Listening to Your Clients' Bodies

Learn how to pay attention to your clients' needs.

By Donna Shryer, April 24, 2018

A study conducted by the Ponemon Institute, in concert with Bob Sullivan and Hugh Thompson for their book The Plateau Effect: Getting from Stuck to Success, suggested that the older we get, the more “hard of listening” we become.1

Here’s what took place during the study: Three videos, each about five minutes, were recorded a husband and wife discussing guestroom paint colors, voting instructions and a reading of Facebook’s privacy policy. After viewing the videos, test takers were asked 15 simple questions concerning content, such as “What color will the room be painted?” Eighteen percent of study participants nailed all the answers. The remaining 82 percent got one third to one-half of the questions right.

The problem, the book’s authors explain, is that even fast-talkers speak around 125 words per minute, while the brain can process as many as 400 words per minute. “That means three quarters of your brain could very well be doing something else while someone is speaking to you,” the authors write.2

The result? According to a textbook published by University of Minnesota Libraries Publishing, we often hear but don’t listen—hearing is the involuntary act of perceiving sound, whereas listening is a choice that’s made to process the meaning behind what’s being said.3

Massage therapists may say, “That’s not me! Each client gets my full, undivided attention.” But let’s look at the distractions competing for your unused brain space. There’s your cell phone, which might deliver an important text at any moment. There are professional tools to consider, like bottles of oil, table linens and music. Perhaps you’re concerned about a client suffering back pain. Since you have a personal life, too, there are family matters to mull over. So, if you’re not processing every word a client says, blame it on your brain. But don’t despair. You can strengthen your listening skills, harness your brain’s train of thought, and remain focused in the moment and on the client in front of you.

Making Sense(s) of It All

Listening to a client and the client’s body requires more than your auditory system, or sense of hearing. You also need to engage your sense of sight and touch, explains Carole Osborne, licensed massage therapist, author, mentor and continuing education provider. In addition, she says, listening includes your sixth sense, aka intuition.

Using many senses is also a powerful way to stay deeply engaged in the moment and ward off distraction. It’s what Sullivan refers to as immersive attention. “Most of us enjoy a movie more in the theater than on a living room TV. That’s because the theater is an immersive experience. Theater owners know this. It’s why they’re trying to engage all your senses by experimenting with smell-o-vision and 3-D. In the same way, a massage therapist who connects with a client in the moment and through multiples senses, is going to be more engaged and most likely more effective.”

Using Sight, Touch and Intuition to Listen to a Client’s Body

Sight. “Listening with our eyes means observing unspoken information, like the client’s body structure movements, expressions, habitual postures and gestures,” Osborne says.
John Bagley, licensed massage therapist and owner of John Bagley LMP in Fort Collins, Colorado, begins every session by noting how the client walks, stands and positions themselves on the table. “These visual cues help me decide which therapy path to go down.”

Touch. “As palpation therapists, we’re always listening with our sense of touch for the quality of tissue—its level of receptivity or push away,” Osborne says. “We’re processing information about the skin’s temperature and texture. We’re responding to the fascia planes throughout the tissues. When we use listening touch to access these things, which are often outside of our clients’ awareness, then as massage therapists, we and our clients can benefit,” Osborne adds.

Jody Marie Bickle, licensed massage therapist and owner of Serenity Medical Massage & Bodywork LLC, headquartered in Duvall, Washington, feels that her sense of touch also keeps the client informed about what’s literally going on behind their back. “I may detect something that the client can’t feel or see. I would never diagnose, but I can use listening touch to boost the client’s awareness and suggest that they check in with a physician.”

Sixth Sense—Intuition. Robin Elledge, president of Janus coaching and consulting, headquartered in Los Angeles, spends her days listening to clients, and that includes what’s not being said. “That’s where intuition comes in,” she says. “If you feel the client’s energy shift, or that the story they’re telling you is incomplete, it’s time to probe. Ask questions that help fill in the blanks. This is important in any profession.”

Michele Kolakowski, licensed massage therapist and owner of Sanctuary Healing Arts in Boulder, Colorado, taps into a therapeutic non-verbal listening tool called tracking when working with her clients. “I may be working with the upper trapezius, but I am tracking the entire body with my senses. I may see responses in other parts of the client’s body—toes wiggling, fingers curling or a change in breathing pattern, in addition to changes in the trapezius. Tracking all these changes prompts me to continue or adjust my technique and pressure for optimal therapeutic effect,” Kolakowski says.

Watch Your Language

Massage therapists listen to a client’s body via heard words, touch, sight and intuition. If you want to crank up the volume, Osborne recommends using listening language. In a nutshell, listening language is about phrasing questions to elicit crystal-clear information that promotes highly customized and effective therapeutic work.

As Osborne explains, that often means avoiding “how” or “why” questions. “Listening language helps engage the client’s right brain, which encourages the client to express nuances of sensation and imagery. So instead of asking, ‘How did your shoulder get tight?’ or ‘Why is your shoulder tight?’ I might say, ‘What does the tightness in your shoulder feel like?’ If I can elicit a vivid metaphor, it’s much more possible to achieve collaborative, individualized, multidimensional and effective therapeutic massage.”

Osborne offers an example. A client reports shoulder tightness. Thinking in terms of a metaphor, Osborne says, “I might ask, ‘What is the tightness like?’ If the client answers that it’s like a knotted gold chain, I am led to push the knot inward, perhaps loosening it by pressing the client’s shoulder blades toward each other. If the discomfort is like a clump of hardened clay, that suggests very different techniques, such as kneading or direct compression.”

Similarly, Bagley asks clients to use descriptive words. If a client says, “ It hurts here,” he follows up with, “Is it sharp, achy, tingly, throbbing or another word?” The answers, Bagley says, lead him to understand the pain and know where and how to start.

Kolakowski relies on stoplight symbolism to activate her clients’ feedback and keep herself actively listening throughout a massage session. “Periodically during a session, I ask the client to assign a color to what they feel. Green is pleasant and relaxing; yellow is experiencing the therapeutic edge—relaxing while contacting tension and/or pain; red is painful and not therapeutic. If needed, I adjust my technique and pressure back into the healing green and yellow zones. It’s a simple way to promote an active dialogue, and it reinforces that I’m listening all the time.”

Enhancing Intake

Listening language and active listening make for perfect partners. To actively listen, the listener makes a conscious effort to understand a client’s words as well as any underlying message, which may be subtly relayed by intonation, body language or what your intuition tells you has been left unsaid.

“Active listening is not so much a technique but a way of being in the moment with a client—immersed in their story—so I can facilitate a creative interaction that tells me how to best use massage therapy,” Osborne says. Active listening also delivers a valuable way to enhance the intake form. For example, Bickle emphasizes, “It’s amazing what some clients forget about or think is unimportant. It’s my job to find that unspoken message that’s not on the form,” she says.

Kolakowski also uses a detailed intake form that helps her better customize a client’s massage session. “A client may not otherwise know to tell me about all her symptoms. My intake form’s checklist of symptoms elicits more information to focus my active listening throughout the session. For example, pregnant women often have sinus congestion that can be soothed with acupressure massage over the sinuses. Listening begins with my detailed intake form so I don’t miss hearing about important concerns that I may be able to address.”

When reviewing the intake form with a client, Elledge urges massage therapists to actively
listen for intonation. “When you actively concentrate on how the speaker speaks, you
learn so much.” As Osborne explains, “Ongoing, personalized interaction—from the initial intake form through post-session follow-up—helps make the client an active participant in their own health and wellness. This can empower the client, increase the treatment’s effect and spark a long-term, trusting relationship between client and massage therapist.”



1. Sullivan, Bob, and Herbert H. Thompson. The Plateau Effect: Getting from Stuck to Success. Dutton, 2013.
2. Ibid.
3. Harris, Leslie J., Stand Up, Speak Out: The Practice and Ethics of Public Speaking (2017). Communication Faculty Books. 1.