Over Exposed

Do you see anything you shouldn’t be because I don’t?

A million moons ago, I remember laying on the table in my massage school’s practice room waiting for my student partner to work me over for the sake of learning. Before any hands on techniques were ever taught, our instructors put massive emphasis on how to properly drape a client. I remember it was sweltering hot down there in that basement room and I asked my partner to leave whichever areas he had finished massaging uncovered. As he migrated to the backs of my legs, I heard this woman’s voice say, “Do I really need to see her tattoos?” About a minute or two later, I heard the teacher who was proctoring our sessions come over and say to my partner that he was exposing too much of me. “Keep the body parts you are not working on covered at all times.” Cringe! He made it sound like I was being dissected on a lab table. I popped my head up and said that I wanted to cool down since the room was too hot and that I didn’t feel in the least over-exposed. In a firm voice he said, “This is New York State Law, young lady” and walked away. The girl who made the comment about my tattoos was shaking her head at my partner adding, “You guys have to be careful.” Really?

This experience poses a conflicting scenario between what “THE LAW” says and communicating client comfort properly as a therapist in a professional setting. Let us dissect draping methods here: Some spas provide their clients towels to be used as a drape sheet. In some European styled facilities, you are handed a washcloth sized square to cover your pubic area and gluteal cleft (anatomical language for one’s butt crack) while the therapist works on you. An equally small cloth is used to cover the chest when laying face up. And if you want to get even less coverage, try the spas that provide just disposable underwear and bra. Our prudish classmate might have popped a gasket if she knew just how little coverage is actually mandated by the law. Still, in order to cover themselves (pun intentional) from potential law suits etc. many spa chains have disclaimers on their sign in sheets that note what our instructor admonished us to do. All parts not being worked on with any variation of said massage techniques (insert list here) will be covered. No genitals and no breasts. Should the client become uncomfortable at any time they have the right to tell their therapist and end the session.

How about that for coverage?

I supposed being a child of European parents has allowed me to be very comfortable with the nude form in a non-sexual manner. Here in the States though, with its Puritanical hypocrisy, everything becomes sexualized. I have seen commercials in Greece for bath soap that featured a fully nude mother bathing her child in a tub, while the father stands by with a towel to dry them both off. A beautiful family moment, au-naturale. This would NEVER AIR in the U.S. and yet other programming featuring pretty overt sexual and borderline sado-masochistic action does. It doesn’t take a psychology degree to know the message being plugged into people’s consciousness.

With that thought in mind, let us return now to the matter of draping per the LAW. I have had clients with major body issues, in the sense that there was a definite discomfort in uncovering ANY part of their anatomy. As an intuitive person and a professional, I addressed their issue immediately to prevent any blurred communication or innuendo. In one case, a young woman kept tucking her hands under her pelvis, which made accessing her arms impossible without having to reach underneath her into the groin region. Without hesitation, I gently told her what I wanted to do and asked if the position she put her hands in was a matter of comfort or otherwise. She sighed deeply and apologized, admitting that she was molested as a child and this face down position was bringing back memories. We decided together to do the massage face up and I let her know that any feeling she experienced was safe and okay in this context. I draped her very securely, folding the sheet into origami like patterns to ensure she felt covered at all times. By the end of the massage, she was almost asleep, which demonstrated to me how trust had been established. Imagine though that I proceeded massaging her without saying anything at all. With such a damaged relationship with touch, can you imagine what this poor young woman might have misconstrued as sexual? I believe this is the reason why many straight male therapists get into trouble with female clients. They are doing their “routine” without picking up on the body language that would let them know the client is not okay.

I have also had a client with hyperthyroidism, who begged me to un-drape him as much as possible due to his elevated body temperature. Even with a hand towel covering his pelvic region, he was still profusely sweating. The thing is, he never wrote this on his intake form. When I led him to the room he immediately blurted that he didn’t like to be covered with anything. Usually, this sets off my pervert flags. After explaining that certain regions of the body need to be covered per the LAW and the facility’s policy, he insisted that covering him up would make him sick. I had to pry it out of him, but he finally told me his condition and we proceeded in the manner I described above. Without this communication, I could have easily felt violated and threatened by this client’s desire to over expose himself.

Ultimately, we all have a baseline of how much or how little we are comfortable uncovering. However, as a licensed professional in an industry that is often joked about or targeted in a sexual manner, it is up to me to bridge the gap between what state of undress puts them at ease and what keeps me licensed and gainfully employed.

**A funny addendum here: Many male clients think they are being helpful when they spread their legs to allow for us therapists to tuck the sheet down properly for draping; however, what they don’t realize is they inevitably flash us their testicles. Every single time. Without fail. Dear future male client: Please just lay there as un-helpful as possible and leave the tucking to the professionals.

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Massage for a Broken Heart

This too shall pass…

One out of every three clients I encountered this past month was in the midst of a break up. Although February is nationally recognized as a time to celebrate love, thanks in part to the mass market holiday that Valentine’s has become, it seems that more and more people choose to end their relationships during this time. Break ups apply to all kinds of human connections like friendships, romantic partners, marriages or family members and illicit the same range of emotions one would encounter within the grieving process. Rather than swimming in the vortex of loss alone, these clients sought out massage as comfort. How is it that heartbreak “hurts” so much? The physical reaction to emotional loss can be explained through medical science.

When emotional stress is experienced, especially loss, our brains signal the release of stress hormones from the adrenal glands and certain proteins that constrict blood flow causing part of the heart to become temporarily enlarged and incapable of pumping well. The rest of the heart has to compensate by contracting more forcefully. The pain felt in one’s chest resembles that of a heart attack; however without the permanent damage associated with it. The heart is described as being temporarily stunned or rendered “helpless” which is an interesting choice of words given the sufferer’s mental state. This condition is known medically as stress cardiomyopathy (formerly takotsubo cardiomyopathy) but many doctors refer to it as Broken Heart Syndrome.

Pain is the brain’s primal way of responding to trouble. That trouble can be caused by stimuli both inside and outside of the physical body. Sensory receptors known as nociceptors register these stimuli and in milliseconds return the signal of pain. When we are in a state of emotional distress, the brain’s blood supply is altered, sending more blood to the area responsible for regulating physical pain. This excess flow has been found in people with depression making them more peaked to pain. The emotions felt during a break up enact this physiological response, registering an ache or hollow feeling often felt within the organs of our core; not just in the heart. The state of pain also kicks in the sympathetic nervous system to respond, known as our state of “fight or flight.” The hormones and proteins released inhibit appetite which can lead to anorexic behavior, keep us over alert which translates into insomnia or disrupted sleeping patterns, constricts blood vessels causing headaches, stops digestive juices from being released causing tummy troubles and for some, their overabundance can lead to panic attacks and adrenal fatigue.

Brain and pain rhyme for a reason, kids.

One of the main things massage can do is kick into gear the parasympathetic (i.e. “rest and digest”) response. This is why it is so effective in stress management. Massage counters a lot of the physiological affects of a broken heart by switching off the sympathetic release of hormones and proteins related to emotional stress. In addition, it counters any muscular and postural imbalances that could develop from protective patterns of movement or the general feeling of wanting to cocoon into oneself. It also prevents the isolation and loneliness that creeps in after the shock, denial, guilt, anger and bargaining stages of the grieving process pass because it allows for touch from another that is warm, therapeutic and outside of any emotional attachment or expectation. It is a safe place to let go of emotions and come back into the body.  Some of us put names on slips of paper in the freezer, bury all the things ever given as gifts, move out of the apartment whose walls are saturated with the memory of YOU and THEM, cut or dye hair in all kinds of ways to deal with a break up. But giving yourself the love you once had for another person, which in the case of my clients was in the form of therapeutic massage, will have the most beneficial overall effect for all parties involved. Acceptance is a whole lot easier when you don’t have to HURT as much.

It’s a matter of choice

Male or female?

When given the choice between a male or female therapist, which would you prefer? There are definitely many factors that play a role in this decision, including your gender, sexual orientation, religious and/or cultural mores and presumed stereotypes to name a few. Although ideally it should be an equal opportunity booking system, ultimately you want to book with someone you feel comfortable with. More often than not, the therapist that fits that bill ends up being female.

While still in school, I remember becoming very anxious about my ability to find work upon graduation. I consulted with one of my teachers, who happened to be male. I was hoping he could advise me on where it would be best to apply and what potential employers were looking for in a “rookie” therapist. Keep in mind that this teacher had a successful private practice, had been a lead therapist/supervisor at a very popular gym/spa chain and super active member of various professional groups related to massage in addition to his position as a core member of the faculty. Despite all this experience, he told me that it had been very difficult for him to obtain clients. He had to work twice as hard as the female therapists to strum up business and eventually reach the level of success he had. His skills and expertise were not the deciding factor; it was his gender that put him at a disadvantage.

Think about the power differential. The client laying on the table is in the most vulnerable state. You are unclothed and in a submissive position. You trust that the therapist towering over you has the education and skills to address your needs properly and respectfully. You hope that they don’t judge you or your body in any way. You pray their touch is firm, focused and has a flow. You want them to put you at ease from the start, so that you can mentally check out and really enjoy the benefits of the work. Regardless of gender, a true professional will be able to provide all of the above to the client, but without a doubt women win out for their perceived nurturing nature, transcending the role of “mommy” on the massage table. A recent article in Psychology Today outlines the gender gap when it comes to caretakers. Society expects women to be the natural choice due to their biology, while men are hardwired to be natural “fixers” and protectors. You might think these qualities would bode well for the male therapist, but not when it comes to massage.

Minus the watch, this is a perfectly normal image of a male therapist working the lumbar region of the back of a male client.

Then there is the tricky area of sexuality. As long as there are “happy ending” jokes circulating and brothels posing as massage parlors, the massage profession will always have to prove its legitimacy. That said, heterosexual men, whether single or married, can feel extreme trepidation at booking with a male therapist because of what other people may assume about their sexuality. Also, since the parasympathetic nervous system is stimulated during massage, an erection could occur and the thoughts of this happening with a male therapist brings on much anxiety. On the other side of the coin, heterosexual women, whether single or married, can feel hesitant to book with a male because of the possibility of an attraction related to their touch or the judgment of their body in a sexual manner. I recall one of my clients telling me she didn’t care if she had shaved her legs or had cellulite dimpling on her thighs with me because “we have the same parts” but if she had gotten a male therapist she would have felt embarrassed. Throw into this mix the complicated and often skewed ways touch could be perceived after a trauma or abuse and again, the female therapist is the “safer” choice.

You may wonder then, how male therapists are ever able to get clients and be successful in this career. There are some stereotypes that work in their favor. With respect to strength, males are definitely viewed as the stronger sex and more capable of delivering deeper work. Even more so if the work is sports specific, as most massage therapists affiliated or employed by sports teams tend to be male. It took many years for Kelly Calabrese to push through these stereotypes and become the first female massage therapist employed by a Major League Baseball Team. All that aside, education and über professional conduct will prove to be the most powerful tools in bridging the gender gap. The more informed the client is about massage and its benefits, about the background of the therapist and their skills through testimonials and reviews, the more likely they will be able to make an informed decision when given the choice of male or female.