MLD, Modalities, Oncology Massage, Thoughts on the profession

Absolutely Maybe

I have spent the weekend at a conference doing one of my favorite things — talking to other nerds about nerd things. The weekend started with discussion of the adaptations of lymphatic drainage protocols for specific types of plastic surgery, and ended with speculation on the titles of our future TED talks.

Mine is: “The Metaphor is Everything.”

But that’s not what I wanted to talk about today. Today I want to talk about certainty. Or, more accurately, capital-C Certainty.

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The end of the first day of the conference featured a panel of super smart guests, ready to talk about their particular view of oncology massage. It was a house tour of the neighborhood where you’ve always wanted to live — a chance to peek into the day-to-day lives, the medicine cabinets, and the private closets. (Metaphor. See what I mean?)

The first speaker made an entrance. She strode out from the wings of the stage and solemnly said her name and her specialty, then went on to spend her allotted time sharing images and stories of her work. I found the images and stories fascinating. I found her approach challenging.

After she introduced herself, she talked about the specific training she received, similar to mine, as it turns out, and talked about the danger of deviating in any way from the tenets and protocols of that training.

Here is where I admit that I have been deviating from the tenets and protocols of that training pretty regularly. I have a whole new kind of clientele — young, healthy people recovering from plastic surgery. For them, the exact protocol is often not as effective as some critically reasoned deviations.

I found myself becoming more and more uncomfortable as she spoke. She has been doing this a long time. She has gotten great results with some really challenging cases. She knows what she is doing. She is certain of it.

That is what made me uncomfortable. The certainty of it.

There are so many things in this profession that we were “certain” of — that massage increases systemic circulation, that mechanical pressure can change certain body tissues from solid to a more pliable gel, that we should never touch people who have cancer. Thank goodness enough open-minded, curious, smart people have challenged these and other certainties and proven them mistaken. Because of these people, who were uncertain, we can reach more people and provide much better care and education about these bodies we live in.

Certainty is a hard stop. It is the period at the end of a sentence and “The End” written at the bottom of the page. Certainty freezes us in time. I don’t want massage therapy to become dusty and desiccated like those life-size dioramas that used to terrify me at the Natural History Museum.

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We are, like the bodies we work with, living and growing. We may be educated, we may be experienced, we may be confident — but I hope, for own future growth and the benefit of our clients, we never become certain.

Inner World, Massage Tales, Modalities, Thoughts on the profession

Chicken Skin and Butterflies

“Rebecca, your touch is so gentle I bet you could pet butterflies.” She said this to me as she dropped into the table and let her arms fall away from her body. She breathed deeply and evenly and within a few minutes I could see that she was asleep, or nearly so. At the end of her session, she smiled at me warmly and said she appreciated being able to fall asleep comfortably.

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She reminded me of my time in Thailand a couple of years ago. I studied Thai massage for a couple of weeks — just enough time to confirm that I really know nothing about Thai massage. The teacher used to joke about “elephant skin people” and “chicken skin people.”

Elephant skin people, to him, were those who wanted more aggressive bodywork. They seemed to thrive on the deepest compressions, the most rigorous stretches, and the rough handling of their bodies. He gave a demonstration on one of these people while I was there. The client, a muscled American motorcycle rider complete with leather vest and chaps, groaned and whimpered his way through the session with my teacher. After the session, he got up from the mat, smiling and testing his newly mobile joints.

Chicken skin people, on the other hand, required gentler handling. Their bodies could not take deep work and they often could not move into some of the postures typical of Thai massage. My teacher teased me that I was a chicken skin person. In that, he was (is) completely correct. I do not respond well to aggressive bodywork.

And, as I am starting to fully embrace, I am a massage therapist for the chicken skinned. I feel most connected and at my best with those whose bodies, minds, and/or spirits require gentle handling and a careful, loving approach.

My client, who found such a vivid and lovely metaphor for the way I work, also gave me the perfect ending to this three week exploration of “just a relaxing massage.” I am here to whisper, gently, to your nervous system and let your body sink into its own healing capability.

Modalities, Thoughts on the profession

Just a Relaxing Massage, Part 2

Let’s talk about your nervous system. How about a quick check in? How’s it doing? If you are alive and reading this, it’s pretty safe to say that your nervous system is functioning.

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Your nervous system, the control system of the body, the keeper of the keys to so many other functions, is, for me, the primary target of massage. If I can facilitate a switch in your nervous system from sympathetic (“fight or flight”) mode to parasympathetic (“rest and digest”) mode, then a whole cascade of benefits happen in your body and mind. These include:

  • drop in heart rate and blood pressure
  • decrease in muscle tension
  • increase in energy required to focus
  • warmer body temperature overall

And these powerful effects come from that thing that is undervalued so much — “just” relaxation. Those effects seem pretty powerful to me, and definitely worth an hour of time.

Today I saw a new client. She chatted during part of the massage, talking about how she was always busy, always running, found it hard to stop and sit for a minute. She booked the massage as part of an ongoing plan to take care of herself. She talked about how it was necessary to take care of herself, but she said it in a way that seemed like she was trying to convince herself. For the last ten minutes of the massage, she grew quiet and her breathing deepened and slowed. Her arms, previously held close and tight by her sides, fell gently out to the sides. Her face softened. At the end of the massage, I said “Thank you,” and she said, “That felt good.”

That felt good.

It is enough, more than enough, to facilitate a space where someone can step out of their busy life and feel good in their own body, their original home.

Modalities, Thoughts on the profession

Just A Relaxing Massage, Part 1

We make a lot of claims in massage therapy. Some of them are proven. Most of them are not. I was thinking about this today as I went to talk to a local clinic about their massage offerings. Their website included the “improves circulation” and “removes toxins” claims that we hear so much, and that have no evidence to back them up.

Much smarter people than me have written about this, at length and with remarkable clarity. I suggest you check out Tracy Walton’s take here for more detail.

I want to talk about why we make all these claims in the first place. There are days when the entire profession feels like a collection of people tied up in some kind of inferiority complex. And, yes, I am including myself in this whole mix. We make all kinds of claims about what massage can do based on anecdotes, or long-standing oral tradition, or sometimes wishful thinking.

It goes, so often, like this: “Massage is relaxing. . . AND it can increase circulation and boost immunity and it might even make you able to fly.*”

(* — massage will not make you able to fly. Unless your therapist hands you a plane ticket at the end of the session.)

What’s wrong with stopping at “Massage is relaxing?” When did it become not enough to facilitate deep, uninterrupted relaxation? I have the good fortune to live a slow life most days, with time for exercise and reading and general contemplation. Most of the people I know are not so lucky. One slow hour with nothing to do but receive skilled bodywork seems like more than enough.

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This week, I am working on removing the word “just” from my vocabulary when talking about massage — as in “just relaxation.” As I know from my understanding of the nervous system, the effects of relaxation are profound and wide-ranging in the human body. I’m going to stop diminishing that.

Next week, I will explore some of these effects and the profound meaning of calming the human nervous system.

massage education, Modalities, Oncology Massage, Thoughts on the profession

Good Conversation, Better Work

For the past couple of months, I have had the immense privilege of hosting Healwell’s online webinar series, The Interdisciplinary Clan of Mystery.  This past Sunday was Episode 2, featuring Janet Booth, my new best friend and amazing, thoughtful human.  We spent an hour talking about end of life care, and what it takes for practitioners to serve clients at the end of life.  By the end it was clear — we needed at least two more hours.

 

marketing man person communication
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Talk is amazing.  And talk is cheap.  I found myself wondering this morning about the practitioners who watched the webinar, and whether anything practical was happening. We talked a lot about doing the inner work necessary to serve other humans.  Across the video conference lines, there was a sea of nodding, agreement, engagement and awareness.  Now, in our separate states, are we doing that inner work, or are we playing Candy Crush on our phones and ignoring our own uneasiness?

 

Since Sunday evening, I have been noticing all the ways I avoid or numb out.  Let me tell you, there are a lot of them.  It’s not always things that are clearly unhealthy.  Sometimes it’s exercise.  Or a book.

 

I had a new client a while back, coming for a massage after several months of not receiving massage.  Healthy, right?  Good self care?  Yet — I wonder.  During the intake I learned this new client had just received some very difficult health information.  Just received, as in about a half hour before the massage appointment.  The client made it clear that the entire massage was a time to forget this looming diagnosis.

 

It is not my place to tell someone how to handle their own bad news.  It is my place to serve without judgement and to create a place of safety.  But that client stayed on my mind for a long time.  I wonder if there is a place where that person can acknowledge what they feel in a place of safety and comfort.

 

Is there a place to be comfortable with our own discomfort.

 

I am working on creating that place and carrying it around me wherever I go.

 

massage education, Massage Tales, Modalities, Oncology Massage, Thoughts on the profession

Interdisciplinary

How about a quick peek into the emerging future of healthcare?

Interdisciplinary:  integrating knowledge and approaches from a variety of different approaches

Interdisciplinary Team: a group of professionals from multiple disciplines working together toward a common goal

I have been thinking and reading a lot about interdisciplinary teams in healthcare.  As the abstract “aging American population” becomes more concrete, both in my practice and my personal life, I am seeing humans who interact with multiple professionals, all for their individual care and keeping.  I am seeing this done very very well, and very very not-so-well.

What is clear to me is this:   the future of healthcare is interdisciplinary.  It is both necessary and desirable that humans have access to multiple professionals to address the multiple and complex needs of their healthcare.  Also:  the future requires us to communicate with one another.  While I know and massage and sometimes take care of people who are receiving interdisciplinary care, that does not always include great communication.

Take, for example, the cancer patient who also has hypertension*.  The oncologist and the nephrologist ask the patient for reports from other physician visits, but they are not asking to communicate directly with each other.  And neither of them wonders about the massage therapist who has been working with the patient since the cancer diagnosis.

In an ideal interdisciplinary world, patients could have access to a wide range of professionals and those professionals would speak to each other on a regular basis.  They might even, I don’t know, learn from each other and gain creative insights into sticky healthcare questions.

Unicorns!  Fairies! Rainbows!, you say?

This is not only possible, it is happening.  Wouldn’t you like to hear from a real interdisciplinary team about how they put it together, how they keep it going, and maybe even how the massage therapy profession can contribute?

You are in luck!

Starting this September, I will be hosting a monthly webinar series for Healwell where we explore these very questions.  We have secured some of the most interesting people working in healthcare today — the people who are asking the questions and creating the change.  Come and join us for the Interdisciplinary Clan of Mystery, where we explore how to deepen our service to the humans we care for, and broaden our perspective to invite collaborations, curiosity and plain old increased clinical knowledge.

We are going to have some fun, challenging, thoughtful, and (best of all) interactive conversations. Join me to take a peek at the disruptors, innovators, and smartest people working in healthcare today.

 

*–patients mentioned are composites or theories and do not represent actual humans

Modalities

Cross Training and Self Care

I am sitting at a table, trying to become more aware of my own movement habits and defenses.  It starts with keeping my posture upright and balanced, feet flat on the floor, trying to breathe into all sides of my ribcage and move from this supported posture, rather than from my usual habits.  Already, I notice how much I rely on my neck to initiate arm movement.  I make a small adjustment to my core engagement and try again.  It feels different, more easy.

I take a break for a short walk around the bookstore where I am working.  As I stop to browse I overhear this conversation:

“Your feet aren’t ugly.”

“Yes they are.  It’s just because I got my nails painted and they uncrusted my feet.  Really, my feet are ugly.”

I just spent the last two days in workshops with Donna Mejia, a scholar, dancer, somatic scientist and excellent teacher.  I have pages of notes and ideas, and a much more clear understanding of why my neck hurts sometimes.  We barely scratched the surface of knowledge she has built through her study, yet we all left with new understanding of how our bodies move.

And we started in a way that I love, and that I wish was unnecessary.  Donna invited us to take a different approach to our bodies.  Instead of thinking of all the things they couldn’t do or the ways in which they failed us, we were invited to be grateful for the all that our bodies were capable of.  Even in a room full of people ready to spend four hours in movement, it is necessary to remind ourselves of what our bodies can do.

four person standing at top of grassy mountain
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This approach resonates with me because it is a position of strength, and from this position of strength — however tenuous — we are able to discover ways to move, breathe live and be with more ease.  It seems to me that we should not give up our position of strength because of ideas about what feet are supposed to look like.

In the time I have been sitting here, fresh from workshops and with movement awareness at the top of my mind, I have been blissfully unaware of what I look like, and yet deeply aware of my body in space.  Areas of ease and tension, habitual defensive patterns, ways to move more efficiently.  The side effect of all of this is a calm mind free of much of my usual internal chatter.

As with all things, maintaining this is a practice, ongoing and ever-evolving.