I have heard it said that the hand is where the mind meets the world. Those of us who are lucky enough to be bodywork practitioners know that the quality of the therapist’s consciousness is a powerful influence on clinical efficacy. The various states of consciousness are influenced by thoughts, emotions and energetic quality.

“It is possible to have an hour massage and never be significantly connected on the energetic level, where essential touch occurs,” wrote Zero Balancing developer Fritz Smith, M.D., in his book Inner Bridges.

I, unfortunately, agree that this is likely often the case. If the therapist is either distracted or over-focused on technique, or limited in her concept of bodywork potential, or too undeveloped to make contact with other than minimal superficiality, either physically or in terms of presence, then the full clinical capacity of educated touch is severely compromised.

What and how you think—your states of consciousness—has clinical impact during a massage session. There are many skillful ways to modulate your working state of awareness. The first step toward developing this skillfulness is to develop your capacity to maintain a witness state of observation.

This is the work that we do on the mat before doing our work in the massage room.

Whether learned through meditation practices, yoga or any other discipline, the ability to observe oneself with a kind, open, curious but nonanalytic, discerning but nonjudgmental state is crucial to learning how to evolve your capacity to engage and maintain peak clinical effectiveness.

Referential Shifting: 8 Steps

Once when I taught this five-minute exercise to a group of massage therapy students one of them said, “That was not easy!” I laughed and said, “Well, it takes practice.” He said, “But at the end of the guided exercise you said, ‘You can easily shift your awareness from one focus to another as needed.'”

That’s true. Once you learn this it is easy, but it takes practice to get there.

Referential shifting can be practiced with a partner, moving through the three references of focus—stimuli, sensations, contact—or alone, shifting between two references of what you are aware of externally in the environment around you and awareness of what you are sensing internally, going back and forth between the two states several times.

  1. Sit comfortably, back-to-back with a partner, with as much contact as possible from your lower back all the way up to shoulders. Take a moment to make sure that you are at ease and not leaning too far back or forward, but that the two of you are poised and balanced in the middle.
  2. Begin to focus your awareness on the stimuli coming in from the environment through your senses. Feel the surface that you are sitting on. See the light coming through your eyelids. Hear the sounds of traffic outside, the clock ticking, the hum of the heat or air conditioning. Smell the aromas in the room.
  3. Gradually re-focus your awareness to sensations within your body. Scan your body for feelings in your hips, back, neck, jaw and back of your throat. Notice where you feel your breathing, its depth or shallowness, its slowness or quickness. What are you aware of in your belly?
  4. Now gradually shift your focus again, to begin to pay attention to the place of contact with your partner. What do you feel where your back is touching his back, in terms of the amount and quality of pressure and temperature? What is his breathing like? Can you feel his heart beat?
  5. Once again, shift your attention back to awareness of the stimuli coming in from the environment. You may be aware of different things this time.
  6. And again, shift now to the sensations within your body. Has anything changed?
  7. And, once more, shift attention to the contact between you and your partner.
  8. Finish with a silent expression of gratitude to your partner before very gradually, leaning away from one another and disengaging from the contact. Take a couple of minutes to share about your experience with your fellow student.

Awareness of States of Consciousness

As you develop this referential, or witness, consciousness, you can begin to be more continuously aware of your working state (thoughts, emotions, energetic quality) during massage sessions. You will begin to notice what your mind is doing when you first lay your hands on a client.

You will notice your thoughts when you encounter tissue restriction and resistance. What thoughts and interpretations or stories does your mind construct as the body changes during the session? During what portion of the session is your awareness focused on the therapeutic moment?

Maintaining heightened states of focus associated with consistent levels of peak performance during long hours of massage therapy practice is an aspect of being a therapist that takes time and discipline to develop. We alternate between a polarity of mind states, focused and distracted, and many states of consciousness along the way.

A third sphere of consciousness is allowing the mind to rest in an expanded sense of space. At times, if we approach our work with too much of a clinical, fix-it mentality, our intellect and the constriction of thinking can actually end up distracting us and distorting our direct experience.

Sometimes we feel more at home with restrictions, with the constricted energy of a massage routine, or a narrow, mechanical approach of cause and effect.

But what if we bring in the potential for more space in our massage work, in our relationships with our clients and in our communication?

Shi-ne: 3 Steps

Shi-ne is a Tibetan practice of spatial consciousness during which the mind is able to rest and rejuvenate itself. With this practice, we relax, let go and invite openness. We begin to discover and savor space. We allow our self, our mind and our thoughts to simply be.

Eventually, with practice, this state of spacious awareness becomes a working state that we can choose while we are giving a massage and that can be a vast source of creative energetic engagement.

  1. Establish brief periods (5 to 10 minutes) during your day when you sit quietly and comfortably and when you won’t be interrupted.
  2. Begin to bring your consciousness inward and pay attention to your thoughts. Bring in space. Release your mental grip. Soften and open your mind.

Imagine that your consciousness is a silken cloth that floats down from above and softly lands over your mind. There is no need to analyze or even follow your thoughts. Just allow them to arise and disintegrate, like clouds moving across the sky.

  1. Continue to allow attention to expand, noticing the space between. The lake of the mind becomes still. Consciousness is liquid, flowing space. Rest in the space where there is no need to grip any one thought or create stories about thoughts. Just let your consciousness be, embraced with silken awareness.

Play with States of Consciousness

We have the ability to alternate between multiple foci of awareness to manage different sources of data simultaneously.

We can receive sensory data through our touch while remaining aware of our environment.

We can be aware of what is happening immediately under our hands while noticing what more global and far-reaching effects are taking place throughout the client’s body.

We can change channels between varying apertures of focus, from small and precise subtleties of a trigger point releasing to vastly expansive and global consciousness of the oneness of all beings through energetic connection with our client.

There are many ways to play with our states of consciousness when working with a client.

  • When doing focused specific work, zoom back out to a broader, softer focus and a more generalized, integrating quality of contact.
  • Alternate between noticing your own breathing and what you are feeling under your hands.
  • Pay attention to images that arise in your body-mind as you are working.
  • Build in moments of stillness and spaciousness amidst the business of active palpation.
  • Verbally check-in with your client to connect your consciousness with his.
  • Set an intention with your client for the session and periodically check-in with the intention to reinforce it and sense how it is evolving.

As we develop our ability to direct our attention and to maintain our focus, we are also able to achieve and maintain a state of being that engages with our clients in a way to invite them into an experience of peaceful calm, expansion and authentic connection.

At this essential level of therapeutic interaction, we radiate an optimal energetic vibration that helps the client resonate and harmonize with that frequency.

A calm and well-ordered mind is the basis for the delivery of therapeutic touch, regardless of style or methodology.

Read the Expert Advice column in the June issue of MASSAGE Magazine, wherein Linda Derick tells us how to practice focus in our busy and distracted world.


Linda Derick has been a massage therapist and educator for 30-plus years. She is director of the Connecticut Center for Massage Therapy. Her leadership weaves together academic studies in movement from Wesleyan University, contemplative education from Naropa University, and her evolving avocation as a certified yoga instructor, specializing in stand-up paddleboard yoga. She is a regular contributor to MASSAGE Magazine; her articles include “This is How Yoga Builds Mindfulness” and “Public Speaking for Introverts: Promote Massage to the Public.”