Ethically Speaking: The Power of Trust
by Dianne Polseno, President of Cortiva Institute
Trust: such a meaningful word in our
English language. Webster’s Dictionary communicates its significance by
defining it as “A confident reliance on the integrity, truth, honesty,
sincerity, or justice of another.” In this definition,
observe the way Webster insinuates that the person who is trusted is
just, honest, sincere, truthful and deserving of the confident reliance
of another. As massage therapists
and bodywork professionals, are we fully mindful of the power clients
give us when they trust us? Moreover, are we attentive to our ethical
obligation to be trustworthy?
Dr. Angelica Redleaf, in her book entitled Behind Closed Doors: Gender, Sexuality, and Touch in the Doctor/Patient Relationship, says that there are six factors for safe practice, the first of which is the “Trust Factor”.
Of it she writes, “Trust is a precious and fragile commodity that is
hard to win yet easy to lose. You have a fiduciary relationship with
your (clients), and this means that you have agreed to set aside your
own interests in order to do what is best for them. You must
put their comfort and welfare ahead of your own wants and needs. Your
personal agenda must be left on the other side of the closed door. This
is the obligation of all health-care providers.”
Even before they know us or know if we are trustworthy, clients
place a certain amount of trust in us and in our abilities when they
allow us to massage them. They trust us with their personal and medical
information, their stress, their fears, their injuries, and their pain.
They trust us enough to lie down, often unclothed under draping linen,
while we stand over them for the duration of the treatment. They trust
us enough to let us touch their face, their abdomen, and their painful
places… they trust us enough to let us touch them.
It is during the first moments of the time we spend with a client that
we must authenticate that initial investment of trust they place in us.
Our demeanor, appearance, language, touch, and very presence must
communicate that we are trustworthy and safe. If we miss this
opportunity, or to fail the client at this critical time, we may
actually do harm to the client, to our own reputation, and to the
profession as a whole. At the very least, we forfeit ever winning that
“fragile commodity” called trust which Dr. Redleaf speaks of.
On the other hand, if we establish and continue to inspire a
client’s trust, we can cultivate fertile ground for a unique exchange
of healing intimacy to occur. Trust, or confident reliance in who we
are and what we can offer a client, is the cornerstone of such healing
intimacy. We, in this fiduciary relationship with our clients, must be
prepared to take responsibility for the full extent of what this can
mean. When clients trust us, they take the advice we give, they buy the
products we recommend, and they value and count on our opinion.
Two particular clients come to mind when I think about the extent of
the responsibility I have to ‘measure up’ to the trust and reliance my
clients have placed in me over the years. A client in his mid sixties
was seeing me regularly for massage because of a back problem. He had
been diagnosed with a herniated disc at L4/5 two decades ago, and
surgery had been discussed more than once. Not wanting to undergo
surgery, he learned to live with the pain. When he found massage therapy,
he realized that he could manage his pain more effectively. Gradually,
though, the pain worsened as osteoarthritis complicated his condition.
He called me one day and said, “I need an appointment to talk with you.
My neurologist is recommending surgery, and I want to see you to talk
it over before I make a decision.” I questioned why he felt it was
important to talk to me, and his response was simply, “I trust you.”
When I asked him to elaborate, he said, “You’ve helped me more than
anyone or anything else, and you explain things to me in ways that I
can really understand them. I want your input.”
His statement made me recall our first conversation when I explained
to him why I needed his doctor’s opinion as to the advisability of
relaxing the muscles of the spine that were splinting the compromised
spinal segment. I also remembered the times in my office that I had
pulled out my anatomy books to show him what intervertebral discs look
like when they’re healthy and when they herniate, and to show him the
muscles I was targeting in the massage. I also thought back to the many
visits when he limped, in pain, into my office, and walked out
straighter and easier. I understood better what he meant when he said
he trusted me, and I knew that my input had to be knowledgeable, sound,
trustworthy.
Another of my clients is a surgeon. He initially sought out massage
to help him with his neck and upper torso pain from standing in
positions that were taxing to his posture while he performed surgery.
In conversations during his massage treatments,
he insinuated that he didn’t have much knowledge about, or faith in,
chiropractic. In these past six years of receiving massage on a regular
basis, he has developed trust in massage, trust in my palpatory skills,
and trust in me, to the extent that he was willing to see a
chiropractor for his recent bout with persistent neck pain. His words
to me were, “If you recommend that I go, I’ll go. I trust you and your
judgment.”
This same client also asked me to evaluate a member of his family
who had injured her neck and shoulder while skiing. She had run the
gamut of traditional medical testing and specialist-hopping to get a
diagnosis and have her pain resolved. No one could diagnose or pinpoint
the cause of her pain. My client, being a physician himself, was
concerned about her pain and wanted to help steer her in a more helpful
direction. He asked me to evaluate his family member because he trusted
my palpatory skills. He said, “I know what the X-Rays, MRIs and CAT
scans say; now I want to know what your hands find.” It turned out that
massage was not effective for her problem, but I was able to report
what the affected tissues felt like. No one
else had touched her, so no one else had palpated the area. In fact, no
one person had spent more than 10 minutes with her. It turns out that a
combination of chiropractic and physical therapy has brought her relief.
My clients have taught me that while it may be easy to trust massage
(after all, massage feels so good!), clients must learn that I am
trustworthy. It is I who must teach them. It is a great privilege to
have a license to touch people in a society that is ill at ease with,
and has so little time for, touching. At the same time, it is a
profound responsibility that continues to bring me to become my best
self.
The New International Webster’s Comprehensive Dictionary of the English Language. Naples, FL: Trident Press International, 1996, p. 1349.
Redleaf, Angelica, with Susan A. Baird, Behind Closed Doors: Gender, Sexuality, and Touch in the Doctor-Patient Relationship, Westport, CT: Auburn House/Greenwood, 1998, p. 177.
ibid
