A woman holds her hand up in front of her, palm out, in a gesture of "stop!" to illustrate the concept of protecting one's personal safety.

There are certain interactions within the therapeutic relationship that can affect our personal safety and well-being as massage practitioners. The private and intimate setting in which massage therapy is performed can create an ideal environment for sexual predators and inappropriate behaviors.

These inappropriate behaviors may include a variety of actions, such as unprofessional touching, sexual harassment, or even just a lack of consideration for the well-being of the therapist. In some cases, these occurrences should be reported to the police and company leadership.

As massage therapists, we should be aware of these predatory behaviors to better recognize when they are happening, in order to prioritize our personal safety. These behaviors are dangerous and can lead to serious consequences.

In this article, we will discuss some of the most common behaviors and red flags therapists should look out for.


Gaslighting is a method of psychological manipulation. A skilled manipulator can plant subliminal doubts into the minds of their victim, causing them to second-guess their perceived reality and undermine their confidence.

We see this tactic used by abusers, but sometimes gaslighting may come from our support system or leadership when we speak out against problematic behaviors. Gaslighting isn’t always intentional or malicious, but it is dangerous.

You can spot gaslighting techniques in phrases that cause you to question yourself. For example:

“You’re overreacting.”

“That wouldn’t bother me, so it shouldn’t bother you.”

“It was just a joke!”

“It’s not a big deal.”

“If that bothers you, you’re in the wrong industry.”

If you begin to second-guess yourself, question if you’re being too sensitive, or lose a sense of what is actually happening – you may be a victim of gaslighting.

Red Flags

In the massage industry, sexual harassment and solicitation are no joke. Massage therapists, like all other professions, have a right to feel safe at work. That safety can become compromised when we encounter sexual predators.

One way to support our own personal safety is by learning to recognize red flags. Some warning signs may be minor, while others may be more complex. If you notice any red flags, do not hesitate to end the session, refuse booking or contact the police if necessary.

If you feel uncomfortable for any reason, do not work with that person.

Some red flags of sexual predators include:

• Drape negotiations, If a client or potential client asks if draping is necessary, requests a hand towel instead of a drape, or attempts to remove their drape during session.

Requesting you sign a Nondisclosure Agreement (NDA) prior to treatment. As licensed massage professionals, we are bound by an ethical code of conduct to honor client confidentiality. In some cases, we may even be bound by HIPAA. There is no reason for a massage therapist to be required to sign an NDA to provide therapeutic treatment.

• Flirting or expressing a romantic or sexual interest toward the therapist. This is inappropriate for the client-therapist relationship and can contribute to an unethical environment.

• Late-Night Requests. What has proven to be a precursor for illicit service solicitation are massage appointments requested after normal operating hours.

Predatory Behavior

Predatory behaviors by clients can cause profound damage to the therapist. While it may be difficult to avoid them, the right steps must be taken to protect ourselves. If a client engages in inappropriate behaviors, end the session. If the behavior is persistent, terminate the client.

Predators often feel justified in violating social and physical boundaries because they feel entitled to sexual gratification from the therapist. There are many ways that sexually inappropriate clients can violate boundaries. They may arouse themselves during the massage, make sexual advances or requests, or ejaculate on the massage table.

These behaviors are not acceptable and should be reported. Sexually inappropriate behaviors often escalate in intensity and can become dangerous. The therapist should document the situation and the response of the client. Depending on the context, these behaviors can be categorized as either sexual harassment or sexual misconduct, the latter being more severe.

When Erections Are Not Misconduct

Erections by massage clients are not necessarily sexual misconduct. They can be a normal part of the body and a physiological response to touch. (Female clients may also experience similar physiological responses during a massage session, but these responses may go undetected due to the positioning of their genitalia.)

When an erection occurs, it may be an uncomfortable situation for both the client and therapist. Erections become problematic in the therapeutic relationship only if they are associated with sexual desire.

If the client ignores their erection, seems embarrassed, or is genuinely apologetic, their erection may be involuntary and it is best practice to approach the situation with professionalism and tact. We should never shame or humiliate a client for a natural and reflexive response within the body.

Some therapists may choose to add weight to the erection with a thick blanket; attempt to distract the client with small talk; or pause the session so the client may regain composure.

If there is any inappropriate behavior associated with an erection, up to and including asking you to help with it, end the session immediately and file a police report if necessary.

Here are some problematic behaviors that would warrant ending the session and, depending on the behavior, filing a police report:

• The client draws attention to their erection or attempts to remove the blanket or drape. This is known as peacocking, a technique used to get the attention of a potential sexual partner.

• The client exposes their genitals, with or without an erection.

• An erection occurs after or alongside hip thrusting or table humping.

• The client grabs, caresses or grazes the therapist. Under no circumstances should a client touch a therapist without consent. This is especially true if they are erect.

• The client attempts to lead the therapist to their erection by requesting a lower abdomen or inner thigh massage.

• The client is intentionally flexing their pelvic floor muscles to trigger movement of their erection.

It is important to note that if any client, regardless of an erection present, exhibits the above behaviors in an attempt to draw attention to their arousal the session should be stopped, documented and reported if necessary.

Protect Your Personal Safety

Massage therapists have a right to work in an environment free of harassment and predatory behaviors. Learning to recognize the warning signs of predatory behaviors can be the first step in creating a safe environment.

It may not always be possible to know what our client’s or potential client’s intentions are, but you can determine your own boundaries in the situation. Once you realize you are the victim of gaslighting tactics or inappropriate behaviors, terminate the therapeutic relationship.

If you believe you have been a victim of sexual harassment, believe yourself, end the session, document the encounter as thoroughly as possible, and report it immediately.

Editor’s note: This is the second of three articles in a series, by Priscilla Fleming, that will address safety issues in the massage therapy industry. Part Three will run on March 1. Read Part 1, “Countering Stigmatization: Prioritize Safety as an MT.”

Priscilla Fleming

About the Author

Priscilla FlemingLMBT, NMT, APCE,is an educator, author and massage therapist practicing in North Carolina. Her ethics course Safety and Solicitation – Gaslighting & Power Dynamics was created after her own experiences with sexual harassment in the industry. This National Certification Board for Therapeutic Massage and Bodywork-approved course is designed to give therapists the tools to confidently screen new clients, recognize the signs of sexual solicitors, and professionally decline clients or terminate the relationship with a client that makes you uncomfortable.