The Therapeutic Relationship or Container: Emotional Safety in Massage Therapy

The therapeutic relationship or container (we will refer to as the therapeutic container from now on) is the space you are able to create or provide for your client during a massage session. This container is a safe space for your client to experience and express emotions while being supported and comforted and without fear of shame or abandonment. Here we will attempt to make this abstract idea more concrete and easily implementable in your practice.

The ‘space’ referred to above is an emotional, mental, and spiritual space that requires the consent and participation of both the client and the therapist. As therapists it is our responsibility to make this space as available, expansive, and secure for the client as we possibly can.

This means that we accept into this space what we can handle and keep out that which we cannot. This is especially true when we are well bounded, dynamically bounded. If our boundaries are too open an experience may find its way to us that we feel unprepared for. A natural reaction to feeling overwhelmed is to retreat into yourself and away from the overwhelming stimulus.

If the emotional situation is overwhelming to you, the massage therapist, then you must break the container and not remain in the situation. Perhaps this means that you simply aren’t willing to discuss something with a client and that’s the end of it. It might be that you need to leave the room. I recommend trying to find a ‘soft’ reason to leave, like you need water, instead of telling the client that they are scarring you.

However, if you are comfortable with the highly charged situation that often accompanies emotional release or a trauma processes of our clients you can help to reverse patterns of abandonment in their psyche and promote the healing process they are attempting to undertake. When things get intense it is of the highest importance that (if comfortable) we stay in physical, mental, and emotional contact with our clients to make sure that they know that another human being is there to support them.

In this realm we must be very careful to not overstep the limitations of our scope of practice and wander into the ground of psychological counseling. A good general rule when it comes to scope of practice as it pertains to counseling is to avoid trying to deepen a discussion.

For instance if a client begins to cry during a session it is completely appropriate to ask questions like “Are you okay?” or “Would you like me to continue the session?”; at this point if a client opens up to you and wants to talk about something it is fine to let them talk. There is never an ethical problem with letting a client say whatever they want, as long as you, the therapist, remain comfortable.

Likewise it would be inappropriate to try to deepen the experience by saying something like “Why do you think you are crying?” or “Let’s explore your sadness.” Unless you are certified as a counselor these would be inappropriate conversations for a massage therapist to start. Unfortunately it is hard to give specific guidelines across the United States as each state has it’s own rules governing the appropriate actions, statements and wording around healthcare and massage therapy.

Maintaining a distinct and balanced therapeutic container during a massage therapy session ultimately allows for emotional and physical release by a client and increases the potential for self-healing because it helps to relax and reassure clients. And remember the therapeutic container is predicated on the massage therapists level of comfort. If you are uncomfortable you have a responsibility to yourself and your client to address the issue by either working through it or avoiding it.

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