Friendships between client and therapist

A while ago I wrote about the relationship between client and therapist. It is generally recommended that a client/therapist relationship never develops into a friendship, even less a romantic relationship.

I have been asked if friendships can be appropriate, to which I will say, that in the vast majority of the cases, no they are not. In this post I will discuss the main reasons as to why.

From the client's point of view.

A massage is about the client. The client is at the centre, not the therapist. It is your problems, health and well-being which should be discussed. When the therapist begins to talk about their own problems and issues, focus is removed from the client; their healing and treatment.

If the relationship between client and therapist is too familiar or friendly, it can be very difficult to maintain that professional approach of focusing only on the client.

Lack of objectivity. Once we become emotionally involved in other people, we lose our objective view. We begin to assume things. Knowing about what you as a person did last week will influence how we treat you as a client.

As a professional therapist it is essential that we are objective and do not jump to any conclusions. Our treatment of you is based on your past health and massage history, not your personal life. It is based on what you tell us during the massage and in the treatment room, not what you told us when you were tipsy last Saturday.

Hurt feelings. When we are in a friendship we will encounter situations where that friend hurts our feelings, or we become angry. Only a very few people are fully capable of not letting their emotions influence and determine how they treat the person who caused the harm.

How will you handle the situation where your therapist-friend doesn't give you a massage to your satisfaction? Will you be able to tell her without hurting her feelings, or will you be inclined to keep quiet in order to preserve the friendship? Can you be completely open and honest that situation?

Can you as a client be confident that your friend who hurt you last week will give you a massage in your best interest? Do you want anything to do with the person who made you so angry? Do you even want them to touch you? Can you be sure that the pain from that sore trigger point isn't because your friend and therapist is still angry at you?

Try to ask yourself these questions. I think the answers speaks for themselves.

Lost focus. Another risk is that the focus of the therapist becomes social instead of professional. It influences not only how you are treated, but how the next client is treated as well.

This is one of the compelling reasons why we as therapists focus on leaving our personal life and problems by the door when we enter the treatment room. We want to give you, our client our full energy and attention. Not be distracted by personal thoughts and feelings.

Too much familiarity. When we become too familiar with a person, we become sloppy. The therapist might assume that the you will mention about all your issues and problems on you own. You might assume the therapist can guess and remember all your problems based on out-of-treatment conversations.

This can lead to the situation where we forget our professional role of asking into the state and being of the client and thereby cover all potential angles before the massage starts.

Confidentiality. Often therapists are told many personal and sensitive things. What happens the day the friendship no longer is healthy? Can you be certain that your therapist will keep that confidentiality when you longer friends? Will your therapist break your confidentiality with your other friends and family?

Lower priority. When your therapist is also your friend, there is an increased risk that you as a client will hold lower priority. Your therapist might book a new better paying client into that timeslot where your massage used to be. She might juggle your appointment around her other clients because you are her friend.

From the therapist's point of view.

Setting limits. For the therapist it is much about setting limits and be able to say "no". We are professional body-workers. We go to work like anyone else and when we're off work, we'd like to have time to relax and not have to think about work. As with a range of professions especially within health and IT, friends tend to ask questions about their health or IT problems.

One thing is to help family and friends out with their computer problems or give them health advice. But if that friend is also a client it can be very hard to stand up and say; "This is part of your treatment/contract, so you have to pay for it." or "We will discuss this at your next appointment."

We're generally kind people who just want to help as much as we can. Saying "no" is difficult when a client-friend asks us for help. We can easily feel frustration, annoyance and feel exploited.

Discounts and friend's favours. This is related to setting limits, but deserves its own spot. It is natural for many of us to want to offer a discount to friends and family because we care for them. We are running a business though and if all our clients are friends and thereby get discounts, we'll soon find ourselves out of business.

The other aspect is that often family and friends expect to receive that discount or free service. Refusing and setting limits can cause the friendship tensions. They might begin to wonder if we don't love them since we don't offer them special treatment.

So a client turned friend might expect special treatment and favours, which a therapist can find it very hard to turn down. The cost might ultimately be losing both client and friendship, resulting in a double loss.

Social visits. When a friend visits us in our clinic or office, there is a high risk that the visit becomes social instead of professional. Catching up on the latest news and discussing common interests can quickly take time away from the actual treatment, administrative work or even from the next client.

Casualness. With friends you are much more casual than you would be with strangers. The need to call well in advance when we want to change plans is often not there, and we easily forgive a forgotten or last-minute cancellation of plans.

This can cause problems for professionals. The friend might come in late and still expect a full treatment. They might cancel their appointment last minute and demand not to pay for it. Or they might even forget to cancel and just not turn up, assuming they will be forgiven.

Not only is this sort of behaviour a cause of frustration and annoyance, we also lose an income and we waste our time. Time we could have given to another client.

Losing friendship and client. Do we really want to lose a friendship because a client no longer comes to see us? Do we want to lose a client because the friendship went sour? Or the more vague cases of a client no longer coming to see us without explanation. We might not know why and that uncertainty might fester the friendship and over time ruin it. What about when the client-friend finds another therapist they like better, does that mean it's a personal thing or a professional thing?

Conclusion

Mixing professional relationships and friendships can turn very messy, and unless you know yourself really well, are completely balanced and can separate professional and personal life 100%, then it is bound to consume your thoughts and energy more than is good.

This said, there are many levels of friendships. A light casual friendly relationship between client and therapist will probably in most cases be without conflict. This could include sharing a cup of coffee together, or perhaps a lunch.

Anything more than this is not recommended. Not only by me, but by most teachers and professionals out there. Both for the reasons listed here and in my previous articles.

Related articles:
http://blog.starkeys.com/2010/05/relationship-between-client-and.html
http://blog.starkeys.com/2010/05/massage-of-friends-and-family.html

Repetitive Strain Injuries

I came across an article on Repetitive Strain Injuries (RSI) written by Paul Ingraham which addresses some rather interesting facts and fictions. I highly recommend you read the entire article if you wish to understand the topic in depth and the science behind it. Here I will just give a brief summary.

1) RSIs are not inflamed.

What is happening instead is that the tissue is degenerating (essentially, breaking down and rotting). It means that the body can't repair the tissue at the same speed as it is breaking down.

The way to fix it is to let the muscle and area rest. Give the body a chance to heal itself. Icing and using anti-inflammatory medication does not work as there is no inflammation.

"So, if not anti-inflammatory treatments, then what? The take-home message is this: anatomical structures fail because they are over-loaded. Therefore, more than anything else, they need rest."

2)  RSIs are not a biomechanical failure.

Correcting posture and adjusting subtle things in the body won't do the trick. If there are a biomechanical failure (poor posture, a leg shorter than the other etc), that would have asserted itself long before any RSI manifested.

"The huge majority of RSI sufferers have no obvious deformity or bizarre walk or blatant muscle wasting. If there’s anything wrong with their biomechanics, it can’t be adding very much stress to the equation … and yet they inspire most of the expensive therapy for RSIs."

It is not a malfunction of the body that causes the RSI - it is too much use or wrong use of your body (eg using the computer all day long with no breaks in a poor work position).

3) RSIs mostly just need rest.

A boring fact, and not something anyone can make money on. Patience is such a hard lesson to learn, and we're usually so busy in our lives that we can't take the time to let our body heal itself. In other cases, we need to keep doing what causes the RSI in order to make a living. So rest isn't the answer to all, but should certainly be tried as much as possible.

It takes time though. "According to Khan, it may take as much as two to three weeks of rest before a tendon even begins to start rebuilding, and rebuilding itself is achingly slow: about a hundred days for the tendon cells to build the collagen molecules that make up the bulk of a tendon. That’s three months!"

Who can stay away from their favourite sport, or their work for so long to let an injury heal?

4) RSIs are musclular.

"Nevertheless, every patient with an RSI, and every healthcare professional treating patients with RSIs, really needs to understand how surprisingly often muscle is a major factor, or even the entire problem. Large numbers of patients are diagnosed with a repetitive strain injury, when what they primarily have is a problem with trigger points, more commonly referred to as muscle knots."

These are good news, as tight and knotted muscles can easily be treated. To put it short, massage addressing these trigger points and tense muscles can essentially solve the problems.

5) RSI plays head games.

Often RSIs are caused by things we either need to do or that we enjoy greatly doing. It is caused by something we do pretty much all the time and as such it affects a very large part of our lives. Our ability to work or play. Because it's such a large part of our lives, we notice the pain and effects all the time, thereby making it feel even worse.

"Pain science research is extremely clear on this point: the emotional context of a pain strongly affects its severity and chronicity."

On the long term, chronic pain can cause a range of emotional and psychological problems which also serves to aggravate the RSI. Depression, poor sleep, stress, anxiety and so on. This means that the emotional aspect needs to be address on equal footing with the muscular problems.

Luckily, massage can also aid on an emotional level as research shows the importance of touch in our lives for emotional and physical comfort.

If you have a repetitive strain injury, either full blown or in the building, do make sure you take the rest needed to let your body heal. If that isn't enough, contact your massage therapist and explain the situation - both on a physical and emotional level.

Together, work out a treatment plan that will address your specific situation. Refer them to the article below if they're still stuck in the old fashioned view on RSI.

Source: http://saveyourself.ca/articles/repetitive-strain-injuries.php

More Sacred Symbols

I have the privilege and honour to work with clients who appreciate and enjoy the Sacred Symbols that are created by the end of each session. I record the symbols and mail the photos to the client. This way they can keep track of their progress and how things change from session to session.

Everybody finds their symbol to be beautiful. It is a touching way to remember the session. Some even read their Sacred Symbol and understand what the messages are, while others carry the image in their heart for later reflection and as a reminder.

These four images below show the progress and change of the Sacred Symbol over four sessions. The client is experiences a lot of changes as a result of the stone massages. Chronic pains have been reduced, fears lessened, emotional pain soothed and growing strength and confidence in many areas of her life.

For her the massage sessions are not just removing physical tension and providing relaxation, but are an emotional, mental and spiritual journey as well. The client is an active participant during these sessions, creating the growth in her self by being aware of every reaction she has during the massage.

The images are published with the client's permission. These are very personal and must be treated with respect.

I am truly blessed and humbled to be part of her journey. I am honoured to be able to serve as the channel and facilitator enabling her to heal physically, emotionally and spiritually.

Thank you.

Workshops at Lamennais

At Lamennais I have the opportunity to offer you workshops. Both as an individual and in small groups (2-5 people).

I can teach the following Workshops and Ceremonies:

Healing Hands Practitioner - a Native American Wellness Practice. Learn how to serve as a channel for the Energies of Creator. Healing Hands can enhance any bodywork, coaching or training practice.

You learn not only how to facilitate healing, but also the ancient Native American rituals behind. You will understand how the altar works, the meaning of the four directions and learn about smudging.

By learning Healing Hands you not only learn how to facilitate healing in others, but also how to take care of yourself. Classes are open for anyone with interest in healing.

Shamanic Journey - A guided meditation into understanding and enlightenment. Alone, or in a small group, embark upon a Shamanic Journey where you will transform and receive messages from your subconscious self.

This ancient Shamanic practice utilizes drumming and guided meditation to help you gain insights and ideas into yourself and your current life situation. Not only is a Journey deeply relaxing, it can be the start of spiritual growth and deeper self-awareness.

Medicine Wheel - A Native American approach to meditation and prayer. Each tribe and family have through centuries participated in this ancient wellness ritual.

By laying the altar, learning about the four directions and their symbolism and tying prayer ties you learn a method to meditate, reconnect with Mother Earth, as well as clarify your thoughts, wishes and needs.


Wellness Rituals - An alternative way to meditate and nourish mental wellness. During this workshop you are presented to various ideas and wellness rituals. Learn how to smudge yourself, meditate over cards, work with stones and participate in ceremonies to facilitate your wellness.

Together we discover what wellness rituals resonate with you and you are encouraged to adapt them to fit into your daily routines and beliefs.

Drum Making - Create your own Shamanic Drum. During this full day workshop you participate in sacred ceremony to create your own Shamanic Drum. The techniques and rituals used are those of the Santee Dakota Sioux as taught by White Bear Medicine Woman.

The drums are made from wood hoops and deer rawhide, and by the end of the day you have created a beautiful instrument which can accompany you for decades to come.

Geothermal Safety - Learn how to safely use hot and cold stones in bodywork. Temperature ranges, safety, sanitation, and precautions.

Be confident that you are working with your stones in a responsible and safe manner. Feel secure that you are not spreading diseases with your stone-work. Know what's necessary to ensure proper sanitation and hygiene. Show the authorities that your geothermal practice is safe and not the cause of disease, contamination and burns.

As soon as I receive the official material from Geothermal Therapy Association (GTA), I will begin to teach geothermal safety, preparing you to take the certification with GTA.