Our Clients, Domestic Violence, the Healing Process, and You

October 7th, 2008

As many as 9 million women a year, in the United States, suffer violence by her husband or partner. We can figure that is one every 9 seconds – more than all those injured in car accidents, mugging and rape, combined. Domestic violence is the major cause of injury to women between the ages of 15 and 44, and the primary cause of death among pregnant women. At least three out of five women in the U.S. will be battered by a domestic partner in their lifetime. Estimates indicate there are altogether as many as 28 million battered women in the U.S.

Learn how you, as a massage therapist, can become an integral part of the healing process.

There are no clear boundaries when it comes to those who are victims of domestic violence and abuse. A person’s economic status, race, religion, ethnicity or age makes little or no difference. Gay or straight, elderly or disabled, illiterate or well-educated, living in a rundown shack or spacious mansion – no one is exempt from the statistics.

The annual medical expenses resulting from domestic violence in the United States are estimated to be anywhere from $3 to $5 billion. Lost wages, sick leave, absenteeism and non-productivity account for another $100 million in costs to businesses.

On average, one of every five clients a massage therapist sees is a victim of some kind of trauma or abuse. Many are victims, specifically, of domestic violence.

As a massage therapist, you are trained to be sensitive to the changes in the body’s energy and have the ability to perceive the subtle variances in muscle tone and physical tension. You can feel if a person constricts when you get to a certain area. Muscle tension within the body of a person who has been traumatized feels different than the tension created from over exercising. You can see the bruising and physical injuries others cannot. Because the act of massage therapy often encourages an intimate trust, it can unlock a person’s emotions and you may be witness to a verbal releasing of what has happened to them.

Signs

Perpetrators of domestic violence often produce injuries and bruises that are concealed under clothing, or otherwise easily hidden. Massage therapists are in a somewhat unique position, as they are able to see what lies beneath. They are educated in recognizing the differences between a normal bruise caused by a harmless bump into something, as compared to one caused by a belt buckle or other weapon.

Some other common signs include:

wearing of heavy makeup to cover bruises
new, unexplained bald spots
frequent injuries, such as bruising, cuts or fractures
cigarette burns
bite marks
rope burns

Bruising, cuts, chronic illness, nonspecific chronic pain, injuries that don’t seem to heal over time, or that don’t seem to ring true with the explanation of how it was received, are all possible signs of battering.

During a massage therapy session, a client often begins talking and, at times, may reveal intimate things about relationships. Perhaps your client jokes about how jealous her partner is, or confesses how afraid she is of him and his temper.

It could be your client simply does not have the usual relaxation of the majority of clients. She remains hyper-alert, and even flinches or pulls back when you approach certain parts of her body. Some clients experiencing an emotional release may even start to cry while receiving a massage. Being alert to signs indicating possible abuse may help you to open a conversation later about various resources available in your community.

What You Can Do To Help

During a session, always be sure to maintain professional boundaries. Be aware of your draping as well as certain techniques or movements used that might appear threatening to a victim of domestic violence. Remain sensitive and alert to the possibility of emotional changes in the client as a reaction to the massage.

If a client has a strong or unusual reaction during the session, you may need to discuss it with him/her. You can ask if they wish to stop and take a break or would prefer to simply end the massage. While it is generally beyond the scope of practice for a massage therapist to offer counseling, you can listen if they are ready to talk about it. Offer them local or national hotline telephone numbers or, if appropriate, the names of local shelters or other places to go for help or advice.

If you have a private practice, keep informed as to what resources are available in your community and place brochures, fact sheets or other various handouts in your waiting room.

If you have created your own intake form, consider adding an optional question like ‘have you ever been a victim of domestic violence, or sexual abuse.’ This way, clients know that everyone is routinely asked, and you can explain, if questioned, that it helps to know if someone has suffered severe trauma as it might make a difference in massage technique.

Volunteer at a local women’s shelter. Many abused women do not seek out massage. This may be out of embarrassment, poor self-image, low self-esteem, cost or simply not being aware of the benefits of massage therapy. By offering your services you are helping battered and abused women to heal and move forward in their lives.

Provide regular classes or workshops at your office. If you don’t feel comfortable as the facilitator, invite an experienced speaker, such as a psychologist or counselor trained to discuss domestic violence issues. You could make it open to the general public, massage therapists and/or other healthcare professionals.

Keep yourself balanced. Dealing with many clients who are suffering from trauma can lead to burnout. Find other massage therapists and psychologists or other professionals who routinely work with battered women/spouses, and form a support group that meets regularly.

Every massage therapist should educate him/herself about domestic violence. Become familiar with the common signs of abuse. In some states, massage therapists are mandatory reporters, legally required to report their suspicions. The laws vary from state to state but, in all states, domestic violence and abuse are illegal.

It is not the responsibility of a massage therapist to ‘fix’ the relationship, or get your client out of it. But by educating yourself and making resources easily available to your clients, you can remain objective and still help those who need assistance.

Domestic violence is pervasive in our society. By becoming aware of the problem and learning what you can do to help, you are becoming a part of the solution and may even save someone’s life.

Recommended Study:

Advanced Anatomy for Professionals
Ethics: Therapeutic Relationships

References

Benjamin, Ph.D, Ben E., and Cherie Sohnen-Moe. The Ethics of Touch. Tuscon, Arizona: Sohnen-Moe Associates, Inc., 2003.

“Domestic Violence is a Serious, Widespread Social Problem in America: The Facts.” Family Violence Prevention Fund. 11 Sep 2008 <www.endabuse.ore/resources/facts/>.
“Fact Sheets.” National Coalition Against Domestic Violence. 16 Sep 2008 <http://www.ncadv.org>.

Hixson, Audra Lynn. “Examining the Benefits of Massage Therapy For Survivors of Sexual and Domestic Violence.” 2006 Boca Raton, Florida: Dissertation.com

Mines, Ph.D, Stephanie. “Healing Triumphs Over Domestic Violence: How Massage Therapists and Bodyworkers Can Change the World.” 11 Sep 2008 <http://tara-approach.org/article_5.html>.

Razo, Rebecca J. “Understanding Domestic Violence: What Massage Therapists Should Know.” Massage Today October 2004, Vol. 04, Issue 10:

“Violence Against Women in the United States.” National Organization for Women. 16 Sep 2008 <http://now.org/issues/violence/stats.html>.

“Would You Recognize a Victim of Domestic Violence?” YWCA. 16 Sep 2008 <http://www.ywca.org>.

About the Author

Linda Fehrs, LMT

Linda Fehrs, AAS, LMT is a freelance writer and massage therapy professional licensed by the New York State Department of Education. She is a professional member of the American Massage Therapy Association and the New York State Society of Medical Massage Therapists. Ms. Fehrs has actively practiced massage therapy in the Mid-Hudson Valley since 2002 with a focus on those with special needs, such as developmental and physical disabilities. She is a graduate of the Hudson Valley School of Massage Therapy as well as a former instructor at the school. Prior to becoming a massage therapist she was former managing editor of a weekly community newspaper and is a veteran of the U.S. Navy. Ms. Fehrs currently volunteers with the Red Cross, helping to educate others about emergency preparedness and disaster relief.