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February 14, 2024 14 mins

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Embark on an eye-opening exploration of the often misunderstood world of massage therapy with me, Corey Rivera, your guide through the intricate landscapes of human touch. We're not only unmasking the differences between a casual massage and professional massage therapy, but also diving into why individuals across the spectrum seek out these services—ranging from celebrations on a cruise to seeking solace amid personal trauma.

This episode promises to stretch your understanding of massage therapy beyond its physical connotations, as we scrutinize the profound therapeutic relationships, the critical role of communication, and the essential education and skill of the massage therapist. We'll even touch on the delicate and often taboo topic of massage's relationship to sexuality, ensuring no stone is left unturned. Ready for a session that's as enlightening as it is provocative? Join me, and we'll navigate the societal currents and the healing power of professional touch with the curiosity and depth it deserves.

Links:
Kennedy, LMT, BCTMB, DrPH, A. B., Cambron, LMT, DC, MPH, PhD, J. A., Sharpe, PhD, MPH, LMBT, P. A., Travillian, PhD, NA-C, LMP, R. S., & Saunders, PhD, R. P. (2016). Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium†. International Journal of Therapeutic Massage and Bodywork9(3), 15–26. https://doi.org/10.3822/ijtmb.v9i3.312

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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Corey Rivera (00:08):
Welcome to the Rub a Healw ell podcast about
massage therapy.
We say the quiet things loud,have a hunger for change and a
desire to connect the dots.
I'm your host, Corey Rivera,and in today's episode I'm going
to tell you Healwe ll's viewson the life-changing experience
that is massage therapy.
This is going to be a quicktour of some very big ideas,

(00:35):
like the difference betweenmassage and massage therapy and
how massage therapy is morecomplex than you might think.
It wouldn't be a Rub episode ifwe didn't include something at
least slightly controversial, sowe'll talk a little about
massage and sex at the end.
All of the topics I'm going totouch on today are quite large
and deserve far more attentionthan they're going to get.
I spend a lot of my timethinking about problems from a

(00:57):
systems perspective, which isbasically a 30,000 foot view.
This means, while I considerthe people involved, I also
consider the unspoken rules weas a society operate under.
At least once a week at Healwell, someone makes a reference
to the fish being the last tonotice the water.
The water we humans swim in areour social norms and often

(01:18):
we've been in them so longthey've become difficult to
notice and it can be incrediblychallenging to imagine something
new without someone elsepointing out a different path.
I can't tell you how much Iappreciate your willingness to
explore this less-traveled roadwith me.
The general definition ofmassage, according to Miriam
Webster, is to rub and knead aperson or part of the body with

(01:41):
the hands.
Massage is something everyonecan do.
It doesn't take training to putyour hands on someone's
shoulders and make like they'rea nice lump of artesian bread
dough.
Oddly, it's the familiarity ofthat experience that makes it
hard to explain the differencesbetween massage and massage
therapy.
If that wasn't a big enoughhurdle.
Massage therapy means differentthings to different people.

(02:02):
Most people define massagetherapy by the last experience
they had with it, and thatincludes the layman bread dough
stuff.
But let me tell you some reasonspeople see a massage therapist.
First, the lighter reasonsBecause they're on a cruise,
because it's their bacheloretteparty, because they traveled by
train, plane or automobile,because their chiropractor
recommended it, because theirwife bought them a gift card,

(02:26):
because they want to do athleticstuff harder, better, faster,
stronger.
They're stress-related reasons,because they can't sleep,
because the holidays are comingup, because the holidays are
here, because the holidays justpassed, because massage therapy
keeps them going, becausemassage therapy slows them down,
because they're pregnant,because they just had a baby,

(02:46):
because they have a baby andthey haven't slept in days,
because they need a time awayfrom their children, because
they're a caregiver.
Then there are some serioushealth reasons Because they've
been in a car accident, becausethey have burn scars, because
they have surgical scars,because they had surgery,
because they have cancer,because they had cancer, because

(03:08):
the lymphatic system isoverwhelmed, because they've
been hospitalized, becausethey're on dialysis, because
they get migraines, because theyhave a lot of pain and don't
want to use opioids, becausethey clench their teeth.
And then there are the deeplypersonal reasons Because they're
depressed, because they'relonely, because someone close to

(03:28):
them died, because they feeldisconnected from their body,
because they've experiencedtrauma, because nobody else in
their lives touches them,because their massage therapist
listens to them and their doctordoesn't, because they feel safe
with their massage therapist,or because they've tried
everything else and it didn'thelp.
What do all these things havein common?

(03:49):
The person experiencing themdidn't go to their friend or
family for a shoulder rubbin'.
They went to a professional,someone they thought they could
trust with their bodies andtheir feelings, someone who has
the training and experience totake care of them in a way that
they can't take care ofthemselves.
Massage therapy isn't justrubbing.

(04:11):
If you want to get superacademic, which I always do,
there's a definition we use inresearch from a paper by Dr Ann
Blair Kennedy.
Bear with me, it has threesemicolons and several commas.
It says "Massage therapyconsists of the application of
massage and non-hands-oncomponents, including health
promotion and educationalmessages for self-care and

(04:34):
health maintenance.
Semicolon Therapy, as well asoutcomes can be influenced by
therapeutic relationships andcommunication.
Semicolon the therapisteducation, skill level and
experience.
Semicolon and the therapeuticsetting.
As far as academic definitionsgo, this one's pretty concise,

(04:55):
but let's break it down a littlebit.
Massage therapy is hands-on,but it also involves talking and
feelings.
Massage therapy can be forself-care or for health, both of
which are very broad categorieswhich you know from your long
experience being a human.
Massage therapy is more or lesseffective depending on a lot of
factors, including thetherapist's education and skill

(05:16):
and where the massage is takingplace.
Its effectiveness also dependson the relationship between the
massage therapist and theirclient.
For a long time our medicalphilosophies have concentrated
on the physical.
We treat wounds and curediseases.
We create medications andsurgical procedures to help fix
people.
But in all that flurry to cureand fix, we lost sight of the

(05:39):
care part of healthcare.
We separated people into pieces, a philosophy known as
reductionism.
This attitude is part of thewestern dominant medical model
called European biomedicine.
There are ideas that addresspeople as a whole, particularly
in palliative care.
Massage therapy at its bestintrinsically does this.
Massage therapy is what's knownas a complex biopsychosocial
intervention.
Try saying that three timesfast biopsychosocial,

(06:01):
biopsychosocial, biopsychosocial.
It addresses the realms of thephysical or biological, the
mental or psychological and theinterpersonal social.
Add them together and you getbiopsychosocial.
If that sounds heavy, don'tworry, it is.
Addressing a whole person is alot more complicated than

(06:23):
treating pieces, and there's avast ocean between saying you
want to take care of a wholeperson and actually pulling it
off.
When people marvel at thedifficulty of being a massage
therapist, they often ask if ourhands hurt, because that's what
makes them stop rubbingsomeone's shoulders, and the
answer is yeah, sometimes.

(06:43):
We learn how to use our bodiesto help take the strain off our
hands.
We find tools and techniquesthat might suit our style, but
really there's only so much youcan do with a neck that doesn't
require the specificity offingers, and if everybody you
see in one day has a neck thinggoing on, well, that's the way
the cookie crumbles.
But remember, massage therapyis a complex biopsychosocial

(07:05):
intervention.
The psycho and social parts areof equal importance and the
training for those is much morenebulous than learning how to
palpate a bicep muscle.
The physical parts of peopleare constant like a box of
crayons, but people's internallives are a complicated rainbow
that's constantly shifting.
So massage therapists needtraining and listening and
responding.
We need to understand how toemotionally regulate ourselves,

(07:28):
because part of massage therapyis helping your client with
their own emotional regulation.
We need to know how to workwith a person who is directly in
front of us, who in all honestymight push some of our buttons.
We need compassion and empathy,but having compassion is not a
skill.
The skill is knowing how torespond when a client suddenly
tells you about a traumaticexperience, and that requires

(07:50):
training and practice.
You should know that massagetherapy as a profession is
incredibly divided.
We've already talked on thispodcast about the disagreement
over how many hours anentry-level education program
should be.
We could also, and willeventually talk about how the
profession struggles with, howmassage therapy should be

(08:12):
studied, how dangerous or safeit truly is, our scope of
practice, what effects massagehas on parts of the body and
mind, who should be performingmassage?
Who should be getting massage?
How much massage therapistsshould get paid, why people
decide to be massage therapists,the best hands-on techniques,
our place in healthcare, thebest ways to teach massage.

(08:32):
We don't agree on anything, andnone of that addresses the
institutions that make decisionsfor the profession or what
motivations they might have forthe ideas they promote.
Those institutions include, butare not limited to these, seven
national organizations, themassage franchises, physical
therapists and chiropractors,the National Institute of Health
, academia in general, and allthe beliefs about medicine and

(08:55):
health we get from Europeanbiomedicine, like the belief
that massage therapy is nice tohave or a luxury.
This is actually reallyindicative of a bunch of social
attitudes in America.
It brushes up against our ideasabout poverty and poor people,
about suffering and what itmeans to be sick, about service
work, about capitalism and aboutpleasure.

(09:16):
And speaking of when thispodcast was released, apple's
Podcast's algorithm immediatelystarted recommending a podcast
that is in the Not Safe for Workcategory.
This frustrated me most becausewe chose to be in the health
and fitness category and thealgorithm completely ignored
that.
But you know what?
We get that all the time andit's a problem, but probably not

(09:39):
in the way you think.
So I want to take a few momentsto talk about that Not Safe for
Work thing Before we get allserious.
Here are a few of my favoriteeuphemisms Shagging boots,
rolling in the hay, netflix andchill Hanky-Panky.
Shagging, amorous Congress, theMattress Mambo.

(09:59):
Okay, ready?
This is a problem, but I don'tbelieve it's a moral problem,
which is how it's usually framed.
I am aware that this topic is atangled web of emotion and
panic.
Today, I want to talk a tinyamount about why our social
system puts massage and sex inthe same boat, and I'd like to
be crystal clear that I amtalking about consenting adults

(10:22):
who chose their profession thesame way you chose yours.
This is not a discussion abouttrafficking or non-consensual
activities of any kind.
The relationship betweenmassage and sex is a social
issue because, as thedescendants of Puritans, we have
very rigid ideas about sex andtouch and anything else remotely
related to those things.

(10:43):
Our society has ideas aboutjobs involving touch being bad
and dirty and low.
This shows up in Europeanbiomedicine in a big way, where
a defining part of the medicalhierarchy is how little you
touch your patients.
Think about it doctors touchpatients less than nurses, who
touch patients less thancertified nursing assistants.
But touch is literally vitalfor human survival.

(11:06):
Remember when I said that somepeople see massage therapists
because nobody else in theirlives touches them?
This is a very real problem,known as touch deprivation,
touch starvation or the veryvivid "skin hunger.
Just hearing me say those wordsout loud probably made you a
little upset.
The idea of paying for touch iseven more complicated than the

(11:32):
need for it.
We have a lot of ideas aboutpaying people for tasks
considered to be domestic orcare-based, and the loudest idea
is that we shouldn't pay peopleat all.
The massage versus sexconversation has more twists
than a Sherlock Holmes story andit's just as foggy.

But one thing is very clear: framing it as a moral problem is (11:48):
undefined
exactly what the current systemwants.
Moral panics prevent nearly allconversation from even starting
, so the system in place willstay exactly as it is.
It is the perfect defensemechanism.
Here at Healwell, we prefer toface difficult conversations
head-on.
As Executive Director Cal Cateswould say, "discomfort means

(12:11):
you're headed in the rightdirection.
Just stay with it.
If you take nothing else awayfrom this episode, please take
this.
Sex workers are not the enemyof massage therapists.
Sex work is work, and thepeople who do that work deserve
the same protections as everyoneelse.
They deserve safe workenvironments, they deserve not
to be harassed, they deserveagency and choice, and the topic

(12:34):
of massage and sex deservescareful, calm, thoughtful and
thorough consideration.
I'm going to end this episodethe way I began it, with a tasty
food metaphor.
This episode is like the flakyoutside layer of a giant onion.
We're going to give this onionall the respect it deserves, but

(12:55):
that vegetable is going to getpeeled.
There may be irritation andthere may be tears.
I might slice it too fine ortoo thick, and there's a good
chance my cutting board is toosmall, but we'll make it to the
core together and then we'llplant it and grow new onions.
And now I'm getting carriedaway, so I'll stop there.

(13:16):
If any topic in this episodejumped out at you is something
you want to know more about,please send an email to
podcast@h ealwell.
Healwellorg.
There's a lot to cover, andknowing what you're interested
in will help focus my magpietendencies.
If these are topics you want totalk about with other people,
you should join us in theHealwell Online community at
community.
healwell.
org.

(13:36):
We're excited to meet you andthank you for listening.
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