Transference for Massage Therapists

Transference is one of the most important concepts to understand for a massage therapist but the least understood and talked about. It is usually covered in a few hour workshop in massage school. Transference is a very complex phenomenon that comes from the psychology profession. The reason that it is so important to understand is the fact that the process of transference is actually what can lead a person to becoming more aware of their thoughts and issues. Transference is what heals.

transference in massage
Ben Benjamin author of the book The Ethics of Touch: The Hands-on Practitioner’s Guide to Creating a Professional, Safe and Enduring Practice
defines transference as this:

Clients defer to the practitioner’s judgment because they desire to be helped by an authority figure that possesses greater knowledge, healing ability and, therefore, power.

Since a power differential exists in any health care relationship, the client may be inclined to respond to the practitioner as he or she would other authority figures, and in doing so, may recreate elements of similar past relationships. This situation is known as transference, a normal, unconscious phenomenon that appears during a therapeutic process. Professional helping relationships usually have a strong transference element in which the parent-child relationship is unconsciously re-established. In transference, unresolved needs, feelings and issues from childhood are transferred onto the helper.

Elliott Greene author of the book “The Psychology of the Body” writes this:

Transference is the displacement or transfer of feeling, thoughts, and behaviors originally related to a significant person, such as a parent, onto someone else, such as the massage therapist. It is a common reaction of clients to their therapists. A bit of transference happens in most relationships in which there is feeling present. Usually, transference-related feelings were formed in the past, so it could be said that these feelings transfer from the past to the present. In transference then, the client relates to the therapist and present moment as if the therapist were the significant person. In this sense, transference is a projection of the internal drama of the client, and the therapist is assigned a particularly important role and script.”

Nina McIntosh in her book “The Educated Heart” says this about Transference.

“Transference may sound complex and unusual, but it’s actually part of our everyday life even outside of our offices. It’s normal for any of us to bring the past into our present relationship. In fact it happens all the time. They are magnified in a manual therapy session because of the intimacy of the setting, the clients altered state and the way that the practitioner/client roles mimic those of the parent/child.””Transference isn’t a rational process.

Terrie Yardly-Nohr in her book “Ethics for Massage Therapists” says this:

“The very nature of the therapeutic relationship allows transference to happen easily. Bodywork can trigger a variety of emotions from clients such as anger, frustration, sadness, fear, or joy. These feelings are generally the result of some emotion the client felt in the past towards another person.”

Cidalia Paiva in her book “Keeping the Professional Promise” says this:

“Transference refers to those situations where the patient projects onto the therapist old feelings or attitudes they had about significant people in their past, often parental figures. Transference is often referred to as ‘the unreal relationship in therapy’. The roots of transference are most often found in early childhood, and it constitutes a repetition of past conflicts with significant people in our lives.

So what is transference then?

Simply put, transference happens when there is difference in authority that resembles the parent-child relationship. The client who comes to a massage therapist receives the nurturing that they never received as a child and puts the massage therapist on a pedestal. The nurturing touch brings out the old feelings and emotions that were repressed or suppressed in early childhood. The client unconsciously begins to see the massage therapist as the nurturing parent and it can bring up feelings of attachment that were not resolved growing up. It is when the client unconsciously thinks that the massage therapist is their mother or father or other significant caretaker. Note the word – UNCONSCIOUS.

Attachment is what happens between a mother and child that allows the child to grow and build self esteem. The infant knows learns about themselves through touch. There are various stages of attachment that occur in child development where the infant feels like they are one with the mother. (And of course they once were in eutero.) As a child grows they learn that they are separate from the mother. This is where things often go astray. If a secure attachment is not formed in their early part of life, they will have life long challenges that result from that.

Massage and nurturing touch re-enacts the process of development. I actually think this is also why spa treatments are so popular with the use of healing waters and body wraps. Getting regular massage and developing a relationship with a massage therapist in which the client feels nurtured and cared for as if they were receiving it from their mothers can help heal the grief of not ever getting those early childhood needs met.

Transference is really important yet difficult to understand. The best way to understand it is to experience it. You may or may not have had some of these feelings arise when you were getting a massage from someone:

  • Feeling like you don’t want the massage to ever end
  • Not wanting to leave the office
  • Seeing the massage therapist outside of the office and wanting to follow them where ever they go.

Or from the other aspect seeing it in your clients:

  • bringing you flowers or special gifts
  • hearing about people’s personal problems
  • being asked to make exceptions in scheduling and payment options.
  • inviting you out socially as a friend
  • asking you out on a date or making other advances on you.

Or if you ever worked with a psychologist or mental health professional in therapy, you can come to learn more about transference from seeing your own. Becoming aware of your projections in a therapy setting can be a painful experience. It is a matter of getting a look at your unconscious thoughts through relationship. It can be a very eye-opening process and really lasts a lifetime.

While some of these things may just seem like normal things, it is difficult to know the difference. You probably won’t know the difference.

What you can do is create a code of ethics and a set of policies and procedures for your practice that will help you make proper decisions in any situation. It is having boundaries that teach people when they are in transference that you are separate from them is what will allow the person to heal and build self esteem.

The other thing about transference is that it not only occurs in these helping types of relationships but almost all relationships. Friendships, significant others, family members and the person who checks you out at the grocery store who seems to ‘look just like your mother”.

Reading and learning everything you can about transference can also help. These are some of my favorite books:

The The Psychology of the Body (Lww Massage Therapy & Bodywork Educational Series)

Ethics for Massage Therapists

The The Educated Heart: Professional Boundaries for Massage Therapists, Bodyworkers, and Movement Teachers (LWW In Touch Series)

Issues and Ethics in the Helping Professions
On Becoming a Person: A Therapist’s View of Psychotherapy

12 thoughts on “Transference for Massage Therapists

  1. Thanks for another great post Julia. Understanding transference is critical in understanding our client relationships. I love that you said, “Transference is what heals.” I’d like to add that exploring our countertransference is where our own personal healing processes can be engaged. When we are willing to delve into our countertransference in our therapeutic relationships, we’re walking through a gateway for transformation and healing ourselves.

  2. Hi Julia,

    What makes you blog content so special and unique are posts on subject like transference or self awareness for massage therapist – It is great to be able to develop oneself, to grow and still be practicing – Thanks for sharing your knowledge and experience through that perspective –

    I added your widget to my blog and would appreciate a comment on any of my post –
    http://www.amatouch.blogspot.com

    Catherine

  3. you have gone a little overboard with your views of transference! many people come for a massage truly to relieve physical tension, not because they missed out something in childhood, then idolize the therapist because of great massages.

  4. They don’t go get a massage thinking that they missed out on something in childhood. The whole transference process it totally unconscious on the part of the client (and most people for that matter) yet it is a part of every relationship – friends, partners, family members, coworkers etc but they call it projection or drama in other relationships.

    They can come to idolize massage therapists just because of giving a good massage. Read some of the signs of transference in some of the articles and books mentioned that should be the core of every massage school.

  5. To pat deas. You are missing the point. The article isn’t saying that people go to a message therapist because they missed out on something from their youth. They are saying that transference happens unconsciously. No one intends to go to one for it to happen. I see a chiropractor regularly and it happened to me. He massages my back and I never want it to end, leave his office and I do want to follow him around. I couldn’t believe how spot-on this article was.

  6. The feelings that he has are real. I think that it is actually in the transference that healing occurs for both the client and the massage therapist. You can’t just say stop feeling that way. I could probably say a lot more but without knowing the details (is he giving the MT your life savings! or does the MT feel like he is a son), I would say it is best to address it directly. In transference, one person has to be the ‘adult’. There is transference in every relationship and it is probably what is causing the issues in your relationship with your partner. We all just want the deep unconditional love of our mother/father! Have you considered seeing a counselor/psychologist together to try to understand it all more?

    That’s a tough one! Not meaning to offend you in any way.

    Julie

  7. Wow. I found this article very intersting. Strangely enough, I found it by typing in “attached to your massage therapist” in the search engine. I’ve just started getting massages over the past 5 months, and I swear that I’m addicted to them…well…to my therapist. I felt so guitly and strange for feeling attached and/or attracted to her (I haven’t yet figured out which). She’s nearly 15-20 years older than me, overweight, of a different race, and so many other features that I’m not particularly attracted to, not to mention I’m a woman! I couldn’t understand it until now. Last month, I actually searched “Can you be addicted to a massage?” and was relieved to find out that I wasn’t the only one. But I still felt like these…thoughts…feelings or whatever weren’t healthy because I actually found myself thnking about her and her massages ALL of the time. I even started to set up more appointments even though I did’nt have the budget for it.! (Crazy, I know). So after today’s massage, I had to find some kind of justification for my response to her, something besides “maybe it’s just that I haven’t been touched in a long time.” And your site really helped me out. The more I began to read your article, the more I began to think about what part of the massages (and yes, I’m ashamed to say…) aroused and relaxed me the most. Strangely enough, it was the back of my neck, the same place my mother caresses me when she wants to show some kind of physical contact (hugs, kisses and all of that were never big in my household. It actually makes most of the members of my family feel uncomforatble). These quick, little, drive-by taps always relaxed me, even though they only last for mere seconds. And I’ve always wanted her to allow her hand to linger there, but just never knew how to ask. The only times I was ever really willing to ask and she was willing to comply was when I had a migraine. The warmth of her hand just seemed to make all of the pain go away. So I guess, in terms of my therapist, I’m paying her so I feel completely justified in asking her to focus on my neck and sholders, which I do ALL of the time. In my twisted mind, I somehow thought my neck was just my “special spot” and never attributed it to my interactions with my mom. But who knows? Maybe this idea of transference is overated, as stated by one post, and I’m buying into it because it’s 12:30 in the morning and I’m stressed and tired. I don’t know…I guess I’ll have to do some research on it a little more (thanks for the book list). At least I don’t feel as weird about having this strong desire just to be around my therapist. I have a little more knowledge that will help me combat this so I don’t make a fool of myself and/or embarrass my therapist, if it hasn’t happened already. Thanks everyone, I really enjoyed reading the article and your comments. And please note that I did NOT intend to write this much, but everything just seemed to…well…spill out as I began typing. Am I just crazy? Should I see a counselor about having a detachement disorder or something?

    Vlaea2

    • It isn’t a detachment disorder but attachment issues. Everyone has them to one degree or another I think anyways whether or not people want to admit it or not. It is the same thing that makes you want to see your partners cell phone records and private diaries! It is really the same thing like when you first start to date someone too I think anyways – but I am not a psychologist. I just have done a lot of attachment based therapy myself. I think in a way it is like getting that from your mother in some way and can be healing.

      Julie

    • Wow. I’ve experienced something similar with my therapist though I don’t feel like like it’s based in some parent child thing. What I felt is a desire to spend time with them, get to know them as a friend and to be needed by them. I have great compassion for them. I made the mistake of telling my MT and it scared her and she terminated my therapy sessions. I’ve been in mourning ever since, miss her terribly and am seeing a psychotherapist to work through it. Actually, I’ve put it in perspective now and understand that I had just really been socially isolated and was really missing human interaction and also touch. My partner is not very affectionate so I was finding that need in MT. Anyway, my psychotherapist feels losing the MT was probably not the best outcome, says they should have tried to help me work through it, resetting boundaries etc. But I think my MT has her own set of issues re boundaries and couldn’t deal. Too bad, I was very clear on how to deal with it and expressed that to her, could have probably been a positive learning experience for her as well. She is 20 years younger than me and I guess not yet mature enough to face issues head on. I don’t know but I’m a little angry now though I still like her and would love to go back as a client because I had a great deal of trust which isn’t easy to find again.

  8. I’ve just found this post myself and though it is long after the original posting I have had a recent experience with what I suspect is a case of transference with my massage therapist. I believe that I had transferred the role of mother to her though at the time it felt to me more like I wanted to be mothering to her. I had a real compassion for her and sensed that there was some bond between us but I didn’t really know what it was or why. Unfortunately I expressed this to her and probably not in the most understandable way. I was quite upset by it and concerned about it because I knew it was not acceptible. Because I am a lesbian I think she mistook my compassion for lust or romantic love which it definitely wasn’t. I have a partner of 30 years and had no desire to terminate that relationship. Anyway, she was told by her mentor to terminate my professional relationship with her which to me was abandonment. Now that I’ve read and learned more about this I realize the best solution would have been for me to continue in massage therapy and to see a psychotherapist simultaneously to deal with what appears to be a lack of parental emotional nourishment as a child, perhaps as early as infancy since my mother was lacking in that regard. She was very non physical. Now I am dealing with it but without the support of the massage therapist who really had had a huge positive impact on both my physical and mental health. I’ve found a new massage therapist so the physical health is being dealt with but the experience has left some emotional scars I will have to work through. So, I wanted to share this because I think that the comment about transference being the healing part of therapy is true but that it can also be damaging if not handled properly and I think it’s important that MT’s learn how to help clients work through it, not abandon them. My psychotherapist has indicated that she felt it wasn’t handled correctly and that she often works with massage therapists and their clients to deal with this sort of thing. At this point though my MT has decided she wants no contact with me whatsoever. She has even threatened taking legal action if I try to contact her and all I did was send a few emails to try to explain the situation to her and to apologize for scaring her! I’ll get through it but it concerns me that there are massage therapists who themselves have problems (she did express some personal issues to me early in my treatment which I think opened the door for the closeness I felt) that preclude them being able to deal effectively with these situations. My psychotherapist feels MTs don’t get enough psychology training. I do want to be clear though that I have no hard feelings toward the MT in question. She was unsure how to deal with it, she sought advice from her mentor and I think the advice was not the best but I suspect the MT felt compelled to do what she was told by the mentor. It was for sure a difficult situation I put her in but I put a great deal of effort into communication with her and I think had she been more open to that it could have been worked out better for everyone.

    • Thanks for your openness about this. It probably did scare her which is understandable. It is also a very fine line all the time to deal with clients coming on to the massage therapist – no matter what the sexual orientation.

      The problem is that our training programs are a basic 500 hours of massage and some places have up to 1000 hours of training but still that is not enough time to teach psychology. It is out of our scope of practice to deal with psychological issues. We are only allowed to massage!

      I wouldn’t say it was handled incorrectly. It was what the MT needed to do to support herself and her needs and keep herself safe in her view.
      Massage therapists are just people who have learned massage. We have so many counter-transferrence issues to work through ourselves. It is actually the same thing that happens in most love relationships too.

      Sorry you had to go through that, but it sounds like it was for the better. Thanks for sharing. Julie

  9. Thanks so much to the author and the comment posters!!!! You helped me figure out the feelings that Ive been having for my masseuse… it’s normal and not to be confused with something it isn’t. It didn’t help that she’s young and hot, but now I can look past that and heal my back fully!!

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