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Practice, Practice, Practice

Introduction  |  Touch, Intimacy and Sexuality  |  Sexual vs. Compassionate Touch
The Senses  |  Desexualizing The Massage Experience  |  How To Avoid Grievances

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Every full and healthy human life includes some measure of three elements: touch, sexuality and intimacy. Challenged to find appropriate balance in our lives, we seem surrounded by a jumble of images, information and misinformation. Only a few helping professions offer the kind of advice or experience that assist us in sorting it all out. Massage therapy is one such profession. Here the reality of touch and the intimate nature of their work allow human beings to explore the truth of human nature, including nonsexual pleasurable sensation.

Certainly massage therapists are aware of the extraordinarily close connection between their chosen profession of touch and the confusion between touch, intimacy and sexuality. Some massage therapists receive training that helps them deal with those close connections. Such training examines the ethics of the therapeutic relationship, and teaches the practitioner how to create clear and safe boundaries for care of the self and the client.

All need such training. In the massage therapy session, personal and societal confusions about touch, intimacy and sex can manifest. That is because caring touch, even in the context of the one-way intimacy of the massage session, may occasionally evoke sexual feelings from client, therapist or both. It is no wonder that sometimes things go awry and people get hurt. The wonder is that in our sex-focused and sexually confused society, massage therapy continues to grow and develop, and keeps enhancing its power to help and to heal.

Radical Change
Most massage therapists love their chosen profession. According to the American Massage Therapy Associations (AMTA) 1997 national survey of its membership, 92 percent of massage therapists cited one reason in particular for choosing their work: the chance to help others, to make a positive difference in peoples lives.2

Anyone involved in a helping profession will tell you that real change happens slowly and occurs first within the individual. When people make significant shifts internally, as from a sense of helplessness to empowered action, then changes in their external reality are likely to follow. These are the people who go on to work on their relationships, quit unsatisfying jobs or take their physical well-being seriously in hand to make a shift in their health and well-being. Thus, changes on the surface of their lives reflect the radical change that has occurred deep within their being.

The word radical here means more than extreme or revolutionary. Radical literally means proceeding from the root. When change happens at the root of a plant, it affects the subsequent growth of its branches, leaves and fruit. When change occurs at the root of a persons beliefs and assumptions about self and the world, it affects how that person interacts with the world from then on.

Confusion surrounding touch, intimacy and sexuality in the massage session arises from the personal and cultural confusion pervasive in Western society. Massage therapists, especially in the United States, tend to be individuals who have freed their experience of touch from the sexually-drenched cultural norm. Their desire to help others also makes them accept the responsibility this freedom brings: They choose to employ their ability to respond in an ethical way with clients who, knowingly or unknowingly, have or seek the same freedom to experience touch in a safe and nonsexual manner. The potential for radical change exists in every massage therapy session. The potential to effect positive change is at the root of a persons being. In this way, being a massage therapist is often a radical act.

Magic Of Connection
The massage therapy experience is filled with possibilities for making connections that can lead to change. Most obvious is the connection between the massage therapists hands and the clients body. Science has little to say so far about precisely how touch works. We do not know much about the biomechanical and neurochemical stimulation of touch. Despite the lack of an explanation, however, scientific research studies are revealing that touch is associated with positive results in a wide variety of conditions of imbalance and disease. The work of the Touch Research Institute provides excellent examples that demonstrate the effectiveness of touch and massage for asthma, diabetes, anorexia nervosa, insomnia, chronic fatigue syndrome, AIDS and many more diseases.3

Without a clear scientific explanation of their mechanism, these benefits may seem like magic to some. But then the effectiveness of making connections has always had a magical air around it. Touch somehow has the power to help people connect, or to reconnect, with their authentic self. This seems to happen in several ways. Receiving massage helps a person make connections with his own body. Increased body awareness means the individual connects, often for the first time, with the bodys true needs and desires. The recipient becomes aware of the bodyÕs innate drives for food, personal relationships, and working and living environments that are health-sustaining. Increased body awareness invites and encourages the individual to take responsibility for his own health, and to take better care of the body he lives in.

The relationship formed between the individual client and the massage therapist presents another set of complex connections vital to the works effectiveness. In its best form, this relationship models for the client a healthy relationship to the body, to touch, and to boundaries. Individuals who have experienced little positive, nonsexual touch after childhood begin to know themselves in new and exciting ways. Those who have been abused through touch often experience the beginnings of trust when working with an ethical and compassionate massage therapist. They can take the healthy model of touch learned in the session into their lives, finding their way into a fuller, more positive sense of sexuality, into supportive relationships, and into confident self-knowledge.

The magic of this connection may happen on physical, mental, emotional, and for some, spiritual levels. Massage therapy has the potential to touch an individual in all of these ways. That is why the experience of massage can be so profound. That is also why the experience of massage holds such potential for harm and confusion.

Downhill View, Uphill Struggle
According to the AMTAs records, for the years prior to 1998-99, the majority of grievances filed by clients against massage therapists concerned sexual issues.4 This statistic can be explained by a number of factors, many of which are complex and interrelated. [See page 90Ed.]

A point of common knowledge in our society is that prostitutes have advertised that their service involves giving massage. This is a means of their circumventing laws that ban prostitution. While this is not the proper forum for discussing pros and cons of prostitution, there is a need here to consider how our culture facilitates a leap from touch to sex. While the Victorian Age often is blamed for this leap, its roots lie deeper in human history. For as long as there are records, there is evidence that some elements of our culture continually attempt to control sexuality with rules and regulations, even as other elements attempt to free sexuality from restrictions.

These two, black-and-white, either/or approaches do not help anyone to deal with the daily gray realities faced by human beings. Instead of being consciously flexible and wise within the sphere surrounding sex and ethical action, we feel confused and lost between two opposing poles. This confusion allows sexuality, at one pole, to be easily disconnected in our lives from the things that enrich it, from emotional intimacy, from responsibility, and from relationships in which sexuality is but one aspect. With such disconnection, sex at the other pole becomes an act isolated physically behind locked doors and isolated, as well, from our hearts and minds. Sexuality then loses its emotional intimacy and spiritual dimensions, and becomes defined by its physical aspects alone. Suddenly, the distance between touch and sex, usually filled with empathy, compassion, trust, humility, desire, intention and so many other rich emotions, disappears. Left is the stark equation: Touch = Sex.

The media of mass communication reflect, amplify, codify and perpetuate this separation and add to the confusion. When not saturated with images of sex, we are admonished by headlines of moral outrage. Everywhere one turns, something a product, an idea a feeling gvies for our attention and energy. As Daphne Chellos writes, Most of the touch displayed is of a romantic, sexual or violent nature. In addition, she says, Studies have shown the United States to be a low-touch culture; the kind of touch we give our children tends to be more for care taking, retrieving and punishing and less so for nurturing and affection.5

Massage professionals must work to regain the lost ground between touch and sex, and all of the riches found in having touch as a normal part of our lives. There is progress, as highlighted by the fact that in 1998-99, the AMTA Grievance Committee reported a tremendous change in the nature of complaints, from sexuality and ethics to office and business ethics. But there still is work to do, and the challenge is especially crucial now that the American/Canadian culture is experiencing positive shifts in attitudes about massage.

Signs Of Radical Change
The signs of these attitude shifts are everywhere. Even the mass media have begun to focus on the positive aspects of massage therapy, rather than on the sexualized stereotypes of the past. According to the AMTA, from 1998-99 more than 5,000 popular articles were published about massage and its benefits.6 Reporters seem to love to write about the premature babies who gain weight when they are massaged, about the workers who are more alert after massage, about the people with HIV/AIDS whose immune function increases after massage. If there is anything reporters love more than a human interest story, it is a human interest story that has scientific evidence behind it. The Touch Research Institute, at the University of Miami in Florida, has documented the above results along with many others in their numerous research studies.7 The Institute and its director, Tiffany Field, have been written up in countless newspapers and popular magazines including The Miami Herald, USA Weekend, Life, and Newsweek.

Another highly referenced study is the 1997 update by David Eisenberg and his research group at the Beth Israel Deaconess Medical Center in Boston, Massachusetts, regarding the use of alternative medicine in the United States. This study found that a total of 629 million visits were made to providers of complementary and alternative therapies in 1997, compared to 386 million visits to primary-care providers. Massage was second to chiropractic in number of visits.8

Accompanying the rise in public awareness of the positive aspects of massage has been a corresponding rise in the total number of massage professionals. AMTA now has 42,000 members; between March, 1998, and March, 1999, more than 6,000 new members joined, the largest single-year increase in the organizations history.9 Through the efforts of these professionals, as well as the increasing attention from scientists and laypersons alike, massage therapy is riding a wave of popularity into the lives of more and more people.

The massage therapy profession has begun to rise above and shed a bit of clarifying light upon the confused cultural morass described earlier; and because of this radical change, the issue of ethics becomes even more important. Clients who seek the services of massage therapy professionals have the right to feel safe in doing so. An ethical professional therapist and a neutral, but inviting, professional setting offer a welcome haven to clients as they approach this new experience. Locations that are safe, offices that are accessible but private, therapists who are knowledgeable, competent and compassionate provide the best holding environment for massage therapy. The client receiving massage for the first time, or from a new therapist, may indeed feel some anxiety. One role of the professional is to help ease these fears. Therefore, when a profession takes on the task of defining itself, one of its most important purposes is to establish ethical guidelines that, as much as possible, guarantee that the public receives a safe and positive experience.

Word To Therapists
Massage therapists are already bringing about positive change in the world, one client at a time. They need to be encouraged to consider extending their reach to the local, state and national levels. Wherever our culture shows its confusion about touch and sexuality, massage therapists can help correct outdated policies or initiate guidelines where none currently exist. Massage therapists can educate those who hold the decision-making power in the board rooms and legislatures where they live. Massage therapists can achieve win/win resolutions. By taking the initiative to work with the AMTA, other professionals and other professional organizations, massage therapists can forward the publics perception of massage as a therapeutic, safe, nonsexual and ethical practice.


1. Daphne Chellos, Sexuality Chapter (unpublished).

2. AMTA Annual Report, 1997.

3. TRI Web site: [www.miami.edu/touch-research]

4. AMTA Annual Report, 1998-99.

5. op cit., Chellos.

6. op cit., AMTA, 1998-99.

7. op cit., TRI.

8. Eisenberg, D.M.; R.B. Davis; S.L. Ettner; et al. Trends in Alternative Medicine Use in the United States, 1990-1997: Results of a Follow-Up National Survey. Journal of the American Medical Association, 280:1569-1575, 1998.

9. op cit., AMTA, 1998-99.

Ben E. Benjamin, PhD in sports medicine and education, is the founder and president of the Muscular Therapy Institute. In private practice for more than 35 years, he is the author of dozens of articles.


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