What is Manual Lymphatic Drainage?

I have letters after my name which are sometimes confusing: CMLDT. This stands for "Certified Manual Lymphatic Drainage Therapist," and it is one of my favorite modalities.  Manual Lymphatic Drainage (MLD) is vastly under-utilized.  I am making it one of my goals for the coming year to introduce this work to a broader audience.

MLD is a gentle technique designed to increase the movement of fluid through the lymphatic system.  The lymphatic system is our waste removal system, transporting fluid from spaces between body tissues into the cardiovascular system for delivery of nutrients and removal of wastes.  The lymphatic system also serves immune system functions. 

MLD has a number of applications.  Most people hear about it in reference to cancer treatment where lymph nodes are removed and the risk for lymphedema is increased.  MLD is certainly a powerful part of lymphedema treatment and prevention, but it has many applications for everyone.

For example, MLD was initially developed by Dr. Emil Vodder and Estrid Vodder as a method of treating the chronic colds displayed by English visitors to their clinic in Cannes.  Their techniques showed dramatic successes, relieving colds and sinus congestion almost immediately.  I have also seen this effect with clients who use MLD to manage chronic allergy-related sinus congestion. 

MLD Is also effective as part of the treatment for whiplash, injury-related swelling and post-surgical swelling.  The techniques are so gentle that they can often be applied very early in the healing process, even before traditional massage techniques can be used.  

MLD can also help with management of chronic illnesses such as fibromyalgia, chronic fatigue syndrome and rheumatoid arthritis.  In addition, people who suffer migraines or sinus headaches often find relief with MLD.  

My clients report that the experience of MLD is profoundly relaxing.  Even a brief, 15-minute head, neck and face treatment can help alleviate overall tension and stress.  I have also noticed decreases in post-workout swelling and recovery time if a client receives MLD right after a training session.  

In short, MLD can benefit you, right now.  I'd love to tell you more about it, and talk about how you can incorporate this work into your overall wellness plan.

Learnin'

I was talking with a friend about the venues in which I teach, expressing love for the teaching, but ambivalence about the venue.  And then she said something brilliant: "You don't have to be in that classroom to be a teacher."

Yes.  Silly me-- I thought the place defined who I was, but I forgot that definition comes from within.  So, now one of my goals for the next year is to find new, supportive venues to be who I am -- educator, massage therapist, kindness-bearing human.

In the grand tradition of what you send out comes back to you, a beautiful opportunity came to me.  Starting in January, I will be teaching an ongoing muscular anatomy class at a local dance and fitness studio.  I am excited and a little overwhelmed.  There is always that moment of "Am I the right person to do this?  Couldn't someone else do it better?"  I remind myself -- I am the best person for this, because I am the one pouring my heart and energy into it.

I can't wait to introduce a whole new audience to their own bodies.  It's like Schoolhouse Rock said, way back when:  "It's great to learn -- 'cause knowledge is power!"

Here we go.

Teacher's Pet Syndrome

Some people read WebMD and suddenly discover that they have multiple serious diagnoses.  Me, I I don't need WebMD.  I come up with my own fake syndromes all the time.  Today I have diagnosed myself with a serious case of TPS, or Teacher's Pet Syndrome.

Symptoms of TPS include: fluctuations in self-esteem, general discomfort around uncertainty, and unexplained desire to receive approval.  TPS is usually identified before the age of 10, although some rare cases may have an adult onset.  Once infected with TPS, the patient can experience long phases of disease inactivity, but flare-ups do occur, often without warning.  TPS manifests most seriously when the sufferer encounters questions for which she does not have an answer.  

Today, I suppressed a mild TPS flare up.  My client asked me to check a bump on the back of her neck.  "I mean, I know you're not a doctor and you can't diagnose," she said, "But I just want to know what you think.  If you think I should see my doctor or whatever." I was seized with uncertainty.  I palpated the bump on her neck.  I had no idea what I was feeling.  I just didn't know, and this made me extremely nervous. As a person who knows lots of other stuff, and enjoys teaching this stuff to people, it feels distinctly unsafe to admit when something is beyond me.

But it is even more unsafe not to admit when something is beyond me.  So, with my heart racing, I told her, "I don't know what that could be, but if you're concerned about it, you should see your physician." My misguided TPS instincts wanted to make up a plausible story about what it was, so that I could receive even more approval for the knowledge I have acquired.  Had I done so, I could have persuaded her not to see her physician at all, and who knows what that bump could have been.  

I often tell my students to be confident in what they say, even if what they say is "I don't know."  The point is that you don't build trust by making up semi-plausible explanations about health questions outside your scope.  You build trust by admitting when something is beyond your expertise, and gently suggesting someone seek the advice of a professional who knows.  

I am happy to say that my TPS is largely in remission now, so I will be saying "I don't know" whenever it is appropriate -- because I am confident in my knowledge, and in my limitations.

Meant to Be Touched

The human hand is a biomechanical marvel, isn't it?  I live I a large city, and I look around at the architecture, the public art, the environments built onto the landscape and I think, "Human hands did this."  Hands with the same configuration of bones, muscles and tendons as mine.

Someone told me once that the human hand is designed to conform perfectly to every part of the human body.  Our bodies were made to be touched.  Our hands were designed to comfort.  So the marvel extends from our hands to the entire body -- pieces meant to fit together as we comfort, nurture and just relate to each other.

I thought of this last week when I was talking with a student who told me she hated being touched, but she really loved giving massages.  Sadly, this was not the first time I had heard something like this.  Like others before her, she was missing half of the equation for comfort.  It is not just the touching, it is the being touched that constructs our humanity.  When I tried to point this out, she shuddered -- actually shuddered-- as if the idea of being touched disgusted her.  

I see her attitude as the extreme end of the spectrum of self-neglect many massage therapists live on. I am guilty of this myself -- finding myself fatigued and emotional after an overscheduled week, wondering why my body will not cooperate with my need to overwork it. The work gives me joy and comfort, but when I neglect to make the time to receive, that joy and comfort fades too soon.  

The human hand was designed to touch.  The human body was designed to be touched.  Living in half of this circle leads to imbalance.  So, especially now when it is cold and dark, give and receive hugs, give and receive hand-holding, and, especially, give and receive massage.

But What About Everyone Else?

I recently had a conversation with a friend about our small businesses.  We were discussing the difficulty of convincing people to take time and money to spend on themselves and their wellness.  Our target markets have a lot of overlap -- busy women who spend a lot of time taking care of other people.  These are women who would move heaven, earth and all the spaces in between to do something for their loved ones, but rarely overturn a stone to do something for themselves.

 My friend runs a dance and fitness studio, and made the (very convincing) case that spending time at her studio actually brings benefit to the people women care for.  The women who exercise are healthier, have more energy, may actually live longer, etc. 

But wait, I thought, massage does that too!  Massage provides a real and tangible benefit not only to the person who receives the massage, but to everyone in her life.  I realized that we as massage therapists don't talk enough about his benefit, and we need to.  So, here is my short list of reasons why your massage helps everyone around you (with links to more information):

--Massage helps you sleep better, giving you the rest you need to stay focused. 

--Massage reduces anxiety and depression, allowing you to stay connected to the people you love, and really experience the joys of your life.

--Massage reduces pain and tension, allowing you to move freely through your day. This also allows you to maintain an exercise routine and have access to all the benefits of that.

-- Massage may enhance alertness, allowing you to attend to what is important.

So, for all of you out there who do for others, who think of others first, I ask you: Don't your family, friends, coworkers, clients, etc. deserve the rested, calm, alert and relaxed best version of you?  Massage is not a luxury indulgence.  It is a vehicle to reach and become your better self.

No Apologies Necessary

"I hope you don't mind a little bald head."

"My skin is kinda dry from the cold."

"I just didn't have time to shave today."

"I need a pedicure."

(stomach gurgles) "Oh! I'm so sorry!"

This is just a short sample of the hundreds of different ways clients apologize to me about their bodies.  I'm sure every massage therapist can relate.  Our clients come in and trust us enough to let us touch them, but they still want to make sure we therapists are comfortable.

This has led me to establish The Rule.  Outside of bigotry or sexual innuendo, I try not to have rules about what clients should or should not say.  My office is a safe, private space.  Sometimes people need a place to say out loud the scary or possibly unaccepted thing they are thinking about their lives.

But, one day, I had enough of the above, so I now have The Rule, which is:
You don't apologize for your body.

And The Subrule, which is:
You don't make anyone else feel that they need to apologize for their body.

Most of my clients are women.  Many of my clients are facing or have faced significant medical challenges which have altered, scarred, or otherwise changed their bodies.  Most of these changes fall outside the subjective norms of "what women are supposed to look like."  I aim to create at least one place in the world where any person can feel comfortable and confident that their body is not under any sort of judgement.  That they are accepted and valued for who and what they are right now.  That on my table and in my space, everyone-- EVERYONE-- is beautiful.

I grew up the official fat kid of my elementary school.  I remember feeling the need to apologize for my body every single day.  When my clients started apologizing to me, I felt tremendous empathy for them.  Those things they apologize for do not disrupt their massage or offend anyone.  Whether you have or don't have hair and where it is on your body, the condition of your skin, the state of your feet -- any of that and more -- has no bearing on your worth as a person.

And that last one, the stomach noises?  That happens when your body is deeply relaxed.  That right there is massage applause.

Not Your Therapist

I often tell my students that not everyone is their client, that they are not everyone's therapist.   As part of my ongoing adventures in learning to market, I am experiencing this very profoundly.

Yesterday, I volunteered at the Chicago Marathon -- a big, boisterous fun day of post-event massage and lots of energy.  I thoroughly enjoyed the entire day, but is also know that pretty much none of the people I worked on were "my" clients.  

I worked in the medical tent, mostly providing cramp relief for dehydrated and/or undertrained athletes.  About two hours after the start, we started to get patients in.  As expected, the first hour or so was filled with people who had pulled out without finishing the race due to injury or other complications.  Early on, I worked with Drake*, a young man who had completed an endurance event the week before, but pulled out of the marathon around mile 19 because of pain in his knees and ankles.  He said it was normal for him to have pain in those areas because of a chronic health condition, but that is was also normal for him to exercise outdoors for several hours a day.  

I was gently working around Drake's knee, trying to identify any muscular issues.  I found an area of restriction, and Drake insisted that I could "go harder. " I said to him: "Yeah.  I could go harder.  But last week you finished this ultra event, and you just ran 19 miles today, so your muscles need recovery, and I'm not going to go harder."  Drake seemed disappointed, but he didn't insist.  Whether it was because I convinced him with logic, or because he was born in the year I graduated high school, I can't be sure.  

Either way, it was clear that Drake's view of massage (hard, rough, painful) had nothing to do with mine.  He was not, and will never be my client.  Earlier in my career, I might have tried to be his therapist and sacrificed my professional judgment for my client's preferences.  Now, I know better.  I'm not going to go harder.  

*-- name and identifying details have been changed

Niche

I am in the process of finding and targeting my niche.  I prefer to call this "knowing and speaking to my people."  This is proving to be more difficult than I thought.  Of course, people who are in or have a history of cancer treatment are my people.  But there is another piece to this puzzle which I am having a hard time defining.

My current (inadequate) description of my people is: stressed-out women over 40.  What I mean by this is: people for whom massage is as much about emotional wellness as it is about physical.  In school, one of my instructors described my massage as having an intensity similar to that of a mother caring for a child.  My classmates teased me about my "momssage."  I labored against this description for a long time.  It is not necessary to be (or want to be) a mother in order to be nurturing.  Clearly, I thought, what my teacher meant was that I have focus, and that I am able to be present for my clients.  Over time, though, I kept coming back to "momssage."  

My people, the ones who respond most favorably to my massage, are carers.  They have people in their lives who rely on them for support and strength.  Most of my people enjoy this role, and they are good at it.  But sometimes, they are exhausted.  I think the shared reason they come to me is for care. I feel like for them, beyond the physical relief, the massage is time to refill.  Of course I am guided by the needs of their physical bodies, and of course we often see significant reductions in pain, iimprovements in joint movement and all those massage-y things.

That's not what makes them my people, though.  It is the intensity of focus (which I have some days better than others) on them as whole people.  When I am trying to define my people, I keep thinking of this scene from "One Day at a Time" where the main character (a single mother of two teenage girls) is arguing with her boyfriend.  She is not feeling well and wants him to take care of her.  He accuses her of wanting to be "babied," and she responds, "I don't want to be babied! I want to be mommied!"  That character is my people.  A stressed-out woman over 40, in need of some time to be taken care of, not in the way where she loses all will and direction, but in the way that acknowledges her challenges and anticipates her needs.  Mommied.

Res(is)t

Of course caregivers don't know how to take care of themselves.  Of course physicians, nurses, holistic wellness practitioners, and massage therapists counsel balance, moderation, and self-care all while running themselves into the ground.  And, of course, most of us think we are the exception.  We are the ones doing all the right things while our colleagues run themselves into the ground.  We can be arrogant, too.

I recall one of my students talking about massaging a veteran therapist.  He was shocked (his word) at the condition of her back muscles, and at the level of postural distortion he saw.  He asked me, "We are trained to know body mechanics.  We are supposed to know how to move and stretch so we don't hurt ourselves.  How does somebody who knows this get so messed up?" I shook my head, said something about the difference between what we know and what we do, and silently congratulated myself on my superior self-care.

Arrogance.  Schadenfreude. But, as a friend once said, the karma train makes all stops.  Last week, it slammed right into me.  I woke up with a painfully sore throat, and over the course of the day, started to feel feverish and dizzy.  Rather than go to bed, or go to a doctor, I muscled through some classes and meetings.  Finally, after three days and no improvement, I admitted that I was sick.  I cancelled all my clients for the next few days, and weakly drove myself to a clinic.  The conclusion: some kind of virus.  Nothing to do but drink lots of fluids, and rest.

Rest? 

I settled in to my couch with water bottles and internet devices in reach.  After the first fluff video and midday nap, I emailed one of my clients, saying that I knew I would be fine by the end of the week, and would she like to reschedule?  This was her response:

"Though I will sign up for more massages (of course), it seems mercenary to schedule something at this moment.  I am solely focused on your well-being this morning! Just keep getting better."

Rest. So, with that coaxing and permission, I did.  I often tell my clients that doing nothing is "the hardest easy thing in the world." I certainly felt it this week.  Clearly, though, I needed it.  Now that I am actually feeling better, I am grateful for taking the rest.

Human Kindness

Several years ago, I participated in a three-day walk to raise money for breast cancer research and prevention.  The whole event was carefully constructed and well managed.  In addition to the logistics of directing, feeding and taking care of thousands of people, the organizers spent time creating an entire worldview.  We were all together, working towards the same goal.  We had a responsibility to each other.  The theme for the weekend was "Human Kindness."  They told us to be kind to each other, and we were.  

When I went home from the event, I felt a little sad that the whole world did not share that basic drive to be kind to each other.  I tried to keep it going in my own life, with varied success.  Some days, the tourist traffic and odd smells of public transportation made it nearly impossible.  

Last weekend, I was reminded again of the importance of being kind.  I went to massage a man who was on hospice.  While I was there, his pastor came to pray with him and the family.  I moved a discreet distance away while they shared their moment.  As the pastor left, he thanked me for my work and called me an "angel" for doing it.  I thanked him and went back to the massage.

Later I had time to reflect on the moment, and to realize how uncomfortable it made me.  Yes, I was aware of and grateful for the kind words.  Yes, I was humbled by the depth of the compliment.  And, yes, I felt boosted up by the acknowledgement of my work.  But I remembered that three day walk, and how just by practicing kindness, we created so many deeply touching moments.  It wasn't superhuman -- angelic -- it was just humans taking care of one another.  Is kindness really so rare in the world that it seems divine to us? 

 So, no, I am not an "angel," I am simply a human, trying to be kind to other humans.  On the days when it works, it can be beautiful.  On the days when it doesn't, usually there is some other human showing me how it's done.  We live on this earth, briefly.  We work on this earth just the same as the people around us.  Our kindness, our attention, elevates us.  Be kind, humans.

Sanctuary

sanc·tu·ar·y

noun, plural sanc·tu·ar·ies.

1.

a sacred or holy place.

Lately, I have been thinking a lot about sanctuary.  Massage practitioners use that word often when describing their practice:  "Welcome to your sanctuary," "This office is a sanctuary," etc.  I wonder if, when we use the word, we also put in the work behind making it true.  

A sanctuary is a sacred place, a place removed from the daily life of the world where a person comes to connect with something higher in themselves.  It takes more than quiet music, warm tables and soft sheets.  It even takes more than a skilled practitioner. Creating sanctuary takes work and intention.  Every time I walk into my massage room, I build this sacred space again.  

I start by turning on the music in the room, for the practical reason of adjusting volume and testing equipment, and to replace all the scattered thoughts in my head with focus on my clients for the day. Then I put sheets on the table, smoothing them down to be inviting and comforting.  The simple act of choosing sheets involves thinking of the client who will shortly be using them.  Does this person run hot or cold?  Is their skin sensitive?

I try to manage myself in the massage space as well -- even when clients are not there.  I save my task-based worries and general anxieties for my desk, with varying degrees of success.  I have been trying to convey this idea to my students, and I am running up against the wall of metaphor:  check your bags at the door, leave your garbage on the curb, put it at the coat check.  At any rate, I know that whatever I set aside will either wait for me to come back and care for it or walk away.

I soften my hands -- easier to let go that way -- and root my feet.  I create in my body something solid and rooted, but flexible and agile.  The truth about creating a sanctuary is that it is a relationship with the space, and as such, requires work.  I can call a place a sanctuary, but if I haven't put in the work behind it, the place is merely quiet.

The Universe Has a Message for You

"The greatest glory lies not in never falling, but in rising every time we fall."
--Nelson Mandela

That quote is the one that convinced me that I am magic.

Well, not magic, really.  It just made me think that there is a possibility of fate being bent and shaped in just the right way -- that meanings are not always constructed in our minds, sometimes they appear outside us like shapes in the mist.

With my first graduating clinic class, I started a tradition, a closing ceremony.  On their final clinic shift before graduation, I gathered up a bunch of inspirational quotes, then wrote them on notecards.  I put the cards in unlabeled envelopes and shuffled them so I didn't know which was which.  Before the students arrived for their shift, I put a notecard in each of their massage rooms.  Everyone got a message.  I didn't know which.  At the time, it seemed nothing more than fair.  What if I assigned quotes to people and someone thought theirs was harsh, or took it the wrong way?  This way, I took myself mostly out of it, and they could make their own meaning out of it.

That day, Kim got the envelope with the above quote.  I have written about Kim before, how during her final term she was mugged, knocked to the ground and beaten.  By the final clinic shift, she was physically recovered, but still mentally reeling.  She came into the student lounge, notecard clutched in her hand and said, "This one!  You planned this!"  She knew I hadn't planned it, and so did I, but the coincidence touched both of us.  We hugged and cried.  Kim tucked the notecard into her shirt and kept it there for the entire shift.

I went home that night feeling contented, thinking what a nice, random thing to happen.  So the next time I had a graduating class for clinic, I did the exercise again.  My most cerebral student got the quote about overthinking.  I did the same ceremony the following term.  One student and I had spent an earlier shift talking over her negative body image and self talk, and I spent a long time gently persuading her to try being as kind to herself as she was to everyone else.  She got the quote about internal beauty.

There are more examples, some beautifully matched like these, some where it was clear to me that meaning was being drawn onto the situation by the students.  Still, every time I did this exercise, people left feeling like they had received a truly personalized message.  I decided to turn down my practical brain, and named the ceremony "The Universe Has a Message for You."

I have just started a new term, and I have a clinic group who will be graduating at the end of it.  I am looking forward to the messages that will come to them.

Trading

In massage school, we talked all the time about trades.  We would connect with each other, with other therapists in the community, and we would set up trades. It was going to be great.  We were going to get so much bodywork, and so much feedback.  We would be healthier than ever.

The reality is, trades are very difficult to set up and delicate to manage.  Once we started working, we realized how little time we had to do trades.  We also realized how little energy we had left over after a full day of clients.  And if we schedule our massage trades all at once, it became hard to enjoy receiving massage because of either being keyed from giving one, or from thinking about giving one.  We started to neglect our self-care in all the ways we swore we wouldn't.  How long had it been since we last received massage?  Well, to be honest, we had no idea.

Recently, a very dear friend and fellow massage therapist started her practice at the Heartwood Center, where I work.  We spent many hours talking over our businesses, planning outreach we could do together, and generally supporting each other in the process of becoming self-employed.  Fortunately, we work many of the same days, so we decided to do regular massage trades with each other -- each of us alternating a week so we both received 2 massages a month.

Since trading with each other, I have noticed that I have more stamina, mentally and physically.  My chronically cramped right hamstring muscle is starting to open up.  I sleep better -- all benefits of massage that I have preached to my clients for years.

What surprised me, though, was that since trading with my friend, my work has improved for all of my clients.  Working with a friend requires careful management of the boundaries between friendship and clientship.  While my knowledge of my friend's life might inform the massage work I did with her, it was (and is) not appropriate to use the massage space to talk over our lives.  That comes later, when we both have a break and are eating lunch in the kitchen.  At first, I had to take some extra time to focus before I massaged my friend -- some more deep breaths, another brief mind-clearing exercise.  Now those extra steps have translated into deeper focus for all of my clients.

The bottom line is this:  we both started our practices thinking we were striking out on our own.  What we found was that community ties actually become stronger.  We worried that we would feel isolated when we started our practices.  In truth, we realized how isolated we were when we worked for other people.

Things She Wants

My new client, Ada*, was in the earliest stages of a degenerative illness which affected her short term memory and her ability to make decisions.  She moved just fine and had no physical symptoms other than what was normal for a woman of her age.  I met Ada as she was walking down the hallway and introduced myself.  I suggested we go into her room, and she squinted briefly -- "Where is that?" -- but relaxed when I showed her a doorway with her picture posted next to it.  

We walked into the room, and she wondered aloud where I wanted her to be for the massage.  I pointed to the closest of two beds.  Ada shook her head and said, "Oh honey.  That's not my bed.  I'm not going to get into someone else's bed . . . unless Brad Pitt is in there."  

We laughed together as I helped her to her actual bed, apologizing for the lack of Brad Pitt contained within.  I thought this was going to be fun -- like my other client who had to give up cigarettes, booze and sex.  

The thing about short term memory loss, though, is that each thought that comes across the mind has to be dealt with, immediately.  Shutting off the mind for deep relaxation requires concentration and focus.  At her current stage in the illness, she had neither of these things.  A devilish grin over her joke, quickly turned to skittish anxiety when she wondered how long she would be staying "in here."  Then that morphed into tear-streaked sadness at her lack of family and friends who could take her in.  In short, she was all over the place, and I couldn't redirect her for more than a few seconds at a time.  

I left her in the care of one of the life enrichment staff -- a gentle, patient woman who walked her down the hall towards a resident social hour.  Myself, I left feeling defeated.  I used to think it was my gift to be able to adapt to people as they are, to sit in their space and bring quiet to them.  I couldn't do it with her.  I fell for the easy, funny moment and forgot to look just underneath at all of her humanity.

*--name and identifying details have been changed

Butterflies, Google, Music and More

I have been thinking a lot about the things that draw clients back to me.  More and more, I am seeing the importance of the things that are not the actual massage.  Here are a few things that have come up lately:

Sheet Handling

A client said to me: "I feel so cared for.  And when you are moving the sheets, it feels like a team of soft butterflies working together.  Other massage therapists do all this pulling and tugging."  She comes back to me because, among other things, she feels like the draping is just as relaxing as the massage.

Internet Presence

A new client said: "I Googled your name and everything.  I know you used to work in senior care, and you started this career later in life.  I saw the YouTube video about oncology massage so I felt comfortable that you would know what you were doing."  She went on to apologize for "stalking" me before the appointment.  I assured her it wasn't stalking, it was smart research.  And I was glad that what she found created a sense of comfort.

Just Being Around

Another new client: "I have meetings close to here every week, so I can just come in for a massage right after." I am in the office when she has time.  It's that simple.

Amenities and Equipment

"Your table heater is always even.  I don't feel any cold spots on this table."  When your equipment is worn out or cheap, your clients can feel it.  I am realizing that I have to spend the money on the good stuff.

Music

My go-to music is a blend of classical pieces, but I started putting together a more varied library after a client told me the music made her tense because one of the pieces was something she had to practice often during her hated piano lessons.  

My knowledge and hands-on skills are still vital, but I am paying more attention to all the surrounding things as well.  Massage therapy is a science, an art, a business, a design project and a calling for me.

And When She Was Good, She Was Very Very Good

For a while, I had the absolute honor to be Lila's* massage therapist.  Lila, a retired musician, might be called "feisty" in some circles.  She has Lived, with a capital "L," and while her current life is not exactly what she hoped for, she still finds some way to grab every day by the ears, sniff in its face and say, "Hi there.  I'm Lila.  What do you have for me?"

Lila is an alcoholic who stopped drinking 30 years ago.  She was a multi-pack-per-day smoker who stopped about 5 years ago.  She was getting ready for surgery to correct a prolapsed bladder.  While I gently massaged around her sacrum, Lila said to me: "I don't drink anymore, I can't smoke, and my bladder is falling into my vagina so I can't have sex.  What vices are left anymore?"  I thought for a minute before responding, "I don't know.  Guns, maybe?"  Lila laughed her (ex)smoker's raspy laugh and relaxed into the massage.  

I spent hours in continuing ed talking and learning about geriatric massage.  We spent a lot of time talking about the person, work with the person, the person comes first, be person-centered.  But, in truth, nothing we talked about allowed for a person like Lila.  A woman: white of hair, stooped of spine, wrinkled of face, and alive with humor, wit and sensuality.  We still have trouble, in our person-centered hearts, giving up the "age-appropriate" trap.  More Lilas are needed, stat.

*--Name and identifying details have been changed.

Defense Against the Dark Arts

In my professional life, I do a really good job of keeping it together.  I can check my baggage at the door, and while I have bad days like everyone else, I can be mindful about keeping other stuff out of my work, my teaching.  

False.

Yesterday I kicked a student out of my class for using the F-word.  It was the third time I've confronted that student about some disruptive behavior (not that I'm counting.)  I went on with class, engaging with the working students, as the student I asked to leave took her sweet time picking up her stuff and shuffling out of the room, grumbling the whole time.  After class ended, three students came up to me to apologize for the way class ended.  Initially I was touched, but as I thought more about it, I realized that my cracks are showing.

This particular class challenges my patience and creativity in ways which are exhausting.  They are noisy, disjointed, and they don't like each other very much.  They are like a particularly smart virus.  Every time I find some strategy that calms them, they mutate and reform into a chaotic mess.  Many of them have significant personal challenges which they lack the emotional strength to handle.  Yesterday was not the first time I have stopped class to cajole or lecture or discipline someone.  I hate doing it every time.  I have even said to them that I am not interested in managing their childishness.  After all of these moments, yesterday was the first time that any one of them came up to me after class to apologize.  Something was different, and that something was me.  

After the class, I went directly to the Education Director's office to relay what had happened.  As we talked, I found my lost compassion and tried to consider what that student was going through.  We talked over the incident, neutrally, with humor.  Then, the ED leaned across her desk towards me.  "Are you okay?" she said, "You seem a little overwhelmed this week."

Cracks. Opening.  I am overwhelmed.  Usually by midterm, I can find some source of delight in every group, even the ones who challenge me.  I have lost the delight.  The first three words I can think of to describe my students this term are: "blood sucking vampires."

And that, of course, is what happens when self-care gets neglected.  I have had some adjustments to my personal life that have left me a little raw.  I thought I could manage the baggage, because I have before, but clearly I am not taking care of myself very well.  It is a teachable moment, and the first student to benefit from it is myself.

Reaching Out

Last night my colleague and I got the chance to talk to the members of Gilda's Club about oncology massage.  Our dear friend, and oncology massage educator, was going to do the talk, but her class was cancelled, so she didn't make the trip to Chicago.  My colleague and I spent time preparing, putting together a slide show, discussing points of interest, and generally trying to calm each other down.  

I rushed to Gilda's from school, trying to shake off the nerves and student frustration as I went.  We arrived early, prepared and ready to speak.  Although we only had an audience of three people, we both felt the evening went well.  We had a long, intense conversation among the five of us, going off script and improvising -- which only seems appropriate in a venue named for Gilda Radner.

All three of our attendees had vastly different stories of their cancer experience. What surprised us (but shouldn't have) was how freely they all shared their experiences.  They all seemed to want to talk, compare and weave in their own experience even as they learned from us.  It made the whole thing much more powerful to be able to give them the space and time to use their own lives to integrate what we were telling them.  

At the end of the presentation I told them, "I learned more today than I taught."  They gave me a richer insight into living with and beyond cancer, beyond what I learned my professional and personal experience.  It strikes me that this is all part of the joy of being a massage therapist.  We give people space and time to be themselves, and share themselves.  We are open to hearing whatever a person brings to us, without judgement.  I am eternally grateful to Greet the Day for trusting me and my colleague with this moment.

Appropriate Responses to Frustrating Moments

Tests make me nervous.  not taking tests -- I've always been a "school-head," and found taking written tests to be pretty neutral.  It's giving tests to my students that makes me nervous.  Did I teach them well enough?  Did they study at all?  How much are they going to argue with me when I mark their wrong answers wrong?

It is almost a sacred tradition that at least one student in every class will argue with the test, and with my marking of their test.  I hate confrontation, so I dread this moment.  I also dread this moment because I recognize how painfully strange the wording is for some of the test questions.  I feel guilty for not taking the initiative to change it.  But, in most cases, there is a correct answer, and I can find a way to explain to a student why their marked-wrong answer is not correct.  When this works, it is a moment where making and correcting the mistake start to insulate the brain circuitry and real learning happens.  (Read The Talent Code for more on this.)  When it doesn't work, people sometimes drop their pants.

In one of my classes, I have a student, clearly (over)educated, who has a reputation for getting into intense circular arguments with all of his instructors.  He has been known to say things like "I can see you don't like your job" or "Why are you so angry with your situation?" during these arguments -- infuriating, unanswerable, ridiculous statements which are best handled by redirecting to the topic at hand or just ending the conversation.  During my class, he spent most of every lecture sitting quietly at his desk, reading some kind of philosophical tome.  (The Prince is the latest one.)  I largely ignored him because he wasn't disturbing anyone else, and because I felt that he was trying to provoke one of his signature arguments.

I gave my first test to the class, and when I returned them, he had a question bout something I marked wrong.  I tried to explain it, but he wasn't accepting anything I said.  He continued to ask about other questions, eventually devolving into statements along the lines of, "Well, isn't it all relative anyway?  How can you be sure my answer isn't just as correct as what's in the book?"  I tried to remain calm and neutral, but I know I didn't.  As we talked, I noticed his upper lip was sweating, the more sweat, the more pointed his disagreements.  Eventually it was clear that he would continue for as much time as I had, and that we would get nowhere, so I cut off the conversation.

I continued to go over the test with the rest of the class.  Out of the corner of my eye, I saw that he had grabbed his bag and retreated to a corner of the room.  I thought he was going to walk out or read his book, or something.  When I glanced over again, I saw a flash of red, which I realized was his underwear.  He was changing his pants, right there in the room, not even bothering to walk ten feet over to the curtains we have set up for just that purpose.

I told the story to a my colleagues, who all found it both hilarious, and unsurprising.  When I told the story to a friend who is also a teacher, he said, "What is he, three?"  Yes, apparently, I had just experienced the 20-something's version of a toddler picking her nose and wiping it on me.  Frustration, and responses to it, are shockingly varied.  Nothing to do but drop your pants over it.

Fussy Massage

I started doing some independent contractor work for a place that calls itself a wellness center.  They call their treatments "wellness" while they rub pumpkin spice scented cream into people's hands and have them rest their head on a fancy, unsanitary pillow which throws their neck into forward flexion.  It is good and necessary to pay attention to the hands as a function of overall wellness, but not necessarily with scented cream or a goopy green masque that makes the whole massage room smell like a commercially cleaned bathroom.

I am confused about why businesses think we need to make massage so fussy.  Adding scrubs here, moisturizing "treatments" there, oils that smell like seasonal foods (and leave me with a raging headache.) Massage alone is powerful, with proven benefits.  Why do we need all this frou-frou?

I offered a little extra to my clients in my last email blast, but I tried to keep it simple and directly connected to massage.  Clients could choose to use extra time to address their body's need: sore feet from months spent in snow boots, or congested sinuses from spending so much time indoors.  They could choose a treatment that would materially affect their quality of life.  I doubt anyone woke up this morning feeling like their mood, productivity, or overall physical comfort could only be improved if they smelled a little pumpkin spice latte hand cream.  

Businesses that try to both join the health and wellness approach and offer these fussy little spa treatments frustrate me.  If you aspire to be a spa, just be a spa.  It's confusing to clients when you try to be both.  Last time I went in to do some work for them, a client asked me, "What is this place? Can you explain it to me?"  I tried to say the words the business owner said to me, about wellness focus and helping people move to optimal health, but the words got stuck.  I was shockingly inarticulate, and I think the client could tell I didn't really believe what I was saying.  She won't be back.

But she was a Groupon client anyway.

Goodbye, Girls. Hello, Colleagues

"No!" She said, looking wildly around the stage.  "No!  It can't be done! This can't be over now!  We need to hug. We need to all hug."

One of my girls was having a hard time with the reality that her massage school experience was over.  She wrapped me and her classmates up in her long arms and held on.  We stretched it out as long as we could.  We posed for their class photo.  We waited while they brought down their small children and tried to get them to smile.  We walked around the auditorium and met their families.  

But it's over.  It ended.  I couldn't be happier.  

The two classes that graduated last Saturday were both small.  They lost a high percentage of their classmates as the program went on, and were left with a couple of tight-knit groups.  The girls were special to me, because I saw them almost drown, and they pulled themselves back up again.  They fought hard for this day, the end of it.  The actual ceremony seemed woefully short, unworthy of the depth of feeling in that room.  This is why we lingered at the end.  Just one more hug.  Just one more photograph.

When I arrived at the graduation, I saw one of the girls walking in.  She looked lovely and proud, leading in her family with her head held like a queen.  I tapped her on the shoulder to say hello, and she wrapped her arms around me, holding on like I was, indeed, the life preserver she had been looking for.  We stood there for a long time, taking comfort and joy in each other.  Saying goodbye to the intensity of school, and hello to our new relationship.  The way she held on to me -- it was like I was her mother and she was the child reluctant to go into a new place where she didn't know anyone.  I was shocked and touched by the intensity of it.  I knew we had a kind of bond, but I had no idea.  "It's all you," I told her.  "You did this."  

In the end, though, after the photos and the hugs and the frantic goodbyes, they stood together, my girls, a tight circle facing inward, celebrating what they had done.  This is right, I thought.  This is how it should be.  I quietly left the auditorium, looking forward to the next time I could talk to --not my girls -- my colleagues.

Language Close Out

My students are, in case you haven't noticed, non-traditional learners. The majority of them do not have an innate sense of "school culture," where you study and do homework in a regulated way.  Most of them have never willingly written anything longer than 144 characters. This leads to some interesting times when I hear their presentations and read their papers. Sometimes I feel like half my work is English-to-English translation.  This has gotten easier because they gradually taught me a new skill -- reading with my ears.  If I imagine a student speaking to me as I read their paper, hearing the spoken words more than seeing them written down, I get a much better sense of what they are trying to say.  And they get a much fairer grade.

Still, some of their phrases are too good to keep to myself.  Here are my favorites from last term. This is heavy on the spoken word, as is their inclination.

PART ONE: THE SPOKEN WORD (quotes from presentations)

A student was furiously scratching her scalp.  This was her response when I asked if she was alright, "Yeah. It's just my head's on too tight."

"Like a book book, you mean.  Like, The Hunger Games."

"I don't wanna say I don't like old people but . . . . . . . . . . . "

"He doesn't like pasta.  I don't know why. Pasta is amazing."

"I learned that people with Alzheimer's, you know, they're just like humans."

PART TWO: THE WRITTEN WORD (translations included)

"Fibromyalgia is diagnosed with an Emory." (MRI)

"He said that PTSD is the little hamstring in your head that never stops running." (hamster)

Well. That was Average.

I have certain expectations about this Population Spectrum class I teach.  I expect that some people will be frustrated and bored by the lack of "real massage."  I expect that multiple people will need to leave in the middle of the lecture on Trauma.  I expect that I will be frustrated that I don't have enough time for the lecture on Cancer.  Most of all, though, I expect to be surprised and impressed by the presentations of their final project.  

They are required to find a client who has some kind of unique challenge or massage-related need, to work with that client for five sessions, and to write a paper about the experience.  Every time I have taught this class, I have been impressed by the insight people show in their presentations, and about the thought they put into their work.  This term, I am teaching two sections of this class, so this week, when their presentations are due, I was looking forward to a boost from their work.  

The first group presented a couple of days ago.  It's not that they did a bad job, because they didn't.  And it's not that they didn't change and grow from the experience, because they did.  At least some of them did.  It's just that their talks were so, well, unsurprising.  I feel like a jerk for thinking this, and an even bigger jerk for writing it down, but I am truly baffled.  This is a group that has the whole formula for surprising work.  They are a close-knit group, serious about and excited by massage therapy.  They listen well and ask challenging questions.  

I suppose I shouldn't be baffled.  In all the "schooly" work they have done (written tests and the like,) they have been pretty lackluster.  Where they come alive is when they get to do hands-on work.  I have never seen a class, especially a night class, so ready and eager to do hands-on work.  Even when they walk into class looking like they can barely stand, as soon as we set up massage tables, they come alive.  

So, it seems, my expectations are based on a flawed understanding of this group of students.  I am failing to truly see and appreciate where they excel.  I am judging them based on past classes who have been inspired with this particular project.  Tonight, I am their instructor for a different class, where they have a practical exam -- hands-on work.  I am prepared for them to come alive and blow me away.

Creatives

This morning I had coffee with the Cabal.  For years, I have teased my friend about the regular group of artists, writers, weavers and other creative types which meets at the coffee shop down the street.  They are forever planning salons, gatherings, and movie discussion nights.  They have deep roots in our local community, and they are creatures of habit --at least when it comes to morning caffeine delivery.  Truth be told, I was always a little envious of this group, and wondered if I had the creative chops to ever join them.

Today, I did.  They were the warmest, most intelligent group of people I've ever shared an early morning with.  Briefly, we talked about my upcoming reading at one of their salons.  It was so friendly, I didn't think to feel inadequate.   After they all left to go to work, I had a bit of time, so I stuck around to do some writing.  In college, I thought that this would be my life.  Meeting bright, interesting  people for coffee, planning readings, writing writing writing.

By the time I got to school, I felt restless. It's the end of term, and the students demand attention, calm, and patience.  So much patience.  But my morning with the creatives opened up the gap between Have and Want, so I found it hard to focus on their needs.  I hope I was kind and thorough, and I hope I kept my resentments for when I was alone in the faculty lounge, entering their test scores into the computer.

I love my work.  Truly, I do.  The problem is it often consumes so much of my energy that I have nothing left to feed myself.   So, I fill myself with junk, literally and metaphorically.  These potato chips are not fueling my body for a long day ahead, and yet another game of Moxie on my phone is not fueling my mind for calm awareness.

I asked a student today what she was doing for self-care to handle an emotionally difficult time.  It is time, once again, to turn that question on myself.  Luckily, I learned this morning that I have the creative resources to figure it out.

Finding It, Losing It, Found.

About a week ago, I got back from a retreat in Costa Rica.  It was life-changing, as these things often are.  I gained valuable personal insight and all that jazz. (If you want to read about it, check out my other blog.)

I worried a bit about keeping the peace alive when I got back here to yet another polar vortex, an inch-thick stack of student papers and a worryingly empty book at my practice.  For a day or two. I had it all in hand. I meditated in my living room in the morning.  I approached my classes with retreat-learned lessons from The Little Book of Talent.  I even gave an earnest speech in my anatomy class about the beauty in variations of every human body, and how you should never apologize for your body.  I was new, fearless, calm.

Then, life.  Snarled traffic that made me late to class.  The still-empty book.  Three no-shows in one week.   The protective calm layer froze away, and I was left raw, once again holding up my outward calm with inward trembling.

Today,  though, I tutored L.  L. failed her muscular anatomy test (one of the papers in that inch-high stack.) Her face showed disappointment, but with an outward calm I could see was supported by inward trembling.  We broke down the spots that tripped her up.   The difference between bilateral and unilateral actions.  How to tell which attachment is the origin and which is the insertion. What the heck the levator scapula does, other than elevate the scapula.  For over an hour, she focused intently on my questions and explanations.  Answers came slowly at first, with hesitation, but she soon got more confident, and came up with a plan to study more at home.

Then, L. just started talking to me.  She told me about how she felt embarrassed to ask questions sometimes, because other people might think she was stupid.  She talked about watching her classmates get tests back with A's while she would get an F.  She talked about wanting this, knowing that she was meant to do this work, and she would do all the work it took to get there.

Somehow, through the force of her trust and determination,  it all came back.  The calm, new, fearless person I found on retreat.  The person who knew - no, LIVED - what was important.  I felt that person drape over me, and I settled into the warmth. I found the fearless place in my heart that got opened up, and I tried to guide L. to that place on her own heart.  I saw a glimmer of it, and I trust that L. will protect that glimmer.  She gave me a hug before she left, and smiled with something like joy.

And I took my new self into the world,  ready to try again.

Palimpsest

Every Tuesday evening, I work at a nursing home.  My room is just down the hall from the chapel, with a beautiful grand piano.  Most of the time, the automatic player function on the piano is on, and I catch snatches of "Sunrise, Sunset" as I walk down the hall.

Around 5pm, though, a woman in her 60s wheels her mother into the chapel, turns off the automatic player, and sits down at the piano.  She asks, "What do want to hear, mom?" Her mother responds, "Just play."

For the next hour or so, the woman sits at the piano, playing through hymns and simple classical pieces.  She has perfect posture, and she sometimes squints a little at her hands.  Her mother sits quietly in the wheelchair, positioned at the side of the piano bench.  At some point, the mother nods off a little, while the daughter continues to play.

When I see them, I can almost see their younger selves just underneath, like a palimpsest. There is the little girl, legs not long enough to reach the pedals, struggling through her first scales.  There is the young mother, sitting next to her daughter on the piano bench, patiently encouraging and teaching.  The young mother has perfect posture, and she sometimes squints a little at her daughter's hands.

I have this habit I picked up from my mother: when I am with a good friend or close family member, I find myself looking at them with focused attention.  It can be disconcerting, as it seems like I'm staring.  What I'm doing, though, and what I think my mother is doing, is looking for the palimpsest.  If I focus enough, I can start to see the layers of younger selves, different lives, years lived.  This reminds me that a person carries with them all that they were and all that they are.  

As the grown daughter continues to play for her elderly mother, my last client of the night arrives.  She moves with a shuffling, Parkinson's gait.  Her speech is slow and stilted.  She requires help to lie down on the table.  But as I look at her, I see the artist she was, the young woman with an unusual independent streak, the compassionate free spirit raising a daughter on music, art and books.  She is all these things, and it is a joy to see.

Two Words

There's this photo-quote going around Facebook which asks what advice you might give your younger self, in just two words.  I usually take a look at these little micro self-help bits, think about it for a minute and move on.  This one caught my eye, though, and I decided to share it along with my own two words.  Exercises like this force us to distill the random jumble of our thoughts to their shining, diamond essence.  We can extract what is truly precious and valuable and leave the rest behind.  Here are my diamonds:

Say yes.

For as long as I can remember, my first response to most things is "No." This changes over time, of course, but almost everything has to pass through this negative space first.  This is why 12 years passed between my first interest in massage therapy and my finally going to school for it.  Everything that has happened in my massage career shows me that this is my happy place, that I belong here.  My only regret about this career is (and will always be) those 12 years.  

Believe it.

Sometimes people say nice things to me, or write nice things on evaluations.  Sometimes I believe these things, but not always.  I am wasting time waiting for the other shoe to drop.  I don't think striving to improve always is a problem, but when I am giving someone a massage and thinking more about what I am lacking than what I am doing, I am not giving my best work.  I tell my students, "Be confident in what say, even if what you say is 'I don't know.'"  Like most advice we give out, I follow this sometimes.  When I teach, I take time to coach people on grounding themselves, bringing focus to their client and what that client needs today.  I need to add in focus on the therapist knowing and believing in their own skills.  If we know and believe our skills, we can apply them more effectively, and know better when something is beyond our scope of practice.  

What are your two words? 

Evaluated

Yesterday I got my course evaluations from last term.  They came bundled together in four neatly stapled stacks, one for each course.  Even though the Education Director told me they were "lovely," I was apprehensive as I started to read them.  It was a fragile week, with my tutoring hours being cut and the true realization that I needed to do something to build my practice, or face difficult financial decisions.  I didn't trust the positive feedback.  Long habits of waiting for the bite after the compliment die hard.

As I read through page after page of comments, I realized that no bite was coming.  The worst I could expect was a push -- a loving push in the direction of being a better instructor.  I laughed out loud often, and found myself touching my heart to say "thank you," as I do often in class.  Each neatly stapled stack had its own personality.  I could which class it was without looking at the labels on the forms.

My girls, who I've written about before, used words like "compassion" and "caring" and "patient." I read in their comments references to our heart to heart talk.  I saw that their experience of that day was exactly what I hoped.

For two classes, I had the same group.  A lively, funny, almost ideal community who embraced the whole shared experience part of massage school.  Their comments were hilarious.  They referenced some of the my quirks and invented rituals -- like the Story Time Chair (for sharing my experiences) and Massage Therapy Theatre (not role play.  Because we're classy.)

The largest group was also my biggest challenge.  They were young and rowdy, unused to self-discipline.  I ran a tight ship in that class, too tight even for me at times.  Many of their comments showed that they liked the strict discipline.  My favorite was the student who wrote that the favorite thing about me as an instructor was my "bossiness."

After I read through all of them, I went to teach that night's Ethics class.  A new group for me.  I hadn't met any of the students before the term started a couple weeks ago.  I am still learning how to work best with them.  Teaching them that night felt like walking through mud pits.  Just one more step.  Then one more.  Somehow we would get through.  And we did -- barely.  I walked to my train in the bitter cold, exhausted from a roller coaster day.  I had a stack of lovely comments from former students back at work, but I knew my focus should be forward, with this new group who still aren't sure what they think of me.  We have things to learn and material to cover.  Now, the evaluations go back in a drawer for a quieter day.

His Eye is on the Sparrow

The Ethics class I teach involves a project and a final presentation.  It seems easy enough -- the students just have to stand us and tell us about how they took care of themselves this term.  My last group made it even easier on each other by being one of the most supportive and cohesive classes I've had in a while.

Their presentations were on the last night of the term, five days before Christmas.  The feeling in the room was anxious, leaning forward into their much-needed break.  One by one, they got up and told us about their self care.  They were funny, sincere, engaging and touching.  I was leaning forward into my upcoming time off, too, so I struggled to stay with them.  They brought me back again and again -- the student who praise danced for us, the one who showed us how she wraps her hair at night, the one who made us all do jumping jacks, the one who broke down telling us about her abusive relationships and ended her presentation in a hug-pile with her classmates.

The last student got up, speaking softly but clearly as she always did.  She kept her eyes to the floor and told us she was inspired by everyone.  She had changed her mind while watching everyone else, and decided she wanted to sing for us -- a song she would sing to herself to lift her spirits.  As I looked around, I could see my feelings reflected on the students' faces.  This is so brave, such a gift.  What do we do if she can't carry a tune?

Still looking at the floor, the last student started singing "His Eye is on the Sparrow."  Her voice was clear, strong -- it felt like someone you love singing you the perfect lullaby.  We sat silent as her voice grew stronger, as she closed her eyes and lifted her face.  We leaned forward. We were still.  I saw tears in some eyes.  With her face lifted and her eyes closed, she sang us through to the end of the song.  We exhaled, then stood and applauded her as she smiled and sat down, once again looking at the floor.

I wonder if she knows what she gave everyone.  She gave her class a memory to hold them together.  I am certain that for a long time, whenever they meet, one of them will only have to say, "Re,beer that time she sang?" and they will once again be connected, part of a loving community.