Kathleen Strauch, JD, is the chairman of the IASI Ethics Committee. Her education includes a BA from the University of Michigan in Mathematics and Psychology, a law degree from Wayne State University, basic structural integration training from the Rolf Institute®, and advanced SI training from the Guild for Structural Integration. She is a Board Certified Structural IntegratorCM. Her first course in ethics was “Law and Bioethics” in 1975. She practices in Michigan and can be reached at kathleenr[email protected].
Editor’s note: The author hereby grants permission to copy this article for purposes of teaching ethics.
We are all familiar with the rule that says sex with clients is prohibited. But beyond the prohibition of sex, what relationship boundaries are recommended? In a discussion among Ohio bodyworkers, it was proposed that ANY deliberate meeting—for coffee, for dinner, with a meal or without—should be delayed for at least a year after the client relationship has been terminated. Also, the intention for the meeting should be voiced. This restriction met with some resistance, because many connections are started with a session, especially among fellow bodyworkers. But with the intimacy created by a structural integration session, maybe this interval would be advisable. And here, I use intimacy in the context taught in some workshops, “in-to-me-see.” Many of us would like more intimacy in our lives, but in the context of a session, this is one-sided. The client shares with us, but our own sharing might be limited to that which will facilitate the client’s growth. Our job is to allow the client to take that potential for more intimacy into their own lives.
This is one aspect of the boundaries that we can create while working with clients.
The Code of Ethics, which all members agreed to abide by, states we are to:
This code is a guide for members; situations must be evaluated in their entirety. The goal is to allow clients to be reasonably comfortable with the growth inherent in the SI process, without encouraging us to be codependent. In my training as an attorney, the guide was to “avoid the appearance of impropriety.” But in an SI practice, the relationship between practitioner and client can involve transference and counter-transference. As the educated party, it is our job to establish professional boundaries, even if the client seems to want to establish looser ones. The result of intense positive transference is often a subsequent negative transference. If we can manage the first, we may avoid the negative consequences of the second.
Interpretation of points 1 and 2 in the code, when taken to a deeper level, can provide an interesting quandary: How many of us, when in training and standing in front of the class in our underwear, experienced some degree of emotional risk? But weren’t we, in the end, empowered in our growth and evolutionary process? Communication is the key. I always warn new clients that this work is different than massage; that I will be having them walk around in their underwear to evaluate their movement patterns; that I ordinarily do not use draping while they are on the table because I am watching for changes in other parts of their body. But if I sense reticence or discomfort, I modify what I do or suggest that they wear loose shorts (and a tank top for women). Sometimes I even ask if a teenage boy might be more comfortable with a male practitioner.
As modeled by my original Rolfer™, I take the time to get to know a new client before having him undress. For me, this involves having him fill out a four-page questionnaire of health history, then look it over and possibly ask more questions, especially about the details of accidents, history of cancer or osteoporosis, and any areas of his body in which he is, in some way, extra-sensitive to touch. I can leave the room while clients are undressing. I also check on allergies; I have cats and some people are so sensitive that I need to change into clothes I keep at the office. I also check for allergies to latex, scents, and lotion I might use on my hands.
The questionnaire asks about any history of abuse and about the client’s comfort-level in his body. If I have a sense he has a forgotten history, I leave it alone; if it is time for it to surface, it will on its own.
If he shares an intimate history, I do not write down the details. We do not have the same legal protection against disclosure of records through subpoena as psychotherapists have. I also ask if he is in therapy, if he has a medical doctor, and if he has shared with these individuals that he is undergoing structural integration.
As I approach the work, I will verbally warn the client as I approach possibly threatening areas, such as the upper attachments of the adductors, the gluteals and deep rotators, pectoralis minor and the upper attachments of the hamstrings, even the rectus abdominus. This might be too picky for some, but other clients might prefer standards of communication as extreme as those found in ‘The Antioch Rules’ which requires a detailed “ask-before-you-touch” policy for on-campus interactions. I am often amazed that someone who has not received much bodywork experiences this more extensive work as actually inside an orifice! To avoid that impression, I will tell them exactly what attachment I am handling.
Finally, I try to dispel any notion that clients “shouldn’t complain, because it is supposed to hurt.” I use a one-to-ten scale, where 10 is “as intense as you care to experience” and ask clients to let me know if it reaches an eight. I check if they are holding their breath (or if I am) and get them to “breathe into the area of pain.” I emphasize that I am not doing anything TO them, I am always doing WITH them what they allow to happen. All too often, the client has tried to tell me that he cannot complain because I’m the expert. WRONG!
Communicating the intent and purpose of our touch is very different than communicating the latest workshop or a history of personal growth to our clients. When I trained, we were encouraged NOT to try to enroll our clients in our latest multi-level market product. Nor were we advised to encourage clients to sign up for some program from which we benefitted in the past. It is important to remember that the vulnerability in this relationship goes mostly one way; some clients want to look up to us as a doctor or as their latest guru. It’s up to us to set good limits and to remind the client that he is really the one doing the work. We are the mechanics, simply tuning the vehicle of the human vessel.
The Standards of Practice also provide that we only give services for which we are trained, keep client confidences, and do not misrepresent our accomplishments and qualifications. It also asks us to address another member whom we believe to be in non-compliance with our Code of Ethics and possibly file a complaint with IASI if our concerns are not properly addressed by speaking with a fellow member. In other words, we are self-monitoring, not just by the Board or the Ethics Committee, but by each member at a local level.
Practitioners are also to comply with national, regional, and local criminal codes. In some states, “practicing massage without a license” is part of the criminal code and all forms of touch are defined as massage, except for exempted professions such as chiropractors, physicians, nurses, salon employees, etc. This is why our legislation committee (mostly a one-woman dynamo) works hard to ensure exemptions for structural integration practitioners. Even with this exemption, practitioners working out of their home may be in violation of zoning ordinances.
The security of establishing clear boundaries will enhance your practice, allow clients to feel safe, and instill trust in your professionalism among other disciplines, as well as any legal entities which may become aware of your practice. Furthermore, it allows you to maintain your own center, the position of the observer, noticing the energy of your client, but not being controlled by that energy. If the client experiences a deep process, it gives you an opportunity to suggest between-session exercises, journaling, or simply that the process will continue without your input, reminding the client of his own strengths and resourcefulness.
The ethics committee is not here to evaluate your practice and professionalism, rather to advise and guide any member who has questions or concerns about his own practice or that of another practitioner. Other members of the committee are Breta Stroud, a massage therapist, KMI Graduate, and Board Certified Structural Integrator CM; and Les Kertay, a psychologist who has been a member of the Rolf Institute® for 32 years. Both contributed to this article through their comments.Ethics Outside the Box[:]
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