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Massage, Sex and Supervision

by Su Fox(more info)

listed in clinical practice, originally published in issue 139 - September 2007

Massage is the most erotic of all the complementary therapies. One person applies smooth, repetitive strokes to the bare skin of another in order to relieve tension and create feelings of pleasure. Sounds like sex, doesn’t it?

Some of the things we do during a massage are very similar to the rituals of lovemaking, so how is it that practitioners and clients so rarely get turned on? Possible hypothesis: it happens, but clients are far too embarrassed and practitioners too scared to mention it, or they tell themselves that it isn’t really happening, a question of mind over matter, a mental cold shower that inhibits sexual response. And obviously, it depends on factors within any practitioner-client dyad that could enhance or detract from sexual attraction. Young heterosexual male client and attractive young female practitioner could be a recipe for disaster. Older gay man with same practitioner – very little chance of trouble.

The massage profession has, by and large, overturned the association between sex and massage as offered in parlours of dubious repute. But I wonder if sex has now become the elephant in the room, something we don’t talk about because we know we aren’t that sort of masseur/ masseusse. Sexual arousal is a normal biological response, yet its occurrence in the treatment room is cause for shame and confusion. This is, I think, one of the areas where supervision is an invaluable resource for the massage practitioner because it offers a non-judgemental relationship where such matters can be discussed and solutions found. Supervision, mentoring or coaching, which are all variations on a theme, are accepted practices, even a professional requirement, in many businesses and areas of the helping professions. CAM practitioners have been slow, I think, to recognize that people whose job it is to help others need support and help themselves.

Case History

Marie, young and recently qualified, had a male client who came for massage because he got stiff hips after his running sessions. Marie knew that she should be massaging his gluteals, hamstrings and quads, but could not bring herself to work any higher than mid-thigh – in case. She took her dilemma to her supervisor, an experienced massage practitioner and also a counsellor, who encouraged her to explore the meaning of ‘in case’. Was Marie worried that she might inadvertently touch his genitals? No, Marie had massaged many men before and had the technical skill to avoid this embarrassment. However, she was attracted to this man and afraid she would get aroused if she massaged close to the tendons around his ischium and ilium. She was afraid that her sexual thoughts were dangerous and she would be banned from practising if anyone found out.

Her supervisor asked whether her code of conduct specifically forbade sexual responses during a massage treatment. After initial confusion, Marie realized what her supervisor was getting at; she wasn’t doing anything wrong if her body had a normal healthy reaction, just as long as she behaved professionally.

Her next concern was, what if he picked up that she fancied him? She had learnt about mindfulness and the possibility that one person’s thoughts could affect another. Together they came up with strategies Marie could use to distract herself from potential sexual responses: focusing on the quality of the client’s muscle tone, or even pretending he was her brother. Finally her supervisor asked whether Marie wanted to stop seeing this client, if the situation made her too uncomfortable. Permission to refer him on was a relief, but Marie decided she wanted the personal challenge of continuing the work, seeing it as an opportunity for professional growth.

This imaginary case highlights some reasons why a supervisory relationship is beneficial for the massage practitioner. It provided a safe, reflective space for Marie to own and explore her embarrassing thoughts and feelings. If she hadn’t done this, there is a possibility that her sexual feelings could have ‘leaked’ into her professional relationship. She could have found herself in a very difficult situation, maybe acting unethically. Supervision helped her to continue working in line with the code of conduct of her professional organization. Marie didn’t just explore her issues; she was also helped to find practical solutions.

How to Find a Supervisor

If someone had good basic training, and keeps up to date with CPD, supervision isn’t necessary to explore practical skills. A supervisor doesn’t have to be a massage practitioner, although an understanding of the therapy obviously helps. It’s relationship matters that supervision can help with; between practitioner and client, practitioner and organisation, clinic, health centre or other place of work, and between practitioner and her own physical, mental and energetic wellbeing.  Counsellors and psychotherapists, particularly body psychotherapists, are trained to do this sort of work, and some also have specific training in supervision.

Practitioners who use writing for self reflection will also find the book Engaging Reflection in Practice by Christopher Johns, reviewed in this issue, an invaluable guide.


BACP (The British Association for Counselling and Psychotherapy)
Chiron Centre for Body Psychotherapy
The Massage Training Institute


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About Su Fox

Su Fox BSc PGCE UKCP Reg MTI Reg CSTA Reg has worked as a complementary therapist and psychotherapist since 1988. For over twenty years she taught massage and related skills in day care centres for the elderly, people with learning difficulties, and mental health issues as well as professional massage qualifications at Hackney Community College. She was director and chair of The Massage Training Institute between  1991 – 2000 and during that time co-authored, with Darien Pritchard, Anatomy, Physiology and Pathology for Massage and authored The Massage Therapist's Pocketbook of Pathology, which has just been revised and reissued as The Massage Therapist’s Pocketbook of Pathology  published by Lotus Publishing.

During this time she was also running a successful private practice in psychotherapy at The Burma Road Practice in North London, focusing particularly on trauma work. She is a trained EMDR practitioner. Su has always believed that the talking therapies need to address the body, and that alternative therapies often failed to consider mental and emotional health, and this led her to write Relating to Clients. The Therapeutic Relationship for Complementary Therapists, published in 2009. In 1993 she added craniosacral therapy to her qualifications and has been a regular contributor to Fulcrum, the journal for the Craniosacral Therapy Association, including a series entitled ‘In The Supervisor’s Chair’. She currently serves on the supervision committee for the Association.

Her current interests are spirituality and its contribution to well being, and the psychology of the ageing process and end of life issues. Su can be contacted via

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