The Psychotherapeutic Relationship in Massage Therapy

BACKGROUND: Psychotherapy and massage therapy (MT) are effective treatments for depression and anxiety. Little is certain about the mechanisms behind these effects in MT, but in psychotherapy they are attributed to a combination of common and specific factors, at the heart of which lies the therapeutic relationship. Research into the psychotherapeutic relationship in MT, therefore, may advance understanding of its impact on depression and anxiety. PURPOSE: This research seeks to elucidate the components of the psychotherapeutic relationship in MT to inform training, research, and practice. PARTICIPANTS & SETTING: Two participants—a therapist and a client—from Melbourne, Australia. RESEARCH DESIGN: A qualitative methodology was employed whereby one therapeutic relationship was observed over the course of three massage treatments. After each treatment, the participants commentated recordings of the sessions. The recordings were transcribed and analyzed using Interpretative Phenomenological Analysis (IPA) and Conversation Analysis (CA). Themes and subthemes were extracted from the analysis. RESULTS: Four overarching themes emerged: Separateness, Pleasure, Merging, and Internalization. Separateness is associated with the subthemes of Boundaries, Performance of Roles, and Power. Pleasure is associated with the subthemes of Safety, Comfort and Communication. Merging is associated with the subthemes of Contact and Empathy. Internalization has no subthemes. CONCLUSIONS: The results suggest that a clearer conceptualization of the therapeutic relationship in MT may help massage therapists more purposefully treat depressed and anxious clients. A greater emphasis on self-awareness in the professional development of massage therapists may also foster this. Additionally, the role of pleasure in the therapeutic relationship in MT warrants closer examination.