November 11, 2011

Why We Don't Tell You How Much to Undress










October 16, 2011

Postpartum Massage

Pregnancy massage gets talked up a lot. I talk it up myself: it's great stuff, and it's fun to work with pregnant bodies. Pregnant bodies are stoked, hormonally: you can practically feel them growing under your fingers. They're vibrant and responsive. They feel extraordinarily alive.

Lots of people give gift certificates for massage to pregnant women. My impression from surfing the web a bit is that pregnancy massage is a booming business. And that's grand: but I tell you, if my budget allowed for only a few massages, I'd save them up for the postpartum year. That's when women need it most, and when they get it least.

Pregnancy stresses the body, but it does it relatively gradually, and the hormones surging around, while they are not always easy to deal with, at least always remind you that you're doing something out of the ordinary. During pregnancy, and especially during a first pregnancy, things feel rather epic. Your body changes drastically, and everybody's into it, often annoyingly: strangers, without permission, will be placing their hands on your belly and exclaiming. Interest in the last couple months is intense. Everybody wants to know: when are you due?

Then, bang, the birth. Huge to-do. Lots of excitement. People cooing over the baby, pictures flying around the web.

And then two weeks later – it's all done. Nobody's interested any more. The party's over. Just when you really need the support, when the new life is really starting, you're on your own. People may still be interested in the baby, but they're no longer interested in you. Your body, which was the center of the world and a matter of absorbing interest, the temple of new life, is now a seedy all-night snack bar. It has, in the space of a few days, gone through huge changes, and it has challenges every bit as big as the challenges of pregnancy to deal with. If you've had a C-section, you've got major surgery to recover from. If you had a hard labor, you have exertions and injuries to deal with that make running a marathon look paltry. In either case, especially if you've been primed by overly chirpy birth-preparation books, you're liable to feel that you somehow failed by not have an easy, radiant birth.

Even if you had an easy, radiant birth – some people do – what your body now has to accomplish is extraordinary. The uterus has to return to its former shape. All your displaced abdominal organs have to find their way back home and re-seat themselves. Your abdominal muscles have to shrink to a third of their high-tide size and recover their tone. All the ligaments and connective tissue has to tighten back up. Your nervous system has to rewire its sense of where your body is in space. And this while, in all likelihood, you're working harder, and sleeping less, than you ever have in your life. But now – at least by comparison to the glories of pregnancy and birth – nobody really gives a damn. No strangers are rushing up to coo over your shriveling stomach; nobody wants to congratulate you on the fact that in some lights your stretch marks will hardly show at all.

What surprises me, really, is that anyone doesn't suffer from postpartum depression.

This is when you need massage. When you need someone focused on helping your body, which is working harder and changing more rapidly than ever. When you need the soothing and the comfort and the being-made-much-of. This is the time when you're most in danger of losing touch with your physical self, when you're ignoring warning twinges and discomforts and spasms because you're too damn tired and there's no time to do address them: when you're tempted to stop caring for your body because nobody is interested in it anyway. This is when you realize that your body is going to be different now forever (it is) and that it's lost all its resilience (it hasn't: it's just that the big hormone party is over.)

Why don't more women get massage postpartum? Lots of reasons. Here are some bad ones:

Sometimes bowel or bladder are untrustworthy for a couple weeks postpartum. Any experienced massage therapist should be prepared to deal with that. Bodies leak: so what? You clean up and go on. No problem.

You can't get childcare. You still have options. There are places, in large cities anyway, that offer childcare as part of the package. There are a number of massage therapists who, like me, offer in-home massage and are not fussed by having an infant on the table with Mom, nor by wide-eyed older siblings wandering into the room from time to time to ask for things. I have clients who get their massage sidelying, with the baby snuggled in and nursing from time to time.

You're too tender to get massage. You do need someone who understands what the body goes through, in childbirth and after. Do find someone who thinks that massage should not, ordinarily, hurt. There are times when trigger point or deep tissue “hurts good,” but that's a special case, and the therapist should know exactly what they're doing. You neither need nor want to be manhandled, postpartum.

Your belly is still too big, or your breasts too sore, for lying face-down to be comfortable. But there's never any need to be face down, any more than there is during pregnancy. Your therapist can arrange you on your side perfectly comfortably. It's a little mysterious to me how little massage is done sidelying. In many ways it's much better position than face down: I can move the top shoulder freely, any way I want, and the hip rotators are much easier to get at. I can't get as much leverage on the thick lumbar paraspinals, but on the other hand, the pressure I do use isn't bearing down on the still-tender abdomen. I have longtime clients who took to sidelying while pregnant, loved it, and now, years later, have no intention of ever getting back on their face.

You're too ugly. This is a surprisingly common reason. I guess it comes of all those spa ads with gorgeous perfect women luxuriating in a massage: you feel you don't look the part, so you'd better wait till you do. But this is exactly backwards. The problem is not that you're ugly: the problem is that you feel ugly. And nothing dispels the delusion of ugliness like a good massage. You always deserve a massage. You don't earn the right to it by being lovely. You earn the right to it by being a human being.

Those are some bad reasons for not getting massage. There is often, unfortunately, one good reason: it's too damn expensive. So plan ahead. Make clear that one of the baby shower gifts you'd love to receive, in lieue of yet another darling onesie that will be too small in five weeks, is a certificate for an in-home massage. Or for a package of in-home massages: the perfect thing to hit up a rich aunt and uncle for. And remind your friends who were so free with offers of babysitting before the baby's arrival, but have since become too terribly busy, that a massage certificate is an acceptable substitute.

October 12, 2011


I wake briefly at five: the full moon has broken through the clouds and its light is pouring over moving boxes, the shining covers of library books, a glittering glass on the bedstand. Then, as I watch, the moon sinks below the stand of trees to the west, and everything dims again to the ordinary city glow. I fall asleep again.

At seven I wake again, wander out to the bathroom. Tori intercepts me on my way back: can I help wake Mom? They need to be going at 7:30.

I make affirmative noises. I can't remember what they have to do, or why Tori is here. But I can wake Martha. I begin with the shoulders, sliding a hand under each scapula in turn, to loosen it up as I work the traps and the back of the neck. Then the arms and the hands, and back again, the pecs and anterior neck, some brief face work, then down the breastbone, over the abs to work the quads and adductors – pushing one of my pajama-ed thighs under hers to serve as a bolster – and the calves, on to the feet. The metatarsal of the big toe gives a satisfying click as it shifts, and Martha gives one of those involuntary groans that tells you you've hit the sweet spot. I'm not really very awake, but I don't need to be. I pay special attention to the feet and work my way back up. Catch the lower back by reaching under – always my favorite route to the QL and the lumbar paraspinals. She's waking, slowly but surely, and finally she turns over on her side. I find myself up on my knees, with a wide stance, working the rich field between the sacrum and the greater trochanter with paired thumbs. There's that trigger point. I'm rounding up the usual suspects. I roll her over and do the other side, and I finish by coming back to the hands, twining my fingers in hers to spread the metacarpals apart and get to the little interosseous muscles that sit between them.

I check the clock. It's been fifteen minutes, and I've done a creditable full body massage. When I worked at the East-West clinic I used to hate trying to cram a full body massage into an hour. I know a bit more now than I did then, but mostly it has to do with knowing the body I'm working with so well: that and not having to fiddle with drapes or lubricants, and not having to worry about steering around breast and vulva. Makes me realize how much time and attention I have to put in, “tying in” different areas of the body by circuitous routes, when I work with clients. We pay for having taboo areas of the body: we pay in time and attention, we pay in a loss of somatic unity. I know, Esalen and the Revolution are history, and we meekly accept the boundaries of a fallen world. But like Galileo, I permit myself to mutter, “still, it does move,” as I leave the court.

Martha's awake and grateful. People scurry to and fro, collecting what they need for work and school. The moon has gone wandering far to the west, hanging now huge over pre-dawn Hawaii, I suppose, and scattering trails of glory over the ocean. Morning and the workaday world, here. And coffee calling me, like a thrush singing in the yard.

September 8, 2011

My Poetry Book





August 31, 2011

Hamlet and Energy Work

On Facebook I wrote:

There's a long overdue conversation starting up, I hope, about whether you have to believe in "energy" in order to take "energy work" seriously. (Hint: do you have believe in Prometheus in order to take "Prometheus Unbound" seriously?)

When I first read Hamlet, as a teenager, there was a lot that I didn't understand, but only one thing that really bothered me: that no one seemed to care about who Hamlet really was. Was there really a Danish prince? Did he really kill his uncle? Nobody seemed to know. Nobody seemed to care.

After a lifetime spent with literature, this seems natural and ordinary to me: I remember my young distress with some amusement. Of course no one cares about the "real" Hamlet, or the "real" Macbeth, or the "real" King Lear. What matters is what Shakespeare did with them. What matters is the poetry.

But actually, it's a more complicated than that. Shakespeare, I've always suspected, cared more about it than his 21st Century readers do. Did Shakespeare believe Hamlet was historical? Almost certainly. Did he know he was making things up, too? Probably. He must have known he was making up words for him to speak. Did Shakespeare believe in Hamlet? That's probably the wrong question. It's more, How did Shakespeare believe in Hamlet?

As a (very minor) poet myself, I know the way that a character from a chance-read history can invade your consciousness. For me it was the confederate general, John Bell Hood. A few details about him from Shelby Foote's history of the American Civil War took root in my mind, and would not get out. There was a poem that needed to be written, and it was crystallizing around the figure of the young, blond-bearded, impetuous, not-quite-smart-enough Hood. There was something I knew about Hood that nobody else knew. Something I understood, and that needed to be said.

I knew well enough that my Hood was not the real Hood. I knew that I'd never seen the eight-year-old John Hood lose a playground fight, and refuse to cry uncle, even when his face was pushed into the mud. But I also knew that didn't matter. I had to write about it anyway. There was a connection that I had to honor, a story that I had to tell.

All of this is second-nature to anyone trained, as I was, in the hot-bed of postmodernism that was the Yale English Department in the 1980s. I had the further advantage of Buddhist meditative training -- a long, if somewhat haphazard course of it -- designed to shake the conviction that the world as we perceive it is the world as it is. It's one thing to think that's true: quite a number of people pay lip-service to the idea. But it's quite another to practice seeing, hearing, tasting the "real" collapse in front of you.

If you don't have that kind of training, and few people do, your response to being told something is not real is almost certainly going to be that someone is denying your experience: and there are few things that make people angrier, especially if the experience is important to them.

If you tell an energy worker that energy is "not real," you can expect some pretty fierce responses: especially if you smugly think that the electricity in your own mind, for instance, is "real." In fact, if you watch carefully how your mind actually handles the concept of "electricity," you'll find that it uses a bunch of silly and downright false images and concepts to manipulate it. When it comes down to it, most of us picture electricity as a stream of warm light running through wires like water through a hose: some of us may have a slightly more sophisticated picture of electrons, like tiny BBs, crowding and bumping their way through a tunnel. But nobody honest is going to be able to tell you that the "electricity" in their mind really corresponds to what science can tell us about electricity, and you won't do yourself and favors by trying to banish the hose or the BBs from your mind. You need to think about it somehow.

So, what is the "energy" that a massage therapist who "does energy work" works with? To me, it's the exact equivalent of the John Bell Hood whose eight-year-old face got pushed in the mud. There was, in fact, a real John Bell Hood: but nobody can know him directly. There is also the John Bell Hood that Shelby and I have in common: a set of characteristics compounded of all kinds of people we have known: a kid I knew from the deep South who had more courage than sense, a shading in of Custer with his long blond hair, antique glimpses of military gallantry. And then there's the poem that I write later, when I reach out through, and with, this phantom "Hood" to try to communicate with other people, to move them, to make them stop and think about the suffering and beauty of a sort of person they might ordinarily hold in contempt. Just so, there's the "energy" in the practitioner's mind, largely bogus; the "energy" as a possibly shared understanding of chakras with their emotional charges and all the images and metaphors gathered around them through a couple millenia's hard use; and finally there's the massage, the interaction informed by all this, which can be as profound and important as any play of Shakespeare's.

So it's not adequate to say that the "energy" is unreal. Pretty much everything that our minds manipulate is unreal, in that sense. The Hamlet in Shakespeare's mind was not just something made-up. It was something he recognized as of desperate importance, something that needed to be said, something he needed to say and that other people needed to hear.

On the other hand, insisting that "energy" is real is the quickest way to destroy the massage traditions that have grown up around it, particularly if you make false medical claims on the strength of it. When you make a medical claim, you step into the arena of science, and you're subject to all of science's laws and procedures. If you say you can improve someone's immune system by balancing their chakras, you'd better be able to do it, in a reasonably consistent, measurable, verifiable fashion. But there's no need to make this sort of claim. There's a certain sort of fundamentalism that equates spiritual health with bodily health, but the two things have little to do with each other. The Dalai Lama is going to get sick and die, just as Mother Theresa did, just as Ghandi did, just as you and I are. Until we get clear on this we're going to be muddying the water on both sides.

August 21, 2011

Looking for a New Partner

I've been thinking I should bite the bullet and find a new partner, so I can do simultaneous in-home couples massage again. (Lauren has up and gotten married and gone off to Taiwan, and I haven't had the heart to look for a replacement.)

If this person is interested, they're so hired!

August 20, 2011

Three Must-Reads for Massage Therapists

I'm going to be writing in response to all three of these, when I get time. For now, I'll just pass them on:

David Lauterstein on "Energy and the Integrative Vision"

Ravensara Travillian's response at POEM

Alice Sanvito's blog post, "What is Energy Work?"

I have been hoping to see this conversation start up for a long time.

August 18, 2011

Why I Became a Massage Therapist

Too many times like passing ships, at both ends of missed
opportunities. Why can’t we touch at the center, in silence?

-- Luisa Igloria, Ghazal of Unattainable Silence

August 10, 2011

Ingraham on Cherkin

I loved this article this article about the Cherkin study on massage for low-back pain.

About the bad news for "advanced massage techniques" in this study, Paul nails it:

Instead, it’s like the New York Yankees accepted a challenge from a beer league softball team and couldn’t do better than a tie score.

July 31, 2011












July 15, 2011

Training and Boundaries





July 6, 2011

Not Quite Enough Air




July 5, 2011

The Cherkin Study on Massage and Low Back Pain

The NPR piece on this summarizes it nicely:





June 16, 2011

Lord of the Trigger Points

A discussion on Facebook reminded me of this mnemonic I made up a couple years ago. With apologies to Tolkien fans!

Two Points in the upper traps, where temple pain is made,
Two in the levator scap causing stiffness of the neck,
Two in the SCM whence frontal headaches trade,
One in the lower traps, starting all the wreck,
In between the low thoracics and the shoulder blade.
One Point to start them all, one Point to goad them;
One Point to aggravate and stir them up and hold them,
In between the low thoracics and the shoulder blade.

June 7, 2011

Why Massage?

A Facebook post tells me that I should hit the streets and sell the benefits of massage to everyone I meet: that my business (as opposed to my work) is all about selling. I bridle at that. I'm useless as a salesman, in the first place: nobody in their right mind would set me to selling anything. The first thing I do with a pitch is queer it. I don't like tooting my own horn, and I don't like tooting horns in the received wisdom parade. I don't like tooting horns at all.

I'm skeptical about a lot the claims made for the general health benefits of massage. For the same outlay of time, spent on exercise, naps, and hot baths, I've argued – not to mention a lot less money – you can get the same or better results in lowering your blood pressure, reducing your stress, and improving your circulation. Massage does these things, it just doesn't do a very important amount of them. And its benefits are transient.

Then there's the various extravagant “healing” claims. In general I take an even dimmer view of them. A shaman is someone who comes from a vigorous tradition, has traveled in other worlds, taken genuine psychic and physical risks, usually blown a fuse or two with hallucinogens. He's not some middle-class suburban kid who's read a Ravenstar book, chewed a little peyote, taken a weekend workshop in Polarity, and changed his name to Wolf.

There's a whole slew of manipulative therapies – more than you can shake a stick at – for resolving specific problems. I practice some of them, trigger point and some MET (muscular energy technique). Sometimes it works, sometimes it doesn't. It shades off into the sort of work that physical therapists and osteopaths and chiropractors do. I don't take most of their claims all that seriously either, and mostly I've regretted it, the few times I've let those people get their hands on me. I know enough now to just look their treatments up and try them on myself, if I think they might work. Occasionally they do. But that's not what my massage practice is about. If I think something will help my client, I'll teach them how to do it. It's unusual for any of these practices, done in the standard “dosage” of therapy – once per week – to be very effective. Daily, or several times a day, is more like it. Mostly, people just get better because they heal up, and the therapy has nothing to do with it.

You see? Salesmanship is not my strong suit.

On the other hand, I get more massage than most of the massage therapists I know do. I walk the talk, even if I don't talk it. I believe in massage: it's an important part of my life.

Why? Well, it's not about health, in the narrow sense of the word. I'm not trying to lower my blood pressure or cushion my cortisol spikes or drain my lymph. It has to do with tenderness and respect, with protected spaces, with wordless friendship. It's about touch.

In a sense, it's all about the boundaries, inside and out. Outside, I measure people's suitability as friends or lovers by all sorts of criteria, most of them ridiculous. If I shake hands with them or hug them it has all kinds of meanings and subtexts. It's all tangled up with prestige, whether I'm good enough, whether they're good enough. I become more and more aware of it, as the years go by, and I hate it, but it's more than a lifetime's practice to shake free of it.

Within a bounded space, though – the physical space of the massage table, the temporal space of the session – we can play the Vajrayana game. Just pretend: for an hour and a half I don't have an ego. I don't care what anyone thinks of me. No one knows that we are in this relationship, so social prestige has nothing to do with it. The clients eyes are closed, so all my trappings – clothes, jewelry, whatever – are out of the reckoning; they're naked, so all their trappings are absent too. It's down to touch, to two human beings, an ordinary pair of hands and an ordinary body. It feels sacred to me, in the same way that wilderness feels sacred to me. There's nothing here that's been put here to mark anyone's power or subservience. Nobody owns anything here. Nothing we do has any social meaning or importance. All the nonsense has been cleared away. This is touch, touch as simple as stone, water, or tree. It doesn't need anything else.

And of course – like all Vajrayana practice – it fails. I do care what my clients think of me. They care what I think of them. We veer into distraction and ideation. There's what the boundary-pros call transference and counter-transference: we make each other into parent or child or lover figures, superimpose old relationships onto this one. But of course that's what we do all the time, with all our relationships. What's different about this, is that there's space and time enough to see it clear, in all its absurdity; to set it aside, with more or less success; and to return to the love, to the hands and the skin. It's not perfect. But it plays, there, with the perfection that we know is possible. It keeps alive our yearning for a connection that is simple and real. And that's gift enough. That's what brought me to massage, and what keeps me here.

May 30, 2011

How to get a Bad Massage

There's a lot more to getting a bad massage than just finding the wrong therapist! For those who don't want to enjoy the experience, I've assembled a few hints on how to have a lousy time on a massage table. It's easy if you know how.

1) Arrive late. This is a simple but effective technique. Make your therapist rush, or worry about whether he'll be able to finish in time for his next appointment! This is especially effective for first appointments, when you have to squeeze in the paperwork anyway. (Though some therapists may spoil this by budgeting extra time for it.)

2) Start off uncomfortable. Arrive chilled, if possible. Be sure not to go to the bathroom before your appointment.

3) Undress to your level of discomfort. It's actually harder than you might think, to make the undressing uncomfortable. Your therapist is going to tell you to undress as much as you want and get under the covers, and then he'll leave the room, and give you all the time in the world. But you can still make it uncomfortable, by imagining that that you're supposed to take off all your clothes, if you'd rather not, or by imagining that you're not supposed to, if you rather would. The sad truth of the matter is that your therapist doesn't give a damn, and he'll keep you modestly covered up with the sheets whatever you do. Five minutes after the massage he won't remember whether you had your undies on or not. So it's up to you to be sure and do what's uncomfortable for you.

4) If you forgot to arrive uncomfortable, it's not too late. You can still get uncomfortable. After 20 minutes, you might find your bladder full, and then rather than saying so, and hopping off the table wrapped in the blankets to nip out for a quick pee, you can just tough it out. Or maybe your nose will fill with mucus, with your face down in that face-cradle. Then all you have to do is not ask for a kleenex, and try to sniff it up, or surreptitiously wipe your nose on the sheets. You'd be amazed how much discomfort and distraction you can leverage out of a simple thing like that! Of course, if you ask your therapist for a kleenex to blow your nose he'll be happy to hand you one, and take the kleenex afterwards and toss it away – he does it a dozen times a day – and you'll get barely any discomfort out of it all. So don't speak up! -- Or you might get too cold, or too hot, or the face cradle might be scratchy: the opportunities are endless. The secret to maximizing your discomfort is not letting your therapist know about it.

5) If you've got an injury, or some part of your body that you don't want your therapist to touch -- for any reason -- don't tell him! Just tense up every time he approaches it. (He's not going to uncover or touch your breasts or genitals anyway: but that doesn't mean you can't worry about that, too.)

6) Likewise, if the pressure he's using is too light or too heavy, be sure to keep mum about it.

7) If not speaking up is too difficult, there's always the opposite approach. Micromanage the massage! Indulge in your anxiety that he might not hit the right spots, before he's even gotten to that area of your body, and direct him to them with vague but plentiful instructions. This will throw off his rhythm, at the same time ensuring that you don't sink into any unwanted state of relaxation. If you keep busy peppering him with directions, your risk of really enjoying anything is small. (Be careful not to confuse this with asking him to do more, if he's leaving an area and it feels unfinished – that's the sort of thing that puts you at risk for a good massage.)

8) Be sure to make a mental inventory of everything you dislike about your body, and imagine that he's revolted by it all. It's unfortunately true that most massage therapists really like bodies, of all shapes and sizes, and they have spent years seeing what people really look like under their clothes. He probably thinks you're gorgeous. But what's to keep you from imagining he doesn't? Be creative!

9) Rush to get off the table. It's important to imagine that your therapist needs you to get out pronto, and to scramble hastily to get dressed. (If you followed instruction #1, and arrived late, this will be a bit easier, but it's certainly not necessary.) Whatever you do, don't spend five minutes looking dreamily at the ceiling and feeling content! Something like that can leave you feeling relaxed and happy for days.

May 27, 2011

Divagation on "Energy"

Wikipedia quotes Feynman:

—The Feynman Lectures on Physics

“Energy,” you might say, is the most boring of all things, in physics at least: it is the name of a quantity, and what's more, the name of a quantity that doesn't even change. There is nothing qualitative or concrete about it: it is, as Feynman says, inexorably mathematical and abstract.

It's a made-up word of pseudo-Greek origin, and I should admit that I have a prejudice against such words. There was a respectable reason for importing Latin scientific terminology into English. Latin was, for many centuries, the common learned language of the Western world. If you were going to learn just one foreign language, Latin was what you learned, and if you were going to write about something of international significance, you wrote in Latin and used Latin terms. The Polish Copernicus, The Italian Galileo, and the English Newton all wrote their books in Latin – and could all have read each other's writing with ease. The loss of this common language is one of the great intellectual disasters of our time. But that's all by the way. My point is, there was a good reason to use Latin terms: everybody who was interested in science knew what they meant, and they meant the same thing from Cracow to Pisa to Cambridge. But there's only ever been one reason to import Greek terms in the post-classical West, and that's to show off. You use Latin if you want to be understood: you use Greek if you want to impress. And often to people who actually know Greek, it's not very impressive: the Greek words get hauled into ludicrously wrong contexts, get fitted up with Latin plurals, and generally look, to someone with linguistic sensitivities, like wizards trying to dress as muggles.

One of them was a very old wizard who was wearing a long flowery nightgown. The other was clearly a Ministry wizard; he was holding out a pair of pinstriped trousers and almost crying with exasperation.





Well, somebody around the beginning of the 19th Century dug ἐνέργεια out of a Greek dictionary, much as Archie dug his nightgown out of a muggle shop, and we all need to pretend that it's a real word now: not because anyone is very sure what it means, but precisely because they're not. It's all very highfalutin and authoritative, but as Feynman, with his gift for isolating essentials, pointed out – it's a name for the strange fact that you can run certain calculations over at the conclusion of a change and get the same answer you got before it. It's not a description of change, or of the operations of cause and effect, or of force: in fact it's very nearly the opposite, and its co-option into English to mean things such as “vigor” or “transfer of force” is particularly inept.

Of course, that's just the way language goes: there's no use in objecting to the process, and I wouldn't even if there was. I'm just explaining my visceral response to the word: it strikes me, before we even get to bodywork, as bogus and posturing.

Don't get me wrong. It is a real word, thought not a common one, in classical Greek: it means something like "action" or "operation." But in the New Testament, where our English borrower no doubt found it, it is, as Strong says, "used only of superhuman power, whether of God or of the Devil." In other words, the English word "energy" has been trying to have it both ways ever since it was born: parading as a technical term, but deriving its energy (so to speak) from being associated with superhuman powers.

May 25, 2011

Energy in Bodywork

On Facebook recently, there was a discussion of the notion that one ought to sleep oriented north-south, to align oneself with the Earth's magnetic fields. Someone asked if there was any evidence for this, or if it was just woo, and a lively discussion ensued. I always know when I'm overstressed because I get drawn into arguments about this sort of thing, as if it mattered. I don't care if people sleep north-south – what skin is it off my nose?

Of course it's silly. How does one “align” a non-magnetized thing like a human body with the earth's magnetic fields in the first place? Who says the magnetic poles of the human body are in the head and the feet, and how do they propose to prove it? Has anyone ever noticed that these planetary magnetic fields curve? And can anyone come up with a plausible – let alone verifiable – way in which the incredibly weak influence of the Earth's electromagnetic fields would have any influence on my well-being? Of all the forces acting on me daily, I can think of few less likely candidates than those fields. My laptop, not to mention my next door neighbor's refrigerator-magnets, are blasting those fields all to hell anyway, as far as local influence goes.

But of course it's not really about the facts: it hardly ever is. The emotional investment is actually in much different things. For me it's the question of: do you believe things because they're tidy and convenient and comfy, or because they're true? I wrote in that thread: “this has 'woo' written all over it.” Not just because it strung together a whole series of absurdities and indefensible assumptions, but, much more tellingly, because it arrived at an improbably tidy conclusion: one should sleep oriented, out of all conceivable choices – “right side up.” North is up, and your head is up, so your head should go to the north. It's the childlike insistence on neatness, on the world obediently lining up with our ideas about it, that irks me. It makes me want to insist on these people moving the foot of their beds six inches away from the adjoining north-south wall, if in Maine, or three inches away in the other direction, if in Texas, to account for the magnetic declination. If you invite science to your party, you're going to have to let it play with your toys.

And on the other side, the emotional investment is in not letting schoolbook-learning quash the questing spirit, not letting your native language – which is one of correspondences, microcosms and macrocosms, the language of poetry, in short – be taken away. The people who are doing polarity therapy may be exploring something terribly important, something that has far more to do with people's well-being than correcting for magnetic declination will ever be. And there is a horrible real-world component here which most scientific people I know poo-poo or just refuse to entertain at all. The question is whether people who can't do math or memorize tables or learn Latin nomenclature get to participate. The people who are all gung-ho on a more rigorous science-based training for massage therapists often seem not to get this. There are people who can't do that stuff, and some of them are marvelously gifted bodyworkers. If you raise the academic bar on these people you really are going to cut them off from work they love, and are good at. Possibly even their vocation, the only work they would ever be really good at.

In any case, and more fundamentally, every one has to take their own journey, and will, whether we like it or not. It's one thing for us to tell people: you're not qualified to make medical recommendations based on your own outlandish misunderstanding of electromagnetics. It's another to tell them, your spiritual explorations and emotional discoveries are invalid. We must say the first, and we must not say the second. The fact that we know that Reiki practitioners are talking nonsense when they talk about “working with someone's energy,” as if they were electricians doing a bit of rewiring, doesn't mean we know anything about what happens in a Reiki session that is a decisive turning point in someone's emotional life.

What will make this easier, all round, is if people who don't really understand science stop trying to pretend they do, and stop mixing up their own terminology with scientific terminology. Don't call the damn stuff “energy.” Call it “chi.” Or make up a new word for it. Don't drag in magnetism and electricity. These are things with precise definitions. They can be measured accurately. They behave predictably. You're only going to make yourself look silly, and aid in your own disempowerment, if you try to make them fit with your meridians or sen lines or polarities.

And if you are going to work with the dream world, bear in mind what any genuine shaman will tell you: the crossing is arduous, and the translation is difficult. It's easy to think you know what things in the dream world will mean in this one, but more often than not you don't. Does it intersect with things that scientists talk about? Of course it does, but you don't know how.

To me, the bottom line – and what scientists and shamans are, ideally, in complete agreement about – is don't pretend to understand things, if you don't. Things are confusing enough already.

May 24, 2011

On the Medical Uselessness of Massage

About a year ago I posted this essay on my personal blog. I reproduce it here on request, together with the semi-retraction I wrote a couple days later, with a further observation or two at the end.

Let's be honest. I am in no doubt as to the therapeutic value of massage, but most of it is more spiritual or psychological than medical. The medical benefits solemnly listed by massage therapists are real enough, but they're mostly trivial. Yes, an hour of massage relieves stress and lowers blood pressure -- but not more than a ten-minute nap. It improves the circulation of blood and lymph -- but not more than a stroll around the block. It triggers an endorphin release – but not more than eating a bar of chocolate. It relieves muscle tension -- but not more than a hot bath. All these effects are real and measurable; they're just not very important, medically speaking, and they are not – quite obviously to me – why people really get massage. People get massage because they ache for the touch, for the physical communication, for the sensation of being physically cared for, physically attended to, physically heard. We dress it up as a medical intervention because that makes it respectable. It's justifiable to spend money on it, if it's medical. But it's no more medical really than a momma cat licking her kittens' tummies. Perhaps that does aid the kitten's digestion, but you and I and every cat knows that's not really the point.

The point is that we must love and be loved; we must touch and be touched. It's fundamental to our well-being. My favorite massage myth is that it “releases toxins.” This has been studied, and there's not a shred of evidence for it, but the myth marches on regardless, because it feels right. It feels like you're getting rid of something poisonous when you get a good massage, when you give your body over to someone and they treat it with interest and love and respect. But the poison isn't metabolic waste: the poison is the anxiety of loneliness, the ache for acceptance, the doubt whether we really belong to the tribe. Those are the toxins massage flushes from the system.

(Okay. An exception, here, is trigger point, which has serious therapeutic value for relieving chronic myofascial pain – what's commonly perceived as joint pain. But the most common “dosages” of massage – one hour once a month, or one hour once a week – are all but useless for trigger point, which typically needs ten minutes three or four times a day to be effective. I do trigger point on myself all the time, and so should you: but save your money. See a good trigger point therapist once or twice, get them to teach you how to work the points causing your pain, and do it yourself till the points resolve. That would be my advice, for all but the gnarliest and most entrenched trigger point systems.)

The thing about the psychological benefit of massage is that it falls roughly under the rubric of placebo treatment, and from what we know about placebo, the more ritual and mystery surrounding it, and the more sense of its preciousness, the better it works. If I could talk a good line about releasing toxins or balancing energy, my massage would be more therapeutic. And if I charged more for it, it would be more effective. There's a serious case to be made for the therapeutic value of driveling, especially if you believe in the nonsense yourself. But I can't do it.

I can say this, in recompense: the love I feel for my clients is intense, and quite as real as any other kind of love. I'll stumble upon pockets of grief, I'll open up veins of lifelong loneliness, that will stagger me. Doing massage is no more soothing, ordinarily, than participating in a meditation retreat is relaxing. On the contrary, like a meditation retreat, it's most often, for me, a wild roller-coaster ride of emotions, waves of joy and sadness in quick succession, glimpses of rare colors and strange countries. The connection can be downright unnerving. You need either a thick skin or a certain amount of contemplative stability to ride it out. The end result may be – usually is – a profound sense of gratitude and well being: but it doesn't come cheap.

I suspect that if you studied people with a life history of getting regular massage, you'd find longevity benefits similar to – and as difficult to analyze as – those of marriage. But a study definitively establishing cause would be, under present funding conditions, prohibitively expensive. After all, people who get regular massage tend to be prosperous, tend to look after themselves, tend to be willing to expend resources on their own well-being, tend to be comfortable with touch and hence likely to be in healthy love relationships: you'd need to randomize your clientele, and track them over years, to avoid all that skew and get real results. A study like that is not going to happen while Big Pharma rules the medical roost.

The trouble is that if we keep making claims for short term medical effectiveness that we can't actually back up, sooner or later we're going to be discredited. Massage could go into another eclipse like that of the middle 20th Century, when it almost disappeared in America as a respectable profession. I'd hate to see that happen, because I do think we help people, profoundly and lastingly, and I do think we are the keepers of a traditional lore – of several traditional lores – that ought to be preserved. But I don't think we can compete with Big Pharma on its own ground of quick fixes and magical pain relief, and I don't think we should try.

And here's the semi-retraction:

Okay, Not Useless

I promise you, if I ever undertake seriously to argue that massage has no medical value, my paper will have footnotes and close argumentation and takedowns of several studies, and it will be longer than 500 words. I promise also that I will try to refrain from tweaking people with inflammatory and outrageous titles, although that will be a harder promise to keep. It's been part of my rhetorical strategy so long that it persists even when the ideology which formed it (essentially, that dull people are improved by being poked) has long since withered away. Habits die hard. I was given Strunk & White at a tender age, and encouraged to think that forcefulness was the prime virtue -- what all writing should aspire to all the time. I now have a middle-aged respect for accuracy and caveat, even when dull; but I still find myself fluttering the cape sometimes.

And anyway, I would never want to make that argument: it's untrue. When my essay was linked to for a group of people who work hard to do medical massage (and justify its use), they were understandably miffed. It was a nice lesson for me in how contexts can shift, on the internets. I can ordinarily assume that my audience here knows that I'm passionate about massage, that my much of my practice is what is called “relaxation massage,” rather than treatment-oriented massage (though I'm doing much more treatment nowadays.) So the “medical benefits of massage” that I was poking fun at are the ones that routinely show up on the web pages of practitioners like me -- not the pain relief, lymph drainage, and trigger point, and all the techniques that shade into physical therapy, but rather the stock list that you learn in Massage I – relieves stress, promotes circulation, lowers blood pressure -- all true, all verifiable, all temporary, and all trivial.

If massage were as effective as many of its practitioners claim, it would blow other therapies out of the water in comparative studies. In fact it comes out lackluster, most of the time. If some therapists have the extraordinary success rates they claim, that only makes the general picture worse: for every therapist two sigmas out on the right, there have to be a dozen or two whose work is completely worthless, to get the kind of distributions we see. Massage came out tops in treating low back pain, in a study a while back, but that was more because the other therapies were so ineffective, than because massage worked so well.

I started reading studies of massage back before I was in massage school, but I gave up pretty soon. What I saw then was mostly very small studies with inadequate controls documenting that massage could have a significant effect on this, that or the next thing. Which, if you're not a science person, might sound impressive. But “significant” doesn't mean “important,” in statistics: it just means “very unlikely to be a random result.” Aspirin significantly reduces low back pain, but we can be excused for not jumping up and down with delight about that fact, especially if we can't get out of bed. These studies were a start, and I'm not mocking the people who did them, who had next to no resources. They established that there's something to study, that the idea of treating various conditions with massage is not absurd. But they didn't take us much further than that.

I know. I have anecdotal evidence too. I have clients who swear that I fixed their necks, backs, hips, knees. I am confident that I've reduced a lot of pain. I even have people I think I really rehabilitated, got back on their feet again. Someone who couldn't go up and downstairs, who now runs up and down like a goat. Another who couldn't hold a pencil, whom I enabled to write again. Someone who thought it was only my work that allowed her still to stand upright, at the end of her pregnancy. That feels good, and I like believing in it, but I can hardly be classed as an unbiased observer. A scientific person has to ask: how many people were just going to get better anyway? Eighty percent of my appointments are with clients who think I'm terrific, but how much of that is because the people who didn't get any relief just didn't come back? How much of it is just because of the rapport and affection that any loving touch conveys? I like to think – be real, I do think – I'm a good therapist. I study and I think and I pay attention. If something doesn't seem to be working, I try something else. But I don't think the comparative studies are lying, and I don't think the majority of massage therapists are incompetent.

Having said that much – and possibly gotten myself in trouble again – I will also say: we don't know a damn thing. The study of massage is in its infancy. Chronic myofascial pain is very mysterious, and much of what we thought we knew about it is being daily disproven.

God, think what we could find out if we had the kind of money that gets spent researching drugs! Everything remains to be discovered. There may come a time when we can confidently tell someone with chronic back pain, “I'll have you on your feet again in a week, and after that you'll never need to come see me again.”

We are not there now, and claiming that we are only makes us look ridiculous. We want solutions that a workaday, non-brilliant, not particularly gifted therapist can execute and get reliable outcomes. The traditional lores are not going to get us there, not on their own, although they are full of hints. We need science. We need to understand how it really works. We need results that are verifiable and repeatable.

In the meantime, I'll do my best to help with the pain presented to me. But I don't have the confidence in the value of that part of my practice that I have in the supposedly vaguer, touchy-feely, cloth-mom-for-the-rhesus part of it. People need to be touched with love and understanding, and I know how to do it. The bottom is not going to drop out of that market if Methylene Blue turns out to fix discogenic back pain, or if someone builds a cool nerve-feedback acupuncture machine that fixes pseudosciatica every time. All that will do is take away one of the pretexts people have been depending on to get the touch they need. They'll find another.

So, a year later, I find this is still pretty much where I come down. I have more experience of helping people recover from auto accidents, now, and those benefits seem to me pretty clear: trauma of that sort doesn't just cause new injuries, it re-activates old, latent trigger points, and after a few days it's often old injuries are causing more pain and distress than the new ones. Massage can do a lot to put them right. It's a prime instance of medically useful massage, and the results are impressive enough to convince even me.

There are things I wouldn't say now. I've come to dislike the phrase "Big Pharma," with its hints of conspiracy and collusion: I wouldn't use it now. But I have become even more skeptical of many therapies, over the past year, than I was when I wrote this: I still think that many massage therapists routinely make claims they can't back up. In this we aren't, maybe, all that different from other health care providers. But we have other traditions and other ground to stand on: we don't have to present ourselves as an alternative to opiates, disc surgery, or chelation. We could say we're doing some else, something worth doing for its own sake.

May 9, 2011


I pull down the blanket, then the sheet, and tuck it around the hips. It's love, pure and simple; the same love you feel when you zip up your child's jacket against the cold of winter.

Here, in the complicated space between the scapulae and spine, are rage and disappointment. I lay my thumbs in the precise center of the lower triangles of the scapulae; and there is the agony of pride. I move my fingers to the striations of the deltoids. This is a gentler woe, the long soft lamentation of vanity.

I read, with my fingers, how tightly the skin adheres. That tells me at once: how afraid is this person? An anxious skin clutches tight to what's underneath.

And then here, in the bunched muscles that rise from shoulder to neck, is the love of God: I hold there, and I can feel it coursing, weak or strong, under my fingertips.

A perfect body is not a perfect person. We live in a time too prone to conflate health and goodness. As a therapist I may want those muscles to let go. But don't mistake a lolling head for virtue.

Gently the head relaxes into my hands. Here, in two thimble spaces under the skull, is the whole story of grief. This is where the shadow of everything lost lingers on, like snow in the northward hollow at the foot of a tree. Listen, there, with one finger in each space, and they will tell you about lovers lost, children quarreled with, a favorite watch gone missing after a harrowing weekend. It's all there.

Follow the narrative, written in a turning scrawl between the ribs. The coda of the diaphragm. Cover the back, visit the glutes, and move on.

There are hidden clauses, reservations, and footnotes in the flesh of the inner thigh, just above the knees: the residue of old, poisonous stories, never believed but never forgotten.

And so to the feet, where it is all recapitulated, written small. At last the thumbs go of their own accord to the space under the balls of the feet, and there it is again, the grief met in the hollows under the skull. Just hold. It needn't always be stroking and kneading and pushing. In my end is my beginning.

Never mind: they won't see it if my eyes fill with tears. Cover the feet. Like tucking a child into bed.

"Thank you," I murmur. And then, "take your time." And I leave the room, careful not to look back as I close the door.

April 7, 2011

Trigger Point















April 6, 2011







April 5, 2011

Fat and Massage













April 1, 2011

Why I Don't Stretch









1) judicious rest
2) trigger point massage
2) skillful physical therapy
3) skillfully taught yoga






March 30, 2011

Under Construction



March 15, 2011

Why More for Two or More Massages?

