Countertransference for massage therapists

As a massage therapist, clients come to you to help them find a solution to a problem they are having – whether it is pain, stress, an injury or other disease. They are seeking an expert to help them with their condition.

Whenever someone is seeking another for help, it creates a power differential in the relationship meaning that the client perceives the massage therapist as having some answer or solution to their problem. It starts from the second they make the effort to find someone to help them. The role of the massage therapist is to provide massage as a solution – to meet the clients needs.
Often in a relationship where there is a power differential it creates a dynamic called transference – the person tends to think of the authority in the way they related to their parents or other significant caretaker early in their life. Without knowing it, a client will often be acting or speaking from an early childhood wound where their needs for attention, nurturing, appreciation and respect were not met. It is an unconscious process and it happens in all relationships. Some signs of transference include but are not limited to:

    a client tells you their whole life story in the first session
    a client wants to see you socially as a friend or even as a date
    a client asks questions like “how many massage have you done today?” or asks more about your personal life.

There is another short list in this article in which
Ben Benjamin defines transference as

In transference, unresolved needs, feelings and issues from childhood are transferred onto the helper

The thing with transference is that it happens constantly in relationships like the one that is created between the massage therapist and the client as well as with other relationships where there is an imbalance of power – boss/employees, teacher/students. Because we have the added influence of touch and how it can relax a person along with the fact that people take their clothes off and feel more vulnerable from the start, the transference is really high in the massage profession. While massage therapists are in no position to do psychological therapy with a client, what they can do is learn more about themselves and understand your own issues around being a massage therapist which are not often clear and straight forward.

Countertransference is when the therapist transfers their feelings and issues from childhood and transfers them onto the client and tries to get their own needs met through the client relationship. Countertransference begins the minute one starts thinking about becoming a massage therapist. The reasons that someone chooses the massage profession where they take on the role of the expert or person of power are usually filled with deeper agendas that are usually unconscious. Countertransfence is what usually brings many to the massage profession. They want to find a job that they are more appreciated in, that they can find more meaning in and help caretake others. Feeling like you need to always have results or you are not doing a good job can be a sign of countertransference along with these other things:

    wanting to be friends with clients
    thinking you have to take every client that calls
    working with cancer patients exclusively because of your past with cancer or any other specialty (working on abuse victims because you were abused, working on sports teams because you wanted to be a athlete or were one)
    thinking you need to work longer on a client than the assigned time to get better results
    feeling resentful of not getting a tip or gift
    feeling unappreciated after all you do
    thinking your work is better than everyone elses and if people go to other massage therapists it will be their loss
    feeling drained after a session or day of work
    thinking you have to resolve the clients issues all in one session.

Transference and Countertransference are a natural part of the helping relationship. It isn’t a matter of if it is going to happen – but when is it going to happen.
It isn’t that doing these things is bad in any way for either the client or the massage therapist. It is just that these old ways of reacting and thinking are just that- based on old beliefs that just aren’t true. It is important to become aware of both sides of the dynamics of transference and countertransference and learn to get your needs for appreciation, attention, to be needed and nurturing met outside of your massage practice.

As a massage therapist we can best serve clients by becoming more aware of ourselves and our own countertransference issues which will allow us to stay more present with clients. In doing so we can serve their needs better as our own are taken out of the picture and met in our personal life rather than in our practice.

Peer Supervision is the best way to get in touch with this other part of being a massage therapist. Group or individual sessions are necessary to help become aware of these issues and it is also a place where the massage therapist can get their needs for appreciation and other needs met.

How Countertransference Jeopardizes the Therapeutic Relationship Nicole Cutler, L.Ac.