Professional Massage

1. Books, magazines and other resource guides

   Two books have been mentioned in alt.backrubs: Massage: a career at your fingertips and International Massage & Bodywork Resource Guide.

   Martin Ashley's book Massage: A Career at your fingertips (published by Station Hill Press with ISBN 0-88268-135-4 in 1992) used to be recommended often in alt.backrubs. It provides a thorough overview of career choices for bodyworkers and massage therapists and a career-planning guide. The extensive section about legal requirements, schools and equipment may be out of date by now. A Table of Contents is in the archive's getting.registered file.

   According to Keith Grant, the International Massage & Bodywork Resource Guide compiled by Robert Calvert and Noel Abildgaard and published by Noah Press (with ISBNs 1-879933-04-7 and 1-879933-03-9 in 1991) contains more than 520 listings of schools, associations, seminars and laws related to the healing arts of massage, bodywork and holistic health along with tips on choosing a school, a glossary of techniques and a book review section.

   Massage magazine (also published by Noah Press, with ISSN 1057-378-X) contains a section for paid advertisements about massage schools and training centres. Because they only accept paid ads I can't tell how complete the listings are. It seems that Massage is aimed primarily at American markets. The magazine publishes a brief list of the most basic regulations for registered massage therapists in each of the United States of America. The list includes telephone numbers for additional information. Noah Publishing's address is

   P.O. Box 1500,
   Davis, CA 95617
   USA.

   They can be reached by telephone at +1(800) 872-4263 or +1(916) 757-6033. The magazine has e-mail address <massagemag@aol.com>.

   Informative postings about massage schools may be found in the archive's mas.schools and esalen files. More information, and much discussion, is available in part b) below and in the archive (see the category about certification; information about the archive appears in question 5.1.2).

   The AMTA (American Massage Therapy Association), the ABMP (Associated Massage and Bodywork Professionals) and the COMTAA (Commission on Massage Training Accreditation/Approval in the USA) often come up in discussions of massage schools in alt.backrubs. For that reason only, the following address and telephone numbers are included here. They were extracted from the archive's mas.schools file. If you have more accurate information please tell the archive maintainer.

   American Massage Therapy Association (AMTA)
   820 Davis Street, Suite 100,
   Evanston, IL 60201-4444
   USA
   +1(708) 864-0123
   +1(312) 761-2682 (for a list of COMTAA schools)
   N.B.: inclusion of this information does not imply approval (or disapproval) of the AMTA, the COMTAA, the USA or any other organization, their policies employees, fashion sense, etc. It is here because it is part of an answer to a frequently asked question.

2. What are the ABMP and the AMTA?

   Before you decide to join any organization you should read part a) above and possibly the relevant archive files. If you want to know what the various abbreviations used in alt.backrubs mean then you should be reading question 1.3.

   In the USA and Canada, the AMTA (American Massage Therapy Association) and the ABMP (Associated Bodywork and Massage Professionals) are major organizations offering malpractice insurance and forms of professional accreditation. It is entirely possible that these organizations also offer these services in other countries, but those are the only ones of which I am aware. If someone from those organizations will supply more information then it will be used to update this document. See question 0.2 for information about whom to contact.

   The AMTA and the ABMP are competing organizations with different approaches to massage, massage and bodywork regulation and many other issues near and dear to the hearts of professional MTs. If you are thinking of getting certified (within or without the USA and Canada) then you might find the discussions in the files in the archive's certification category helpful. The archive and its categories are the subject of question 5.1.2.

   Please feel free to submit an unbiased summary of the posts in the archive files relevant to this question. If such a summary is received it, or some version of it, will replace this answer.

1. The alt.backrubs newsgroup has had many discussions of issues related to massage as a profession and tools and techniques for massage professionals. Copies of many posts on these topics are available in the alt.backrubs archive (see question 5.1.2). For example, the archive contains information about massage tables, professional organizations, exams and draping standards.

2. Emotional response considerations

   Keith Grant, a massage instructor (amongst many other things), has submitted the following notes about emotional response considerations in professional massage. More information about this topic is available in the archive file emot.release (see question 5.1.2 for information about the archive).

   EMOTIONAL RESPONSE CONSIDERATIONS

   As a massage professional you should be aware that some clients might suffer strong emotional release during massage. You need to be able to recognize signs of such sublimated emotions and to know how deal with such issues when they arise in your massage practice.

   Background
   Unresolved emotions can become anchored in the body as a result of physical and emotional traumas. One can think of the body as maintaining `physical memories' of such emotions in the tension of muscles. The condition is especially common with those who suffered physical or sexual abuse as children. It can be that over time, the body becomes habituated to the unbalanced muscle tensions. Eventually, patterns of body usage and posture are changed in an unconscious attempt to compensate.

   Massage can bring anchored emotions and associated memories back to conscious awareness. Indeed some psychotherapies involve forms of bodywork intended to focus the patients attention on tension in their body (more information is available in the mas.vs.psychotherapy file in the archive, which is the subject of question 5.1.2). While the re-awakening of emotions is a process that can contribute greatly to re-integration and healing, it is important as a massage practitioner not to assume the role of emotional therapist or become caught up in listening to verbal stories.

   Indications
   It is equally important, however, to bring your focus and awareness to bodywork sessions. A massage professional should be aware of their client's overall way of inhabiting their body. Watch how they hold themselves, walk and gesture. Projections of being overly rigid, collapsed, or inanimate/dissociated can be indications of past abuse.

   Abuse survivors can have trouble `owning' their bodies. They may feel loss of breath or voice. If their physical memories are triggered, such clients may remove all of their conscious awareness from their body. Not feeling able to `own' parts of their body can lead to discernible splits in the use and vitality of their body, e.g. left/right or upper/lower.

   Be aware that a client may verbally agree to a technique while disagreeing with their body language. An example could be saying yes while shaking their head or retreating slightly from your hand. Such incongruence in presentation is a subtle indicator of the incongruence between their conscious and unconscious thoughts and feelings. Try to be attentive to subtle changes in breathing, tension level and small movements, that might be early indicators of emotional responses during a session.

   How you should react
   In the event that one of your clients has a strong emotional response to deep tissue work, you may need to forego further work planned for the session. Keep your own centre, stay calm, and remember that your goal is neither to `fix' the problem nor to add your own emotional reaction to the client's process. Instead assume a role of offering the quiet acceptance and support that will enable the client to reach an acceptable level of equilibrium by the end of the session. This may include gentle grounding work around the head, neck, shoulders, or feet and ankles. Remind the client to breathe. Often the most important thing you can do is to quietly convey to the client a sense of connectedness and support.

   Aside: The words people use
   Although many people do refer to storage of memories in the body I tend to avoid referring too literally to this as a mechanism. I prefer to think of memories, not necessarily available via conscious cognitive paths being indexed (hence my phrase `bookmark') or reached by the more primitive and unconscious sensory paths from touch. It's not necessary to understand the mechanism or location of memory storage for the metaphor to useful. I've come to this view, partly from some training I've had in Ericksonion trancework.

   In a similar vein, I try to avoid limiting the bodily causes to habitual tension. The interactions are complex. The original abuse could have been any (or all) of: physical abuse, emotional abuse, sexual abuse, or neglect. The abuse or neglect survivor often loses both their voice (in the physical and metaphorical senses) and possession of parts of their body.

   Many times they lose all conscious sensation in parts of their body. The physical outcomes can include tension, disruptions in movement, breathing and speech. However you should not assume that these symptoms are necessarily a direct result of tension. One of the outcomes can be muscular collapse that leads to a lack of normal tonality or tension. On the emotional level, the ability to establish normal boundaries may be lost or never learned. Incongruence between verbal and nonverbal responses (e.g. saying yes and shaking the head no) often indicates the resulting conscious/unconscious split.

If you are not sure what to expect from a professional massage you might find some of the information in the archive (question 5.1.2) of interest. The files in the professional category and the what.to.expect and what.price files should be of especial interest. If you'd like to summarize that information for inclusion here, please see questions 0.3 and 4.4.

1. Either way typical advice is to get a referral from a trusted friend, physician or other health care professional, local massage school, health food store or Chamber of Commerce. Steve Brooks <XFWB90A@prodigy.com> suggested (in article <3eco5n$1a0m@usenetp1.news.prodigy.com>) that major hotel chains that cater to Japanese tourists should be able to refer you to reputable Japanese style massage therapists. How you're supposed to locate such hotels is left as an exercise to the reader. Some people like to search advertisements in the telephone book and so-called New Age or Holistic Health stores and publications. Other people say this is a terrible way to find a MT. I suppose it depends on where you live and what your local publications are like.

   If all you care about is whether you are going to get a professional massage or sexual services then ask. Be aware however that if they are using massage as a cover for sexual services then they probably won't answer direct questions about whether or not they offer sexual services. Many of the suggestions in this answer come from the finding.a.MT file in the archive. The archive is the topic of question 5.1.2.

   Someone suggested some questions that might help you detect whether the prospective masseur offers such services as `relief massage' (often a codeword for masturbation). You might also ask what professional organizations they belong to as members of the AMTA (American Massage Therapy Association) and ABMP (Association of Bodywork and Massage Professionals) are strictly forbidden from sexual involvement with their clients. Not all professional MTs belong to either of these organizations -- you can read some of the arguments in the archive (see question 5.1.2) if you're really interested. Those arguments appear in the `certification' file. The medical.model and other files in the Professional category may also be of particular interest.

2. When you're satisfied that you have found an above board MT you should try to find out if they will be suitable for the type of treatment you want. Be clear about what your needs are and tell the MT. Perhaps you want massage for relaxation or you have a specific area that needs attention, for example. A good MT will help you pinpoint what it is you want from the session, often just by talking about it with you.

   If you are at all uncomfortable with the thought of being unclothed, then discuss draping with the MT before the massage begins. Absolutely no professional MT will demand a client remove any clothing that the client is not comfortable removing regardless of what impact this will have on the massage. Are you comfortable with a male (or female) MT, or would you prefer a MT of the other sex?

   Please note however that just because a MT graduated from a professional school they aren't necessarily going to give you a great massage. It has been said many times in alt.backrubs that some MTs have the technical knowledge of what to do but lack the sensitivity to detect what clients really need. Corrina Perrone has written that, in her experience, it almost always takes at least two years of practice after graduation for MTs to a develop a truly professional calibre of massage.

   Once you have a short list of MTs you want to consider, then you should ask questions to determine what services these unknown massagers really provide, and how skilled they are in the type of massage you want (see question 2.1). You could ask about their professional education, e.g. how many hours of training have they had (this varies from about 250 to 2000), which massage school did they attend, what their favourite course was and what types of massage they prefer.

   Corrina Perrone <corrina@cs.colorado.edu> recommends:

   If you still have doubts about the qualifications ask direct questions about the types of bodywork they do -- and expect some technical answers [such as those in question 2.2]. Ask them to describe these techniques, and how they use them in a session. You'll get a lot of `it depends' answers, but a good therapist will be able to give you an example, such as, `I warm the muscle tissue up using mostly Swedish massage strokes, and then use deep tissue techniques to work out tightness. If there is limited movement I might use NMT [neuromuscular massage therapy] work on the muscle attachments, and some Trager techniques to integrate the work.' Find out how long they have been in practice.

   If you are screening the therapists by phone, look for qualities that indicate they would be a good person with whom to work:

   Do they listen to what you are saying and respond to it?
   Do they ask questions about your needs?
   Do they impress you as professional?
   Do you feel like you are being listened to, or do you feel like you are getting a lecture in physiology?

   Take some time to consider those questions strategically. You want something from the bodywork, and you are picking the best partner to help you achieve that goal. You should also be clear in your mind about what you want. The MT's answers will tell you something about them and their massage practice.

3. In the finding.a.MT file mentioned above Brother Bernard Seif <monk@epix.net> noted that the Associated Bodywork and Massage Professionals (ABMP) offer a free referral service. To use the service call +1(800) 862-7724.

   Please note that the inclusion of information about a commercial organization (the ABMP in this case) does not indicate in any way approval or disapproval of the organization in any way by anyone responsible for this document. The information is included because it is deemed useful to the readers of alt.backrubs and is part of the answer to a frequently asked question. If you have corrections to the telephone number or additions (e.g., the number of another referral service) then please inform the FAQL maintainer.

Remember that any MT needs to know if you are seeing another practitioner, in order to make sure the massage won't interfere. Many people don't know for instance that if they are taking drugs, even for chronic illnesses, their dosages will often need to be decreased if they regularly receive bodywork treatments.

What follows is adapted from some advice that MayaWay <mayaway@aol.com> posted the following advice for the Maine Massage Guild:

How To Enhance Your Treatment Experience

• You'll feel more comfortable if you don't eat for two hours before your session.
• Draping will be employed for traditional massage. For other therapies wear loose fitting comfortable clothing.
• Let your therapist know if you have any medical or physical conditions which might contraindicate certain types of treatment. (See also part b) of question 4.3, about finding a capable MT, above).
• Remove any unnecessary jewelry that could cause scratching or interfere with having a smooth massage.
• If you wear glasses or contact lenses, consider removing them. It may add to your relaxing experience.
• If you're concerned about getting oil on your hair, inform your therapist. You won't want to miss out on a head massage!
• Quieting yourself will allow you to tune in to your experience and relax more deeply. Do give your therapist feedback regarding your experience and feel free to ask any questions you'd like.
• Breathe deeply and regularly, stressing your exhalation. Imagine your body becoming heavy and sinking into the table or mat. As the therapist locates areas of tension, consciously allow yourself to breath and relax into those areas.
• Sometimes during a massage or other type of treatment emotions will surface. It may be of great benefit to release and work through them if you feel comfortable doing so. (See the archive and question 4.2 for related information. Information about the archive appears in question 5.1.2.)

That file also has suggestions for where to seek less expensive professional massage than usual. Some of that advice is presented here, but is not meant to replace a thoughtful reading of that file. Some MTs will accept trades of good and services in place of money. Some are listed in the exchange file (see question 5.1.1). MTs-in-training often need to practice :) -- local massage schools can often put you in contact with the trainees. Question 3.2 is about where to find people to give (and receive) massage.