I recently watched a stand-up comedy routine by Steve Soelberg that was completely focused on the meaning of “undress to your comfort level” when preparing to receive massage. The comedian explained that his “comfort level” is fully dressed because that is what society has taught him. He went into hilarious detail about the dilemma of interpreting the meaning of this and other massage terms. I laughed so hard that I cried. And then I thought, of course there is some confusion. Most therapists assume that this term is self-explanatory and a lot of people are embarrassed to ask what we mean. So, I will shed some light on what I mean when I say, “undress to your level of comfort.”
As a therapist who has been doing massage since 1999, this is something I say all the time yet rarely am I asked what I mean. The truth is that this is what we are taught to say in massage school, and when I taught massage I told my students the same. Now, in a three and a half hour class there was always time to explain what that means. We would go into great detail on things like how we greet people in a professional way, the importance of informed consent, and how to protect a person’s modesty through proper draping techniques (this is what I call sheet origami). In the class environment understanding is not assumed and there is plenty of time to get to a great variety of comfort levels and how to work within them.
When someone is about to climb on a massage table, however; there is an assumption that clients know what we mean when we talk of comfort levels. There is also an urgency to start the massage that often prevents a lot of questions from our clients. As a result the most important person in the room is sometimes left with this dilemma. “What IS my comfort level?” So, let’s take a look at some things to consider.
Your comfort level is what you are comfortable with. It sounds simple, but in many cases it is anything but simple. I remember my first massage and how I wrestled with this concern. I was at the Utah College of Massage Therapy student clinic on the weekend I enrolled in massage school. I knew that massage therapists were used to working on people who have nothing but a sheet on their bodies, but this was a student who would be working on me. Was this person ready for me to take all of my clothes off? I had read something somewhere in the school’s policies that made me think that she might not expect me to take everything off. So, I didn’t take off my underwear. In the end I found that I misunderstood the policy and I was sad because it clearly got in the way of the work she was doing. She did an amazing job anyway, but it would have been even better if I had removed all of my clothes. As a client I was too timid to ask a question that would have made my decision easier and the massage better. I have not repeated that mistake. For me though, this is easy and an easy conversation to have with another therapist.
Receiving a massage is an intimate experience. I know that may make it sound inappropriate, but I do not mean that in a sexual or inappropriate way. When you schedule a massage appointment you plan to go into a room that is often dimly lit, soft music is likely playing, and a person will be touching you for nearly an hour or hour and a half. Most people are not used to experiencing this kind of focused attention. When we are touched for these long periods of time we must completely trust that the person who is touching us has our best interest at heart. You are literally putting yourself in the hands of another person, that alone can be overwhelming. Now on top of that you may have no clothing on as you lay under a sheet.
When you are on the massage table you bring life experiences with you. This includes things like, your touch history (good and bad), your body image, and your culture of modesty. Each of these categories on its own can provide a lot of concerns. Some people have been through various abuses, or invasive medical procedures. In current society we are becoming more aware of the emotional aspects of our body image and what a real struggle that can be. Many of us feel as if we are constantly being judged for how we look. Modestly is sometimes determined by body image, but the root is often based in on a person’s theological or cultural background. All of these factors and many more affect comfort levels in individual ways. These differences are not always apparent from first impressions. For example, one week I had two women in their late 60’s from the same region of country, each with at least 3 grown children, and many other similar life experiences as far as I could tell. We could expect that they would have similar outlooks when it came to receiving massage, because each had received many massages before they came to me, but that was not the case. One held strongly to her modesty and the other said to me, “Honey please, I have 3 grown children. I am not modest.” In both cases, of course I provided the strict modesty protection I do with everyone. It is our duty as care providers to understand that each person has different concerns and needs, but we also need to set and follow consistent professional boundaries.
Is it ideal for the therapist if a client takes everything off? In many cases, yes. Clothes can inhibit the use of some techniques and limit access to areas of the body that may need attention in order to relieve pain or dysfunction. The hip is an area of the body that typically carries a lot of tension and often affects the lower back. If underwear is in the way it can be difficult to address the cause of these types of back pain. In a similar way, a bra can get in the way of shoulder work that could relieve neck pain and headaches. Also, we can do really nice long flowing strokes that are soothing and show the body how it is connected. Few things are as comforting as a long flowing stroke that starts at at your foot, goes all the way up your leg, around your hip, slowly up your back, over your shoulder and down your arm to your fingertips (now reread this sentence nice and slowly feeling it as you read).
Not fully undressing is okay though, because if a person is lying naked on my table and worried about being vulnerable, that will get in the way of the healing process. When you are not able to relax into the experience and release the pain or discomfort that is the reason for the massage, the entire session can be lost. Wasting your time would be more of a problem for me than working around your clothes. There are a number of different modalities of bodywork that are performed on people who are partially or fully dressed. John Barnes approach to Myofascial Release, Craniosacral Therapy, and Structural Integration are all modalities where the person being treated is partially dressed. Seated massage is performed in a variety of different locations, many of them being public and the person receiving the treatment is typically fully dressed. Now, if you do not want to receive these types of services that is okay too. Massages can, and should be adapted to suit your comfort and needs (now reread this sentence with a firm parental tone).
Your comfort level is where you can surrender to the session and be open to healing. When you receive a massage your comfort level is up to you and no one else. It may even vary over time. Your therapist should meet you in that space of comfort, honoring and working within your boundaries. There are so many different techniques in massage and related bodywork that your therapist should be able to provide the comfort and healing you are looking for, without you worrying if you are wearing the right amount of clothing. In the end I would advise you to talk to your therapist so that (s)he has the opportunity to provide your best session.
Every person deserves to have access to therapeutic touch. This means that providers must come to the table with compassion for everyone who walks into our practices. We must remember that it takes a great deal of trust to lie down on a table and surrender to the therapy we have the privilege to provide. We are honored that people come to us and trust us. The mere act of walking through the door and asking for help can take a great amount of courage and we always need to understand this. With this understanding we must leave all judgments at the door.
Don Devine LMT GA # MT012315