Caring Communication
Heart of Bodywork

By Nina McIntosh

Originally published in Massage Bodywork magazine, February/March 2005.
Copyright 2005. Associated Bodywork and Massage Professionals. All rights reserved.

We touch clients with our voice and words, as well as with our hands. What we say and how we say it can either add to or detract from the client's comfort and ease. How can we talk to clients in a way that enhances our hands-on work, makes our jobs easier, and adds to a positive experience for them?

Most of us realize that talking with a client, especially when she is on the table, is not the same as talking with a friend. Our clients are more vulnerable in significant ways. First, clients are more emotionally exposed. Clients want to -- and usually will -- enter into an altered state during a session, a state of deep relaxation. Although the best way to help clients enter that state is by our silence, there will be times when talking is necessary or useful. We have to keep in mind that, during a session, clients are more emotionally open, less defended, and closer to their unconscious mind than in their everyday lives. As a result, our words can sink in more deeply.

In addition, our clients are physically exposed (even if draped, they have little or no clothing on.) They are also in a relatively passive, dependent position. In these circumstances, we can become, in their eyes, the expert, the authority, or even a parent figure. Clients will give more weight to our words than they ordinarily would. For instance, they may hear us as being critical when that isn't our intention. Likewise, our kind and comforting words can have greater effect.

We want to provide a space within which clients can turn off their thinking minds and drop into an altered state, and we also want to be sensitive to a client's vulnerability during the work. Following are some guidelines for how to accomplish these goals.

- Speak softly -- not in a normal conversational voice.
Use a lighter tone and softer volume than normal conversation. Take care not to say anything that might be upsetting or jarring. You want to speak as if you were talking with someone who is about to fall asleep.

Even though there are times when you want to educate your clients, you don't want to engage people's brains with long explanations, speeches, or stories. Don't ask them questions that take thought to respond to (except very early on in the session before they are deeply relaxed). A question such as, "How many times have you hurt this foot?" -- harmless as it seems -- would take a client too much into his head. You don't want to get clients involved in left-brain activities such as figuring out, counting, or analyzing. You can ask them questions about feelings or sensations, such as, "How does this feel?" or "How is this pressure?" Anything you say to clients who are in an altered state should be a no-brainer. Or at least a no left-brainer.

- Keep instructions simple.
To avoid getting people to think, you want to keep instructions simple. For example, some people have trouble distinguishing between right and left, and most people, when they are deeply relaxed, have to think to remember which is which. It can be helpful just to tap lightly on the appropriate side and say, "Would you turn over on this
side, please?"

- Avoid interpretations and analysis. Say the obvious.
Honor clients' vulnerability by staying within your scope of practice. Don't intrude on clients with interpretations and analyses that are beyond your training or not what they have agreed to. If clients want only a relaxing massage, for instance, we can violate their boundaries by offering our opinions about what is going on with them psychologically or emotionally.

However, it can be very effective to describe what you see in front of you, if it is part of your expertise. For instance, you could say, "You seem to be having a difficult time letting go of your hand. It's been in a fist for much of the session." You don't have to make up fancy explanations or add interpretations. Sometimes just bringing a bodily habit or pattern to a client's awareness makes a big difference.

- Use images that convey the possibility of change.
You want to let clients know they can get better, not give the idea they are stuck in an uncomfortable condition. As an example, rather than saying, "This hip is like concrete," you can say, "This hip joint seems to need more flexibility." Or if an area doesn't have much movement in it, don't say, for example, that it looks "dead." You can say that it looks "quiet" or "asleep" or "as if it wants to move."

- Find something positive to say about clients or about how they are taking care of their bodies.
Compliment them for their self-care. They're coming to get a massage or bodywork -- that's a good start. However, don't comment on how attractive they are. It could sound as if you're interested in them sexually. Speak of "healthy-looking tissue" and legs that "look strong," for example. Avoid making negative comments. A colleague reports, "I didn't appreciate when a massage therapist told me, 'You have the tightest shoulders I've ever seen.' That's a title I didn't want to have."

- Use images to express possibilities.
Images can help clients stop thinking and let go. They can also enlist the client as an active partner. Images can touch clients who are in an altered state more deeply and stay with them longer than dry instructions. For example, you could say, "What if this shoulder were as loose as a rag doll's?" or "Think of your back as a vast Montana sky." Tailor the images to the client's background and interests.

- Use only gentle humor.
Teasing and sarcasm have a hidden hostility, whereas gentle humor can work well. For instance, to a client with a tight upper back, you could say, "I've been wondering who's been carrying the world around for the rest of us. Looks like it was you."

- Of course, no flirting.
There is no such thing as harmless flirting. It is sexual harassment to flirt with a client. Take care even with your tone of voice so you don't give the wrong impression.

- Be extra careful when working around a client's head or face.
When you're near a client's head and face, your words can go even more deeply into the subconscious. Also, you're so close to clients' ears that it's easy to sound loud and jarring. It's best not to talk at all. If you do speak, use positive words and images.

If you say, for instance, "I want to make your neck looser so you won't have a headache," what may stick in the client's mind is the word "headache." You could say, "It would be great to have more ease here." Or using an image: "See if you can let your neck be as soft as a kitten's."

- Be sympathetic in your tone.
It's easy for clients to think we're criticizing them. For instance, a comment such as, "You're so uptight" can sound like a judgment. You could say instead, "It looks like you've been under some stress."

- Keep the focus on the client.
When a client says, "My husband makes me mad because he won't wash the dishes," you don't need to add, "Oh, mine, too. Isn't it a drag?" Clients are paying for your time and attention, not your life story. There are times when such a remark would go unnoticed, but sometimes it could be a problem. Suppose your client is an overworked person who feels she doesn't get enough personal attention in her life anyway. She may -- rightfully --feel intruded on if you take the spotlight away from her.

- Suggest and persuade rather than order.
What could be less relaxing than to have someone order you to "RELAX!"? Instead of that, or commanding, "Let this arm go," you could say, "I wonder how it would be if this arm could let go."

Knowing the right words to say isn't always easy. Because each client and each situation is unique, there will always be challenges. No matter how long we are in practice, there will always be times when we find ourselves searching for the correct words and occasionally stumbling. Our goal is to know that what we say makes a difference and to keep looking for words that connect with our clients.

Nina McIntosh has more than 20 years experience as a bodyworker and is a Rosen Method Bodywork intern. For more information on her book, The Educated Heart: Professional Guidelines for Massage Therapists, Bodyworkers and Movement Teachers, call toll-free 877/327-0600 or visit

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