Guidelines or Guidance?

by C. JeAnne Frey, CMT
10 August 2009

One of the most delicate balances in our work is boundaries. Regardless of which code of ethics we subscribe to, everyone has a code of ethics. Obviously, not everyone's are the same, but everyone has some code they follow whether or not others agree with it. Discussions about scope of practice, standards of practice, and ethics in general have long been among my favorites. With that in mind, I invite comments here or in the MassageResource.com forum.

I recently experienced one of those situations where the letter of the law, and perhaps even the spirit of it, carried less weight for me than the human element. With the permission of the radiant soul I am calling Dawn in this story, I'm offering up my response to an ethical grey area. Throughout this very abbreviated "case history" are incidents which could raise an ethical red flag. I offer them up (ideally not at risk of my licenses) to illustrate that as massage therapists, body workers, whatever title we go by, we and those who seek our services benefit when we behave as complex individuals rather than assembly line objects.

Dawn is one of my more energetically minded clients. She speaks energy with ease and has her own regular energetic and spiritual practices. She has requested energy modalities as well as massage from me over the years, and she is one of those with whom I am welcomed to use whatever tool from my tool kit seems best suited to the matter at hand.

She came in a short time ago having missed several months. Before I left her in privacy to settle on the table, she told me she felt "toxic" which I took to mean energetically buffeted by life in general. Because this was something she had said before, and I did not follow up on it immediately.

As the session progressed, it became apparent she was feeling physically ill, so we stopped the session. After getting sick, she said she felt much better and asked to resume the session, which we did for a while until she felt nauseous again. After her second emergency trip to the bathroom, I offered her rest time as long as she needed.

She asked it we kept antacids in the office. We didn't, and since she wasn't up to receiving even energy work and clearly needed rest, I offered to walk to the grocery across the street and pick some up while she rested in my office. We still had plenty of time we'd not used in her session, and it seemed the most helpful thing I could do for her.

"I love you, JeAnne," she said as I was leaving the room to walk across the street to the shops. She was lying on her side on the table and looking as exhausted as I've ever seen her.

I walked the three steps from the door to my table to give her as much of a hug as I could while she was lying down. I had an impulse, second guessed it, and then over-rode the second thought and kissed her on the forehead and said "I love you too."

After I returned with what she'd asked for, I told her we still had plenty of time and she could rest as long as she felt the need to. She was very conscientious about my need to prepare the room for the next person, so I told her I'd let her know if she was still resting in my office at that point. Dawn didn't take as much time to herself as I'd expected, and said she still felt a bit off but had things she needed to take care of. I called her at home that evening to see if she'd made it home safe and ask how she was feeling. She had, and was feeling better. She went on to thank me for being so nice to her when she was feeling so awful.

"I didn't realize how much I missed someone taking care of me," she said. She mentioned the kiss on the forehead and how it had been so long since she'd had the same from her mother who lives in another part of the country.

From the way Dawn describes it, that small gesture and running out for what she requested were absolutely huge. I don't doubt for a moment that she would have respected my stance had I said "no I can't go pick something up for you because that's outside of my professional code of ethics." As for the kiss on the forehead, she'd have been none the wiser. On the other hand, she would not have felt cared for, and she probably would have had another errand to run when she was already not feeling her best.

As for me, had I not done what I felt needed to be done in the moment I would have felt like, well, crap. Dawn came to me to feel better needed extra assistance this time. It was a small thing for me to take a quick walk to the shops. It was an even smaller thing to respond to an expression of appreciation with words and actions in kind. Not being in the habit of even considering, let alone actually kissing my clients, I decided to interpret the impulse as guidance as I do during some of the energy and soul modalities I've learned. I stepped outside of the guidelines to follow that guidance.

We have our ethical guidelines for good reasons. Still, if the massage field becomes so regulated that we as providers don't feel we can go above and beyond when those who come to us are in need of a little extra compassion without fear of losing our licenses, then something will have gone frightfully wrong. It's understood that we will touch our clients, yet that form of touch can become strictly clinical. There are situations when that is entirely appropriate. Many people are seeking strictly medical massage. Without the option for compassion however, we'd be no more than the rolling tables, G-5s, and Spa Capsules.

C. JeAnne Frey has been a Certified Massage Therapist since 1999. She operates her private practice, Treat Yourself Right! Massage and Bodywork, in Charlottesville, VA. She is happy to put a stick in the hornet's nest of ethics if it will spur thought and discussion. She can be reached at jeanne@tyrmassage.com.