Self-care is a part-time job for any massage therapist. On average, therapists perform 15 hours of massage each week.1 Adding another 10 hours of record-keeping, phone calls, marketing and laundry bumps those hours up to 25. By grand design, this is an optimal scenario because that leaves a portion of the remaining workweek for your other job: taking care of yourself.

In a profession prone to injury and burnout, where therapists continually give of themselves, longevity depends on living in balance—or routinely showing up for the job of self-care. Each time you “clock in for your part-time job” (self-care), it means a healthier you at the end of the week.

This is not another article on diet, exercise and stretching. My intention is to inspire you with thought-provoking concepts and strategies that will improve the quality of care you provide your clients and help you avoid ethical pitfalls. There is an intimate link between self-care and an ethical massage practice. More often than not, our attitudes shape our actions.

Stress and the CEO
We are all CEOs of our own corporation: the ever-complex human body. With 206 bones, 650 muscles and a circulatory system 60,000 miles long, it takes a lot to comprehend how it all runs so smoothly. The stress and demands of our lives and our profession require mindful attention to our corporations if we expect them to perform well.

Proper nutrition, exercise, sleep and relaxation improve performance in any profession. Learning to manage the demands of daily life through a practice (meditation, yoga, music, prayer) is proven to reduce the harmful effects of stress. In fact, primary-care physicians report that 80 percent of visits to their offices are for stress-related ailments.
Speaking of stress, do you want to take a litmus test to see how well you handle stress? Imagine yourself in each of these situations and how you might react:
• Driving your car in rush hour,
• A client no-show,
• Misplacing your keys,
• Double-booking a client,
• Missing your connecting flight,
• Planning your budget, or
• Waiting in a long line at the grocery store.

If we are brutally honest with ourselves, situations like these often trip our wires. I have discovered several principles that drastically reduce my stress levels in life, especially when it comes to my massage practice. Although simple in theory, most require discipline, patience and the courage to implement as habit.

The Five Pillars Explained

1. Show up and be present.
Most success in life comes from being where you need to be, ready to do what you need to do. Director Woody Allen once said, “Eighty percent of success is showing up.” Albert Einstein had a more poetic way of saying it: “All means prove but a blunt instrument if they have not behind them a living spirit.”

Showing up for your massage practice takes different forms. When you are truly present, you relate to clients moment by moment, leaving behind past or future events. You allow your spirit—the essence of who you are—to reach out and touch another. Presence is palpable—and without it, massage techniques become flat and mechanical. With it, you are in touch with and channel the life energy that informs, heals and empowers.2 Listening to this energy, you can make mindful decisions that support health and well-being for your clients and yourself.

Moreover, being present for your business can produce practical results. You can be the most technically skilled, creative, artistic, wonderful massage therapist who ever lived, but if you don’t answer e-mails, return phone calls or show up for appointments on time, your clients will soon disappear. They will find a less talented but more conscientious person to do their massage.

2. Pay yourself first.
Although this immediately conjures up images of money, expand this concept to include all areas of your life.
In The Automatic Millionaire, author David Bach shares his belief that the road to financial freedom is to do one thing consistently and automatically: give yourself the first piece of your paycheck. We often pay our debtors first, provide for our families and spend recreational cash—and then, maybe, if there is anything left, invest or save money for our future. He advises placing 10 percent or more of your paycheck in an automated account before doing anything else with your money. Making it automatic takes away the stress of saving. By paying yourself first, you invest in yourself.

Likewise, imagine filling in your calendar at the beginning of each month with self-care activities before you book a single client. Schedule time to work “on” instead of “in” your massage practice, allowing for a creative space to plan and envision.

I have a challenge for you: Pick a week that has yet to be scheduled next month or soon thereafter when your schedule is clear. Before all else, schedule some time to take care of yourself with an activity you have been longing to do.

Once you have blocked the time out, guard it zealously. Resist the temptation to change your personal time for another activity, client, family obligation or social commitment. If tempted, try the next tip.

3. Learn to say “no.”
The most powerful word in time management is “no.” As caregivers, some of us have a hard time saying no.
However, Thomas Merton had it right: “The rush and pressure of modern life is a form, perhaps the most common form, of its innate violence. To allow oneself to be carried away by a multitude of conflicting concerns, to surrender to too many demands, to commit oneself to many projects, to want to help in everything is to succumb to violence. The frenzy of the activist neutralizes work for peace. It destroys the fruitfulness of work, because it kills the root of inner wisdom which makes work fruitful.”

Notice the way Merton uses the word “violence.” It is not the connotation we are used to hearing. I would translate his usage to the word “depletion.” I suspect he meant we should know when to say when and realize our limitations, even when we want to save the world.

Our subconscious informs our body when our boundaries are breached and reacts in self-protective ways. The guilt we may feel by declining a request pales in comparison to the cumulative effect of over-commitment on our nervous system. The next time you are tempted to book another client in an already full day, try saying no.

4. Learn to state the obvious.
Closely akin to being able to say no is being able to identify and name the “elephant in the middle of the room.” The elephant in the room is an English idiom for an obvious truth that is being ignored. It is based on the fact that an elephant in a small room would be impossible to overlook.

Simply put, small fires are easily extinguished with a quick response. Recently, I avoided a potentially disastrous situation by relying on this approach.

I was the massage instructor for a wonderfully diverse group of students. They spent the first two months under my wing getting to know each other and, for the most part, getting along fine. I bid them farewell and met up with them again for the last three classes before graduation. To my surprise, the class was severely divided, with more than a few students refusing to attend closing ceremonies. Amidst rumors of he said/she said and talk of false accusations and confidences being broken, I was immediately faced with a dilemma: How would I re-establish trust and safety in the classroom?

I mustered up the courage to say, “There is a lot of tension in this room, and not everyone likes each other. In fact, some of you can’t stand each other.” Almost immediately, there was a collective sigh of relief. “The truth is, you don’t have to like each other, but for the next three days you will treat me and each other with respect, or I will ask you to leave the classroom.”

The classes went off without a hitch. In fact, all of us ate pizza and sang songs from the Red Hot Chili Peppers and Jimmy Buffett in relative unison on the last day.

5. Establish a support network.
While I was grateful for relative unison in this case, we need more than relative unison in our everyday lives. A meaningful career is nurtured by connecting with other therapists to share our successes and challenges.
Feeling disconnected and struggling with ethical concerns on your own can lead to burnout. By joining the local chapter of your professional association or a healing-arts support group, you can stay connected, personally and professionally.

In his book Love and Survival, Dean Ornish, M.D., concludes that the single-most-important element in his program for reversing heart disease is support groups. Surprisingly, this support supersedes a vegetarian diet, not smoking, exercise and regular meditation. From this, we may conclude that when the heart is open to sharing with others, the physical heart heals.

If you are geographically isolated, there are online support groups and blogs that provide a forum for instantaneous connections.

Weave a web
An ethical massage practice weaves these concepts into a web of comfort and safety for our clientele. By showing up and being present, we are more attentive to each client’s individual needs and become better listeners. In any given moment, we can move from being present to being filled with upsetting thoughts that trigger emotions based on the past and future. At this juncture in a massage session, boundaries often get crossed, enabling projections and transference to be acted upon, often with harmful consequences.

Being human, boundaries often are crossed. By addressing concerns immediately by stating the obvious, we enable ourselves to avert potentially stressful situations. Therapeutic relationships become stronger by establishing honest, direct communication from the start. It is in this way that clients begin to trust our integrity as a therapist. When problems linger, their complexity increases along with the stress to both parties’ nervous systems.

Much of this stress is sidestepped by learning how to manage time and resources. Investing in ourselves through responsible financial- and time-management will alleviate the constant worry about our livelihood and the need to hurry from activity to activity. Remember, oftentimes this will depend on our ability to exercise the power of saying no.

Finally, never underestimate the importance of staying connected. Support is empowering.

“Take good care of yourself,” we often say as we bid farewell to each other. It is my fervent wish the next time you hear those words, you will we be standing atop the pillars of self-care responding confidently, “I truly am!”

1. Associated Bodywork & Massage Professionals:

2. Heckler, R., The Anatomy of Change. North Atlantic Books, 1993.

Eric Stephenson, L.M.T., N.C.T.M.B., is director of education for imassage, Inc. and teaches continuing-education workshops on a national level. He encourages a creative-learning environment and is passionate about assisting therapists with self-care and career longevity. For information on upcoming workshops, visit or e-mail him at