or counselling, enabling us to ultimately serve our clients better. Working individually with a client- centred counsellor is one option; creating a support system with other professionals with a similar interest is another. Alternatively, finding a peer counselling group (eg. re-evaluation counselling (RC) in the local community or finding a mentor in the field willing to work as a clinical supervisor are also solutions.

CONCLUSION In summary, if we can facilitate greater harmony and respect for the body, perhaps our clients will move towards wellbeing and we can help to maintain and facilitate this path for them, not just “fix” the machine when it breaks down. Box 3 shows some body image- boosting activities. This message does not always have to be communicated overtly: if we come from a place of acceptance rather than judgement, if we are conscious of our own body- shaming statements and if we try to move towards more neutral responses when our clients state them, we can offer truly unconditional touch – a rare gift.

References 1. McCabe MP, Ricciardelli LA. Body image dissatisfaction among males across the lifespan: a review of past literature.

OF THEIR WORDS AND ACTIONS

Journal of Psychosomatic Research 2004;56:675–685 2. McCabe MP, Ricciardelli LA. Body image and body change techniques among young adolescent males. European Eating Disorder Review 2001;9:1–13 3. Vincent MA, McCabe MP. Gender differences among adolescents in family and peer influences on body dissatisfaction, weight loss and binge eating behaviours. Journal of Youth and Adolescence 2000;29:205–211 4. Lorenzen LA, Grieve FG, Thomas A. Exposure to muscular male models decreases body satisfaction. Sex Roles 2004;51:743–748 5. Thompson JK, Stice E. Thin-ideal internalization: mounting evidence for a new

CASE STUDY I have been intrigued with the concept of body image within our profession since I began my massage training in the USA in 1996. In an informal pilot study that I conducted for my independent study, I worked with four women. The women had four 1-hour massages over the course of 4 weeks. I asked them to complete a body-image questionnaire before the first treatment and after the last treatment. I also asked the women to shade in a “body map”, indicating with different-coloured pencils which areas of their body they felt positive, neutral and negative about, with them adding adjectives connected to these areas if possible. I let the women indicate each week which areas of their body they would like me to include in our session, offering them the choice of full body (back including gluteals, legs, abdomen, arms, upper chest, neck and head) or any areas that they felt comfortable with. Over the sessions, the women allowed me to work on progressively more areas; by the last session, the majority of the women received a full body massage, including the abdomen (the first time any of the women had received massage there). The women showed improvements in body esteem and mentioned that they felt “accepted”, more “comfortable” and “connected” with different parts of their body. When they re-shaded their body maps, the negative areas had become more neutral and a few of the neutral areas had even become positive. The women I worked with knew I was interested in body acceptance, and perhaps this paved the way for our success, indicating that massage can be a powerful way to help our clients heal in addition to relaxing their tight muscles or enhancing their sports performance.

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risk factor for body image disturbance and eating pathology. Current Directions in Psychological Science 2001;10:181–183 6. Haimovitz D, Lansky LM, O’Reilly P. Fluctuations in body image across situations. International Journal of Eating Disorders 1993;13:77–84 7. Juhan D. Job’s Body: A Handbook for Bodywork, 3rd edn. Station Hill Press 2006. ISBN 1581770995 8. Field T. Touch therapy on development. International Journal of Behavioural Development 1998;22:779–797 9. Calogero RM, Herzobo S, Thompson K. Complimentary weightism: the potential costs of appearance-related commentary for women’s self objectification. Psychology of Women Quarterly 2009;33:120–132

BOX 3: BODY IMAGE-BOOSTING ACTIVITIES (ADAPTED FROM GARNER (10) n Find benchmarks other than appearance alone for self-evaluation – recognise your achievements at work, in your hobbies or in your relationships. n Think of your body as an instrument rather than as an ornament: focus on how your body functions rather than how it looks. n Do activities that help you feel good about yourself. Move your body in ways that feel good, and find ways to appreciate and take care of your body as though it were a trusted friend. Buy clothes that you feel good in – don’t wait until you are one size smaller. n Reduce your exposure to harmful media images: stop buying fashion magazines and watching celebrity- focused TV programmes. Focus on reality and self- nurturing rather than comparing yourself with unrealistic role models. n Exercise for strength, fitness and health rather than focusing on weight control. Throw away your scales! Focus on the actions you have done rather than on a number on a somewhat unreliable machine. n Find others who respect and care about your body. n Identify and begin to change negative or body- shaming statements.

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THERAPISTS OFTEN UNDERESTIMATE THE POWER