Using Accurate Language, Thinking Accurate Thoughts: Why Words Matter

Massage is older than humans. Monkeys will often groom another monkey when it becomes agitated. Nit-picking among primates is not just a matter of hygiene, it's a manner of soothing and bonding. All mammals engage in some sort of stroking of one another. Tigers lick their cubs, rats lick their pups. We are biologically wired to respond to touch, to stroking. Massage has been with us since we humans became human, since before we had language. It comes naturally to us.

We take its benefit for granted. We know, from direct experience, that it feels good. 

How we first spoke about massage

We know that systematized approaches to massage have been around for a long time. Hippocrates made mention of "rubbing" and its use by physicians. Ancient Egyptian decorations depict massage and ancient Chinese texts describe it. In more recent times, what we have come to call "Swedish massage" began to be organized as an approach during the 19th century. 

Whatever its roots, we notice repeatable effects when we stroke the body in various ways. Some types of stroking can feel invigorating. Others may feel soothing. Some make the skin turn pink and warm. Massage can be relaxing to the point of being almost hypnotic for both the recipient and the practitioner. As humans, we like explanations for the changes we see and feel. Until recently, those explanations had to come from the outside and were often made by people who had little knowledge of physiology. As our ability to understand the processes of the body has advanced, some of those explanations have had to fall away. That's okay. The experience remains the same. We know what feels good to us. Our explanation for why it feels good may change as our knowledge changes, but the feel-good part is not usually dependent on our explanation.

Possibly because of our pre-scientific (and even pre-human, pre-language) origins and our roots in folk medicine, the modern language and culture of massage has not been particularly focused on accuracy. Until recently, most states in the U.S. did not regulate massage or the training of massage therapists and so massage therapists often came to the field with little understanding of how the body actually worked. Before licensing, many were taught from a purely aesthetic point of view with little or no regard for the biology of the body or of touch.  As our understanding of the internal workings of the body evolves, as more and more people make use of massage, and as massage therapy begins to take a place in health care, having an accurate understanding of how the body works and how our touch can affect it becomes ever more important.

We want our words to be true so that we can be trusted.

We want our words to be accurate so that people know they can trust us. We want our language to reflect what is actually happening in the body so that our thoughts can be based in reality, so that we can communicate with each other and understand each other. 

Currently, training for massage therapists in the U.S. is measured in hours. Five hundred hours is common, some states require more. That does not leave much time to devote to understanding the details of how the body works and developing an accurate understanding of it. Many massage therapists have to learn this on their own outside of their initial training. As a result, they can have vague and inaccurate ideas about how the body works and how we affect it.

Language is important. We use language to formulate our thoughts and to convey them to others. When our thoughts are vague and unclear, our language is vague and unclear. If our thoughts are inaccurate, our language will be inaccurate. When we are learning something new, our concept of what we are learning is inevitably limited and imprecise, but our goal should be to become more clear and accurate over time. As we learn more, our mental images and understanding become clearer. Our language becomes more precise. We are better able to communicate our ideas to others. We are able to make finer distinctions and to understand in more detail. The more accurately we understand how the body works and how we can affect it, the greater the potential that we can help our clients achieve their goals, whether it be for pain relief or relaxation. 

Sometimes therapists do not understand the value of accurate words. They may witness a vigorous and detailed discussion of therapists who appear, to them, to be "arguing over semantics." While sometimes people do engage in pointless arguments over language, more often these therapists are trying to better understand how the body works. In the process of engaging with each other and trying to get the words right, they are trying to get their thinking right. 

Words have meaning and the words we choose should be chosen thoughtfully and carefully so that they accurately convey our thoughts. As professionals, we should be committed to having accurate thoughts about our work and speaking in a manner that represents our thoughts. We should be continually learning, continually deepening our understanding, continually engaged in the process of getting our thinking and our language right. This is what learning is about. It is a life-long process. 

How long does it take to become a massage therapist? Your entire life. 

Unfortunately, the importance of language and clear thinking has often been undervalued in our profession. Vague and inaccurate ideas, vague and inaccurate language, is considered acceptable.  If our profession is to move forward, we need to think and speak more accurately and use language with more precision. This is what is needed to be true professionals.

Thinking accurately about physiology

There are two areas in particular where massage therapists tend to become vague and inaccurate in both their thinking and their language. One is in the area of physiology. In spite of most therapists getting a basic education in physiology, often their understanding is vague. They sometimes don't make the connection between some ideas that are popular in massage and how they contradict what they learned in physiology class. Massage therapists may make statements to the effect that massage may "squeeze toxins" or "waste products" out of muscle tissue without considering whether that makes sense. They are forgetting what they learned about the structures and workings of cells. They are forgetting that muscles are not like kitchen sponges. They aren't thinking about how, when we sit, we apply pressure to our bottoms for much longer periods of time than we do during massage and it doesn't seem to squeeze anything out of the tissue in our bottoms. It's a kind of sloppy thinking and sloppy language that is, unfortunately, too common. It doesn't serve us well to think in such inaccurate terms and, in fact, it holds us back. By accepting this picture as accurate, we do not go on to think about what actually does happen in the body when we push on it or stroke it. If we repeat these ideas in the presence of other health care providers who have a better understanding of how the body works, it lets them know that we don't know what we are talking about. We cannot expect them to consider the possibility that we could be a valuable member of the health care team. In fact, they would be irresponsible to refer patients to us. So, it benefits us, our clients, our relationship with other health care providers, and our profession when we educate ourselves to understand how the body works and to speak about it accurately. When our clients and other health care providers see that we do understand how the body works, they can trust us. 

Speaking accurately about the psycho/social aspects of massage

Another area where we need to strive for more accurate language is in the area of the emotional and psychological aspects of massage. In pre-modern times, vitalism was popular and still is believed in by many massage therapists in spite of the lack of evidence to support it and a significant body of evidence to refute it. Clinging to implausible and indefensible explanations in the face of very good natural explanations is damaging to our credibility. While some massage therapists are letting go of vitalism, they sometimes cling to to the language and ideas of it to describe the emotional and psychological components of massage. They do not realize there is better, more accurate, and more expansive thinking and language available. Like the fuzzy thinking around physiology, this perpetuates inaccurate beliefs and holds us back from more deeply understanding the effects of massage, thus depriving our clients of its true benefits.

There is no doubt that both clients and therapists can have interesting, sometimes unusual, sometimes very meaningful internal images and feelings and emotional experiences during a massage session. Some of them can seem very externally real. One of the things we know about the brain is that, in the absence of stimulation, it will create its own stimulation. This is not a strange or foreign idea. Those who practice meditation are familiar with this phenomenon. Experiments with sensory deprivation tanks demonstrated that, deprived of stimulation, the brain could manufacture some very unusually and vivid subjective experiences. It is not surprising that both the therapist and the client, who are often in a quiet room with subdued lighting and quiet, soothing, sometimes hypnotic music, might find their brains producing effects that are different than the external, observable, objective reality. Both client and therapist, in such an intimate and relaxing environment, may experience emotional and psychological effects that may be purely personal or even shared. This, again, is not strange and is something massage therapists should understand so that they can protect the integrity and safety of both client and therapist. Deepening our understanding of and appreciation for the emotional and psychological aspects of massage, and even the aesthetic aspects of massage, does not detract from it in any way. In fact, as with the biology of massage, greater understanding enhances our appreciation of the process and may give us tools to better serve our clients. 

When we use vague language and magical thinking to describe the rich variety of emotional experiences, reducing them to a simplistic "exchange of energy" or referring to them as "energetic" experiences, we hold ourselves back from true understanding of what is happening and limit ourselves. It is the equivalent of thinking that our muscles are sponges that we can squeeze the yucky stuff out of. It perpetuates the discredited ideas of vitalism. Like inaccurate ideas about physiology, it interferes with our ability to communicate with other health care professionals and erodes our credibility before those who know better.

The study of the brain and its workings is amazing and of immense benefit to massage therapists. Studying psychology, the psycho/social aspects of pain, the nuances of human interpersonal interactions, and neuroscience (which is not as scary as it sounds, is fascinating and actually very accessible at its most fundamental levels) are rich areas to explore and very relevant to massage therapists. By having more accurate understanding and more accurate language to describe the experiences encountered by client and therapist, we can only enrich and elevate the practice of massage. The language of "energetics" holds us back by keeping us stuck in vague, false thinking that doesn't go anywhere. 

Clear and accurate language and thinking serves us no matter what the setting or goal

Massage is practiced in many different types of settings with many different goals in mind. A ten minute pre-event massage with an athlete at a noisy, outdoor competition is different from a quiet, relaxing, 60 minute session in a private massage office. An orthopedically oriented session in a physical therapy office is different from a session focused on caring attention and compassionate touch with a terminally ill hospice patient. The practice of massage encompasses a wide variety of applications. Biological, psychological, and social factors are at play in each one of them. All are important, all need to be understood, and they need to be understood clearly and accurately for us to provide the most benefit to our clients. 

Knowledge will not make us less effective. How we think and the words we choose to use do matter. We have nothing to lose and much to gain by striving for accuracy in our thinking and in our language. It is good for us to try to get it right. We will never have it completely right, but we can strive to become less wrong over time. This is what will move us forward, individually and as a profession. 


Submitted byJason Silverna… (not verified)on Sat, 05/18/2013 - 4:36am

Great post, Alice. You might like this quote: "To speak or write in wrong terms means to think in wrong terms." - Geoffrey Maitland PT