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Hi Everyone,

I wanted to share with you all an experience I've had in my private practice so that we can all discuss and learn from it.  A client became inappopriate with me and I have to terminate our relationship, but looking back on it now, I can see that there were some red flags...

Dan (name has been changed) was a yoga student of mine and regularly attended classes.  He was a dedicated student and clearly had been practicing yoga for years.  One day, he approached me to give me some feedback after class.  I informed him that I have a massage practice in town and I handed him my card, thinking that he might be interested in receiving massage.

About a week later, I received a call from him stating that he would like to book a 90-minute massage with me.  I was happy to have a new client and especially someone with whom I have a similar interest.  I had him fill out my paperwork and lead him to the table to explain that he was to undress to his level of comfort and lay facedown underneath the topsheet.  Our first massage went well, I noticed that he was directive and would indicate exactly where he would like me to work on and for how long, then move me on to the next muscle group.  He requested very deep pressure.  Afterwards, when it was time to check him out, he asked for the "super best friend's discount."  I laughed and told him that I could take $10 off his total. 

Dan came in for massage about once a month for the next four months or so.  During our second massage, Dan asked if I would like to come over to his house some time to practice yoga with him.  During another massage, he suggested that we could do a massage trade sometime, because he has had a lot of massages and he thinks that he would be a good therapist.  And during our third massage, he started to undrape himself to expose his buttocks and gluteal cleft while I was working on his back.  I would continually redrape him, and he would continually undrape himself.  I asked if he was hot, and he replied no.  I redraped his entire back and moved on to his posterior legs.

During the last massage, I felt things were getting inappropriate.  It was a 90-minute massage and I worked on the posterior side of his body for an hour before having him turn over.  He asked me to work on his quads so I undraped his left leg.  He started talking, "You know, I've been divorced for 10 years but my ex-wife and I used to massage each other all the time.  It was really nice; I miss it."  I told him that I only receive massages from professionals.  He then asked, "Well since we know each other, do you think you can give me something extra?"  I replied, "Absolutely not.  That is not what I do."    He said, "Oh, I figured you'd say no."  I finished the massage as quickly as I could because I felt uncomfortable, however, I did not want to escalate a situation by being rude--I was alone on the floor of the building where I work. 

After the massage, I ran out of the room and ran up and down the halls to make sure that no one else was in their office.  I even ran upstairs to the apartment above, just to let someone know what had happened in case things escalated when I checked him out, but no one was around.  I went back to my office and Dan was waiting for me by my desk.  He handed me his payment and said he was sorry if he upset me.  I asked him what had given him the idea that it was ok to ask me that.  He said that it was nothing I did, that it was him, his energy is all messed up.  I explained that I have a professional practice and that I would need to speak to other professionals to handle this.  He became upset, whiny even, and said what I good therapist I am and how his judgement was just off.  He said my massage has helped him so much and how sorry he is to upset me.  I told him that I appreciate his apology, but that I do need to think about how I wish to move forward because I want to maintain the integrity of my practice and that this has never happened to me before.  His response was, "Oh, really?" as though he was surprised that I have not encountered this behavoir.  I told him that I do not want to take on the role of counselor, but that it seems, based on what he said, that he is having some feelings of loneliness that would lead him to do something like this and that he needs to learn how to control those feelings.  He said, "I think a lot of people are lonely though."  I told him, "I don't want to be targeted for those emotions." 

Now I am thinking about a proper email to write Dan to explain that he has crossed boundaries and should not be receiving professional massage until he is able to make clear distinctions between a therapeutic massage and a massage given to him by his ex-wife.  I am thinking back to what I learned in ethics class and some of the terms we learned.  Does anyone think that there was some transferrence here?  What do you think about the events leading up to his suggestion?  Do you think I could have stopped this progression much earlier on?  Thanks all for listening and I am looking forward to discussing this with professionals.

 

 

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Personally, I wouldn't tell him that he should not be receiving a professional massage. I would tell him that I would no longer be available to provide him professional massage services. I would not ever want to massage him again. That's just me. 

 

I also would have stated boundaries out after asking him if he was too hot. I would have said that the sheet needs to remain where placed for my comfort. If he was too hot, then next time, I would have a fan or turn on the ac. But, that sheet would remain where I placed it if the massage is to continue. 

 

Not that his first appointment was a red flag. However, I have not had a client direct my massage during the first session. I explain and discuss the treatment plan before the session. My regular clients may ask if I can do something different like starting prone or supine. I'll explain why I prefer my sequence, but will try it their way. When they don't get the same results, they trust me to massage them without directing the massage. 

 

Suggesting a massage exchange is a red flag for me. But, an innocent one. Kinda like testing the waters, depending on the tone of voice. 

 

I don't know if I would tell him that I would discuss the incident with other professionals. It may come across as violating client privacy. Even though, it isn't. Clearly, he has a fuzzy idea about privacy and boundaries. Also, I already know that I wouldn't massage him again, so discussion with other therapists to decide how it should be handled would not be necessary for me. I would not care what his excuse was or is. 

 

I have had other massage therapists and clients tell me that I come off very clinical and professional. Maybe that is why I don't have an issue with inappropriate behavior. I had a client once mention massaging leading towards sex, I told this client that I don't view massage that way. I then discussed how I viewed massage by discussing the fascia, muscles, kinesiology, etc... on the body part I was massaging. That was enough of a signal for this client to know my boundaries and what topic I was willing to discuss concerning massage. 

 

I have more thoughts. But, I have to run. Sorry to cut this short. I would have stopped the massage as soon as he asked that question. If he refused to pay, well... I don't need the money that bad. I would have left the room and called or texted someone and have them on the phone when he entered the office area. 

 

Also, I don't blame you. Just looking at what happened to you as a learning experience. 

 

 

I kinda think there was a bit of transference going on for Dan.  Causing him to blur the lines of the dual relationship.  Its good that he realized that he made you uncomfortable and apologized for it.

Now comes the difficult part.  Drawing the line.  If I was in this situation I would have to fire him as a client.  Explaining that because of what occurred it would be difficult for us to have a professional therapeutic
 relationship because he crossed boundries.  As far as him getting a massage from a different therapist, let him.  I think it would be inappropriate for you to tell him he needs to seek counseling.

I would just end the professional relationship and move on.  As far as saying something to him sooner?  Maybe.  It's difficult to say.  You don't want to over-react.  But the comment in the last session is enough to end the relationship.  
Today I received an email from my client apologizing for his actions. He even stated that he's reached out to a friend to discuss his emotions and what had happened. Nevertheless, I wrote back that I would need to terminate our relationship because boundaries were crossed as well as his misunderstanding of what my role is as massage therapists. I left it at that. Thanks all for your input.

This is an interesting discussion as I think it is highly gender oriented. From my viewpoint he asked, you said no, matter ended. But I see you viewpoint that it continues to have repercussions. I don't see anywhere that he questioned your professionalism as a therapist. He is not a massage therapist and probably unaware of the importance to most MTs of a code of ethics. However, the fact that the request was made, does that violate ethics? You refused and upheld the code. He was under no such requirement as a client. I am interested in why the relationship now firmly defined could not continue. Is it embarrassment resulting from the incident? He would probably be your most proper client from that point on. Is this regarded as harassment that can't be forgotten? Harassment only occurs when an inappropriate request is repeated after being rejected. If you don't mind my questions, I am curious to better understand this viewpoint.

To me, it seems like solicitation, not harassment. I was being solicited for a sexual favor, although it was within the context of me being his massage therapist and his misunderstanding of my role. While I am glad that the client and I were able to calmly discuss things after the incident, and clearly he does feel remorse, I wish to protect the integrity of my practice. I want to maintain my practice as a safe and confidential place for clients and I feel that when a solicitation occurs it violates the standard of professionalism that I uphold. My main concern is in protecting myself and my reputation, so that is why I deemed it best to end our relationship.

ER,

Your client may have confused the boundary when you gave him your card as an MT. This may be a dual relationship or at least confusing to him as to where the line is drawn. I'm not sure about the transference but he was really pushing against your boundaries with the draping as well as being unaware of his offensive behavior.  I'm wondering if  he is really unconsciously acting out something -maybe there is some transference. I think you did the right thing, this is a learning experience for you and next time you will know how to act.

Cheers,

jh

Just out of curiosity, why would it challenge your reputation?  The only way people would find out is if one of you talked about it. I'd guess that your reputation would be firmly established as having good, clear boundaries.  BTW, does your client intake form include a clear statement that you won't tolerate anything of a sexual nature, and that you won't offer anything of a sexual nature?  That might be a good addition, if you don't!

I want to comment on the gender orientation issue because I think Daniel is right.  However, I can't find a way to do it that is clear enough to make me happy.  If I find a way, I'll post it later. 

Looking back you always see more. It is imprtant to keep discounts fair and standard. I think he was asking if you were friends or if you could be friends with the discount. As a teacher you also have to look out for situations related to that environment. Students often 'know' you more than you know them ie you are a larger personality in their life than you are in theirs since their is 1 teacher(student perspective) verses many students(teacher's perspective of ineraction) Gender issues: while this guy might seem okay now it's hard to be sure he is safe, sorry boys after that you're kinda gulity and can't be proven innocent. Thank you so much for shareing.
Hello,
To answer a previous question, I do indicate on my intake form that inappropriate behavior of a sexual nature will not be tolerated. Interesting thought as to whether this is a gender issue. I think not, because if a woman had asked me during a massage for "something extra" I would no longer see her as a client either. I think it is an issue of my comfort and my choice in working with clients. I don't think that there's anything wrong with turning away clients whom you don't feel are gratifying to work with. Has anyone ever read Book Yourself Solid? The author suggests you eliminate clients who aren't in line with your values or who aren't bringing out the best in you professionally. His argument is that you aren't doing your best work with them, which could affect your reputation, and by eliminating them energetically and physically you are freeing up space for others to come in who are more in line with you.
My priority is to protect my business and so I think I am acting accordingly by not seeing him as a client. Who knows what more he is capable of? What if he were to get upset that I refuted him and turns the story the other way around? Things can happen much after the fact, so that is why I wish to keep him away to protect my reputation.
On another note, after writing the client an email clearly stating that we can no longer work together, he wrote me back asking if he can just come in to get his back massaged. I think this shows his lack of respect for me.

Erica, I'm glad you have that on your intake form.  That in and of itself is enough to "fire" him as a client, because he knowingly disregarded a contract between you.  And yes, asking if he can get his back massaged after your email is a problem - either lack of respect or desperation, both of which are a big issue.

The gender issue - I think (Daniel, correct me if I'm wrong) that Daniel is referring to the way men vs. women handle difficult situations, not necessarily whether the client is male or female.  Men tend to keep things simple and straightforward while we women tend to tie ourselves in knots!

On the note of turning away clients, I did that just a couple of weeks ago.  She cancelled several times at the last minute, and the no show and not returning my calls was the last straw.  I sent her a very professional email and she replied positively and professionally as well.

For myself, this is a zero-tolerance situation. My intake form states clearly that any attempted inappropriate interaction, be it verbal or by action, will absolutely result in immediate termination of the session and the therapist/client relationship. Years ago I had to deal with a similar scenario and due to inexperience and shock it became an uncomfortable incident where I had to involve the police and get a restraining order. I learned a valuable lesson, which is to be clear, strong, and deal with such problems immediately and without hestitation. If you don't prevent it or put a stop to it at the moment it begins to develop, your hesitation will be interpreted that you are tempted and are thinking about it, not that you are so surprized you don't know what to say. The time you take struggling with yourself, trying to decide if you understood what they just said, or if they were just kidding, or if you are hoping to think of a way to resolve it without losing a client - is all the time they need to think you really do want to participate. If you don't have it firmly worked out for yourself in your own mind as to how you will respond, you could end up in situations that are not just uncomfortable, but dangerous.

Yes, Therese, I am referring to the gender difference in how it is dealt both from client and therapist's viewpoint. I think it may be related to the dating game we learn as children. Men learn to take a chance at being turned down by a woman they want to go out with. We learn it is ok to ask or you have no chance. Ask and you may be rejected. Try again if you think there is still a chance. But if the no is clear that's that and it is done with no other repercussion. I also doubt that a person asking for "extras" on anyway thinks of it as a reflection on a Therapists professionalism, only their (the client) need/desire.

The other day two men were talking in front of our door for about 3 minutes. They were reading everything on our front window and looking in at us. One asked the other if he had used a neti pot (they were peering through at our display of neti pots for sale). They actively were looking us over. Finally one says to the other, do you want a happy ending? The other replied no I just want a good massage today. They turned and walked away to check out a place across the street. one wanted what they figured we don't supply from the look of the place and the clients (men, women, families coming and going. open front visible doors to the therapy rooms) and went on to seek what both wanted. Kind of like two people going to lunch. One wants a Burger and one wants Soup. They settle on a place that does both. I am looking at it matter of factly without judgement. Do not read this as saying I think MTs should go beyond scope of practice, because I don't.


Therese Schwartz said:

Erica, I'm glad you have that on your intake form.  That in and of itself is enough to "fire" him as a client, because he knowingly disregarded a contract between you.  And yes, asking if he can get his back massaged after your email is a problem - either lack of respect or desperation, both of which are a big issue.

The gender issue - I think (Daniel, correct me if I'm wrong) that Daniel is referring to the way men vs. women handle difficult situations, not necessarily whether the client is male or female.  Men tend to keep things simple and straightforward while we women tend to tie ourselves in knots!

On the note of turning away clients, I did that just a couple of weeks ago.  She cancelled several times at the last minute, and the no show and not returning my calls was the last straw.  I sent her a very professional email and she replied positively and professionally as well.

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