“As manual therapists, we are privileged to be at that intersection of the individual and the world, as our clients present with a variety of chronic stress-related challenges: TMJ problems, digestive disorders, sleep difficulty, muscle tension, pain disorders, emotional difficulties, environmental sensitivities and autoimmune difficulties among them. Most of these problems defy single-session answers, and too much time can be wasted looking for a cause of what is really a much more global problem of a system burdened by patterned and chronic stressors. Our clients are looking for help.” (Moya, 2017) When we build ongoing therapeutic relationships with our patients, not only can we see if or how effective our work is in treating their problems, but we also become a trusted source of care. As the relationship grows, we can custom tailor our work to best suit each client’s individual needs. No pill can do that. Even if you aren’t likely to see your clients regularly, take the time to have a brief conversation with them before the session. While you listen to their words, also be aware of their posture and general physical presence. Stressed people generally look stressed. Don’t skip your client assessment before getting them on the table. Chronic stress situations are where we can pull out more tools from our toolbox, especially when we are thinking about making progress for the long term. One session of deep tissue work probably will not eliminate a client’s pain, but several sessions working on the same affected area may greatly improve function and reduce pain over time. Clients often come to us hyperalert and hypersensitive after spending too much time in fight-or-flight mode, and they may present with a high level of muscular tension in one or more areas of the body. During the session, they may also become aware that they have more tension than they realized. How often do you hear individuals on the table say, “I didn’t realize I had so much tension”? This may be the only place they allow themselves the opportunity to be fully present and listen to what their body has to say, if they are even capable of that. As you get to know their musculature, their symptoms, and their comfort threshold, you can begin to apply combinations of modalities that might work for them into customized bodywork sessions. Seasoned practitioners know there is no such thing as a one-size-fits- all bodywork technique. If a healing crisis, as mentioned above, should occur, clients who are not experiencing acute stress may be more teachable as to why this happens and what they can expect in terms of results. As your therapeutic relationship grows, ask for feedback as to what worked for your patient (on your table and in the days following) and what did not. Listen to their feedback with an open mind, work with their best interests in mind, and be sure to keep your ego in check. The goal is to create a mutually beneficial relationship and get them better. The long-term effects of consistent soft tissue therapy on chronic stress will be discussed further in Section 4 of this course. Reflection Question #4: Know Your Numbers! How often do you feel stressed? Keep a journal for one week and log how many times you feel stressed.
that is more like their usual session. On the other hand, if your client is undergoing a major life event like the death of a loved one or another major crisis, your work will be more effective if you primarily address the immediate state of the nervous system. Their body is likely coursing within stress hormones, in which case your time in the session is best spent addressing that alone with relaxation work. Lighter work will also make them feel comforted at a time when they might desperately need it. There can be much fatigue surrounding acute stress episodes. From a client relationship standpoint, knowing when to back off a little and take care of your client will further build the trust they have in you. Having an objective, trusted source for stress relief will make them healthier. By the same token, having a steady flow of clients who trust and value you will make your bottom line healthier. Attempting to do deep therapeutic work on someone in a heightened stress state could also backfire and end up causing them more muscle tension and pain than they came in with because the fight-or-flight response is still predominant in their sympathetic nervous system. Working their soft tissue too aggressively during an acute stress episode can cause what is called a healing crisis. A healing crisis occurs when a client’s symptoms temporarily get worse before they get better as the body struggles to process information. Under normal circumstances, a healing crisis may be something you can explain to the client and prepare them for before it happens, but it is not appropriate to do so under an acute stress situation. If you have a patient who regularly receives deep tissue massage and comes in during a period of acute stress, you may have to explain what is going on in their nervous system, what a healing crisis is, and why deep tissue soft tissue work may not be appropriate for this session. You can put a positive spin on lighter work by suggesting that you want to try a different approach under the circumstances, while emphasizing that you are looking out for their best interest. Explain what they can expect from a session that is geared more toward calming the nervous system and relaxing the body in another way and that you can resume their usual treatment at the next session (if appropriate). Remember that our patients come to us to make them feel better, not worse. Clients who are experiencing a traumatic emotional state like grief may also have an emotional release during the massage and begin crying or shaking on the massage table. If that occurs, the best we can offer is an empathetic touch and letting them know that the treatment room is a safe space to let it out. Others may use the time and safe space to vent their feelings without judgment, which is something they may not be able to do with family or friends. Sometimes, the best stress relief we can offer is to listen and soothe as objective parties. On the other hand, chronic stress is another kind of beast to tame. Chronic stress occurs when the stressor is present consistently over a period of time. It is the more rampant, disease-causing problem and a bigger concern for our collective national health. It is also one of the primary reasons that people seek therapeutic massage. Chronic stress leaves our clients depleted and irritable, exhausted, and often in some degree of pain. However, this is where we as therapists can make the most difference with a safe, drug- free method. Our job is to provide relief, and it is something we can do without any tools other than our own two hands. Scope of practice and privacy Once you have built a trusting therapeutic relationship with them, it is not unusual for your patients to occasionally verbally unload when they come to your office for a
session. We have probably all had at least one client who vented about their frustrations the entire time during the session or another client who came in with a laundry list
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Book Code: MNJ0626
EliteLearning.com/Massage-Therapy
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