How's the Pressure?

At some point early in your massage, your massage therapists may ask you: "How's the pressure?'  or, "Is that pressure okay for you?"  Why do we do that?

Massage therapy is, by definition, the manipulation of the soft tissue of the body. This involves a certain amount of force.  When your massage therapist asks about pressure, she or he is checking in to see if you are comfortable with this amount of force.  We can feel lots of things in your tissues, but we don't feel when we have crossed the threshold from therapeutic into painful.  For that, we rely on your feedback.

Most of the time, the person in control of how much force gets applied to your tissues is you.  Your massage therapist wants you to speak up when something feels like it is too much (or too little.)  If it is safe and reasonably possible, your massage therapist will adapt to your preferences.

There are exceptions, however.  Your massage therapist wants to have a long and healthy career, so she or he may not do some techniques that cause pain and strain in their own body.  Your massage therapist also wants to make sure the session is safe for you, so she or he may adapt with respect to any medical challenges you may be facing.  For example, for anyone in active cancer treatment, deep pressure will not be a part of the massage.

Part of our responsibility as massage therapists is to listen to your requests and communicate our response clearly.  Sometimes our response to a request will be "No," which should always be followed by our clear explanation.

Your responsibility as a client is to listen and ask for clarification.  When your massage therapist asks "How's the pressure?" she or he is open to continuing the conversation about how to create the most effective session for you.  We are looking for an honest answer.  Don't like to talk at all during your massage?  Tell your massage therapist in the intake that you will let her or him know if something needs to change during the session.

"Take a Deep Breath In"

You are settled in on the massage table, tucked neatly under the sheet and blanket, a bolster under your ankles and music and lights adjusted for maximum relaxation.  Your therapist stands near the table, gently lays her or his hands on your back and says:  "Take a deep breath in . . ."

What?  Why do they say this?  And am I supposed to just hold my breath or what?

First, a confession -- I don't say this.  I find it a bit strange, but I understand the reasoning behind it and why it works.

Many of us live our lives in a state of chronic sympathetic nervous system dominance -- meaning we are always managing a certain level of stress.  This causes our heart rate and blood pressure to increase and our breathing to become more shallow.  Even if we are not in a state of chronic stress, we may experience stress flare-ups, and it is often these flare ups that send us to get a massage in the first place.

When your massage therapist prompts you to "take a deep breath in," she or he is trying to jump start your relaxation response.  Have you ever been so angry or frustrated that you felt you were going to explode?  And in that moment, have you ever just counted to ten while slowing down your breathing?  This is the response your massage therapist is going for.  Even in less extreme emotional states, a slow, deep breath gets your body started on the process to deep relaxation.

Your intention when you come in for your massage is to enjoy and get the most out of the time, but often your outside stressors will not leave you alone.  By focusing on taking a deep breath in, you give your mind something else to do besides run on its endless hamster wheel.  Physiologically, it also slows your heart rate and lowers your blood pressure.  Getting you started on this process makes your massage therapist's work more effective.  When you take a deep breath in (and exhale), you are actively participating in creating the overall benefit of your massage.

"Undress to your Comfort Level"

Right before she or he leaves the room, your massage therapist directs you to "undress to your comfort level" before getting on the table.

What does that mean?

Some clients have told me that they feel like they are being handed a riddle or a trick question with that one little direction -- like they are being tested to see if they are really good at receiving a massage.  This couldn't be further from the truth.

When you get a massage, you are making the decision to trust a massage therapist with your body.  A good massage therapist will also understand that this can be a very vulnerable position for some.  Her or his highest priority will be to keep you feeling safe -- like you can trust this therapist with the issues in your tissues.  A good massage therapist is also a quick, creative thinker who can adapt and craft an effective massage for you no matter what clothing you choose to leave on or take off.

When your massage therapist says "undress to your comfort level," what she or he literally means is "take off as much or as little clothing as you wish."  What is also meant is that how much of your body you undress is completely your decision, and your therapist will respect your boundary.  You will receive a great massage regardless of how much (or how little) you undress.  And you will be professionally and respectfully draped for the entire session.  When we give you that direction, we are letting you take control of when, where and how we work with your body.  It is just another way of letting you know that our work is guided and directed by you.

Supposed to Be

Life happens, and lately it has been happening all over the place for me.  Some unexpected changes and the need to scramble to keep up has led to some chaos and too few hours of just doing nothing.  My office remains my sanctuary, though, as was brought powerfully home to me the other day.

It was the middle of a week where any time I spent at my home was spent asleep.  Every morning I packed for the three or four different people I needed to be in a day, and I felt like I was living more in my car than my home.  I arrived at work a little rough around the edges still, and found that the simple act of setting my space was taking forever.  I kept forgetting things and must have walked back and forth between my room and the storage room about 5 times.  It was a day where I needed to check my phone to know what day it was.  (Thank goodness for the "Today" button on my calendar.  If I'm not living in the present, at least my technology can get me there.)

Chaos remained at bay while I was working.  It greeted me outside the room every time I stepped out, but it maintained a respectful distance.  The energy required to keep it there was starting to wear on me.  Towards the middle of the day, I saw a newer client -- an oncology client.  She doesn't talk much, but always listens deeply.  This day, she arrived with her head shaved, having decided to accept the havoc chemo was wreaking on her hair.  I asked her if she was comfortable with a scalp massage and she said yes.  As I sat at the top of the table and laid my hands on her head, I heard a whisper in my inner ear,

"Supposed to be."

As in, I am who, where and what I am supposed to be.  Right in that moment, all was right, and it would be alright.  I said a silent thank you to my client for trusting me with her vulnerability.  I thanked my teachers and mentors for teaching me to do this work.  I thanked the chaos for highlighting what peace looks like.

Mind Switch

The oncology massage portion of my business has been picking up lately, which is wonderful.  I have spent many busy days feeling so deeply in my element that I forget what it feels like to doubt my skill.  Right place, right time, all the time.  Life is beautiful.

Last week, though, I got a little kick in the massage pants.  It was a quiet day, with two clients.  the first, straightforward manual lymphatic drainage to deal with complications from cancer treatment.  The second, a new client.  An athlete who came to me via a referral from a current client.  The first session was gentle, quiet and rhythmic.  There was snoring,  snd a report of reduced pain and swelling.

When my second client arrived, I was briefly thrown by her health history form.  No illnesses, chronic or past, no medications, no accidents, no surgeries.  I got a little tongue-tied.  What information do I need from this person?  I jump started with the question I used to make all my students ask ("What are you hoping for from your massage today?") and eventually got rolling.  Then, just before I stepped out to let her get on the table, she threw me again.  "I like pressure," she said.  "It's okay with me if it hurts a little." I gave her my standard response ("If you are holding your breath or tensing, the pressure is not therapeutic.")  She nodded doubtfully.

Her massage was an exercise in digging deep for my shelved sports massage skills and attentively monitoring any changes in breathing or body position.  I felt muscle tension in the places where I expected it, and, novel experience for me, I worked with it until the muscles released.

In short, I enjoyed the work.

It was a colossal mind switch for me.  Not only to switch from the gentle mindfulness of an oncology session to the more clinical mindfulness of a sports-based session, but also the realization that I kind of like the clinical work.  I know I don't want to do it all the time, or even half the time, but these little clinical breaks might be good for keeping me engaged with my career.

My heart and my best work is still with oncology massage, but it is nice to be reminded that my particular art of massage can take other forms, all of them effective.

Let It Go

I said to my family member: "You don't have to hold on to all the things."  I heard the echo in my own ears and, to be honest, it sounded just like irony.  I am getting better and better at the idea of letting go, but I still don't excel at it.  It's a practice, after all.

This week, I let go of something that I had held on to for just that little bit too long -- my teaching job.  For a little over 2 years, I taught in the general massage therapy program of the school where i learned massage.  Even though it was clear almost immediately that it was not the same school in philosophy, attitude, or almost anything I recalled, I hung on because I loved it.  I loved the teaching and the students.  I loved it so much I wrote about it, a lot.  I loved it so much that I stayed, even when going to the school made me physically ill, and I could watch myself being a straight-up jerk to my boss.

But I could keep it all together in class.  I could bring my best self for the students. That's what it was all about anyway.  Sure I could.  Until I couldn't.  This last term, every day was a struggle against entropy.  It took all my energy just to hold it together for the 4 hours I was in the classroom.  By the end, I stopped trying to engage students who were slipping away and managed to give just enough to keep the rest of the class afloat.

This was my last week of teaching at that school.  I got a colleague to cover my final class so I could sneak out quietly, avoiding the need to think too much about the finality of it. I wrote "So long, and thanks for all the fish" on the board and snuck out while everyone else was teaching.

I say I'll never go back there to teach, that my teaching outlet is now focused on Oncology Massage and other Continuing Education classes, but I can't be sure.  I can't be sure that I have really let it go.  For now, though, I feel like it's right to be away.  There is a space opening up for all the other things I want to do, and I am gathering the courage to trust fall into that space.

I can't fall, though, until I let it go.

Bearing Witness

I have a new client*.  She fills out her health history form with abundant detail, and takes me through it step by step, anticipating every question I have or clarification I need.  She walks me through her entire cancer journey, over 15 years in the making, procedure by procedure, chemo by chemo.  She often accompanies her narrative with information about her mental state at that time, or how that time impacts her current mental state.

"Just naming," she says.  Or -- "Just so you are aware."

A while back, I had some news that was difficult for me to handle, but which I felt should not be shared with my whole support network.  I chose one person to tell, and when I went through the whole thing I told her, "I just needed one other person to know what is going on."

These two stories live together in my mind because for me they illustrate an important part of my job as a massage therapist.  The bearing witness.  Just being the person who hears a voice and says, "Yes.  I heard."  Just being the person who sees a face wince and says, "Yes.  I see that your pain is real."  The simple of act of allowing another human being to name, describe and acknowledge their experience with no fear of judgement or contradiction -- this is a powerful part of what we all do.

I looked up the definition of "to bear witness to" and found this:

"to show by your existence that something is true"  

This, for me, is the heart and soul of both of these stories.  By listening while someone speaks and names whatever pain or challenge they have faced, we show that it is true.  Let us never forget,  even with all of our training and all of our knowledge, our clients are still the authors of what is true in and for their bodies.  Let us remember to always bear witness.

*-- any identifying details have been changed