Having encouraged you to ask your massage therapist what his or her approach to massage is, it is just fair that I state where I stand in the discussion on the mind-body relationship.
So, here goes.
But first a bit of my history ...
My own introduction to massage training in the 1990’s consisted of a jumble of esoteric and scientific teachings reflecting the tendency to combine the two approaches to massage, vitalistic and mechanical, which we spoke about in previous posts.
We would learn anatomy, physiology and pathology alongside what was referred to as ‘subtle anatomy’, a series of psycho-spiritual systems of living beings both surrounding and permeating the physical body via meridians and chakras.
With a background in philosophy and journalism, I must have been a royal pain in the class what with questioning everything and asking for evidence and references to statements.
Yet, as I mentioned previously, just as with most massage clients, my frustration with these contradictory ideas did not take away from my enjoyment of learning about this wonderful touch therapy and I persevered.
Soon after starting my own practice, thanks to the major changes in South Africa’s national health system (the same transition which made it possible for traditional healers to be assimilated into the system), massage became a regulated health profession with a standardised qualification.
This meant the curricula had to conform to educational and professional standards and be interconnected with other qualifications such as physiotherapy (physical therapy).
Suddenly I was on familiar terrain again and using a language I knew: clinical reasoning, analysis, refuting hypotheses and evidence-based practice.
For the next seven years I taught massage students and helped develop study programmes based on the structural and biomechanical approach to massage.
Naturally, this also informed my own practice for many years where I treated clients with postural misalignment issues, muscle and fascia patterns and mechanical injuries.
Still, more than ever I was enthralled and overawed by the complexity of the human being - body and mind.
Yet all the time I was aware that a lot of the physical discomfort I witnessed in my clients was in some way related to their emotional and mental state rather than mechanical injury.
Their experiences could not always be directly linked to the severity of the physical markers I observe
The problem for me however, was that the explanations which I had come across during my initial training and which linked certain emotions or mental states to particular pain spots or diseased areas, did not make sense.
It just sounded too glib, too generic and not context bound.
Above all I considered a lot of the theories completely unsubstantiated.
And then I met this one client who required pain relief from a frozen shoulder or adhesive capsulitis.
This condition tends to be self-limiting and usually resolves over time. However, excessive tightness and lack of mobility and pain even after this condition has run its course is not unusual.
In this case however, even after we had improved the range of motion and balanced the overly tight and the weak muscles and doing everything the structural model allowed, she still experienced severe pain.
I was confused. Very confused!
So I did what I always do when stumped, I started doing extended research, first about the anatomy of the shoulder, then about the pathophysiology of a frozen shoulder and eventually about the experience of pain itself.
MIND, BODY & PAIN
A brief introduction to pain science at a workshop by physiotherapist and pain expert, Jacqui Koep brought some insight.
At the same time I was also learning about the latest developments in neuroscience having enrolled for a degree in psychology.
Pain science, neurobiology and biochemistry opened new worlds for me.
It forced me to rethink the dualistic mind-body approach while at the same time offering an alternative to the approach of esoteric and modern day vitalism.
Instead of body-mind, it turned into a triad of body-mind and brain
MIND, BODY & BRAIN
Off course as I better understood the relationship between body and brain, my approach to massage changed yet again.
My focus started shifting from mechanical and tissue damage (the body) as the origin of the pain response, to the role of the nervous system in this phenomenon.
Our bodies are in constant communication with our brains about the the internal and external environment. These stimuli are interpreted by the brain and modulated by many factors including our personalities, histories and mental states.
And in the end our experiences of the world including experiences of touch and of pain are determined by the brain.
Body-mind or mind-body? If you are struggling with physical and mental pain and feel that the dominant health paradigm’s dualistic approach to mind and body seems inadequate to explain anything, I want to talk to you. Join me under the tree in my garden for a cup of rooibos tea and let’s talk massage and SomaSense!