Article for AMTA newsletter:
I was ready for my next client when she appeared at the door to my office. In an instant, before any words were spoken, I had the clear picture of a woman who was in pain and very unhappy. Have you ever had that feeling – after seeing a client for only a moment?
Her contemporary clothes did not hide what her body language was telling me. Her face and posture projected sadness and hopelessness – head leaning forward and slightly to one side, arms folded in front of her, shoulders rounded, expression forlorn, helpless. Her weak smile seemed to draw upon a very limited supply of energy.
This snapshot took about one second. Obviously, I could be wrong. But as we’re often taught in massage school, assessment starts at the door. I’ve learned to trust my gut – but not be attached to first impressions. Meanwhile, my brain was already generating ideas as to what I would see on the table and how I would work with her.
I expected to see tight neck muscles, especially on the side that her head was leaning toward; weak rhomboid and middle trapezius muscles, coupled with tight pectoral muscles; tight upper thoracic erector spinae, upper trapezius muscles, and other posterior neck muscles, all doing a wonderful job of holding her head up against gravity. And that was just the upper portion of her body.
As she spoke ever so softly, she conveyed self-consciousness and low self-esteem. I looked at her client history – extreme neck pain, depression, anxiety, low energy, sleep disorders, and lots of headaches. She’d already gone down the slippery slope of multiple medications – pain killers, anti-depressants, sleeping pills, and more. And she’d had some nerves in her neck medically ‘burned’ to – as she said – kill the pain. I knew I had my hands full.
I wondered if I would be able to help her at all. Sometimes, when a client has fallen deep into the world of pain, depression, and pills, it’s hard to achieve long-lasting relief. I accept that. So I focus on where I can make a difference, even if it’s only a small difference.
On the table, all my assumptions about her muscles were confirmed. I used many of the tools in my toolbox – Direct-Indirect Technique™, gentle forms of Myofascial Release, NeuroMuscular therapy, Foot Reflexology, and more. I loosened and lengthened the hypertonic, shortened muscles in her neck and pectoral area. I worked the upper and lower back, working to bring some more tone to the weak muscles and helping her to relax more and more. I knew what suggestions I’d make about stretching and exercise and where I’d refer her to get more help with balancing out her tight and weak muscles.
Toward the end of the session, I focused on specific Cranial-Sacral techniques that I knew would help integrate the bodywork nicely with the central nervous system, so that she had a chance for lasting benefit from the session. As I did the occipital cranial base and sphenoid releases, she dove into a deep relaxed state, as reflected in the ‘whoosh’ of her breathing pattern.
When she came out of the massage room, she had a big smile. She said, “I feel wonderful – relaxed – floating – no headache! And my neck is moving like – like my neck is supposed to move. Wow! That was great.” I smiled back and gave her some water as we set up her next appointment.
After she left, I wondered how it all started – the tight muscles, the low energy, the pain, the depression, the anxiety, the low self-esteem, the pain-killers and all the other pills. What was the chicken and what was egg? How do you break such a cycle? All we can do is do our best – and listen to what the body is telling us on the table. It usually knows a whole lot more about what it needs than we do.
I watched her walk away with a spring in her step that I didn’t see when she came in. She turned and said, “Thanks”, with a big smile that seemed perfectly natural for her, as though she felt like herself once again. I knew she was going back to her world – most likely filled with all the physical and emotional patterns that got her to where she was when she first stood at my door. And I knew that I can’t control that. We do the best we can do. We help people feel better – some for a lifetime, some for a day. Then it’s time for the next client.