August 30th, 2007 Julie Onofrio
One of the challenges the massage profession has is a major obstacle in educating the public as to what massage is or is not. Since we do not have a clear definition of it for ourselves - how can we educate people as to what it is?
The definitions created by states with licensing are quite varied. I am collecting them at my website www.massagetherapycareers.com and in doing so have been able to see why it is so difficult to be accepted by the public and to not be confused with prostitutes.
What is massage? What is bodywork? Is massage bodywork? Is bodywork massage? Is Reiki, structural integration, polarity therapy, reflexology, Bowen therapy, Trager, Rosen method, Rubenfield synergy, Shiatsu, Hakomi considered massage? Is it bodywork? Do you need to know Swedish Massage for those types of therapies (and go to massage school and be licensed as a massage therapist to do those types of massage techniques?)
Then there is the whole problem of defining ‘Medical Massage” - is medical massage a technique or just the ability to bill insurance companies for massage therapy services. If it is a technique - what technique or techniques are included and not included? Some are claiming that relaxation massage is not medical massage but if stress is the number one cause of most diseases and conditions and relaxation massage is the best modality for treating stress will we be cutting our own throats by not allowing relaxation massage therapists (who usually have less than 500 hours of massage training) to do medical massage? The problem now is that because it is not defined by the massage profession - the insurance companies are defining it.
The definitions of each different type of massage/bodywork or whatever you want to call it can be further defined for clarification. What is deep tissue bodywork? What is myofacial release? What is triggerpoint therapy? What is sports massage? What is swedish massage?
What type of training and experience is needed for doing each and every type of massage/bodywork?
The reason why we need to start clearly defining these words and techniques is so that we can then show these to state boards when they try to limit what we do or define what we do in other ways. It is also important in educating the public and promoting our profession as a whole and it really affects each massage therapist’s ability to work successfully with each client. This is seen when you go into a spa like I did a few months ago asking for a relaxing massage but not deep tissue as I have a lot of experience in getting Rolfed and doing structural integration. Deep tissue to me means challenging the deeper muscles of the body which usually has a degree of discomfort to it. I said that I wanted very firm relaxation massage and then when I got there I could hardly feel the persons hands on me. Now the clients experience is also so varied, but in this case the massage practitioner had no means of connecting to my needs. She never asked questions to find out how much pressure that meant to me or tried to figure it out in any way. I tried to keep telling her but I got no response and gave up (which is a whole other story - how many people getting a massage do not get their needs met because they don’t say anything?) Needless to say, I got a free deep tissue massage out of it later after speaking to the management. How we define and teach people to use such techniques really has a global effect of creating an image for the massage profession. How can we start defining ourselves to create a more professional and cohesive image? How can we start defining what we do so as to have a common language that ALL can understand?
Massage Definitions by State -www.thebodyworker.com
This research study attempts to help define massage -”Development of a taxonomy to describe massage treatments for musculoskeletal pain”
Posted in Ethics, Massage Schools/Students | 1 Comment »
August 8th, 2007 Julie Onofrio
Building relationships with clients is an art form. It is really the basis for healing. While your techniques may get people in the door with promises of relief from pain and stress, what heals is your ability to be present with another. This is the therapeutic relationship and I would say that it is a sacred part of being a massage therapist but is the least talked about subject in your massage training.
People can learn massage techniques and use those techniques to help others but the thing is that after working with a variety of people you will find that the same technique does not work for all situations. You can also teach 10 massage therapists the same exact technique in the same class and you will get 11 (not a typo) massage therapists whose work all feel different to the same person and of course that effect multiplies by the number of people who are worked on. Each persons touch will differ because of who they are and their ability to be present with the client. Each client will perceive the touch in a different way depending on who they are and what they are thinking/feeling.
Being present means that you are totally focused on the needs of the client, the healing relationship and not on yourself. Your presence requires attention, interest, acceptance, compassion, empathy and a non-judgmental response. While this may seem like what you are doing or may seem easy - the challenge is to do this but be able to feel whatever is coming up in you without acting on it. When you react to a client, you are acting on the basis of your old patterns and beliefs which has nothing to do with the client. This is countertransference and it happens in all relationships. There are two types of countertransference negative and positive. Negative countertransference is when you are reacting on old issues of your own. Positive countertransference is when you can feel your own feelings but not act on them and stay present with the clients process. This requires that you have a certain degree of individuation -the ability to separate your own feelings from what is happening in the client and the ability to feel your feelings without acting on them. Peer supervision and Psychotherapy can help with the process of individuation.
The book “The Psychology of the Body” by Elliott Greene is a great way to get a better understanding of all of these things related to the therapeutic relationship. He explains some of the components such as transference, countertransference and projection. While this is a much needed start for the massage profession, the book talks about it mainly from the aspect of what the client is going through. What is most important is what the massage therapist goes through and the process of learning to be present with a client in order to be of service to massage clients. It isn’t just something you need to understand from a mental aspect. It is something you need to be able to experience internally. The best way to get that experience is through the process of peer supervision.
The other part of the therapeutic relationship requires that the massage therapist be able to create healthy boundaries for this therapeutic relationship to occur within. This involves setting clear policies and procedures around such things as payment, late fees, cancellation fees, length of treatment session, dual relationships, dating clients, being friends with clients to name a few. The clearer your boundaries are in these simple things the more successful your massage practice will be. People will respect you more when you respect yourself and creating boundaries that serve you will show people that you respect yourself.
Posted in Building Your Practice, Ethics, Peer Supervision, The Code of the Caretaker | 2 Comments »
July 14th, 2007 Julie Onofrio
One of the major
themes in all helping professions revolve around the idea that people need to be helped and don’t have the resources that they need inside to take care of themselves and heal.
I just read a great explanation of it in a book called “Living in the Light” by Shakti Gawain
She says:
Victim consciousness is the belief that we are helpless; that the world, people and the economy do things to us and we have no choice but to accept what is dished out to us…
As victims, people enlist rescuers to save them. Rescuers do not know how to take care of themselves, so they focus on helping others, unconsciously trying to fulfill their own needs in and indirect way. They need victims to care for. A rescuer believes that others are weak or powerless and need his help…
You can’t be a rescuer, though unless you believe in and have a victim inside you…
To transform rescuing, we need to take responsibility for our own pain, and get in touch with the poser of the universe within us to help with our own healing…
The energy stays stuck as long as people are focusing on others as the problem or the solution…
Rescuers do not see how much they need help. They are so busy helping others, they cannot see their own pain. When they start to feel their own feelings, they cover them up by finding someone else to take care of…
The only way to help others is to do exactly what you really want to do.
OK I could probably quote the whole chapter but what it is saying really sums up all that I have been saying and learning for myself. The clearer I get about what I desire and I do that by checking in to see what feels the best, the easier things come to me in every aspect of my life.
Resources:
www.thebodyworker.com
The code of the caretaker
Posted in Ethics, Recommended Reading, The Code of the Caretaker, The Wealthy Massage Therapist | No Comments »
July 13th, 2007 Julie Onofrio
I was just about to take some books to the used book store to trade in when I came across a copy of a book written in 1986 called “living in the Light” by Shakti Gawain.
I am sure I read it a long time ago but when I started re-reading it yesterday I was delighted to find another explanation of the theories I write about - the ‘code of the caretaker’ - which involve learning to take responsibility for ourselves and take care of ourselves first before taking care of others. It leads to learning to be of service which is different from helping.
There are a few great chapters - on on the “Tyrant and the Rebel”. Here is what she says:
“The tyrant is the inner voice that tells us what we should and shouldn’t do. It’s all our rules and rigid expectations. The rebel is the part of us that refuses to do anything it’s told to do. It reacts in total rebellion and trusts no one. When the tyrant says ‘do this’ the rebel says ‘No way’.
The rebel was developed early in childhood in response to pressures and demands from outside authorities. The rebel originally protected our feelings by refusing to believe anything our intuition knew was untrue.
The tyrant wants to be heard and wants cooperation.
Neither the rebel or the tyrant are listening to or protecting you anymore. They have taken on their own personalities and are working in reaction to each other. When this happens, people feel stuck.
Neither the tyrant or the rebel are truly you. By learning to trust and follow your intuition both the tyrant and the rebel dissolve and you emerge into who you really are.
So when you are struggling in your life somewhere it is a good idea to take a look at who is speaking and taking the actions. Is it the tyrant who keeps driving you making you think that you should or should not be doing something? Is your rebel reacting and stamping their feet saying “no”?
Learning to trust your intuition is a process. Taking it easy and being gentle on yourself and taking very small steps can help you get unstuck. When the tyrant and the rebel are fighting it really is a form of beating yourself up which is what you were probably taught to do at an early age. It happens when we are told things like “big girls don’t cry”, “stop crying or I will give you something to cry about”, “you can’t sing - you should be an accountant” and all of the other critical voices of others told you. Everytime you beat yourself up you are continuing the cycle.
Learning to be gentle with yourself requires that you develop a certain amount of strength
Gentleness comes from a place of spiritual abundance. We can
only afford to be gentle when we are secure enough to lay aside
our instincts for self preservation, defensiveness or aggression when
we know what we need.
Taking the time to really go inside and find out what you need is really about taping into your intuition - your inner guidance system - your feelings.
The wealthy massage therapist is able to honor both the tyrant and the rebel and get in touch with their deeper selves and finds out what they need and value and is able to start taking the steps to tune into their intuition and take care of their inner needs.
Posted in Ethics, Peer Supervision, Recommended Reading, The Code of the Caretaker, The Wealthy Massage Therapist | No Comments »
July 5th, 2007 Julie Onofrio
Working as a massage therapist has ways of bringing out the best and worse in us. We are faced with the expectations of relieving pain and of knowing what a person should do. Massage school teaches us techniques to use to do just that. We take continuing education classes in techniques and theory.
We are trained in knowledge of anatomy and physiology and how massage affects the body and are taught to be authorities on the subject. Massage therapists are taught to fix and be responsible for others health or lack of it.
We work closely with people who are in pain which is usually much more than just a physical issue. As a result of such close encounters our lives are constantly touched which sometimes leads to our own wounds.
It isn’t so much what technique you use with a client but rather who you are as a person that will lead you to success in the massage profession. Being able to be with a client who is in pain and not give advise or try to fix -but just being present for the other and experiencing their presence and not just their symptoms allows a deeper level of healing to occur.
Our techniques are tools that allow us to communicate with the client. Working with different techniques with a client allows us to learn about ourselves. Taking a technique and making it your own requires that you take a look at what is in your heart and assimilate that technique into your own way.
The client really does not care much about the technique. They don’t care if they are getting cross fiber friction or if they are getting effleurage. They only care about how it feels.
Bevis Nathan in his book “Touch and Emotion in Manual Therapy” asks the question “What is it that heals - the technique and its tissue-specific physiological effects or the experience of being held/healed?”
“The intention of touch is to create a therapeutic physiological event in the tissues of the patient, and the rationale underlying the technique is physiological, kinetic or mechanical in nature. From the patients point of view, the touch has it’s roots in non-verbal communication or communion. She does not experience the touch as merely a technique or procedure on her body tissues, it involves her self. She is being held, cradled, stroked, caressed, valued, cared-for, healed”.
He goes on to say “If most therapeutic touches will evoke emotional responses in addition to mechanical ones, the question arises: which component is responsible for the healing?”
Posted in Changing Your Beliefs, Ethics, Peer Supervision, The Code of the Caretaker | No Comments »
