To complement the MASSAGE Magazine article, “The Fully Responsive Massage Therapist: Integrate Emotions Through the 5 States of Awareness,” by Carole Osborne, in the April 2012 issue. Article summary: In any given session, your client will transition from the ordinary awareness state she entered your session room with into other states of awareness. Catalyzed by your touch and presence, she will enter into a witnessing state of mindfulness. From that vantage point, deeper self-understanding, memories and feelings may emerge. This phase might even widen into a child-like state of raw emotion, vulnerability, curiosity or emotional process. Carefully completing and integrating her experiences, she will reach closure. This readies her to shift back to a state of ordinary awareness, where she re-emerges with the insights, relaxation or pain relief you have created together.

by Carole Osborne

Deepening our clients’ awareness states starts with deepening our own perception. No matter how extensive it is, a health-history questionnaire doesn’t give me enough information to go deeply. Here are some of the questions I like to ask myself as I contemplate how to best respond to my clients.

These questions call my attention to the many nuances available if I observe more keenly. They remind me to analyze and think logically about what I have heard, seen and palpated, and that my hunches and impressions are just as relevant. Finally, given the answers I have, I ask myself how to best proceed, both for an individual session, and for the course of my work with the client.

Try answering these questions with your clients before each session you perform. Track the awareness states that emerge to see the effect of your heightened perception.

1. Observations, what have I observed in the client’s:

  • breathing patterns
  • body language
  • posture
  • quality of movement
  • energy level
  • eye contact
  • voice and expression
  • mental loops
  • beliefs, attitudes, rules
  • temperature and texture of areas touched
  • any tests I performed

2. Analysis

  • What muscles are involved in holding patterns?
  • What areas need more length? Tone?
  • What areas seem emotionally charged? Empty?
  • Are there any applicable contraindications or precautions?

3. Intuition

  • What is my impression of this person?
  • What are the salient issues and needs that emerged from today’s interaction?
  • What is my sense of what this person wants?
  • What emotions are most evident?
  • What emotions are most undercover?
  • What spiritual issues seem relevant?

4. Directions

  • What is the overall goal(s) of our work?
  • What are my expectations of the client both in session and in any outside follow-up or homework to our sessions?
  • How am I planning to explore with this person in our body therapy?
  • Are any referrals to other providers necessary before or during our session series?

Carole Osborne, 2008 National Teacher of the Year (American Masasge Therapy Association Council of Schools), has been an integrative body therapist since 1974. Her work focuses on facilitating somato-emotional integration, particularly related to childbearing, trauma and nurturing. She is author of Pre- and Perinatal Massage Therapy and Deep Tissue Sculpting, a contributing author to Teaching Massage Therapy, and a widely sought continuing education provider. For more information, visit