Wednesday, December 29, 2010


I am not fond of the medical profession and I don't want to be part of it. I dislike how it parades the authority of science, while so seldom paying its scientific dues. I dislike the priestly status of doctors. I dislike how quick they are to dispense medicines and to whip out the scalpel. And above all I dislike the credit they take for modern health, which is largely due not to the ruinously expensive and ever-expanding practice of “medicine,” but to medical research and civil engineering: clean running water and sewers have done far more for public health than all the doctors ever spawned.

I have lots of reasons to be less than enthusiastic about being regarded as a health care professional. The modern pattern of American health care is this: 1) you get sick or injured, 2) you go to a huge factory building called a “hospital,” (although few human refuges have ever been designed to feel less hospitable) where you are ignored for an hour or two, until 3) a person of huge status grants you a fifteen minute interview. This person, oddly, since he's ordinarily a stranger to you, is commonly referred to not as “a doctor,” but as “your doctor,” (as in “ask your doctor.”) The implication being that this person is as intimate with you as “your husband” or “your wife.” Actually, you've never met him before. 4) “your doctor” asks you a few brusque questions, ignores your answers, orders some tests, and writes a prescription for some poisonous substance or other. 5) you go get your tests, at a couple hundred dollars a pop, and 6) you go to the store and buy your prescription, go home, take your drugs, and either get better or don't. Sometimes there's a step 7): A couple days later someone (not “your doctor” -- he's too important) may call and tell you that someone else would like to cut you up with a knife and see your insides, depending on how the tests went.

Well, whatever you may think of this model, it's not one that fits massage as I practice it very well. Most of the people who call me aren't sick or injured. I don't “treat” them. I would never give a person drugs to take, or cut them with a knife. My status is roughly even with theirs, which is where I like it. I listen carefully to what they say and try to address their concerns. I do have some expertise in touching people; I have a good working knowledge of anatomy, particularly of the muscular and nervous systems, and I follow the research on stress and chronic pain, and the other conditions people typically call a massage therapist to fix -- although what this research mostly tells me that massage can't do much to address them. You can boil the results of most research on medical massage down to a pretty simple summary: it does people good to be touched lovingly. It doesn't usually solve their physical problems, but it makes them feel better.

Well, that's plenty for me. But it makes me a “health care professional” only in the most oblique, tenuous way.

In fact, I think what a massage therapist of my sort is most like is a “counselor,” a talk therapist. Like talk therapists, we have dozens of “modalities,” which mostly turn out, when studied comparatively, to be equally effective: i.e. about as effective as any untrained but caring and sensible person doing the same thing would be. People need to be touched, and they need to have someone to talk to. In a humane society, probably neither of these would ever be commercial transactions at all. But we are not in a humane society. We are in a mean, dehumanized, isolating society in which you can't even find someone to touch you or talk to you in a sustained, gentle, loving way, unless you pay them for it. The fact that there's a brisk trade in massage and talk therapy should make us ashamed of the world we've made.

For years, before I became an LMT, I muddled along trying to find people to exchange massage with. Sometimes I found people and sometimes I didn't. I had a couple wonderful massage buddies over the years: but people move, or get married to people who aren't comfortable with the idea. Convincing people in mainstream culture that “massage” isn't code for “sex” takes some doing: and getting clear on it in your own mind takes some doing, too.

When I got my license, and started practicing, suddenly it was easy. For the first time in my life I had all the touch I wanted. Touch is my primary mode of communicating with people: the one I'm most comfortable with and most fluent in. It is, to me, incredibly grounding and restorative. I am an introvert, in that a dinner party or an hour-long meeting at work ordinarily “takes it out of me,” and leaves me feeling depleted for many hours afterward. One thing I discovered, upon entering the massage subculture, is that touch restores that deficit. I can socialize or attend meetings for hours and hours, if I can be rubbing feet or shoulders at the same time, or getting my own rubbed, and feel no depletion at all.

A massage therapist needs to be careful about boundaries. Taboos about keeping covered up, and about touch, are the main way our culture maintains sexual boundaries; if you take away that framework, you have to create a new one to do the same job. Massage therapists have different taboos, with each other, but they're just as strong -- in some cases stronger -- than mainstream ones. Massage therapists get undressed around each other without much ado: a few perfunctory gestures of modesty, a little polite turning aside or looking at the ceiling, is plenty. But it would, for example, be entirely unacceptable to make a comment about someone's appearance. Something like “oh, you look nice today,” which would pass at any mainstream work meeting, would meet strong disapproval in a massage workshop. In fact, I think the main impression most people would take away from a conference of massage therapists, once they got used to all the flesh, would be of a particularly sober, unflirtatious community.

That really is much of what you pay for, when you buy a massage: for the boundaries. I'm not sure that most professional massage therapists give a better massage than a motivated amateur -- certainly more confident and practiced, more technically accomplished, easier with draping and so forth -- but better? More tender, more attentive? -- but one thing no massage therapist survives long without is a strong sense of boundaries, of how make clear that this is not erotic or romantic love, and how to stay clear about the matter themselves. The problem with amateur massage is not that it's so likely to be technically incompetent, but that its social and sexual implications are so unpredictable: it's likely to be more trouble than it's worth.

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