Printed in The Crazy Wisdom Calendar May-August 2002 You can reach Crazy
Wisdom at http://www.crazywisdom.net/
Regulation of Touch Therapies Is Not
An Easy Thing
In an effort to weed out prostitution, the city of Ann Arbor is considering
an ordinance which might potentially regulate massage therapy and bodywork
who can practice and what training is required in an effort
to be certain that massage therapists and bodyworkers are not sex workers.
We asked a leading local holistic health practitioner to comment on the
By Linda Diane Feldt
(Editors note Linda Diane Feldt is a Past President of
the American Polarity Therapy Association, and a former Board member of
the National Certification Board for Therapeutic Massage and Bodywork.
A student of the healing arts since 1973, Linda Diane has had a full time
private practice in Ann Arbor for 22 years. She is the author of Dying
Again: Thirteen Years of Writing and Waiting and Massage: Learning
to Give and to Receive.)
Ann Arbors reputation as an alternative friendly place
is widespread. In the area of alternative health and healing, Ann Arbor
has been a prime location for conferences and trainings, and has nurtured
many leaders in the field of complementary and alternative medicine.
The Ann Arbor area is home to approximately 1,000 practitioners in the
fields of massage therapy, bodywork, skilled touch, movement education
and somatic practices. The presence of a National Institute of Health
Complementary and Alternative Medicine Research Center affiliated with
the University of Michigan has further cemented our reputation as a hot
spot for alternative therapies. For two years, the University of Michigan
Medical School has required that all first year medical students be exposed
to information, lectures, discussions, and a personal visit to observe
and consider CAM practitioners. I had the privilege to be a part of the
faculty for a popular graduate level interdisciplinary course on Complementary
Therapies and Alternative Healing last semester.
Readers of the Crazy Wisdom Calendar would not be surprised that there
are over 100 types of healing work being practiced nearby. The Eisenberg
studies of 1993 and 1996 reported in the New England Journal of Medicine
showed that 42% of the population had used CAM therapies, and that number
was even higher for women. It would be reasonable to assume that Ann Arbor
which has supported CAM practitioners for decades -- would boast
an even higher rate of CAM use, and that a substantial portion of that
would be with hands-on therapies, similar to what Eisenberg found.
All of this exists within the non-regulated climate of the state of Michigan.
Consumers have had success finding the practitioners they want, reasonable
prices are charged, and people generally confine their work to what they
are trained to do. We have been helping people. We have been contributing
to our community through our work, by being dedicated healthcare providers,
and by living and contributing as everyone else does volunteering,
paying taxes, supporting local businesses.
How, then, did we ever end up in the situation we now find ourselves in
fighting to stop a proposal to regulate massage and bodywork, a
regulation proposed for one reason only for bodyworkers to prove
that they are not prostitutes.
Many years ago, but recently enough that it affected my work when I first
began to practice in Ann Arbor 20 years ago, massage and prostitution
were often linked. Claiming to be and advertising as a massage parlor
was a well-recognized euphemism for the sex trade. In the seventies, when
I began my training, Ann Arbor had a number of massage parlors in operation,
where sexual services were also for sale. They were closed. A few health
spas continued to be operated, rather openly and blatantly, were
sexual services were presumed to be available. These spas were recently
closed after an Ann Arbor police investigation. Neighbors of these closed
spas I have talked to have noted that they were not surprised that the
spas had illegal activity going on, only the extent of the exploitation
of the women involved.
It is notable that the closed facilities used the term health spa
rather then massage parlor. This is part of a national trend,
which would appear to be the result of successful work on the part of
many professionals in the field over the last few decades to legitimize
the term massage. Research and consumer surveys leave no doubt that massage
is now thought of first and primarily as a legitimate, legal, and honorable
profession. Skilled touch and bodywork are also gaining recognition and
their share of consumer awareness and respect.
We have won the war, but suddenly have been challenged to a new battle,
here in our aware and supportive community. The Ann Arbor Police response
to the closing of these health spas, and the attention on prostitution,
is to inexplicably determine that massage therapists and possibly bodyworkers,
should now be regulated as the most cost effective way to prevent future
episodes of prostitution in Ann Arbor. No new attention or regulation
of escort services (another euphemism often used by the sex trade) health
spas (where the alleged illegal activity took place), or others who have
a direct association with adult entertainment has been announced, and
in a meeting with the Chief of Police he affirmed that the only plan was
to regulate the legal profession of massage.
Regulation of a profession is most often accomplished at the state level.
Doctors, lawyers, dietitians, social workers, contractors, cosmetologists,
are all licensed by the state. To single out a profession for more stringent
local attention is rare indeed. It is however something that massage therapists
have been subjected to nationwide. Over the last decade this has been
gradually changed to state regulation, more than 30 states now regulate
massage and sometimes bodywork on the state level. Massage therapy and
bodywork are emerging professions, still in a somewhat state of adolescence.
Repeal and replacement of local regulation with state oversight that conforms
to how other professionals are treated is a part of that maturation process.
In this case we have a progressive community, with a great acceptance
of alternative therapies and bodywork, turning back the clock thirty or
more years to address an association that no longer exists. If this local
ordinance to regulate massage therapists passes, it will link massage
and prostitution by law a link that hasnt existed in the
minds of the general population for at least a decade, and more nearly
Regulation of touch therapies is not an easy thing, nor is there agreement
about how and if this should be done. There are some areas of greater
agreement, however, that have emerged from the ongoing debate on this
Let us begin with the intent of regulation. To regulate with the sole
intent of identifying and stopping prostitutes has few supporters in the
bodywork community. There isnt evidence that this works, it is insulting
in its premise, and prostitutes certainly have the capacity to become
legitimate massage therapists although combining the two would
be a violation of ethics as well as state and local law. Ideally regulation
benefits the consumer, provides information on the education and training
of professionals, and standardizes the use of terms describing a profession.
There is no consumer benefit that can be derived from this proposed ordinance.
If anything, the costs associated with regulation would add to the costs
of doing business, which is passed on to the consumer.
The current context for alternative therapies is one of exploration, evaluation,
and acceptance. It is important to nurture the alternative practices in
place, and that are developing. Any regulation needs to be mindful of
the importance of diversity for consumers, the difficulty in defining
and setting standards for new and traditional approaches to healing, and
the real lack of resources that part time and other fringe
practitioners have available. Excessive or overly encompassing regulation
could easily put people out of business, undercover, or never to venture
Regulation, by its nature, creates a boundary of those who are in and
those who are outside of the law. This deserves very careful consideration.
In Ann Arbor we have practitioners who have been in practice for years
who may not meet the current standards for practice, such as education
from a state approved school. Many of us trained before there were state
approved schools, often by a succession of workshops and apprenticeships.
In most local and state ordinances, there is no room for recognition of
this sort of training. Who is qualified to determine who is qualified
to practice? While many find this question easy to answer, there is no
universal agreement and those who are deemed unqualified certainly
deserve to be heard. Regulation also requires a very clear definition
of who will be regulated, and who will not. Defining massage too broadly
has resulted in some legitimate professionals in other fields of bodywork
to be unable to practice in their state. With more than 100 identified
touch therapies in Ann Arbor, drafting an ordinance to affect
massage therapists and only massage therapists is not a simple task. Scope
of Practice is a concern in many healing fields. The scope of practice
is best determined and defined by the professionals, often through a professional
association, who practice each modality. For your profession to be defined,
and limited, by a sister profession is problematic. For a state or locality
to regulate a profession without substantial agreement and input from
members of that profession is also egregious.
Using a national certification exam (NCE) for regulation is another complex
topic. In short, a national certification program: offers the benefits
of a psychometrically developed examination; restricts by having established
requirements who can sit for the exam; provides an ethics document and
complaint process; and includes continuing education requirements. Many
states and cities have chosen to use only the exam part of the program.
This results in the peculiar situation of having a formerly nationally
certified practitioner, as well as allowing for those who have lost
their certification through a complaints process to continue to be licensed.
Including reference to a national certification process has to be carefully
considered, with full awareness of the costs to the practitioner and the
restriction inherent in the exam process. Becoming nationally certified,
and continuing that certification is not inexpensive. At the state level,
a professional would expect to pay hundreds of dollars for state recognition
of their profession. For this investment to be limited to legal
standing for just a few square miles within a certain city is not
as clearly beneficial. A much longer article on this topic, which goes
into more depth on important issues, is available from the author.
By the time of this publication, this issue may have been put to rest
for Ann Arbor. It may also have heated up to the point of open conflict
and argument. In either case, state regulation is very likely to be next
on the agenda and we must prepare, either proactively or reactively. Creative,
consumer positive, regulation would be welcome. Regulation that favors
one group or approach financially or otherwise should be resisted. An
essential component of any regulation is recognition and nurturance of
the diversity of the touch professions in their approaches and training.
The Federation of Therapeutic Massage Bodywork and Somatic Practice Organizations,
in their consensus document on legislation recommends that a coalition
approach be used. (http://www.adeptsys.com/federation)
A coalition [a temporary alliance of distinct parties, persons, or states
for joint action Websters New Collegiate Dictionary] has
been formed to oppose the creation and passage of an ordinance designed
to target massage therapists and bodyworkers as potential prostitutes.
Information on this issue and the ongoing process can be found at www.holisticwisdom.org/aaordinance;
P.O. Box 3218 Ann Arbor MI 48106-3218, or e-mail email@example.com
This issue is real, and should be of concern to all Complementary and
Alternative Medicine (CAM) practitioners, their clients, and their peers
in allied health fields. What is at risk is our supportive climate for
alternative therapies, our reputation as a leader in the field of CAM,
and the livelihoods of some of your friends and peers.
Ann Arbor has been a model of support for alternative therapies for decades.
Help us to ensure that we will not become a national model for an archaic
and outdated perspective of touch and healing that associates massage
with illegal sex acts. We deserve better than that suspicion, and we have
all worked too hard to give up on the understanding and acceptance we
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