An Open Letter Contemplating Thai Massage Regulation in the U.S.

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1 An Open Letter Contemplating Thai Massage Regulation in the U.S. Nephyr Jacobsen, LMT, is the founder and director of The Naga Center, llc., School of Traditional Thai Medicine, in Portland Oregon. She is a massage therapist of 17 years, and has spent extensive time studying Thai massage both domestically and in Thailand. A graduate of the Tao Mountain teacher training program, she sees Thai massage as a never ending path of study and continues to this day to seek out teachers for an ongoing deepening of understanding. Sharing her knowledge of Thai massage and Thailand with her students is one of her many passions and she hopes you will join her in a class or a journey to Thailand soon. For more information, contact [email protected], I ve done deep tissue Swedish massage for 17 years. I mean really deep, no fluff and buff stuff here. But it doesn t come close to Thai massage. Nothing I ve seen does. It s yoga and Rolfing and acupressure and tapotment and chiropractics and Reiki and deep compression work and myofacial release and hydrotherapy with herbs and the power of spirit, all rolled into one. And I swear I m not even hitting on all of it here. At the same time, it s none of those things. Because those aren t Thai and the truth is, Thai massage really is Thai. It s not a new brand of Ayurvedic medicine or a twist on Chinese meridians, it s seriously Thai, and it s serious medicine. And here in the United States you can practice it after watching a do it yourself video. Or taking a two-day workshop. Or reading a book. Or none of the above. And you can teach it after going to Thailand and taking a five-week course, or a two-week course, or a one-week course, never having actually had a working practice of it in your life. And people do. So long as you meet the regulatory professional massage laws of your state (which are all written with Swedish massage in mind) you can practice and teach Thai massage without a day of training if you so choose. And in some states you don t even have to be a licensed massage therapist because you can claim that this extremely physically intensive bodywork modality is technically energy work. You can twist people s bodies into a rat s-nest tangle, walk on them with full body weight, and perform spinal swings that were originated with bone setters, and in a few states you don t have to be able name a single muscle or know the location of your kidneys. 16

2 Yeah, I know, it s crazy. But the truth is, there is no regulation of Thai massage outside of the Swedish massage laws, in the United States. And the thing is, I m not even sure if I think there should be. Regulation is a sticky subject, and with Thai massage, it gets complicated very quickly. At this time, the majority of states have some sort of regulatory agency that establishes the specific requirements to practice bodywork professionally and governs all massage modalities. On the other hand, a few states have no massage oversight at all, and little to no requirements concerning practice. In those states with explicit oversight, all massage modalities are grouped together and have the same requirements. There are no specific laws for specific modalities. In general, schools wanting to help aspiring massage practitioners reach their state requirements primarily teach Swedish massage. They may have a Thai massage continuing education class, but these classes rarely go beyond an introduction to the modality. There are no exceptions made for those who have studied Thai massage in Thailand, they must still attend a massage training program here in the States and jump through any and all hoops required by the state they wish to practice in. This means that once you are a licensed massage therapist (in some states, massage practitioner, or massage technician ) you can practice massage professionally. Any modality. Regardless of if you have been trained in that modality. In sum, all modalities are grouped together for licensure, and most schools require only that you learn Swedish massage techniques anything else is optional, if it s even offered. With Thai massage in a period of global discovery, Thai massage organizations are increasing in numbers around the world. While some of these organizations may appear to be official regulatory agencies, in truth they are privately-owned and -operated Thai massage trade organizations that may be voluntarily joined for a fee. At this time, no organization in the U.S.A. has the authority to regulate, certify, register, or accredit Thai massage practitioners, therapists, body-workers, instructors or schools specifically. So long as one meets their state massage licensure requirements, one may practice and teach Thai massage without belonging to any such organizations. 17

3 A Case for Thai Massage Regulation Thai massage has the potential to cause injury if not done correctly. This applies both to the therapist and the receiver. In my opinion, Thai massage is a far more dangerous modality than Swedish massage could ever be. Not meaning to scare anyone off here - with proper training, it is amazingly therapeutic and is, in fact, my favorite modality; however, proper training is not required. And knowing effleurage, petrissage, cross-fiber friction and the diaper drape doesn t prepare anyone for practicing Thai massage. That s like saying that if you are a highly trained golfer, it follows that you are qualified to play professional basketball. It s apples and oranges. Or maybe even, apples and pizza. My Thai massage classes are open to anyone, professional or novice. What I have found is that those students who have been practicing massage therapists for many years, those students who are freshly graduated from massage school, and those students who have never done a day of training in massage prior to taking my class, are all on nearly equal ground. They are all beginners, because Swedish massage is nothing like Thai massage. Nothing. Only the common language of anatomy, and a comfort with touching bodies sets the Swedish massage therapists apart from the total massage beginners. When it comes to Thai techniques they are all novices. What this means is that states that require that Thai massage practitioners be licensed massage therapists have really not done anything to protect the public safety in regards to Thai techniques. Because none of the required massage training (I m not talking about the sciences of anatomy/physiology here) have anything to do with what you must know to practice Thai massage. It is left up to the practitioner to voluntarily seek out quality instruction. Some do, some don t, and some try to, but end up with shoddy instruction and don t even know it. But whatever they do, it s voluntary, not determined by the state or any other agency. This is why the regulation of Thai massage by a body of professional practitioners can be seen as necessary. In this case, oversight must come from within the community of Thai massage practitioners, because these are the individuals who truly understand the techniques and the proper methods of training. Of course, these individuals would also have to be professional licensed massage therapists as well, in order to comply with state laws. 18

4 A Case Against Regulation And here is where I start to sound a bit inconsistent, because you see, a part of me believes that the way one trains should be voluntary. I have always felt that massage, like herbalism and midwifery, belongs in the layman s hands, where some of the best teachers are quietly hidden and carry no state governed credentials. I am deeply suspicious of massage regulation, with its pandering to large corporate schools and its focus on written exams for a field that involves the un-measurable ability to touch and feel with intuition and competence. In the end, you can be a very good massage therapist without knowing how to speak anatomically, and all the science training and test taking ability in the world won t make you qualified to touch. I have had some of the best massages in my life from untrained hands, and some of the worst, from those with walls full of certificates. Some of the most quality instruction is coming, of course, from Thailand, but how can U.S. regulatory agencies begin to know what schools and teachers and training programs on the other side of the world are legitimate and which are not? Only those within the Thai massage community have a glimmer of how to sort through this, and we are often in disagreement with one another. Perhaps Thai therapists in the U.S. should be pressing for American regulatory agencies to recognize Thai credentials and accreditation, but we certainly should not be imposing our standards on Thai institutions. In the world of Thai massage, regulation is nearly impossible anyhow. While schools and practitioners have begun to be regulated by the Ministries of Education and Public Health in Thailand, it remains a fact that some of the most proficient therapists in Thailand are unlicensed, unrecognized, and unofficial. Some of these practitioners are masters of hereditary methods, and some live in the far-out villages where licensure is not possible. Legends aside, massage has existed in Thailand one form or another for many hundreds, if not thousands of years. It is an integral component of traditional Thai medicine, with applications far outstripping its general usage here in the West for relaxation. Until recently it was taught parent to child, master to apprentice. There were no schools of Thai 19

5 massage, and the desire to learn did not equal the right or the opportunity to learn. A potential student would have to prove himself worthy and then dedicate years to the tutelage of a master. There were no two-week courses and there were no workbooks with step-bystep pictures (then again, there was no step-by-step sequence). There were no certificates, no licenses, no regulations. There only were quality masters of an ancient healing craft. Currently in Thailand, there are new schools of Thai massage popping up in alarming numbers that promise quality instruction in 10 days, 5 days, sometimes even 3 day courses. Students learn to heal by the numbers. Step one, step two, step three.don t color outside the lines. Practitioners and instructors abound, and anyone with the cash can learn Thai massage, anytime they want. There are governmental regulating agencies certifying schools and instructors. There are certificates and licenses with numbers and photographs and official seals. There are standards set in ink. There are businesses on every street advertising traditional Thai massage, ancient Thai massage, authentic Thai massage. What there aren t much of, are quality masters of this ancient healing art. The vast majority of the true masters are hard to find, harder to become a student of, and even harder to learn from. With a couple of exceptions, if you are fortunate enough to find one of these quality instructors, few will have heard of him/her, and you won t be issued a certificate when you are done learning. (Because you re never done learning.) This means that if we decide to regulate Thai massage separately from Swedish massage in the U.S., we will end up in a situation where those who attend the shiny schools with the big marketing budgets and the embossed certificates will be validated as worthy to practice, while someone who studies with an unknown monk in the forests of Thailand, even if they study for years, will not be recognized. A Case for Maintaining The Status Quo There are some who suggest that Thai massage practitioners should not have to be licensed massage therapists at all, meaning that they should not have to meet any existing state requirements in order to practice their profession. This position holds that Thai massage is not the same as other bodywork modalities, and should have either no requirements, or only those of our own regulatory agencies. They propose that we should 20

6 not even call it Thai massage, suggesting instead names such as Thai Yoga Therapy or Thai Intensive Stretching. It s as if a change in semantics will change the fact that we are manipulating soft tissue, the common definition of massage in most states. While I agree that Swedish massage licensure does not qualify one to practice Thai massage, I do not think that it hurts. In fact, the scientific study of the human body cannot help but increase your knowledge for the better. And when it comes right down to it, for a profession, it s a small hoop to jump through. After all, how many professional trades can you become licensed to practice in less than a year? Another factor in this issue of creating regulatory agencies specifically for Thai massage, is the need to be wary of self-absorption to the point of forgetting the public who we serve. I think it is important to remember that we are not the only non-swedish bodywork modality out there. If we think we should exist outside of the regulations of the existing massage world, then so should Rolfers, Shiatsu practitioners, all somatic and structural integration modalities, reflexology practitioners and many others. In truth, this article could have been written with any one of these modalities in mind. It would be a nightmare for the public to try to track all these different modalities and know who to report to should there be a problem. In the state where I live, if a body-worker of any kind does something harmfully inappropriate, I can report to the massage board. I don t have to understand what modality they practice and find the specific regulating agency. There is only one. And while it may be obvious to me how different Thai massage is from Swedish, where is the line to be drawn? Once all the different modalities begin to branch off, who is to say that Lomi Lomi practitioners, hot stone massage practitioners and Watsu practitioners shouldn t have their own regulation as well? Like it or not, the common perception of Thai bodywork is that it is massage, and as such, we are a part of something bigger than just Thai massage. We are a part of the greater massage community, and our actions can and will affect this community. So how do we regulate Thai massage? How do we say whose instruction counts, when some of the best instructors in the world may be hidden in a village in Thailand (or in the vastness of Bangkok), known by only three westerners (or none)? How do we organize, when those who form the organizations are in competition with one another? How do we fit into the western massage world when the overseeing agencies know little to nothing about 21

7 Thai massage? How do we protect the public and at the same time not become a place where the only form of Thai massage that exists is an homogenized step-one, step-two, stepthree sequence, with no room for variance and the deeper training that is unquantifiable? I don t have the answers to these questions. I have some thoughts for the conversation, but they are truly just thoughts. I have not set my opinions in concrete. Here is what I think: we set the standards not by creating more regulatory agencies and attempting to separate ourselves from the rest of the massage world, but by creating classes and schools with a high bar and by being practitioners who do not balk at training. We must care enough to go the extra mile at all times. We show that we are serious enough about this to become licensed massage therapists (if that is what is required.) To all who have not yet done this, I would like to say that massage school can be fun, and learning anatomy, physiology, kinesiology and pathology is amazing. I recommend it even if you live in a state that does not require it. What if, instead of using our energies to fight the existing system and create new regulating agencies, we were to work together within the system? This could be the best of both worlds. Thai massage does not become regulated unto itself (hopefully avoiding homogenization), and by following state requirements of licensure, at least in states that have requirements, the people who can practice will by default be those who are willing to put in a little extra work. While there will never be a system that can guarantee that every practitioner is great (even with the best teachers in the world, not all students become great), at least this ups the chances that they will have a minimum of dedication and commitment. I have heard people say that they wish Thai massage was not regulated by state agencies at all. I have heard people say that we need our own regulatory agencies, separate from the Swedish massage world. I have spent time in both camps. For a long time I wanted no regulation, period. Then I changed gears and wished we had our own. I have looked through both lenses, and agreed with what I saw. In the end, I have come to a place where I accept things the way they are. It s not perfect, I know. But I also know that the things that bother me most about the present and likely future of Thai massage, are not actually going to be fixed by less or more regulation. They are not being fixed by the states that don t require that Thai massage therapists be licensed in massage, and they are not being fixed in Thailand, where there is very specific government regulation of Thai massage. They are 22

8 things like gaps in integrity and the need for better understanding. They are things like the tendency to call Thai medicine Ayurvedic, or Chinese because we don t understand it enough, or respect it enough to grant it its own standing. They are things like in-fighting amongst practitioners and teachers. More importantly, they are things like the actual danger of an ancient art becoming watered down and distorted until it no longer exists in its true form. Luckily, these are things that we can change without having to restructure the system. These are things that we change through personal commitment. And I see it beginning already. It only takes a few people digging deeper, asking questions instead of purporting to know it all already, sharing what they find and always, always, always, crediting our teachers in Thailand, giving back to Thailand and being thankful to Thailand. It only takes a few people doing this to initiate the changes we need. It s the sharing part that holds the key. As we teach our students and teach each other, we set the bar higher and encourage quality in the Thai massage community. I believe it is up to us as individuals, not laws, to keep Thai massage safe and authentic. Those who do will shine brightly, and eventually be sought out. 23