Thailand as Fire Prevention Strategy

"I love my job, but there is also a high potential for spiritual and emotional burnout."  

I am meeting lots of new people.  They are interested in what I do, so I find myself saying things like that a lot.  Because it's true.  

I intend to do this work (and train other therapists to do this work) for a very long time, so I have a simple burnout prevention strategy in place.  I will tell you my secret:  

Get the heck out of town.  

Yes, it's true.  In order to give my clients and students the support and kindness I know they deserve, I need to get away for a while.  Perhaps this might resonate for some of you if I replace "clients" with "family," "co-workers," or even "partner."  When I take care of myself, I can give more to others.  For me, taking care of myself involves shifting what my eyes see so my brain can release and find new ways to interact with the world.  

It has been a particularly challenging kind of year, so I am taking a particularly dramatic break in January and February.  I will be going to Thailand and Costa Rica to explore the world and other things I love about it.  And because my clients and students are some things I love about the world, I am sharing with you here (in FAQ format) some idea of what I will be doing:

How long will you be gone?

Almost a month.  

What are you doing in Thailand?

I am going on the Thailand Adventure Trip organized by Blue Lotus in Chicago.  We will study Thai massage and other healing modalities.  I am also hoping to learn something about traditional Thai temple dances, and of course to eat all the food.  

Can I get a Thai massage when you get back?

Of course -- but not from me.  Learning to practice Thai massage takes much longer than the short time I am in Thailand.  I'm sure I will learn techniques that I can incorporate into your regular massage, but for a full Thai massage, I recommend you connect with a Registered Thai Therapist.  

Wait -- Costa Rica?

Yes!  This part of the trip is all for joy.  I am going on a bellydance and yoga retreat with one of my favorite teachers, the incomparable Rachel Brice.  It just happened that this trip starts just as the Thailand trip ends.

Can I learn to bellydance when you get back?

I hope you do! And why wait for me to get back?  But, again, learn from someone more qualified than I am.  I recommend my first and continuing teacher, Malik at Hip Circle Studio in Evanston.  

What will I do for massages when you are gone?

I am preparing a list of colleagues at the Heartwood Center who have similar training to me, and who may have openings during that period.  I look forward to working with each of you when I return.  I sincerely hope that you continue to make your wellness a priority while I am gone.  

What if I have more questions?

Ask me!  

When the Student is Ready . . .

. . . . the teacher will appear.

In high school, a funeral director came and talked to us about how she prepared a body for viewing.  She passed around the plastic disks they use to keep eyelids shut.  I immediately wanted to go to mortuary school.  Even though the funeral director was standard American beautiful, blonde and bubbly, I felt this ambition would be frowned upon.  I was already quiet, drawn to Edgar Allen Poe and stormy Victorian novels.  I had both a black leather jacket and an ankle-length black trenchcoat, and enough sense to know that further tipping the "weird" scales might cause more anxiety than I wanted.  So instead, I studied literature.

Eventually, through a series of twists and turns and misdirections, I found my way to being a massage therapist -- drawn there because I had been working in nursing homes and retirement communities.  I felt compelled to train for something that would be more directly of service to older adults.  Most of all, I wanted to work with the people in later stages of dementia, or in hospice.  My ambition still tilted towards the end of life, and finally I was able to express it and mostly ignore anyone who acted like I just tipped the weird scales.

After becoming a massage therapist, through a series of twists and turns and absolute serendipity, I found my way to oncology massage.  I found myself still working with people near the end of life, but caught at that stage much sooner than we feel is natural.  I needed to do more than trust my compassionate instincts and really learn about the dying process.

And that is how I found myself in this end of life class last month.  We sat in a circle on the first day and our teacher asked us to introduce ourselves and say why we were there.  Here is my best memory of what I said:
"In the same way that many people are drawn to children, I have always been drawn to people at the end of life.  So I thought I should learn more about it."

And we went around the circle, and each person said their reason, their carefully curated truth.  So our teacher nodded.  She paused.  She looked around at each of us and said:
"Okay.  Now tell me why you're really here."

And the only thing I could think of for an answer was:
"I don't know why I'm here.  But I'm supposed to be here."

I know what I said was true, and I am just now finding out why.  Soon after I got back from that class, I was presented in rapid succession with clients whose conditions were deteriorating, and friends whose family members were actively dying, relationships ending, and general life upheaval.  All that talk and meditation and reflection on the impermanence of life was (is) constantly, practically, in-my-face, REAL.

I've been in this place before, but I haven't been this person before.  I felt all the lessons of my own past life upheavals finally came together inside the nurturing touch of that class, and I could finally just be.  That fix-it instinct wasn't gone, but it was quiet.  This is it.  The still-emerging reason why I was really there.  I was ready to just be, and just in time the teacher appeared.

Thank you, L.  The learning continues.

Transcendent Moments of Massage.

I have the good fortune to be in the middle of seven straight days of classes.  We having been learning about and discussing some pretty hard and heavy things — childhood cancers, extended hospital stays, the dying process.  All of us are here because for our own reasons, we are drawn to this kind of work.  

I am noticing again, though, a story we tell ourselves that I find unsettling.  It is the story of the Sainted Massage Therapist.  The one professional who floats in on waves of compassion and caring and leaves behind a moment of comfort and peace in an otherwise cruel world.  We say things like, “I could provide that moment of comfort . . .”  or “I gave her that connection . . .”  or “This is beautiful work.” 

Here’s the thing — we are not necessarily wrong to say these things.  Those tiny moments of comfort in the midst of suffering make the work worth doing.  And it is beautiful.  Sometimes unbearably so, because it puts our hearts on such clear display.  

Where I get unsettled, though, is when we start to believe our own mythology.  We can start to tell these stories a way to keep ourselves ultimately separate from our clients.  It turns into a protective barrier, emphasis on barrier.  When we make ourselves into Saints or Superheroes, we isolate ourselves.  (Wonder Woman, Spiderman, Batman — their lives were all solitary.)  We need to find a way to stay in the human realm.  

One of my favorite massage moments illustrates this perfectly:

I was doing my clinic rounds for a Geriatric Massage class.  We were working on the dementia floor of a Skilled Nursing facility. My client was confined to her bed, and clearly had been for a long while.  She had limited verbal communication, and was about 80 pounds.  I brought a chair over to her and held her hand.  She turned her face towards me and started humming — no specific tune, just a gentle humming of different notes.  It felt like I should join in, so I started humming along.  Somehow we matched each other’s pitch and tone and made a little music together while we held hands.  The class instructor stopped in the doorway to watch and called some of the staff over to see this beautiful, transcendent moment.  

After about 5 minutes, the woman stopped humming and turned even more towards me.  She reached her other arm over and held my hand in both of hers.  I could see she had something to say so I leaned in close to her.  She took a deep breath and said, “It’s poop.”  

And I took a breath in and knew that it was.  

I plan to remember these messy human moments, right next to the transcendent ones. 

Letter to a Client, Long Passed

I am regularly asked things like "How can you handle that work?", or "What do you do when someone dies?"  This letter to one of my former clients is yet another attempt to answer those questions.

______________________________________________

This is how I knew that you had died:  your husband called me.  He used your phone, so I knew to answer the call.  I was not surprised to hear his voice instead of yours, since you had missed our last few appointments because you were too fatigued.   He told me that you had passed away, just the night before.  He seemed collected until I thanked him for calling me, then he started to sob so much that he just hung up the phone.

Just the week before your husband had called me on your phone to see if I would come to the house to give you a massage.   You were too weak to call yourself, he said, and you had family visiting for a while.  He felt sure, though, that after they left you would want a massage.

There were many things about you that brought me joy, but one of them was not even you -- it was your husband.  The way he looked at you.  Even when you were half-asleep in a lounge chair, connected to an IV line with your bald head covered by a crooked felt cloche, he looked at you with the purest love and admiration I have ever seen.  

There is a story about you that I tell to every class I teach.  You came to my office for a massage, and you had been having a rough week.  We did a very gentle, slow massage without much movement and lots of attention to being present and breathing.  After the massage you asked me what kind of energy work I was doing because you felt something come in and strengthen you.  I told you that I don't do energy work; that I am not trained in that kind of work so I couldn't claim to be doing it.  You grinned at me and said, "Bullshit!"  You were right.  What you felt was true, even though I had no explanation for it.  

I met you first by reading your chart at the cancer treatment center.  Your chart was dismal, to be honest.  An advanced stage of a notoriously difficult-to-treat cancer, inoperable tumor, one of the nastiest chemo combinations I knew of.  But then I met you in person.  You were so thrilled by the idea of getting a massage that you grinned through the whole thing.  You told me hysterical stories about your family.  You knew exactly what you were in for, but still managed to say "I feel like crap today" in a way that sounded like optimism.  

Okay, confession time.  First:  as soon as I met you, I was preparing myself for the idea that you would die soon.  There are fantastic, unexplained, miraculous things in the world.  I wanted and hoped for this for you -- but I also knew the statistics of your kind of cancer.  As one of my favorite books says, "Hope for the best, prepare for the worst."

Second:  I kept your number in my phone for a long time.  Occasionally, as I scrolled through on a data-clearing mission, I would think about deleting it.  Most of the numbers I delete are from people I don't know (or care to know) anymore, so deleting your number felt wrong. 

And finally:  I don't remember your name.  I remember your face, your laugh, some of the exact details of your treatment and disease progression.  I remember that the last time I saw you, you were wearing new jeans and you had trouble getting into your pocket to get the check you had for me.  But your name is gone.  

I am left, lucky me, with all the joy I got from your spirit, and all the learning I got from your heart.  

Thank you.

Love Always,

--R

Synonyms for Pain

There are moments in this work that bring home the absolutely clear distillation that only comes from great pain.  Today I saw a child reach out for his loving mother as the only response available to significant pain.  Never mind that the child was a nearly 40-year-old man*, and the mother, for all her loving kindness, could not begin to touch the pain arising from his multiple abdominal tumors.

He was short with her, sarcastic in a way you expect from teenage boys who don't want to clean their rooms.  She hovered over him, carefully avoiding mentioning certain procedures so as not to upset him.  It was an entire boy's childhood enacted in a 30-second vignette.  And draped over it all was the presence of his physical pain.

The hospitalist came while I was there, so I stepped out to give them some privacy.  When I came back in the son was looking at his mother, clearly needing someone else to help him decide.  "Should I take something, then?" he said.  She nodded, "I think it would be a good idea."  He called the nurse, who gave him a small dose of a large painkiller.  He settled into a comfortable position, ready to receive gentle, soothing touch.  I held his feet, head and hands with a warm, weightless hold, visualizing a space clearing in the center of his pain -- one small, comfortable space where he could sit for a little while.

After his massage, I walked down the hall with his mother, who held my hand the whole way.  "What are you doing to take care of yourself?" I said.  She stopped and turned to face me.  "I don't know," she said, "that's a good question."

She walked back to her son's room without an answer.  Her hands worked at her sides and her shoulders slumped, trying to balance the weight of her own, significant, excruciating pain.



*--names and identifying details have been changed

Your Attention Please

As part of the preparation for a continuing education class, I am reading a book called The Grace in Dying by Kathleen Dowling Singh  It is a brilliant, deep and thoughtful exploration of the transformation that happens in what the author calls the "nearing death" experience.  I have started keeping a notebook next to me as I read because there are phrases in the book that I want to capture for later --  little snapshots I am collecting for my own personal album.

Remember snapshots and film?  When we used to take pictures without knowing what they would look like until we got the pictures back from the developer?  Remember the surprise moment of seeing again those things you experienced?  As I am going back to my notebook for these phrases, I am having these delicious surprise moments.  When I write down a phrase,  I often don't know why it sent a hook into my attention, I just know I want to capture it.  When I see it again, my eyes are new.

Here is one (where the author discusses the Surat Shabd tradition):
" . . . . attention itself, in its directed coherence, is none other than that which we call the soul."

I wrote that down in a rush, hurrying to continue a particularly engrossing part of the book.  I looked back on it this morning, and thought, "Yes!"  That thing we sing songs to, go on retreats to cultivate and share only with our most intimate of friends -- the soul -- can be understood as focused, direct attention.  This makes perfect sense to me, because I know I feel most connected when I am using my attention.  When I listen intently to a friend, when I stop to examine the exact shade of red on a newly-changed leaf, when I massage.  It is these moments when I am less of a lone individual walking this earth, and more of a connected, integral part of the deeper rhythms all around -- what Singh calls "the ground of being."

I am taking this idea into my work, trying to create a space where in addition to stepping out of the mad rush of life for a while, my clients can step into a connection with something beyond themselves, in whatever way makes sense to them.  You have my attention.  

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

Reschedule

Monday morning I found myself with a lot of time on my hands.  The combination of early spring snow, public transportation, and recent cancer treatment led all my morning clients to reschedule.  I gathered my things to go into the office anyway -- it seemed like the perfect time to get some paperwork done.  I just couldn't make myself get out the door, though.

Do you know those times when the couch feels absolutely magnetic?  When putting on a coat and striding purposefully through the door feels like climbing out of a well with no rope?  This was one of those times.

As someone who has been at this massage thing for longer than five years, I am acutely aware of the symptoms of burn out.  I counsel my students about it, and I schedule regular days off to keep myself away from it.  But I'm not perfect, and I started to worry -- is this burn out?  Is this it, the beginning of the end of my career in this field?  It felt so much heavier than other days when I've been tired, or have chosen to do something besides paperwork.

I got a little bit panicked, and tried even harder to will myself up back up from my chair and out the door -- which only made me get more stuck.  So I paused for a minute and decided to re-view the whole thing.  Because that was not the beginning of the end, it was merely a little breathing space cleared out for me by circumstances and seized by that subconscious part of me that always knows better.

Like my clients, I took the opportunity to reschedule.  I spent the morning productively, but in a different part of my life.  By the time I met with my afternoon client, all thoughts of burn out were gone.  Just another moment to remind me -- sometimes you just need to reschedule.

Masajear la Cabeza

Another client story:

Deirdre* is young.  Barely out of childhood young.  She has a rare cancer, which, in her body, showed up in an even rarer form. This massage appointment is a gift from people who can't stop telling me how rare and remarkable she is.  She greats me at the door with a knit cap on her bald head, tape over her port, and the biggest, most open smile I have ever seen.  She hands me her completed intake form -- she is so close to school that she turns it in and asks for feedback as if it were something I was going to grade.

Deirdre tells me the story of her cancer so far.  Diagnosis received while out of town for vacation ("I thought I felt sick because of all the partying I was doing.") Confirmation that her cancer was a very rare presentation ("I guess I'm rare and special.") Description of how debilitating her first round of chemo was ("I was completely out of it, and it was my birthday.  But if I wasn't in the hospital, I would have gotten wasted on my birthday anyway, so it's alright.") She tells me this story with her big, open, gorgeous smile.  She apologizes for how much she sweats as a side effect of her treatment.
I talk to her about oncology massage, and I ask her if she wants me to massage her scalp.

She puts her hand to her knit cap.  "My scalp?  You can massage my scalp?"  I nod.  I didn't think it possible -- but her smile gets bigger as she pulls off her knit cap.  "I never thought I could have a scalp massage."

She settles into a comfortable position for the massage.  Deirdre's mother comes into the room and folds blankets around her.  Deirdre smiles at her mother and tells her, in the language they share, that she is going to have her head massaged.

Deirdre keeps her eyes open at first, taking mental notes like the good student she so recently was.  As soon as I cradle her head in my hands, though, she closes her eyes and breathes.  Her hand rests gently over her tumor site.  Without her knit cap, bald head exposed,  Deidre's features emerge in stark, gentle purity.  Her head radiates heat into my hands as I hold it.  

I try to be neutral about my clients' prognoses.  They are with me to experience what it feels like to have a comfortable present.  That respite, that moment out of time, is my honor to provide.  Deirdre, though, with her face too young for lines and smile too open for tragedy -- she makes me hope.  Maybe, just this one time, a rare and difficult cancer could end in a rare and special cure.


*--name and identifying details have been changed

Sweetness in the Belly

I started this blog because so many lovely and amazing things happened with my clients that I found myself just wanting to tell stories whenever I got together with friends.  And also because some of those things were very emotional, and writing has always been a place where I could untangle emotional things.  I had a couple of new client experiences recently that are making me glad I started this blog.

This one came out in the form of my first writing love, poetry:

I kneel at her side, my two hands cradling her one,

catch sight of the book on her nightstand —

Sweetness in the Belly —

a bookmark tucked about 100 pages in.

Pages left unread that her eyes will never see.

I’ve seen skin like this before.  

Papery, tinged with yellow, fading bruises in a path from foot to head.

I’ve seen eyes like this before.

Sunken back into dark sockets, withdrawn and piercing in their largeness,

no eyelashes soften the steady gaze.

Animals know.  

The dog curled at her head, still as breath,

looks up and right at me.  

He dips his head, raises it, settles back to sleep —

This is good.  What I am doing is good.  

Her almost-adult daughter plays with attitudes.

Looks over my head —“Does the massage therapist know not to go in there yet?”  

Avoids eye contact, moves like she’s wearing a chain maille helmet.  

Later I hear her voice, muffled, to her father:

“I can’t do this.  I can’t put up with this any more.”

Her husband rides up in the elevator with me.  

“She’s not exactly, you know, compos mentis right now.”

He takes another asthmatic breath.

“We are nearing the end of the road, you see.”  

Yes.  I do.  

Between a Smoke Shop and a Cemetery

This was the location of the wellness center where we were teaching the oncology massage workshop -- smack dab between a smoke shop and a cemetery.  The business itself was impressive -- a well-organized staff, therapists always busy, a personal trainer and chiropractor both seeing clients in fully-equipped spaces.  All this built and managed by a powerhouse of a woman.  I was impressed and inspired and I told her so.

My co-teacher and I looked forward to three days of open exchanges and a great workshop experience that only happens when the participants are already comfortable with each other.  Within the first hour, though, it was clear that this would be different.  Every time we asked a question, everyone in the room looked at the owner before they answered.  On every break, the owner spent time shifting and arranging the room, or telling her therapists about tasks they needed to do once the workshop was over.

My co-teacher and I knew -- what we had here was the biggest control lover we had ever seen.  And she had assembled a staff who mostly thought, worked and acted just as she wanted them to.  Usually, when we teach this workshop, there is a moment of pure sweetness or deep understanding for most students.  There are times when the whole room swells with compassion and kindness so palpable it feels like a  warm hand on your shoulder.  We kept waiting for, hoping for, trying to create those moments -- but they never happened.  Not even close.

The driving emotion for the therapists in the room was caution.  How do we limit our liability?  How do we make sure no one sues us?  And, unspoken but there, how do we not piss off the owner who is sitting in class watching us like a hawk?

We gave all the energy we had, but not more than we could spare, to that room.  We left hoping for the best, trying to focus on the heartfelt thank you letter we received from one of the volunteer clients.  (I found it very telling that the letter was slipped into my hand at a moment when no one else could see it happening.)  We shrugged our shoulders and said, "Well, I hope some of that sank in."

On the drive home, a colleague sent me a text message to ask how it went.  This was my response:  "We showed that video that makes everyone cry.  Nobody cried."

This remains one of my most unsatisfying teaching experiences.  I don't think it's necessary for someone to cry to demonstrate compassion, but I do think it is necessary to step out from behind caution, control, and the need to be in charge and expose just a little of your vulnerable, beating heart.  Sometimes life puts you in a hard place -- between a smoke shop and a cemetery in a gray midwestern town -- and the only thing that keeps you going is just a touch of softness.

Non-attachment

With my new, most challenging crop of students, I have been thinking a lot about the concept of non-attachment.  Every Thursday, I walk into class feeling that being completely detached is the only way to survive, and also that being completely detached is the worst thing I could do for these students.

Today I came across this blog post about the nature of non-attachment.  In it, Sandra Pawla writes that when you understand non-attachment:

• Emotions arise, but you have space.  You have perspective.  Emotions don’t catch and torment you every time.

That is it.  That is the crux of what I wasn't getting.  I thought cultivating a calm non-attachment in the face of a room full of challenge was to shut it all down, to put my hands over my eyes and get down in a defensive crouch.  But the answer is to open and soften my eyes and stand, strong and flexible and present.  It is a daily practice which begins with a few minutes of awareness of breath every day.  

Last week, I kicked two students out of my class.  One went without argument, clearly upset but keeping it in check for a more appropriate time and place.  The second -- well, she would. not.  leave.  I found myself getting increasingly angered and frustrated that this person was taking up time I should be using to teach to draw attention to herself.  For a moment, I was caught and tormented by anger, unable to handle anything else in the room.  I had it on the tip of my mind and heart to give up, just let her stay and I could struggle through the last hour of class in anger.  I took a breath.  And another breath.  And stood up straight, and repeated, calmly, "Leave."  Then I turned back to the group of students I was helping and continued my work.  She left.  

Although there is no victory in someone disrupting learning enough to be removed from the space, there was a small bit of growth in standing -- strong, flexible and present -- while that little bit of chaos washed over me.  There is also a small bit of growth in the knowing and acknowledging my own sadness and concern about that one human being.  That kind of cry for attention comes from a deep ache, and I can't help but have compassion for her on a human level.  

Still, the gift of non-attachment that draws me into a compassionate place, also gives me strength to do what I feel is the greater good in the moment.  I hope, for the rest of this term, that I don't have to exercise this gift in this way again.

Having It All

Yes, here I am.  Yet another woman musing on the difficulty of "having it all."  I went about my tasks this morning -- eating breakfast, folding laundry, mentally preparing for a busy day -- and as I usually do, I let my mind wander a bit.  And, as sometimes happens with former Literature geeks, I started musing on the real meanings of words.

All.  It All.

What is "it all" anyway, and how do I know when I have it?  And while I'm on the subject, do I really "have" any of it?

This last thought stopped me for a minute.  Having equals holding equals grasping equals fear of losing.  So when I have, really and truly have, I put myself automatically in danger of living from fear of no longer having.




I see this often in my clients, and even more often in my students.  We acquire something -- knowledge, a skill, a new range of motion, and after the initial joy of the thing has faded a bit, we work extra hard to protect that thing, so we stop taking risks.  And we forget that taking a risk was how we got the thing in the first place.

For me, I have worked very hard and (for me) very patiently to get approved to teach S4OM-approved Oncology Massage Workshops through Greet the Day.  I finally got that approval, and for a while, I just held that approval in my hand.  I had it.

But not It All.  So, now I am taking the risk and reaching out to people I know, trying to create opportunities to teach this workshop.  I have put together a proposal for a formidable former teacher, I have contacted friends and acquaintances in other states, I have said out loud that I am qualified and ready to do this important and scary thing.  The risk of asking will soon (I hope) be overtaken by the risk of someone actually saying yes -- which requires doing.

Which brings me back to my Lit geek headspace -- having it all is an action, always in motion.  It is a goal which shifts as soon as we near it, and rather than frustration, that inspires a new burst of creativity.  Journeying.  Learning.

It is an excellent adventure.

My Guilty Pleasure

I did a lot of driving over the holidays, and a lot of switching around to unfamiliar radio stations.  Formats are similar everywhere, but there was still some regional flavor in the way the DJs interacted with each other and the audience, and in the time of some of the commercials.

Somewhere in between playings of "Dark Horse," I landed on a station playing a teaser for one of their end-of-year "person on the street" features.  The subject was guilty pleasures and holiday season indulgences.  In between the gushing over chocolate and sleeping in, one woman said this: "Massages.  That's my guiltiest pleasure."

What?

Apparently we still have a way to go in the public education area.  Because while a massage may be a pleasure, it should never be "guilty."  I have written in this blog about how your massage really benefits everyone you care for.  I have written about the modalities I practice, and the science behind massage.

Now I think I need to take a minute to address the idea of guilt and massage.  We overuse guilt for many things, but especially for those things which give us pleasure, and even more so if that pleasure involves touch.  Somewhere along the way, many of us learned to associate pleasure with things that were "bad for us" -- the taste of chocolate or coffee, for example.  And somewhere along the way, especially in American culture, many of us were taught that excessive touch was "bad for us."  The truth, as research proves again and again, is that touch is necessary for our emotional health, and really our basic survival.

So, please, stop calling massage your "guilty pleasure."  Where is the guilt in taking care of yourself, and engaging in activities which are necessary for your survival?  And when you hear someone else talking about massage this way, remind them that they are worth the time and the cost of massage.  Because I think that's what the guilt boils down to -- somewhere along the way, we decided that we are not worth it.

But we are.  You are.  

Oncology Massage?

I am in the process of getting all the training and experience I need to teach other massage therapists how to do Oncology Massage. This is one of my specialties, along with Manual Lymphatic Drainage, and one of the things I am passionate about teaching.

When I talk to people about it, usually the first reaction I get is a slightly quizzical look, and a statement like, "I didn't know there was such a thing," or, "Is that just massage for people who have cancer?"

Well, there is such a thing, and no, it is not "just" massage for people who have cancer.  It is so much more.  Anyone who has been through cancer treatment knows that the treatment (not just the cancer) can change and challenge your body in so many ways.  And often the treatment has long term, or lifelong effects.  Oncology massage therapists are trained to ask about these effects and work safely within them.  The Society for Oncology Massage has a great resource for patients and family members here.  If you want to know more about Oncology Massage, or if you wonder why it might even need to be a thing, I highly recommend you check out this link.

For myself, I have been struggling with one of the exercises we give to students in the Oncology Massage Workshop.  We ask students to come up with their own (short) definition of Oncology Massage.  I struggle because I find it difficult to convey all the education and all the mental maturity required to do that kind of work.  I struggle because the second reaction I usually get when I talk about it is, "Oh.  I could never do that.  It would be too sad."  Which puzzles me.  Why is it sad to give someone respite, space to breathe, an hour to reconnect with their physical body as more than "cancer patient?"  And how can I convey all of this in a short statement?

Here's my best attempt.  I'd love to hear yours, if you have one:

Oncology Massage is informed, mindful massage adapted to the effects of cancer and cancer treatment on the body.  It combines all of a therapist's education and training with an awareness of how cancer and cancer treatment change the body so that therapist can use their skills to create a safe, effective massage for anyone with a history of cancer treatment.