. We need to be sensitive to the differences.”
  2. Make your massage session with co-workers as professional as with your clients. “Casual touch in the workplace is confusing. Therapists should exercise caution when they have the urge to massage their coworkers off the table.”
  3. Respect people’s sensitivity about touch and modesty. “To a touch provider, hearing someone has a headache or aching shoulder means they want hands-on time. This isn’t necessarily the case.”
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