Exposure

Exposure.  

How does that word make you feel? 

What kind of thoughts begin to run through your head?  

We are in the midst of massive, chaotic shifting of our world.  The concept of “exposure” is a source of fear these days as we all take preventative measures, follow recommended protocol guidelines from state and federal levels, and hope it all works. Coupled with limited understanding, the general climate of panic and fear raises issues with responsibility, blame/shame, and liability; however the concept of “exposure” also has the potential to act as a catalyst to serve us in our process of societal and communal recalibration.  I ask you to consider “exposure” in the context of business ethics and transparency.  “Exposure” and “integrity” are interlinked concepts. 

Massage and Bodywork is part of an industry based on integrity, and practitioners spend much of their energy creating and maintaining ethical boundaries while cultivating trust between clients.  We aim to unapologetically walk these lines with grace, while fostering an environment of safety in order to promote healing and personal growth for those we touch.  This sense of safety is something very difficult to provide as we are all feeling the collective discomfort of change and instability in the chaotic climate of our world these past few months.  Our culture of immediacy is no longer relevant as incubation periods demand time to reveal the results of any preemptive actions we have taken. As we collectively navigate the results of sudden, remote business operations and the effects of rapid, broad policy changes in most industries, we are also faced with tenuous, unstable socioeconomic and political climates.  Those we are relying on to lead us have very limited information on the proliferation and long-term effects of COVID-19; as well as the efficacy of testing, treatment, and transmission control protocols.  We are working with what we have, but it is as if we are feeling our way through a large, dark cavern with a very dim flashlight.  Infection control is not within our scope of practice, beyond universal precautions and mandates from state and federal levels.  How we define our responsibilities and respond as a professional community is paramount to the integrity of the Clinical Wellness Industry going forward.  

Recently, I experienced an exposure risk at my business.  I was tested and isolated immediately. I take pride in the efforts I have made to limit spread and transmission as part of my professional, personal, and social responsibility; however we know that no single person is responsible for the transmission of a disease.  I had followed mandated protocol and guidelines of operation throughout the reopening, and shut down immediately when contacted by the health department.  I cooperated with my county as instructed by the state and my professional organization, and I was in contact with effected clients. I encouraged them to take precautions, get tested, and follow up with any contact they may receive from health officials.  I did everything I could think of to the best of my ability.  Even so, I was grappling with the guilt and shame of my result: I tested positive.  

The collective panic and fear has created an environment where people are quick to judge and blame others for what they don’t fully understand- especially when we see the massive impact this disease can have on others.  The weight of those implications is a heavy load.  As a business owner and sole practitioner, this exposure presented me with an ethical tightrope as it challenged the very boundaries I had set between the professional and personal structures of my life.  Although I was asymptomatic and physically doing well, I grappled with revealing my result as I suddenly realized the conflict: I felt it was socially responsible to share my result considering the global health emergency; yet maintaining that social responsibility in a professional context meant I would personally be held responsible for the shame of possibly inducing panic in effected clients; as well as the fear of personal blame and liability promoted by our current cultural climate.  I was afraid of what that all meant: a major violation of a boundary between my private and professional life.  I was responding with integrity no matter what, but the right thing is usually difficult, scary and requires a sound mind. I needed to slow down and regulate the emotional rollercoaster of fear and shame in order to respond thoughtfully.  

I had reentered my workspace with an abundance of caution.  Prior to reopening, I read over the mandates and guidelines at the state, federal, and professional levels; listened to panel discussions with leaders of the conversation within our industry; read articles from other therapists and respected, qualified professionals; and made sure to implement everything I could.  I created and followed a COVID protocol based on the mandates and recommendations, posted it for my clients to see, created and maintained a cleaning log, created a business safety plan, and communicated with clients openly about their comfort levels.  I had taken this seriously and I hadn’t done anything wrong, but this situation still occurred. I had done everything I could, and this wasn’t my fault…but it was still my responsibility to respond with transparency and integrity.

I work every day to consciously live a life of integrity.  I believe as long as truth is out on the table, fear of disingenuous assessments will never find a foothold to fully manifest.  To truly live with integrity, we must be willing to expose truth- even when it’s hard or scary.  For me, this initially felt like a violation of my personal boundaries.  Why should clients have my personal health information?  Was I justified in keeping this information from them if they weren’t directly effected? This decision ultimately rests with individual practitioners, but I have chosen to be open with my result in order to help open up a conversation.  A major fear of those in this position is that we are personally responsible for the discomfort, panic and fear of others. While this is of course not the truth, more and more of us will be finding ourselves in this position, or a similar one, across all industries. In order to move forward, we need to begin working toward easing the stigma of shame and blame created by the collective societal fear of the unknown.  The weight of personal responsibility for others can be incapacitating in those moments, but we must not be afraid to expose the truth in an effort to actively participate in comprehensive communal response.  Fear generates blame, and the fear of blame and liability generates shame and more fear; but the truth is no one is to blame…and willing vulnerability while in fear is actually strength, not weakness.  

There is no shame in a positive test result.  In order to begin to heal our communal fears, we must adjust our lens and view the information as an illumination; information which sheds light and provides opportunities for action.  In the absence of testing and symptoms, the spread of most illnesses are otherwise undetectable.  In a climate of chaos, a positive result exposes what is otherwise invisible, empowering us with knowledge. If we return to the cave analogy, it is as if every positive result flicks on another flashlight, revealing just a bit more of the darkness before us. “Unearthing,” “revelation” and “manifestation” are all synonyms of the concept of exposure. If we shift our focus in these directions, we begin to realize that a positive result is not a symbol of inadequacy or ill-preparedness; but rather a direct opportunity to locate, corner, and personally impact the pervasive nature of this illness.

The reality of this disease is that most of us will eventually be directly affected, whether or not we are aware of our infection status.  The reality of testing is that there is a lack of unified response on the national, statewide, and regional levels; with varied testing recommendations based on transmission risk levels, and varied responses to test results and contact tracing.  Each region and industry is working within guidelines and doing their best, but ultimately they are creating their own containment and tracing protocols. This is all in good faith, yet the reality of protocols is that they are only as effective as they are consistent…and infectious disease doesn’t care about industry standards, individualized industry testing protocols, or county lines.  Understandably, coordinating across all of these levels is an economic nightmare and just doesn’t seem possible in our sociopolitical culture.   

We are learning as we go.  We can take all recommended precautions, and still be exposed to risk.  Risk itself is always present in life.  We are always calculating risk through conscious and subconscious judgement as part of our innate survival skillset, which is part of the reason our species has succeeded.  As a culture, we are well aware of the risks surrounding us, so we choose between things like going to the store or having our groceries delivered; or we choose an outdoor activity over an indoor activity.  All individuals choose their degree of personal protective measures, and uphold our own standards outside of our professional lives.  We are well aware of the risks, and our country allows us the freedom to choose our risk factors.  The fact is our clients have chosen to return to our workspaces, knowing the risks they are taking. Life is never perfectly safe, and we cannot live forever in fear.  We can only do our best to take mandated and recommended precautions, uphold our social responsibility, and cooperate with health officials who are working for the good of the entire community.  This situation is not limited to specific individuals, so the more we respond as a community, the more effective we will be in containing it.  

The close proximity of bodywork means our industry is inherently high-risk for transmission.  With all of this in mind, I have decided to move forward with some adjustments in the workspace, and a direct form of risk acknowledgement communication with clients.  This acknowledgement provides a foundation from which a client is fully aware of the level of risk, even with precautions; and gives the practitioner a basis from which to respond to an exposure situation, prior to the emotional rollercoaster which the situation inevitably presents.  Practitioners can do nothing more beyond simply acknowledging, remaining calm, direct, and encouraging clients to cooperate with health officials should they be effected. We are already following mandated and recommended industry precautions, and we can only act within our scope of practice: we are soft-tissue experts- not infection control specialists.  

If we willingly return to work, then we are accepting the exposure risk of the profession. This exposure encompasses both contagions and the possible pressure of a spotlight on our individual values.  Our response is a direct reflection of our professional and personal ethics, and that has the potential to expose some very deep, personal, existential fears of inadequacy, judgement, and blame.  By allowing that exposure to occur, we are opening ourselves to a dialogue which could help our entire community cope.  Once again, there are so many unknowns- even at the highest levels in our leadership- and we can only proceed with precautions in place, and respect and regard for others.  Perhaps embracing exposure requires us to respond with vulnerability: having those difficult conversations without apology, even when there is a deep fear of judgement.  We are responsible for our actions and responses alone. I believe the concept of exposure is an opportunity for healing, and the key to maintaining and continuing to foster an environment of trust and integrity; especially in times of uncertainty.