Some people seem like natural communicators, some of us have to work at it. The good news is, you don’t have to master this, and you don’t have to do it exactly like anyone else. Don’t be intimidated if you don’t feel like communication comes easy to you. I absolutely believe that everyone can get better at this and with understanding and practice, anyone can be a good communicator.
Our work isn’t easy, and communication as a massage therapist is harder than “normal” communication. Patients often want to tell us personal and sometimes difficult things, we have a power dynamic to work through, our words carry weight and we are always talking about topics that deeply matter to our patients. (Even when we don’t know it!)
As a massage therapist, your hands are your tools, but your communication is the foundation you build on, and even your hands are always communicating. Getting better at patient communication, is the fastest way to get better at this difficult work, and to have patients that seek you out again and again.
We often think of communication as spoken conversation. But human interaction operates on two distinct levels: conscious and subconscious, conveyed through both verbal and non-verbal channels.
Conscious & Verbal (or written): This is the explicit information exchanged. It includes the intake form questions, greeting your patient, discussing health history, setting goals, and explicitly asking for feedback during treatment, as well as saying goodbye and any follow up.
Subconscious & Non-Verbal: This is the implicit dialogue happening beneath the surface.It includes your posture, tone of voice, breath rhythm, facial expressions, pacing,and even the quality of your touch.
The non-verbal, subconscious communication is harder to master but again, with practice and awareness, we can get better!
To systematically improve how you communicate with patients, break down communication into three core steps:Intake, Processing, and Output. If you are ready to go deeper, break down each step of patient interaction and try something listed here to improve.
If you want more guidance with this, consider joining one of our mentorship programs. We start one cohort each fall, and the mentorship is based on these concepts. You can see more info here.
- Verbal/Conscious: Ask open ended questions, but specific ones: Avoid “How do you feel?” but “How did you feel after our last session?” or “What are you noticing about your body today?" On the table: Ask questions that allow them more agency. Avoid “How’s the pressure?” and try “Would you like any more or any less pressure than what I’m doing now?” When you palpate, ask “How does this feel to you” and avoid “Wow,this is pretty tight isn’t it?”
- Nonverbal/Subconscious: Notice their posture (what does it tell you about their stress?), their affect (how dynamic and natural their facial expressions are,)how they walk, their breathing patterns as they sit in your chair and tell you about their body. On the table, notice their breathing, any guarding, involuntary movements, and ease of passive movement.
- Synthesize the Data: You have lots of information from them to work with. Remember what they said their goals were for today, where their pain points are, what type of treatment they said they wanted. Compare the info you have with what their body is telling you. Check your assumptions and biases and ask for any clarification if there’s confusion. Notice what your brain is telling you about their body while you are working.
- Identify Conscious vs. Subconscious Needs: A patient may say they want heavy deep-tissue work (conscious desire), but their nervous system state tells you they are exhausted and overwhelmed (subconscious need for soothing, parasympathetic activation). Paying attention and processing the data allows you to notice and communicate about it.
What you choose to say and how you say it matters deeply. What your hands say with pacing, pressure, and technique matters just as much. Output is your chance to empower, soothe, encourage, and care for your patient.
- Verbal Output: Use your patient's name when you greet them, avoid pathologizing language, explain your plan clearly and gain their informed consent. On the Table: Check in during treatment, ask questions about their body instead of giving your opinion (unless it’s asked for, and even then be cautious) and frame your thoughts positively: “How does this area feel to you?” “I’m feeling healthy tissue that could be holding some tension, I’m going to try something different to see if the guarding relaxes, tell me how this feels to you.”
- Non-Verbal Output: Breathe, un-furrow your brow and smile, sit in a relaxed way, lean forward to show interest, slow your breathing and speak calmly. On the table: Your hands are your primary output tool. Slow, intentional, and calm touch communicates safety and competence instantly. Spending extra time in an area that feels different to you show the patient you are present and paying attention. Try to match what you are communicating to their stated goal. If they are there to “fix” maybe you need more clinical language and a more educational tone of voice. If they are there to relax and find some stress relief, slowing your own breathing, and speaking pace will help to regulate their nervous system toward relaxation.
Bring some intentionality to your communication in treatment today and notice what changes. Download our free guide “Be a better Massage Therapist Today” for some fundamentals and a taste of what the mentorship includes.
