Table Talk: Self Care

Shamanic Healer  Painting by Phillip Hoyle

     I wonder why I have so much trouble providing myself massage. Why do I put off going to others for massages I surely need or even doing the work myself? Why is setting aside time seemingly such a problem, dedicating energy so difficult, and appropriating money such a block?

     My lower back hurt. I awoke with the pain on the morning after Halloween. Dressing for a dinner party the previous evening, I had hurriedly selected a pair of slacks that were too tight. I tucked in my shirt to look nice, and I looked good. But I realized when I sat in Frank’s car on the way to the party, I could hardly breathe. Since the hostess was wearing her 40th Anniversary Barbie Doll dress and her husband a tux, since people who didn’t know me were in attendance, I didn’t feel free to get comfortable. Usually I would simply pull out my shirttails and unfasten my pants. But that night I sat in uncomfortable, rented chairs for way too many hours, and I paid for it when I tried to get up the next morning.

     Somehow, I don’t find the above explanation quite convincing to account for the amount and persistence of my pain. It reminds me of a client who suggested his awful shoulder pain was due to sleeping on a new pillow. I do like the humor of the scene--barely being able to breathe and enduring the too-tight pants for the sake of a public image--but I suspect there was more at play. Probably the constriction of the pants and belt activated a latent, painful spot or two that had bothered me some months back. I had suffered similar back pains from giving too many hours of massage, and years ago I had hurt my back in a snowmobile accident. Whatever the cause, I did hurt.

     That morning I could hardly move, but I had to get going since I was scheduled to give an early massage. A hot shower and all the movement of the massage left my back less painful and freer, but that afternoon, while drinking coffee with a friend, I felt a deep soreness settling in. The friend, a massage therapist, volunteered to work on me. His fifteen-minute massage helped, but it didn’t get rid of the pain. I asked another guy to work on it a couple of days later. The pain persisted. A third therapist worked on me two days later. He made other, related muscles hurt from his very deep work, but the back pain did not go away.

     A week later I awoke thinking, “I need to work my abdomen,” but I couldn’t make myself do the work. Many arguments and several hours later, I finally lay down on the floor and worked my abdomen. I approached the area using traditional Thai massage techniques. During this self-treatment, I further realized that to get rid of my week-old pain I would need to do more work on deeper muscles that pass through the pelvic girdle. Several hours later I also talked myself into doing that work.

     The massage that resulted in the release I needed so badly did not take much time, but apparently it did require a commitment to myself I haven’t yet found. I want to change myself in ways that encourage sufficient and regular self-caring. I wish I’d quit putting off work I can either do on myself or ask someone else to do for me. I would like to find the freedom to spend money and time for work that will give me pain relief and muscle releases. I want to feel vigorously healthy in my work and pain-free in my play. How else will I stay fit for the years to come? How else will I be able to encourage others to spend their time and money on massage?

I desire to find ways in which I can best live as an artist and a massage therapist: unleashing my creativity, caring for myself, loving myself in practical yet occasionally extravagant ways. In order to do so, I suspect I will need to overcome accusations of selfishness I sometimes aim at myself. I have work to do, growth to realize, and self-love to develop.

     My family was not very physical. Dad played tennis but didn’t encourage us children to do the same. We played neighborhood games, but none of us became sports players or even fans. We weren’t touched much. We watched Mom and Dad touch and kiss, but we were rarely folded close into our parents’ bodies, at least not to my recollection. I watched my sisters run from my father when he threatened to kiss them and scratch them with his whiskers, but I was never touched by either him or my mother. We rarely went to the doctor. Fortunately, I was healthy and seldom ill, but these things together--our family’s reluctance to touch, independence from health care, and general good health--may have become part of my distancing from myself, my own body, my own self-care. They may hold some key to my figuring out how to give better care to myself.

     My wife observed during the nearly thirty years of our marriage that I had become increasingly physical in my relations with people. I gave and sought more touch, a phenomenon that has contributed to my becoming a massage therapist. Still, I did not seek this touch from health care professionals or even hair stylists. I hated to spend money on such things. I did not provide for myself what I was happy to provide others. Luckily, I have been healthy; unfortunately, I have not learned to seek help for myself when I need it. I need it now.

     As I was writing this piece, I cut my finger with a knife intended to cut an onion. I evaluated the damage. If I were not trying to make a living doing massage, I’d probably put an adhesive bandage on the place, but I really did need stitches. Here was a blatant opportunity to provide self-care. I called my friend Tony for personal support and for a ride to a family practice clinic where the wound was properly stitched. I can consider this as being practice for further dimensions of self-caring. I am thankful for my friend who drove me to the clinic. Still, I need more assistance. To whom can I pray for help in making these changes? What holy figure showed such self-care? Jesus? Mary Magdalene? Another saint? I don’t know, but I suspect I will have to pray to myself. I will have to ask my own self-neglecting hermit saint to open himself to the divine communication that will take place only when I love myself and care for myself. Amen.

Table Talk: Trauma

     Melissa came to my practice at the suggestion of a friend. She was looking for a massage therapist near her home who would help her recover from an accident. We set a time for a first session in which to evaluate one another and decide if we should work together.

     While walking across an alleyway, Melissa was run into by a moving automobile. The car was not moving very fast, yet it hit her on the left side and dragged her several yards. She then landed on the asphalt on her right side. Her terror turned to anger as she confronted the driver who then, freaked out by what he had just done, drove away from the scene of the accident.

     For three months she had been working with a massage therapist and a chiropractor. Her masseuse left the practice, hence her search for someone else to continue therapy complementary to the chiropractor’s. As we talked, I observed Melissa’s anger. Three months after the accident she was still angry with the driver. The focus of her fear, though, had changed. At age 21, she was afraid she would never recover fully and would live in pain for the rest of her life.

     The initial session went well. Melissa scheduled several more. In the subsequent months of therapy, I discovered in practice what my teachers had told me over and over: integrative massage techniques can address issues resulting from trauma to soft tissue. Thus I used deep tissue massage, neuro-muscular therapy, and connective tissue techniques wrapped together in an organizing package of Swedish massage, and complemented by verbal therapies. I chanted, so to speak, a prayer of recovery as I worked deeply between her ribs, and inched my way into the anterior hip muscles deep in her abdomen. I stretched out shortened muscles in her neck and shoulder, speaking all the while about the body’s amazing power to heal itself. I released trigger point after trigger point in the tissue around her knees while engaging her in conversation about school and the direction of her artwork. I was pleased, even impressed, as I watched her heal.

     Certainly her healing was enhanced by massage. But this independent young woman didn’t need to remain dependent on others for pain relief. I demonstrated and encouraged her to practice some self-massage techniques for muscles in her face, neck, ribs, and abdomen. She did them at home and started setting her appointments farther and farther apart as she mended.

     I suspect Melissa will feel some pain in her neck, ribs, knees, and hips for the rest of her life. She will remember her accident whenever she is tired, and occasionally, she will revisit her feelings of terror, anger, and fear. But also, she will carry with her the memory of healing and of the simple, but not insignificant, part massage played in helping her muscles to mend. She will be able to apply simple techniques of self-massage when the pain is slight or seek further help from a massage therapist when the pain persists. 

God, help us see the complexity of the healing process. 

May we learn how to balance our acceptance of pain with our doing something about it. And in so doing, 

may we recognize your voice and touch. 

Amen.

Buffalo Ceremony by Phillip Hoyle after a group of Kansas petroglyphs

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.