Showing posts with label Deep tissue. Show all posts
Showing posts with label Deep tissue. Show all posts

Monday, June 24, 2013

Table Talk: Hold the Line



Starburst (mixed media) by Phillip Hoyle
Some images are just dazzlers getting your attention immediately. That's how I felt when I first saw this design carved in a rock near the top of the north escarpment of Shavano Valley. I worked with it a couple of times but my best try was this one in which I added color, the color I saw in this explosion. Some people have affected me in the same way.



     The expression “hold the line” is not always an allusion to war or football. Sometimes it serves as a child-rearing image: the parent draws a line at certain behaviors and holds the child to it. Many children stand right at or even on the line in a posture that may be taken as either a show of defiance or a need for the security that comes from knowing the parent will hold the line fast. These parent/child images have proved helpful to me in massage.

     Jeremy wanted to cross a line I was trying to draw. The line related to our signed agreements: no sexual advances or language are to be tolerated in massages at the clinic. But while I massaged his shoulders, he reached over and placed his hand on my calf. I moved out of range. He touched me again when I was working at his side. I took his hand off my leg and, patting it, told him he had to keep his hand and arm relaxed or the massage wouldn’t work. We made it through the massage just fine. The next month, in our second massage, I had to repeat the same line drawing. When the massage was completed, we talked. I reminded Jeremy we had both agreed “not to be bad.” He took well the mild discipline, which combined my accepting attitude toward him with my patient insistence that the line hold.

     The conflict had started right at the outset. That first day, as I opened the therapy room door to say good-bye to one client and to greet the next, there stood Jeremy. He was dressed in what Denverites sometimes refer to as the Boulder look. He sported a red tank top, lime green cutoff sweats, and brown Birkenstock sandals with wheat-colored socks. Tall, with wavy red hair and body-builder muscles, Jeremy introduced himself and said in a caricatured sexy voice that he had come for a “butch” massage. I was amused. While I’m not feminine in appearance or manner, I certainly am not butch! Perhaps the seeming absurdity of his request signaled play acting and cast me in a parental role. I listened to him with interest and carefully kept my laughter aimed at what he said, not at him. I read Jeremy as both sexually promiscuous and humorous. He appeared to have ill-defined personal boundaries. What a challenge.

     I would give him a massage to remember, butch or not. Images of strength, aggression, and even pain flitted through my imagination. I thought, “Too bad I don’t have on my hiking boots. He might like that.” I chose to supplement my regular Swedish massage technique with some dramatic stretches and deep glides I had learned in a sports massage workshop. At one point, I clambered up onto the table with Jeremy and planted my knees in his buttocks. I pushed my fists into the muscles alongside his spine and glided from his lower back to his shoulders. He loved it, and his muscles started to relax. I repeated the glide, this time with my elbows one at a time, and the muscles softened even more. While I felt tiny atop this tall, muscle-bound man, I knew I could deliver a helpful and memorable massage.

     Ethics, goals, and personal strength come into play in every massage. My training established standards and offered methods for dealing with difficult clients and tricky situations. It emphasized that I know what I am trying to achieve in massage and that I avoid situations that will detract from that goal. I was instructed, if I should not have enough strength to control a situation, to announce I was ending the session and walk away. One cannot always anticipate the needs and desires of a new client or even of a therapist’s own developing interests. I learned to recognize behaviors, phrases, and non-verbal clues in both the client and myself, and I was encouraged to be alert to their potential for small or large disasters.

     Superficially, there are similarities between massage and sex. Two people are alone together. One gets naked; the other rubs his or her hands all over the first one’s body. But the point is not to move the feelings engendered toward orgasmic relief, to communicate love through sexual contact, or to enjoy the other person’s body. Rather, the massage employs skilled touch to invite muscles into relaxation, the mind into rest, and the person into a caring relationship that will result in self-care. While there is physical intimacy and often a loving climate in both massage and sex, the outcomes sought in massage contrast clearly with those of sex.

     Jeremy was a strong, insistent person who seemed to want to have sex and to be worshipped. Perhaps I could note and praise some aspects of his body while I massaged his muscles, but I would keep to the conventions of common modesty and professional ethics. He didn’t need sex with me; he needed my skill to bring relief to his body. He needed massage to provide him new experiences of his body, not to repeat old ones.

     I believe I was prepared for this interaction with Jeremy years earlier by watching my wife Myrna, when she successfully took on the task of youth work in a congregation. She confided in me that her training and experience in preschool education prepared her to work well with teens. She was gentle, playful, accepting, and at the same time, firm. Her instructions were clearly enunciated, her expectations lovingly presented, and her acceptance of failure graciously offered. The teens responded to her with enthusiasm and trust. Under her direction, they achieved peer leadership and group success. She was especially helpful to kids who were the most wild. She gave them her unconditional love, encouraged their participation in socially constructive projects, and showed her genuine interest in their whole lives. I took my cue from her experience.

     Jeremy seemed to me like one of those wilder kids who would respond best to acceptance with a clearly marked line lovingly, humorously, and consistently enforced. I knew I wasn’t going to cross over the line with Jeremy. I was his massage therapist, not a buddy or a mate. When he persisted in touching me, I figured it was compulsive behavior on his part and so treated the behaviors in relationship to how they helped or detracted from the massage. For a year and a half of massages, Jeremy persisted in pushing at the line. He quit touching me but from time to time crossed the line verbally. He got great massages and, perhaps, some parent-like security from knowing that I would hold fast. He wanted the massage enough to keep his appointments, and while he may have lacked one kind of respect, he did praise me to myself and others as a massage therapist and a healer. Jeremy never did learn to keep consistently on his side of the line. Perhaps more time would have helped him grow into this, but his life ended before that happened. In response to his consistent pushing, I learned to hold dependably, with loving candor, laughter, and firmness. Now anytime someone pushes too much, I think of Jeremy and remember both the need to let massage be what it can be and how to hold the line for myself and my client.

Monday, March 25, 2013

Table Talk: Macho Dos

Bear  painting by Phillip Hoyle
     Clients often do not want to tell their therapist about the pain they are experiencing in the massage, and when they do, their communications are sometimes hard to interpret. It took me quite a few massages to understand that when Richard laughs, I’m hurting him. With Tom, silence means all is well, but moans indicate pain. Some people scream or say “No,” but more folks seem to grit their teeth and bear the pain in silence. I imagine that they lie there chanting over and over to themselves, “No pain; no gain. No pain; no gain....”

     One evening Sergio called. “Can you work on my brother-in-law?” he asked. “He fell at work and hurt his leg.”

     “Sure, but you come with him because I’ll need a translator,” I replied.

     Juan, Sergio’s brother-in-law from Mexico, had fallen off a ladder while painting a house. His facial expression and his noticeable limp while climbing the stairway indicated that he was in a great deal of pain. I examined his leg, compared it with the other. There was no bruise or significant swelling, but Juan winced at my touch. I began working in Swedish mode, knowing I would apply deeper pressure to his injured leg if he could bear it. I warmed up the tissue near the injury employing a variety of strokes and explained, while Sergio translated, what I hoped to do. Since I would have to work deeply, I taught a monitoring system so the work wouldn’t cause unnecessary pain. I asked Juan to respond to my inquiries with a number on a scale from one to ten. One, uno, indicates pressure with no pain; ten, diez, indicates way too much pain, “get out of there now.” My training considers numbers between four and seven to be therapeutic. As I worked, I asked periodically, “¿Que numero?”

     Juan answered, “Uno.” Again he replied, “Uno.” Still again, “Uno.” 

     I was a bit surprised at his tolerance for the pain. As I began working right at the point of injury I asked, “¿Que numero?”

     With a ragged voice he barely croaked, “Dos.”

     “Oh,” I exclaimed, laughing gently, “¡Macho dos!”

     Sergio almost fell off his chair in a fit of laughter. An embarrassed Juan amended his numero. “Ocho,” he admitted. I lightened my touch slightly to lower the pain level and continued to work, but I wondered whether I would ever know how much this work hurt my client.

     My colleague and friend Tony gave me a massage. He worked deeply, but I didn’t feel pain as his elbow hooked into my lower trapezium muscle and then as it bumped over my rhomboid minor muscle. I was surprised since this move often causes a high level of pain in my clients. Why the difference? I’m not quite sure, but some of my clients, like myself, don’t feel much pain at all. Other people, like Juan, bear high levels of pain out of some notion of self-image.

     Still others feel intense pain but really seem to like it. I realized one client had grabbed onto the legs of the massage table and was hanging on as if for dear life while bearing extreme pain. He seemed to love the pain I didn’t intend to give. When I noticed his grasping of the table, I lightened my pressure. Another client told me, after our second deep tissue session, “Phil, I’m really starting to like the pain.”

     I hope he was only kidding. My intention is to reduce pain. I don’t like to cause my clients discomfort, but I am capable of it and not unwilling to do so when I believe the painful work may actually prove beneficial. The big problem is that similar pressure doesn’t feel the same to different clients. The client must monitor the pain since one person feels uncomfortable, another one is in unbearable agony, and still another one is not registering any pain at all.

     In general, I want my clients to become more aware of their pain so they can do things to prevent or relieve it. Sometimes they can correct their posture, learn relaxation, and otherwise help themselves. I want them to learn self-treatment--how to massage themselves and how stretch their muscles. To accomplish such goals, the client and the therapist must work as a team, cooperating and communicating. I want them to think about themselves in order to discover what they can do to lessen their own pain, both during the session and in the weeks that follow it.

     Juan was in pain. I didn’t want to cause him more. My goal was to get the muscles out of spasm and to increase circulation in them so they could heal more readily. I hoped to lower pain in the area through the treatment of any trigger points that might have formed in the muscles from a prior accident. I was sure the work would cause additional discomfort, but if he would monitor me, I could keep the pain within a therapeutic range. I needed Juan’s help. When he finally gave me realistic responses, I was able to adjust my pressure and work carefully and appropriately in the affected area. Juan helped me, and in so doing, increased the effectiveness of the massage.


Brown and Black
painting by Phillip Hoyle

People of all kinds and sizes and with all kinds of expectations come for massage. Some want pain; others want only the softest touch. Both types of massage can be effective in dealing with pain. I figure whether I'm dealing with a grizzly bear or the gentlest black bear on my table I know I can help them with their pains. Actually I find the factor of the unpredictable in massage keeps me alert. You never know what kind of work will be called for to help your client.