East Versus West in Massage
Thai Massage and Western Massage are quite different, and in more ways than in their techniques. In Western countries, there is an ongoing effort to prove scientifically how and why massage is beneficial.
Most of the massage therapy profession has accepted science as their official or at least unofficial regulator.
Therapists feel compelled to demonstrate that their therapies hold up to the demands of science, and that they comply with scientific standards.
What do massage therapists have to do to not get sued?
Western therapists have to function within the framework that the effectiveness of massage has to be proven by scientific methods in order to prevent allegations of unproven, unscientific, or unsubstantiated claims in regards to the therapy.
Wow – what a mouthful that was! If you think I am exaggerating, read some of the disclaimers on massage intake forms that you have to fill out before you receive a session.
Massage therapists in the West go through great lengths to state that they do not fix, cure, diagnose, treat, prescribe, or improve any medical condition, and that only doctors can do such things.
Gasp! I know, they have to do that so that they don’t get sued.
Common sense to the rescue
Let’s use some common sense here. Before the advent of medical science, people all over the world were treated with all kinds of natural and traditional therapies and remedies.
Sometimes they worked – and sometimes they did not.
Today we have modern hospitals. Sometimes their therapies work – and sometimes they do not.
The one big difference is that hospitals and their treatments, medications and procedures are one of the leading causes of death in the US.
In comparison, tell me how many people died on massage tables!
Does anyone really believe that a well-trained massage therapist who has maybe a decade of experience of working with and directly touching hundreds or thousands of people cannot ever improve any medical condition?
Compare that to a typical doctor who is forced by the insurance companies to spend as little time as possible with patients, who hurries into the room, and then spends five minutes with you without hardly touching you at all.
And then they leave you with a prescription of chemicals which they often know very little about except what a pharmaceutical rep told them.
My disclaimer about medical science
I want to put it on record that I have the greatest respect for many incredibly useful medical procedures.
Modern doctors can do amazing things when they stitch together victims of horrible accidents, or enable amputees to function again, or replace worn out joints.
But at the same time, the track record of modern medical science for curing most chronic and immune system-related diseases is very poor.
Massage in Thailand is very different
Now let’s compare this to the Asian model, especially Thai Massage. In Thailand generally nobody has to fill out intake forms, nobody sues massage therapists, and no therapist has to comply with scientific demands.
Massage therapists or other natural healers can diagnose conditions to the extent of their knowledge, and they can treat such conditions to the extent of their abilities.
If what they do is not working, then clients vote with their feet. They go to another Thai Massage therapist, or they try their luck elsewhere, like in a doctor’s office. Or they can do both.
No Thai Massage therapist has to explain scientifically what exactly their therapy is doing. No client expects that either.
The foundation of Thai Massage
The therapists don’t know anything about the science behind it because the entire model of Asian natural medicine is not so much based on anatomy, physiology, and science.
Instead it is based on invisible energy flow and energy lines that cannot be seen by the eye, nor through a microscope, nor can they be detected in a test tube.
But the energy can be felt by experienced therapists, and it can be affected by Thai Massage treatments.
Can Thai Massage fix or cure anything?
From my vantage point of having lived in Thailand for two decades, I know from personal experience that Thai Massage can and does improve many conditions. Some of those cannot be improved by medical science.
After all, a stiff neck is certainly better treated by massage therapy than by chemical muscle relaxants.
And stress, a leading cause of so many diseases, is treated more effectively by massage than by chemicals.
Here in Thailand, everyone knows that some massage therapists are fairly useless while others are incredibly good and effective.
So – people who need quality health care simply go to the good ones.
Here Massage is not a luxury treatment like in western countries. Most people in Thailand can afford a massage without breaking the bank.
There is no competition here between massage and medical science. They coexist quite peacefully.
East and West can help each other out
Does this mean that everything is better in Thailand? No, that’s not the point. We are comparing two very different systems.
But one thing is sure – it is definitely more relaxing and much easier to deal with the massage system in Thailand.
The Asian model could benefit from some western input like more anatomical knowledge or more exposure to additional healing therapies that are more widespread in western countries.
And the western model could benefit from the more energy-focused and holistic approach of eastern therapy.
Massage in Thailand is easier, cheaper and often more fun
Anyone who has ever been in Thailand knows the great feeling of being able to get a full body massage or even a quick foot massage almost anywhere and for very little money.
You can get treatments on the beach, on the sidewalk, in open-air massage shops, in temples, in busy markets and malls, in airports, in spas, or in your own home.
Nobody has to worry about privacy since it is all done fully dressed. Intake forms do not exist and neither do legal threats.
Ethics rules are very flexible since massage in Thailand is often as much a social event as a therapy.
You don’t have to budget a session since you can get one starting from US $5.- per hour.
Some things in life are better felt than explained
In Thailand people generally don’t discuss the scientific benefits of massage so much. They just know from personal experience that it works.
After all, when you fall in love with someone, would you feel better if you would know exactly which neurons fire, which nerves send your feelings to which place, and how much your skin temperature changes in passionate moments?
Some things are better experienced than dissected. Or, in other words, the experience of Thai Massage is more important than the science behind it.
For you, if you must know the science, at least make sure you don’t think about it during your session. You will feel and benefit more that way.
How can you learn authentic Thai Massage?
Thai Healing Massage Academy provides a wide range of online training courses that are tailored to western therapists, yet incorporate the energy focus and holistic approach of Thai Massage in Thailand.
The author, Shama Kern, has been practicing and teaching Thai Massage for 2 decades. He is the founder and director of Thai Healing Massage Academy and the creator of 20 Thai Massage online training courses.
Nice article, Shama! And it’s not just Thailand where it’s like this. It says a lot about Western culture, particularly how things are in the U.S.
I started practicing in the U.K. over 20 years ago, after training in India. That was quite an eye-opener, and over the years, now practicing in the U.S., things have got progressively more restrictive.
Thanks for your comment Jyoti. I spent most of my massage career in Thailand, so for me it seems cumbersome and unnatural to have so many rules and restrictions and forms and disclaimers and all that. I am used to a free-flowing way of practicing. I understand (some) of the reasons for all the rules, but there is the risk that at some point instead of the rules serving us, we end up serving the rules. This is a delicate balance. If we look at history, generally rules create more rules, until the system starts choking on itself. I hope that massage therapy can avoid this scenario and maintain its beautiful spirit.
Unfortunately it is the massage schools that play a big role in getting the state to mandate all of this nonsense. Not to mention the sue happy culture that we live in today. Just one more reason I love Thai bodywork, anyone can do it! Really enjoying the videos Shama. good stuff.
Kimberly, I am glad you enjoy my Thai Massage video course. I am working on a Heavenly Head Massage video course and on a Rocking Massage Therapy video course. I love making these courses.
It is quite refreshing to be in Thailand where we don’t have to comply with a plethora of rules for the healing arts. But to be clear, the Thais do have to get official training and a massage licence to practice, and the schools need to be officially certified to be able to teach massage. But aside from that, there is no matrix of rules to encumber them, luckily.
Hi there,
thank you for the article. It is true, here in the states the regulations have much more to do with profit than with public safety. Large corporate massage schools benefit from ever more regulation and higher educational hours requirements; they use fear to drive states more and more regulation of the industry, which in turn requires massage to become an increasingly medicalized art form despite the constant need to say we are not doctors. They want to have it both ways, so there is a strange disconnect between the medicalization of massage and the insistence that massage therapists cannot diagnose or “treat”. Following the money is illuminating; not only does it show who benefits from all this regulation and law suit fear, but when you consider that you can get millions of dollars of insurance for your massage practice for a couple of hundred dollars a year, it becomes clear that massage is not a high injury dangerous practice. Insurance companies simply do not give that kind of coverage for an industry that is dangerous!
I would like to point out that with Thai massage, there actually IS a vast medical knowledge base behind it; it is more than energy work, and the therapy is no mystery to a traditional Thai medicine practitioner who understands the traditional medical theory behind the work. True traditional Thai medicine practitioners do indeed understand anatomy and physiology; although the language they use to describe it does not always immediately match western scientific understanding. Traditional medicine speaks of balancing the elements within us; which can seem unscientific at first glance, however the deeper your understanding of the theory, the less conflict there is between it and western science.
Most western practitioners of Thai massage are not taught the underlying theory, or if they are, it is quite limited. Hence we think that sen lines are not anatomical, or that the elements exist only on an energetic existential kind of plane. The deeper one goes into Thai medical theory, the more nuts and bolts it is, without losing any of its beauty and mystique.
I think that your points about the fear based approach seen in the states and the more casual acceptance of the validity of the work found in Thailand are important, and I thank you for the article.
Hi Nephyr,
thanks for your in depth comment. You shared a lot of good points. I like your observation about the disconnect between the medicalization of massage and the insistence that massage therapists cannot diagnose or “treat”.
And you are right, Thai massage is not just energy work, there is medical theory behind it. However the average Thai massage therapist in Thailand does not know much about that since very few of them have gone through the in depth education required to learn about it.
There are those practitioners here who do understand Thai massage on a deeper level, but with mass tourism there has been a proliferation of Thai massage therapists here in Thailand who just have fairly superficial knowledge.
In recent years the Thai government has instituted higher educational standards and licencing requirements for Thai Massage therapists, but like many laws in Thailand, this is not enforced very much.
And like you said, westerners are not taught the underlying theory. I think there are two reasons: Most schools do not have teachers who have this knowledge (since every corner massage store here functions as a “school”) and even if they do, they are not able to communicate it in English.
There are educated therapists who actually have undergone lengthy schooling, but your average Thai massage therapist in Thailand cannot afford the cost and the time that such training requires.
A high percentage of Thai massage therapists in Thailand come from Isaan, a province with very few job opportunities compared to the more prosperous areas. Many move to the larger touristy towns, and for them Thai massage is a way to make decent money with a very short learning period.
So the economic realities here do not allow easy access to lengthy and more in depth education. But again, as you pointed out, the knowledge does exist and there are therapists who do understand anatomical principles.
So Thai massage is not just energy work, but the component of energy work adds a lot of value to this modality in my mind. It gives it more “heart” compared to the more clinical approach in western countries.
Whenever I hear about the state of affairs in the west regarding rules and laws and the influence of the big massage schools, I am very glad that I live in Thailand.
Thanks again for your well thought out comment (more of an article in itself). If you ever feel like writing a guest post for my blog, I would be happy to publish that.
What a profound and meaningful article, Shama.
I was especially moved by this section,
“From my vantage point of living in Thailand, I know from personal experience that Thai massage can and does improve many conditions. Some of those cannot be improved by medical science. After all, a stiff neck is surely better treated by massage therapy than by chemical muscle relaxants. And stress, a leading cause of so many dis-eases is treated more effectively by massage than by chemicals. Here in Thailand we all know that some massage therapists are fairly useless while others are incredibly good and effective. So we go to the good ones. Massage is not a luxury here like in western countries. Most people can afford massage without breaking the bank. There is no competition here between massage and medical science. They coexist quite peacefully.”
What a beautiful description of a lovely coexistence.
The work you are doing is very impressive. I highly recommend you to all of my clients, friends and colleagues, Shama.
I believe in the importance of the healing energies you are sharing and creating through the vehicle of Thai massage.
Blessings be, Ariana Vincent, Ariana Institute
Thank you Ariana, I am always honored to see your comments. I value your input and your opinions very highly.
Hey, sorry it took me awhile to check back here and see that you replied to my response. I just want to give a whole hearted agreement to your followup comments!
cheers and well wishes,
-Nephyr
It’s funny that everyone who has responded to this post seems to think that the regulation of the massage industry in the United States is a bad thing, that it’s a profit-driven ploy by massage schools. Yet everyone also seems to value the importance of knowledge (e.g. anatomy) and understanding of the principles that underlie massage therapy.
I know in Illinois I’m glad there is a mandated license that massage therapists must possess in order to be called a professional massage therapist. The license requires 500 hours of training and verification by the state (which involves a fee), but it nice to have professional standards based on knowledge. Nearby, in Minnesota, where there is little to no regulation, anyone can call themselves a massage therapist, even those with no training who can harm individuals if they massage them the wrong way.
I think regulation, done properly, can be an extremely valuable thing for massage therapists and consumers, and can help limit the number of untrained massage therapists who try to present themselves as professional therapists. This will help make massage therapy stronger and more respected.
Thanks for your reply. I think you summed it up nicely when you stated that “regulation, done properly, can be an extremely valuable thing for massage therapists and consumers.” My interpretation of the comments to my post is not so much that regulation is a bad thing, but that it is sometimes carried too far. Regulations and required hours seem to increase consistently in some states and the question is this: where is the balance between those regulations – when are they serving a good purpose, and when are they becoming cumbersome or restrictive.
I don’t know the answer to that, and it surely varies from state to state. But I am aware of a trend to increase rules in general in the US in many areas, and so I think that this is a healthy discussion.
For me, I would see the ideal balance at a point where rules serve a good purpose but do not restrict the beautiful spirit of massage.
Thanks again for your contribution.
Hi Shama! Thanks for your reply! I’m glad we seem to see eye-to-eye on this topic. I run into a lot of therapists who are so upset about continuing education requirements that sometimes I get frustrated. I think that CE credits can be an opportunity to expand your understanding of massage therapy and the services you can provide your recipients. To me, in Illinois, the reqs seem appropriate, and I get upset when MTs claim otherwise. But, again, I think you’re right that regulation can be overdone and sometimes needlessly burdensome.
Thanks again for your collected response. I really appreciate it!
I live in Australia. Fortunately we don’t have too many regulations regarding Massage Therapists at the moment. I have offered Thai Massage to people at $25 per hour as a means of getting practice. A hundred odd massages and I have not harmed anyone.
I contrast the highly regulated medical fraternity have a massive rates of misdiagnoses. And they have a medical associations that takes care of all the legal cases.
So they want to bring in regulation that would prevent me from practicing unless I did a few years study and knew all my medical anatomy stuff.
Its all pretty stupid I think. We live in such an incredibly regulated society and I gotta tell you that many of these regulations are more about protecting the establishment than the health of society.
Graham, you are right that regulations are often initiated by the establishment who want to protect their business. For example in the US and in Europe there has been a lot of pressure to make vitamins and herbal products available only via a prescription by a doctor. And some laws that regulate ‘touch’ seem pretty extreme to me. I feel fortunate that here in Thailand this is not a problem at all.
I agree Graham. In my experience, going through massage school doesn’t necessarily make you a better therapist. The massage courses are padded out with a lot of stuff that you could work out yourself, and function mainly as a way of raising revenue for the RTOs. Meanwhile the sort of touch awareness that is required for a good massage isn’t something that can be modulated. I also practice Thai massage in Australia, and I worry about the forces that are pushing us to adopt the American model of regulation.
Hi Shama,
I found your comments on Eastern/Western therapies most interesting. I to have a theory on the matter between the two:-) The western world is only interested in how much money can be made…hence only the doctor can heal, which in turn how much can the pharmaceutical companies con out of people(most drugs are failures) I do agree our hospitals do on the whole a magnificent job in putting broken bodies back together but diseases and other problems!!! Holistic therapies play a major role but greed will win in the west
I totally agree that the pharmaceutical industry, which controls the medical profession to a good degree, is only about money. I sure hope that the holistic therapies will provide more and more of a counter balance. May be I am dreaming, but it is a good dream.
“Some things are better experienced than dissected.” I like how you put that. Many clients miss out on the experience of massage because they are in their heads, trying to think what they should be feeling–instead of going with what is happening in the moment. Thai massage seems to help keep people in the moment, because of the stillness and movement that occurs during a session. I have more choices in technique during Thai massage than on the table because I can move the client into so many different positions an be effective. I feel my “multi-dimensionality” when receiving a Thai massage. I am able to treat my clients like the multi-dimentional beings they are w/ Thai massage, too!
Susan, I like how you describe your experience with Thai Massage as “multi-dimensionality”. I think that’s a great way of putting it.
with all respect, the reason to prove something scientificaly is not to get sued or not! anyway science or not, you should know how the body works in a holistic way, and how the different touch work psychologically on humans and there effect, the physiology of the body and how they are connected to each other and how it responses to different touch. then you can truly help and treat your patient with massag. and that is why I am not agree with you state here. what that happens in Asia, my home country is that 80 % of all this type of thai massages, and 1000 of different alternative treatments are based on the placebo effect, which is ok if you dont have any or little light disorder, but if you have an infection or cancer or other serious disorders/diseases then if you don’t have the scientifical back up of knowldege you might kill the person, and that is different than when a complication happens in the hospital. anyway you know and every body with litte understanding of psychology and anatomy/physiology understand what you have written here is not good. even my grandmother can give you some massage that feels good and you will feel good for a short term, but in reality you are not helping the patient but just postpone his disease and disorders…
Thanks for your comment. Since you are so scientifically oriented, could you please cite some statistics how many clients were actually killed during their massage sessions, since you imply that this can easily happen.
I can assure you that I am aware of quite a few statistics which show that thousands of patients die every year because of wrong prescriptions, wrong treatments, or infections in hospitals – despite the most advanced scientific treatments by the medical establishment. I have never heard of any cases of massage clients being killed by their therapists, so you don’t have to worry about that. Statistics prove it.
Regarding your statement that Thai Massage and a 1000 different alternative therapies are all based on the placebo effect, I am afraid that you are not using your own scientific orientation. There are countless studies that have documented the beneficial effects of many alternative treatments in quite a scientific way. Even a little bit of research would show you this quite easily, but obviously you have not done any such research. I have studied such research for several decades, however.
Regarding the placebo effect: Again it has been clearly documented that this plays a major role in any kind of healing environment. There are lots of studies showing that the placebo effect can be almost as effective as the real treatment in many cases. And this has nothing to do with alternative treatments – I am talking about mainstream medicine. The placebo effect is not something that is specifically associated with alternative treatments. Again a little research would show you this, but you have not done such research, otherwise you could not make such a statement.
The placebo effect is not a bad or unreal or ineffective thing. It is the power of the mind and of our belief system in action. Do you see anything wrong with a sick person being cured because of the placebo effect?
If a cancer patient manages to totally reverse this disease through the placebo effect, would you tell him or her that it is all fake and advise to get an operation and do chemotherapy instead? Would you tell them that the power of the mind and the belief system is all imagination?
What does it matter if someone gets cured by an operation or by a strong belief as long as the results are there. And even if the placebo effect plays a major role in alternative therapies, what is wrong with that? The purpose of medicine or any treatment is not to push a particular point of view, but to help the sick person get better.
Maybe your grandmother can do more than you think. Nobody expects her to cure serious diseases, but to make another person feel good, even for the short term, is contributing to the well being of humanity, step by small step. Every sincere, well meaning or loving touch adds to the positive balance sheet of our planet.
Good thoughts, Shama! Thank you for everything you do and for this answer particularly.
Yes, there is a Placebo effect. And there is Anti-placebo effect too…it’s all in the belief. The mind is powerful!
And, no one HEALS, even a doctor…they TREAT, and only body heals itself.
Enjoy your site. Some day will take some course online. Would love to come to Thailand but it’s so far away.
Respectfully,
Aldona
Thanks Aldona. I like your statement “No one HEALS, even a doctor…they TREAT, and only body heals itself.”
I would add to this that we can facilitate or accelerate healing. We can create conditions in the body and mind which set up an environment where healing has a better chance of happening and succeeding.
And as you say, in the end the body is doing the healing.
It is a luxuary when massage is available cheep. The reason why that can be in still developing countries is because of the difference in wage and lifestyle that some people are afforded. When we’re all expecting to be middle class, we therapists here in the US don’t feel comfortable providing $5 massage when the cost of living, self health maintenance costs so much more. There are cheeper massage providers, often those victims of abuse issues or human trafficking, but not because that’s a fair wage I don’t think.
Ideally, many people would be massaging your loved ones, and positive energy be exchanged that way where ever you go. I miss my grandfather’s backrub, and walking on my father’s back growing up – they are still in Japan, and I’m an immigrant to the US.
This is not a comment based on in depth pondering, which I’d love to do more when I have a chance. But based on some of my own personal experience & observation put together with the topic you’ve provided. I always enjoying your articles Shama – thank you!
Yes, cheap massage is a wonderful luxury. Naturally US therapists could not work for that kind of money. Therapists here in Thailand can actually make much better money with massage than an average worker without a degree.
The minimum wage per day has just been raised to about US$ 10 a day which is quite a bit more than it used to be. Massage therapists can easily make multiples of that if they are in a good location.
And just to set the record straight – massage therapists in Thailand are regular folks, and there is no abuse or human trafficking involved. Unfortunately we cannot say the same thing about the sex industry in Thailand, but then again this is a similar problem in many countries.
In Thailand the children walk on their parents back as well, and massage within the family is much more common than in western countries. That’s something the West could adopt from the East.
I am glad you enjoy reading my posts, and thanks for commenting!
Hi Shama
what a fantastic article, born in asia , i exactly lived like this environment, like thailand . It was very touching article, and very brave. It felt deep in to my heart. keep it up shama
I am glad that it resonates with you. Anyway you are quite familiar with Thailand. 🙂
In India we say “You wake up a person who is sleeping but you can do nothing with a person who pretends to be sleeping”
We all know who is pretending to be sleeping.
Very honest article !
That’s a good saying, Bharat!
I wholeheartedly agree with your article Shama. I think the obsession with ‘science-based’ therapy is not very deeply thought out. It’s more of a modern religious dogma. The fact that we have forgotten the experiential dimension of the healing arts is a revealing reflection of how disconnected our culture has become – lost in a pseudo-world of abstractions and very dis-empowered by those mental constructs.
“Modern religious dogma” is a pretty good description! I also feel that it can be quite disempowering to always refer to mental constructs and relegate our experience and instincts to second place.