Ethics in Thai Massage

The most basic ethical code observed traditionally in Thailand regardless of lineage is the Five Precepts of Buddhism, which are said to be basic rules laid down by the Buddha to encourage harmony among men. These principles are followed by Buddhists worldwide, and are translatable roughly as:

• Refrain from killing
• Refrain from stealing
• Refrain from dishonesty
• Refrain from drugs and alcohol
• Refrain from sexual misconduct

Buddhist culture traditionally emphasizes humility, honesty and compassion, and encourages the devout to practice these virtues in everyday life and livelihood. The practitioner of Nuad boran is no exception to this rule.

In addition to classic Buddhist guidelines, the traditional Thai massage therapist abides by a separate code of ethics for the healer, taught in most of Thailand's massage schools on the very first day. This moral code is designed to protect the integrity of the tradition and to protect the client from unscrupulous therapists. These rules of conduct, as taught by the Traditional Medicine Hospital, are as follows:

• Study diligently the techniques and the practice of the massage.
• Do not practice in a public place or in a place otherwise unsuitable for massage.
• Charge a fair price.
• Do not take clients from another practitioner.
• Do not boast about your knowledge.
• Ask advice and listen to people who are more knowledgeable than you.
• Bring a good reputation to the tradition of nuad boran.
• Do not give certification in Thai massage to a person who is not qualified.
• Give thanks to the Father Doctor before and after massage.

Despite the existence of this code of ethics, however, in more recent times, nuad boran has been somewhat tarnished by its association with the sex industry. In the last four decades of the twentieth century, particularly during the Vietnam War era, Thai massage became almost synonymous with prostitution. Countless massage clinics--particularly in Bangkok and Patthaya--served merely as fronts for brothels. The damage done to the tradition and the reputation of nuad boran during this time has carried over to the present day, and many still associate Thai massage with steamy Bangkok alleyways and illicit sex.

In the twenty-first century, however, this picture is far from the truth. While there remains in Thailand an illegal sex industry hiding behind many facades, most massage clinics today practice a legitimate, serious, traditional healing art which is an important continuation of ancient medical and spiritual knowledge into modern times. This is particularly true in Chiang Mai, which has long retained its well-deserved reputation as the most important center of traditional medicine schools in the country.

Attempts have been made in the last decades to develop a centralized organization on the national level in order to control the education and licensing of practitioners. Up until now, any traditional massage existing in Thailand could typically be given the label nuad boran. One of the goals of centralization is to standardize the practice and teaching of Thai massage to more accurately reflect the theoretical foundations of the Royal tradition. As already mentioned, part of the colorful diversity of traditional Thai medicine is the fact that there are so many different regional and cultural influences. While a national committee may do wonders in terms of quality-control and safety, it will have to tread lightly and carefully when it encounters and attempts to codify such diverse and mutually contradictory traditions as currently exist in Thailand. The unfortunately outcome of this process will be the loss of a large part of the informal beliefs and practices of the rural traditions.

Be that as it may, nationalization has already gone a long way towards restoring the legitimacy of the massage industry, and has done wonders to revive the respect due to these institutes of medical knowledge.

The Spirit of Nuad Boran

Thailand is an extremely devout country, where the most casual observer can readily see a deep and extensive Buddhist tradition influencing everyday lives. Buddhism and medicine have always been intimately interlinked in Thailand. In fact, it was the monasteries that carried herbal knowledge, Ayurvedic theory, and hatha yoga to Thailand from India in the first place. In addition to Wat Po, monasteries throughout Thailand continue to be important medical resources. In major urban centers, the monastic schools continue to produce many of the most educated individuals in a given city, and doctors are often present among the ranks of a monastery.

In rural Thailand, where formal education is more difficult to come by, charismatic monks are central in the practice of rural medicine, and still serve as modern-day shamans, offering healing amulets, magical protection charms, incantations, and exorcisms for the devout. While these practices may hearken back to pre-Buddhist times, the imagery of the rites of rural medicine are Buddhist, the language of the incantations is often riddled with Buddhist phrases, and the location of the shamanic healings are usually community temples, indicating that Buddhist symbols play an important role.

Altar with good-luck charms at Chiang Mai University.

At the center of the Thai healer's spiritual practice is Jivaka Komarabaccha (pronounced in Thailand as "Shivago Komarpaj") who is recognized as the progenitor of the traditional medical system. Shivagakomarpaj appears to have been a historical person. Buddhist historian Kenneth Zysk recounts the story of his early life, as told in the Pali scriptures:

Salavati, a courtesan of Rajagaha, [gave] birth to a son who was then given to a slave woman, who placed him in a winnowing basket, which was thrown on a rubbish heap.... The infant is taken and raised by the king's son Abhaya.... The boy is given the name Jivaka because he was "alive" (from the root jiv, to live), and because a prince cared for him he is called Komarabhacca (nourished by a prince). Jivaka, as he approached the age at which he must seek his own livelihood, decided to lean the medical craft. Hearing about a world-famous physician in Taxila, he traveled to that city, famous for education, to apprentice with the eminent doctor. After seven years of medical study, he took a practical examination that tested his knowledge of medicinal herbs, passed with extraordinary success, and, with the blessings of his mentor, went off to practice medicine. [5]

Shivagakomarpaj is a minor figure in Buddhist scripture, but this story appears in various forms in Pali, Sanskrit, Chinese, and Tibetan translations. All versions of the scriptures agree that Shivagakomarpaj later became a Buddhist convert, the physician to the monastic order, and that at one point even treated the Buddha himself for an imbalanced dosha (Ayurvedic constitution).

Throughout the Buddhist world, Shivagakomarpaj has largely been forgotten, but in Thailand, this man has been elevated to the level of a deity. Shivagakomarpaj is believed by most Thai healers to be the ultimate source of Thai traditional medicine, and the inventor of the practices of Thai herbalism, massage, and acupressure. During my own research in Thailand, without exception, every healer I visited possessed a statue of the Father Doctor, seated or standing on the altar alongside the Buddha, in recognition of his position as the practitioner's primary ajahn (teacher or guru). This was the case equally for unlicensed, unofficial practitioners of hereditary forms of rural medicine and for formally trained practitioners and teachers of the royal tradition.

Shivagakomarpaj's statue is also placed in prominent locations in many monasteries and temples, including Thailand's national temple, Wat Phra Kaew, in Bangkok. A typical healer prays to Shivagakomarpaj for help in healing work, and patients often pray for a cure. Shivagakomarpaj is said to benevolently intercede on a patient's behalf, and is also said to transmit healing "through" the hands of the traditional Thai healer, who is seen as a conduit for this energy.

While most massage therapists put stock in the knowledge they possess and the techniques they perform, they put much more faith in the ability of the Father Doctor to guide their hands during the massage. Healers kneel at their client's feet with folded hands and closed eyes and pray to Shivagakomarpaj for guidance in order to prepare themselves before each massage. Most practitioners feel themselves to be channels for the healing energy of the father doctor rather than healers in their own right. For the true master, every movement of the massage is an exercise in meditation and piety.

Many traditional massage schools teach as their first lesson the prayer to Shivagakomarpaj (click here). This chant to Shivagakomarpaj is recited in the Pali language, the traditional language of Theravada Buddhism, and is reproduced here as it appears in the student manual of the Traditional Medicine Hospital's basic massage course.

In most Thai schools, this prayer (or a version of it) is chanted or sung every day in a ceremony known as wai khru, or "saluting the teacher." In the Traditional Medicine Hospital of Chiang Mai, where I first attended classes, it was chanted twice a day by the entire hospital staff, teachers, and students. Even at this, the most prestigious secular Thai massage and herbalism facility in the country (unaffiliated with any monastery), Shivagakomarpaj's ceremony is quite elaborate, incorporating Buddhist and pre-Buddhist rites, and reaffirming the central role of Buddhist faith and shamanic lore in the practice of Thai medicine.

In fact, one of the main teachings of the Royal tradition is that religious practice is one of the major disciplines of Thai medicine, alongside herbalism and massage. The "Three Branches of Thai Medicine," as they are referred to, are represented in the architecture of the hospital itself, which houses a massage school and clinic in the West wing, an herbal dispensary in the East wing, and a pagoda containing the main shrine to the Buddha and Shivagakomarpaj in-between the two. The very placement of the shrine at the midpoint of the complex points to a self-consciousness about the centrality of Buddhist religion in the practice of traditional medicine.

Another example of the spiritual nature of the practice is apparent in the various initiation or graduation ceremonies conducted by Thailand's massage schools. Many schools stand by a timeless tradition of initiation before the teaching may be imparted. Some of my Chiang Mai teachers asked me to bring nine fresh lotus flowers and nine sticks of incense (or another suitable offering) to perform a ceremony at their altar--which included images of Buddha and Shivagakomarpaj--before being accepted as a student. Equally noteworthy are the graduation ceremonies, such as the Traditional Medicine Hospital's farewell ritual which includes chanting, consecration of diplomas, and a binding of the students' wrists with sacred thread.