Massage Therapists, Are You Tired? Presence and Boundaries to Avoid Burnout

A review of Healwell's "Presence, Boundaries, and Emotional Resiliency" webinar

I recently earned a continuing education credit through ABMP's website by watching a recorded webinar called Presence, Boundaries, and Emotional Resiliency, led by Cal Cates and Kerry Jordan of Healwell. Healwell is an organization that trains massage therapists to work with clients in serious suffering, including hospital settings, oncology, and end-of-life care. I went in expecting a standard ethics module that would be about strict boundaries and rigid professionalism, but their topic was more in alignment with how I manage my Las Vegas massage practice. Cal Cates opened with something I wrote down immediately: "If you can't practice with presence, boundaries, and emotional resiliency, it will be hard to do anything else in your massage practice."

Las Vegas Massage Therapist, Christina Aldan's Certificate of completion for "Presence, Boundaries, and Emotional Resiliency" course by ABMP

Boundaries Matter

Most of what massage therapists are taught about boundaries follows a familiar script: be the expert, stay in control, know what's coming next, follow the rules. There are good reasons for that framework, I get it. It protects clients and practitioners by creating structure in relationships that might otherwise get murky.

But Cal and Kerry pushed on something I've always felt: hiding behind that version of professionalism… the "if I prepare well enough, pain won't happen" version is exhausting, and a little dishonest. Because a lot of things aren't fixable. And our presence alone, without a perfect plan, is often enough. If there’s anything I’ve learned from speaking about leadership and emotional resilience on stages in various cultures around the world, it’s that being completely present in someone’s vulnerable moment is “enough.”

They referenced Dr. Rachel Remen's essay "In the Service of Life," which draws a distinction between helping and serving. Helping positions the practitioner as the expert who fixes things. Helping incurs debt. Whereas serving positions both people as human beings working together, where surprise is allowed, where control is acknowledged as the illusion it is, and where the relationship has room for something unexpected to happen. Helping is a form of judgment, creating disconnection. Serving opens us to surrender and awe, fostering connection. The presenters were clear about which approach is more beneficial to clients.

"We are not the same person day-to-day. We can't shut ourselves off from that experience and still be present at the same time." — Cal Cates, Healwell

The Stories We Tell Wear Us Out

One of the most useful threads in the webinar was about the internal narratives massage therapists carry into sessions. "This is tragic." "This client shouldn't have cancer." "What if my plan doesn't work? What if I cry? What if I can't ease their pain?" Cal named these stories plainly and then asked:

aren't you tired?

Because the stories are exhausting. They pull us out of the moment and into a kind of anxious performance of competence that doesn't serve anyone. Spending energy resisting the fact that things are hard, or that some situations are genuinely sad, doesn't make us more effective, it makes us more depleted. And the research on nurse burnout backs this up: burnout isn't primarily caused by a stressful environment. It comes from pretending the environment isn't stressful. "Holding it together" is precisely the thing that breaks people down over time, not the blood and guts, or the pain and death.

I’m lucky in that I was able to take a Healing Hands Seminar with John Barnes where he stressed the entire weekend, the importance of walking into the massage room with neutrality. I have strived to be fully-present from day one of deciding to become a massage therapist and stepping into the classroom and earning my license. There's a difference between having a feeling and being swept away by emotions vs. holding space for them, and the webinar was asking us to practice the latter without always defaulting to suppression.

Into the Fire

Cal and Kerry quoted a Wendell Berry poem during the webinar that landed for me:

To go into the dark with a light is to know the light. To know the dark, go dark, go without sight and find that dark, too, blooms and sings and is traveled by dark feet and dark wings.

In our home, my life partner and I call that going into the fire. The instinct to run from suffering is natural. Going toward the discomfort, sitting with it without trying to solve it, showing up to the moment as it is, that's the practice my spiritual teachers have encouraged. That John Barnes encouraged. Not because it feels good, but because it's the only thing that's sustainable. And clients can tell when you’re bullshitting. They can tell that the massage therapist isn’t ok, when they are suppressing emotions and say, “I”m fine. This is part of the job.”

You can be with someone who is suffering without becoming part of the suffering. That takes practice and it doesn't happen automatically. The webinar's argument was that it's a learnable skill, and the place to start is small: notice your pace in a given moment, notice where you're putting undue pressure on yourself, notice what you're trying to control that you can't. Let some of it go. See how that feels in six months.

Your Body Knows

Kerry Jordan brought in the somatic piece toward the end, and it connected directly to how I think about my work. Your body is the seat of intuition. It can only ever be in this moment. Every emotion has a physical sensation before it has a name. When we learn to read those sensations in ourselves, we get better at reading them in our clients, and we get better at not carrying them home.

Their practical suggestions were genuinely actionable. As a long-time presenter myself, I prioritize leaving actionable strategies for the audience. Cal and Kerry suggest: instead of reacting immediately to a stimulus in session, pause and notice. Don't try to make it perfect. Let go of "should." Stop judging your own responses and start observing them instead. "Humans are interesting" is a more useful frame than "I'm doing this wrong."

What I'm Integrating Into my Las Vegas Massage Practice

I've been a bodywork client for decades, as well as a Las Vegas massage therapist so I understand bodywork from both sides. I know that the massage therapists who last are not the ones who are the most technically perfect. They're the ones who figured out how to stay present without pretending, how to hold space without absorbing everything, and how to keep showing up to moments they can't control without letting that uncertainty grind them down. That’s how they avoid burnout and protect their body/mind/spirit.

That's what this webinar was about, underneath all the ethics language. Not a checklist of professional dos and don'ts, but a genuinely different way of thinking about what it means to show up for another human being. And if you’ve watched any of my keynotes, you’ll notice the same underlying theme.

If you want to explore Healwell's work you may find them at healwell.org. Cal and Kerry are doing something important over there. And if you're in Las Vegas and want to work with a massage therapist who thinks about this stuff, book a session with me. And find me everywhere online as @luckygirliegirl.