Is Your Compassion for Clients Healthy?

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Healthful vs. Unhealthful Compassion

Healthful compassion encourages clients to feel empowered in their healing process. In today’s practice, awareness of compassion fatigue in massage therapy is essential, since unhealthful compassion can have the following three consequences. Unhealthful compassion:

• Limit the client’s potential to heal
• Lead to practitioner burnout and compassion fatigue
• Make the therapist vulnerable to ethical breaches

Studies confirm that compassion fatigue—a state of emotional, mental, and physical exhaustion from caring too much—remains a major risk for helping professionals.

Understanding Unhealthful Compassion

In order to better understand the possible outcomes of unhealthful compassion, it must first be defined. When the desire to help someone is not accompanied by the ultimate vision of them helping themselves, a dynamic of unhealthful compassion exists. Being a caregiver with a healthy, compassionate approach involves allowing and even encouraging the recipient to take as much responsibility for their condition as possible.

A simple analogy to grasp the idea of healthful compassion is aligning being a caregiver to being a parent. As a parent, you progressively teach your children independence; how to abandon diapers, dress themselves, drive a car and manage their own affairs. Fostering their continued dependence on you is detrimental to both parent and child; the parent’s life is controlled by the demands of the child and the child never experiences the freedom of self-reliance. The same is true of a practitioner’s relationship with his or her clients. The more responsibility the client assumes for his or her own state of health, the faster the client’s attitude shifts towards empowerment and the faster the person permits him or herself to achieve a state of well-being.

Codependency

According to the APA Dictionary of Psychology, codependency is a dysfunctional relationship pattern in which an individual becomes psychologically dependent on or controlled by another person, often one with a substance use disorder. Psychology Today further describes it as a dynamic where one person sacrifices their own needs and well-being for another, creating an unhealthy imbalance.

The classic label of codependence often drives individuals toward a career in the healing profession. Initially identified by 12-step programs for addiction and recovery, a person exhibiting codependency tries to control his or her relationships without directly identifying and addressing his or her own needs and desires. By caring for a client excessively in lieu of their own needs, codependent therapists set themselves up to be needed by their clients.

Some signs that you may be headed towards codependency include:

• Your happiness relies upon the health of your clients.
• You are making repeated concessions, sacrificing your own self-care for your clients’ care.
• You feel selfish when putting your needs above your clients’ needs.

Codependency is typically bred from an underlying, unconscious need for appreciation, to be needed and acknowledged, to be listened to and cared for. Recognizing one of these emotional motivations for choosing a profession in helping people is the first step in the practitioner’s own healing journey.

In recent years, researchers have expanded this understanding. Current literature also notes that codependency overlaps with compassion fatigue, where emotional exhaustion and blurred boundaries can reinforce unhealthy caregiving patterns.

Returning Control to the Client

Massage therapists have the opportunity to work with people seeking a new way to relieve pain and restore health. Irony exists in the pain’s purpose. In general, pain serves as an indicator of some type of imbalance. Taking away the pain intended to bring a message to your client may be doing them a disservice. To ensure a therapist’s work goes beyond fixing a symptom to truly benefiting the recipient, the practitioner must develop a deep understanding of themselves and their motivations.

Truly being of service to your clients means allowing them to have pain or discomfort while assisting in figuring out what it means to them. To professionally accomplish this goal, therapists need to set their personal motivations aside from wanting to help in order to remain present with their client. By helping the client listen to the message his or her body is telling, the practitioner gives up the control of healing to the client. Once a client takes ownership of his or her own healing process, the extent of the recovery is virtually limitless.

In order to set personal motivations for healing aside, the therapist must recognize his or her innermost desires and consciously choose to fulfill those desires in ways other than bodywork. An example of this is a therapist wanting to feel appreciated by others for his or her contributions. By making others responsible for your feelings, therapists set themselves up for codependence. Fulfilling this need in a healthy, consistent manner can only come from self-appreciation.

Therapist Self-Care

For the therapist, setting personal motivations aside is different than forgoing taking care of themselves. Consistently putting clients’ needs ahead of their own will progressively drain a therapist’s energy. In turn, sacrificing one’s health and wellness to be of service to their clients, results in the therapist having less to offer. Taking whatever steps are necessary to preserve physical, emotional, and spiritual health is the only way a massage therapist can avoid burnout.

Modern research emphasizes that self-care is also the most effective safeguard against compassion fatigue in massage therapy, helping practitioners sustain energy and resilience.

Boundaries

Making it a top priority to do everything within your power to help clients with their issues can jeopardize professionalism. Wanting so badly to help someone such that it overrides your comfort, time restrictions, scope of practice, or other boundaries makes the therapist vulnerable to ethical breaches. For example, a client in a great deal of pain may request financial exceptions, a technique you are not authorized to perform, or time extensions on the session. Succumbing to such requests can stir up a plethora of ethical dilemmas.

Being 100 percent clear on your boundaries portrays professionalism and self-respect to your clients, which ultimately enhances their respect of you. Practitioners who have codependency issues will find it harder to set and enforce limits without feelings of guilt. Working through these feelings of guilt and commitment to leaving codependency behind will enhance your professionalism, ability to help people, your client’s respect for you and the quality of your own life.

Ethical guidelines highlight that boundary clarity is also a protective factor against compassion fatigue, reinforcing both professionalism and therapist well-being.

Conclusion

Evaluating your motivations for healing will reveal your professional strengths and weaknesses. Once practitioners recognize their propensity toward unhealthful compassion, this self-awareness will begin to shift the unhealthy motivations. Ultimately, returning the power of healing to clients is the greatest gift therapists can offer—both to their clients and themselves, while protecting against compassion fatigue in massage therapy.

Originally posted September 2013. Updated December 19, 2025.

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