What we have learned recently is that sexual assault and harassment of women is prevalent in almost every aspect of society. Thanks to the #MeToo movement, which exposed rampant harassment and assault, our society is being forced to confront this upsetting reality and change it for future generations.
What is happening in the massage therapy profession is a microcosm of the greater society, and so we sadly find the same types of issues there. We typically focus on therapists with predatory tendencies who have abused clients—but it happens in reverse quite frequently.
So Many Stories
Almost every massage therapist and bodyworker, including myself, has at least one story of sexual harassment. Typically, the offenders are male clients who feel entitled to say inappropriate sexual things, touch their therapist, and breach social and physical boundaries in myriad ways. It is much rarer, but sometimes female clients also behave inappropriately and ask for sexual acts from their therapist.
Much like in the greater community, more attention needs to be paid to this phenomenon in the field of massage. Massage therapists are entitled to work in an environment free of sexual abuse and harassment. If violations happen, you have the right to make yourself safe, remove yourself from the situation, and take all available steps to have the abuser reported and made responsible for their actions.
You are not alone, and you are not powerless.
It is clinic and spa owners’, industry leaders’ and educators’ responsibility to expose these issues and devise ways to protect massage therapists from this mistreatment.
One of the principal challenges is that many people in power across our country are condoning or committing sexual harassment and assault, so it becomes particularly challenging to avoid replicating this in a given field, like massage therapy. This means it is all the more important for us to set clear boundaries in our field and support all our practitioners.
Physiological Response in the Treatment Setting
While an erection is one of the most obvious indicators of physiological arousal, it doesn’t necessarily mean that emotional or sexual desire is also present. Touch, itself, on any part of the body can stimulate a physiological response that results in a partial or complete erection. Not all forms of (accidental) arousal or discussion of sexual anatomy is inappropriate.
Practitioners need to talk to their clients about erections or arousal anytime the client or practitioner is uncomfortable. Once one party is uncomfortable, the session isn’t going to be truly beneficial because their attention is diverted.
It is also important to be aware of clients who repeatedly expose themselves during the treatment. One or two episodes may be accidental, poor boundaries, or a lapse in the client’s judgment. Regardless of the reason, the practitioner needs to verbalize the physical boundary of draping at this time.
It may be helpful to distinguish the context surrounding the behavior. What were the client’s verbal cues? Did the client watch to see your reaction? With a sexually inappropriate client, the number and intensity of behaviors usually escalate.
Educating yourself as to the many different forms in which these boundary crossings may occur, and what you can do without under- or overreacting, allows you to safely address or remove yourself from such situations.
Effects on MTs of Inappropriate Client Behavior
Therapists experience a range of emotions depending on their own personal history and the nature of the client interaction. They might feel violated, upset, shaken, shocked, surprised, embarrassed, shameful, guilty, angry or appalled. Some reactions shared with me include:
“I was so upset and angry, I closed my office for a week.”
“I felt violated, confused, and angry. I questioned every person who ever was on my table and wondered if they had done the same and maybe I just didn’t realize it.”
“It damaged me to my core. I know we’re trained to understand it will usually happen, but it rocked me.”
“I never really thought it would happen to me. I tried to make my office as clinical as possible after that.”
“I was really stressed and scared, being a survivor of sexual abuse.”
Some massage therapists who work as employees report not feeling like they have the authority to end an uncomfortable session. The feeling is that the person with the money is held in higher power by the employer. Some massage therapists even fear that if they report a client’s inappropriate behavior it will reflect poorly on them.
This is not true in all settings; many employers support their therapists who are in this situation. But should you be in this situation, know that it is your right to end a session at any time under these circumstances. When you are interviewing for a job, you can ask the interviewer questions about their policies and the support they offer their massage therapists if this situation occurs.
“If we are to be taken seriously and respected for our commitment, we must stand up and speak up to all inappropriate behavior,” one massage practitioner told me.
Here is what you need to say: “I’m not comfortable with what’s going on here, and it’s time for you to leave.” Depending on the severity of the situation, therapists describe doing the following when a client behaves inappropriately:
• Promptly stop massage, leave the treatment room, explain why through a closed door, and tell the client to leave.
• Tell supervisor, if you have one, immediately.
• Call law enforcement.
There is also something called “The Intervention Model”—a communication model developed by Daphne Chellos for practitioners to use when verbal or nonverbal communication from a client is unclear or when practitioners feel their boundaries are being violated. The Intervention Model is a gender-free, orientation-free model. Depending on the situation, you may need to go through all the steps or stop after step one.
1. Stop the treatment using assertive behavior. Assertive behavior means that you address the client with body language congruent with what you say verbally. Make eye contact, if possible, stand in a relaxed, yet grounded, manner and use a firm voice. Do not shrink and get quiet (passive) or violate your client through yelling or touching inappropriately (aggressive).
Make sure the client is properly covered (i.e., re-drape the body part being attended, adjust client’s draping fully draping their body. This provides a literal boundary that reassures both client and practitioner. Additionally, if touch has contributed to a sexually aroused state, this ensures that you’re stopping a potential cause of the stimulation.
Maintain safety. Store your belongings, including a cell phone, in an easily accessible place. If the client’s behavior feels intimidating, don’t stay too close to the client and position yourself so that you have easy access to your exit door. Leave immediately if the client actively threatens you and then call 911. If you’re in a spa or clinic with others on site, go to the front desk. If you’re in your private office or doing an in-home or hotel session, leave the premises—you can return later, accompanied by someone, to retrieve your equipment and supplies.
2. Describe the behavior(s). Respond directly to the client’s verbal or nonverbal communication by stating the obvious. Describing a behavior lets the client know you’re paying attention without judging the behavior. Examples of this kind of communication are:
• “I notice you’re tightening your muscle and grimacing when I pass over this area.”
• “I am aware that you made a comment about my appearance, then made a sexual joke, and now you have an erection.”
3. Clarify the client’s intent. Once you state the obvious, ask the client a direct question as a follow-up. Something simple like, “Tell me what’s happening?” or “What are you experiencing?” allows the client to tell you what the behavior means. Some clients respond in a more straightforward manner about this than others depending on many factors, including their comfort level or their intent in receiving treatment.
Two cautionary reminders: resist answering for the client and wait for a clear answer. Often, when we are uncomfortable, we tell someone what his experience is even if we asked him to tell us. Or we accept any answer even if the response does not give us any information, so that we stop having to talk about it. Either way, if the practitioner does not clarify the client’s intent, she cannot accurately assess the situation and might put the client or herself in a difficult position.
4. Educate the client. Some clients experience unexpected, disturbing emotional and physiological responses during a session. When this happens and we become aware of their concern, we can share information. For instance, an educative statement for a client who has an erection and has expressed embarrassment is, “Sometimes clients become aroused as a physiological response to touch (or movement). It is a normal body response.”
5. Re-state your intent. This statement addresses and clarifies the therapeutic contract so that client and practitioner feel safe. After and educational statement as in step 4 above, you might add “It is never my intent to create sexual arousal during a session. If it happens and I am clear that your intent isn’t for sexual inappropriateness either, then I am comfortable in continuing the session if you are.”
6. Continue or discontinue the session as appropriate. You should terminate the session of any client who has sexual intent or is behaving inappropriately. Remember, you do not need to go through all the above steps to exercise this option! Set conditions if necessary and get the client to agree to them. Sometimes after going through all the above steps, the client’s intent is still unclear to you. Perhaps he gave an answer that sounded good but felt inauthentic to you and you are left uncertain. Let the client know that you will continue the session but will stop if he behaves in any way that does not work for you.
7. Document the situation. After the client leaves, document the occurrence and obtain supervision or peer support. Documenting the situation, and what you did to address the matter, is vital should a client decide to lodge a complaint against you. Demonstrate your commitment to ethics and professionalism by recording that you sought supervision to address the issue.
Allowing any boundary crossings makes sexual boundary crossings more likely. Massage therapists have had success in reducing or eliminating client boundary crossings and violations with the following procedures:
• In an intake interview, ask what sort of work they are looking for, how they heard about the practice, and what their problem is
• Trust your gut
• Ensure all intake forms and establishment websites clearly state that sexual inappropriateness results in immediate termination of the service and full payment for the time
• Have clients sign a policy statement (when booking massage and with email confirmation)
• Include some basic written information in your client intake. If you model a healthy comfort level talking about all physiological changes a client might experience during a session, you have provided several things: an opening for the client to express concerns; an education for a client about how the body works; good boundaries; and a safe environment.
• Don’t allow any sexual conversation
• Put up a visible camera system in the reception area
• Let them know their information can be provided to the state attorney’s office
• Carry mace
• Desexualize the touch experience by doing the following: be prepared, be conscientious about your language and behavior, have a clinical feeling office space, monitor treatment interactions, and be thoughtful about the representation you give in your marketing materials.
It is essential that massage therapists feel safe in the work that they do. It is our field’s responsibility to do all that we can to educate about, prevent, intervene, and recover from boundary crossings in the massage and bodywork setting.
I hope that by explicitly naming the issues and offering up some suggested policies and procedures, we can contribute to minimizing these instances of sexual misconduct and their harmful effects.
About the Author
Since 2004, Ben E. Benjamin, PhD, has worked as an expert witness in cases involving sexual abuse by massage therapists and bodyworkers. He has authored many articles on professional ethics and co-authored The Ethics of Touch with Cherie Sohnen–Moe (Sohnen-Moe Associates, 2013). Benjamin has taught courses in ethics, boundaries and communication to somatic therapists for more than 34 years.