First Published in Massage Magazine, Nov/Dec 1993, Issue 46, 44-52
Melissa B. Mower, author and interviewer
My first real introduction to Carole came in February 1991 just after I had written a comprehensive article for this magazine about the development of a national certification examination for massage therapists and bodyworkers. When I sought her opinion on the piece as an editorial advisory board member of magazine, Carole criticized some aspects of the article.
We had a long discussion about the article, and while we basically agreed to disagree on some of the issues, we were able to openly speak our minds and maintain mutual respect for one another.
This was the foundation for our professional relationship. Since then, we have continued to communicate warmly, and I have been able to rely on her candor on other subjects as well.
In order to better understand what Carole’s work was all about, I asked if she would be willing to give me a mini-session. She took nothing for granted of me as a client. Her work was done with a sparing amount of oil as I lay face up in a room lit by the natural light of the windows. She explained that much of her bodywork is done face up, primarily because it’s easier for her to monitor the breath and that for most people, especially if emotional processing is involved, lying on one’s back is more comfortable.
A lot of her work involved deep holding with movement. It felt as though each part of me was being embraced and hugged. At times it seemed as though she was probing the depths of my soul, though her touch was never invasive or in any way felt threatening. She encouraged my breathing and free movement by simply and frequently saying “yes.” My comfort was of primary importance. It was wonderful session, one that instilled a sense of peace.
As a person and a professional, Carole embodies sensitivity with strength, compassion with caring, as well as empathy and enthusiasm with little ego involvement or judgment. She’s a delight to be with and to learn from.
I understand you were inspired toward bodywork through a group, called Arica. Would you tell us about that?
Osborne-Sheets: “Arica offered me a distillation, so to speak, of many of the traditions around the world of development of enlightenment and consciousness practices and had a very heavy emphasis on body-related methods.
“It is a school that relied a lot on Tai Chi and Tai Chi-type exercises, a lot of movement, meditation and some bodywork. It had a sense and a psychology of the body and of the psyche that truly acknowledged what seemed to me to be the truth – that we had a physical part of ourselves and an emotional part of ourselves and there was something intellectual that was there as well. Uniting all of that was a sense of spirit or life force or soul….Arica was extremely important in reconnecting me with my Source.”
How do you feel your psychological and consciousness background has benefited your current practice?
Osborne-Sheets: “What I have gotten from the theories of the psyche from Arica, and the Jungian theory of an internal male inside each of us women and an internal female inside each man…is that balance is achieved as you move freely between those two sides….
“When I first was introduced to the idea of yin and yang energies from the Eastern cultures, it was the first time I heard a theory that coincided with what my perception of what reality was….All of this affords me as a practitioner a relatively easy non-judgmental stance because I can see both sides, and I believe that both sides are valid. That means that I can give my clients a tremendous amount of permission to be.”
You advocate that physical and emotional balance is crucial for a therapist to accomplish his or her work. How do you maintain balance?
Osborne-Sheets: “My most consistent practice has been in Tai Chi. One of my purposes in coming to San Diego was to study Tai Chi, and I have continued to do that, studying under Abraham Liu. I do a lot of writing and journaling and emotional clearing on my own….
“One of the ways that I maintain emotional balance is that I experience myself and I think of myself in relationship to my clients as almost a neutral element that just provides some sort of environment.
“When I think I am going to fix someone or that I am going to help someone, I find it is emotionally unsettling. It depletes me, and I don’t generally do a very good job at fixing or helping someone….My family life helps me keep perspective that bodywork is not the only thing in life and makes a big difference.”
Describe the work that you do and what makes it unique.
Osborne-Sheets: “There are two aspects to the work that I do. One of the things that I do is somato-emotional integration. I work with people to explore what the relationship is between their physical tension and their emotional tension. I do that through using a very firm but gentle and deep pressure called deep tissue sculpting, done simultaneously with passive joint movements that are rhythmic and very gentle, for the most part.
“That sets up an environment that, if someone is interested, they tend to be able to feel and understand and have an ability to explore: What is my body saying? How does that relate to what my emotions are? What are my belief structures? In what ways am I unable to move freely in my body, feelings, or mind structure?
“I think what is perhaps unique about my work is that I don’t have an agenda with a client. It is not my idea that what we would do should have to create an emotional release or that there would be some kind of catharsis.
“I frame what I am doing as an exploration and often times those things happen… The second part of my work is work with women during the childbearing year, focusing on their pregnancy, the birth of their babies, their birth as a mother, and their interaction with their babies afterward, using the same techniques in working with people who are exploring their emotions, and also utilizing a number of other techniques.
“The approach that my (now former) business partner, Kate Jordan, and I have in this kind of work is unique in that while we are technically and medically very attentive, there is not exclusivity. It is equally as important as providing a place this mother can feel that she can talk about some of the fears she has, for example.
“The uniqueness of the deep tissue work that I do and that I teach lies in my feeling that I don’t feel benefit in creating pain in my clients. The work I do is not painful, at least not predominantly painful; it can be very intense, and I work very deeply, but I take the time that it takes biomechanically to enter into a body and enter in slowly enough so that it is not painful or invasive. I think many forms of deep tissue work and myofascial work can be very aggressive and painful for some people. I know that a lot of people accomplish some very wonderful results from that kind of work, but it is just not my style.
“One of the things that I think is unique about my touch is the way in which I combine a constant pressure and omni-directional movement. As far as I know I haven’t run across anyone who combines technique in that kind of way….
You were a co-founder of IPSB, formerly the Institute of Psycho-Structural Balancing. Do you still utilize the psycho-structural balancing approach that the school was founded upon?
Osborne-Sheets: “Yes. My apprenticeship training with Ed Maupin was and continues to be profoundly impactful, although the focus of my work is not structurally oriented. Ed, a psychologist, was one of the first few students Ida Rolf trained in structural integration.
“The wisdom and the genius of Ida Rolf, as Ed conveyed it to me, continues to be a foundation for my understanding of the structure of the body. That coincides with the Tai Chi principles of grounding through to the earth, and at the same time extending up to the heavens that you accomplish through alignment of the spine. On a physical level those structural parameters are the basis of my work. The psychological orientation is a ‘well, what does that mean in terms of what this person feels and what this person believes and how they perceive themselves and how they interact with the world?”‘
How would you say your work has evolved?
Osborne-Sheets: “My view of the structure is still based in that sense of alignment but instead of seeing a shoulder that is higher than another one, for example, what I now see is an expression of where someone is in their structure and in their emotions….
“When studying [Milton] Trager’s work, and in having lively discussions with him about how one could combine deep tissue work and passive joint movement, I gained a tremendous amount arguing each of our perspectives about that.
“I had the opportunity to work in an osteopathic physician’s office, and I learned strain/counterstrain work, some muscle energy work, myofascial release, and just the osteopathic perspective on health and disease. While I am not practicing craniosacral work, my sense of the body changed tremendously through taking a [John] Upledger course.
“Movement wise, I have been greatly influenced by a woman named Emilie Conrad-Da’oud. The focus of her workshops is rather eclectic and esoteric in some ways. They focus on micromovement, cellular movement.
“Her work is called continuum movement, and I’ve always combined some form of movement with whatever deep tissue work I do. Focusing internally on that level of movement has really enriched my work.
“I’ve learned a tremendous amount from Kate. When Kate and I began collaborating on the childbearing year class, I learned a very different and complementary approach to the body….
“I’ve got an amalgam of influences. Throughout all of it there has been the steady precision of pressure, holding pressure. That is what I started with in my own self-explorations before doing anything that you might call massage. That has been the stable center from which all sorts of other things have been added. Also the attention to the client’s emotions through the body has been consistent throughout. This amalgam is what I continue to teach in my courses at IPSB.”
What evaluation techniques do you utilize in assessing a new client?
Osborne-Sheets: “I use a lot of visual cues including my sense of vertical alignment, horizontal planes, of structure and the balance of fascial planes. I also evaluate visually for places where the body feels empty or where the body feels full or where there is a feeling of a lack of vitality. That is a visual impression that comes when I soft focus my eyes, when I let my eyes go and see without focusing on anything.
“Also, a lot of my assessment is in the words that I hear. I get a lot from what someone says to me, not just the words themselves and the choices of words, but also from the tone and the expression, what isn’t said….
“Maybe even more importantly than those two, I assess kinesthetically. I assess with omni-directional movement in the form of gentle rocking and shaking movements that help me to feel where the body is not moving, generally a place where there is some myofascial restriction…”
How would you say that massage therapists can better develop their abilities to read the areas of tension and then evaluate a client?
Osborne-Sheets: “I think probably the first thing I’d say would be to gain an internal understanding of the kinesiology and the way the structure is intended to be. Have some sort of paradigm for evaluating the structure…. Understand how bodies move, what are the components of gait, and how does one erect the spine.
“The second thing would be to develop the ability to see individuals without a preconceived idea of who they are or what they are….
“It seems to me that one of the best ways for a therapist to be able to assess is to truly commit themselves to some type of internal discipline that provides for clarity of mind, appropriate use of the body, and attention to the essence of things….”
What kind of issues come up for clients who are adult children of alcoholics or incest survivors, and how can practitioners be prepared to deal with them?
Osborne-Sheets: “The kinds of issues that will frequently come up are, first of all, body awarenesses that can be alarming or unexpected because there hasn’t been attention paid to the body.
“There needs to be ability on the practitioner’s part to stay with the client, stay with whatever intensity level the client is experiencing. The best way to do that is to stay in touch with one’s own breathing and to monitor what is happening with the client’s breath. It is the simplest and yet the most profound indicator and connection between what the body is experiencing and what the feelings are saying.
“I think it’s important for therapists to realize that just being with someone is profoundly therapeutic…What it requires of the practitioner is an ability to be with (the client) and to recognize and own when you are uncomfortable being with and, at least, have a recommendation of someone who you know who can be with (the client).”
Do you recommend that these clients also seek individual counseling?
Osborne-Sheets: “Absolutely….I have a tremendous amount of respect for what psychotherapists and counselors are able to do. I see us as complementary, neither one better than the other. We probably are the same profession and just don’t know it. Our tool is just different. As bodyworkers I think we grasp the soul through the flesh, and they grasp the soul more through word and through thought….
“Until training programs substantially prepare bodyworkers for the emotional aspects of the work, I think it’s an ethical imperative that we only work in a way that is respectful of the limitations of what our training and our abilities are….
“I don’t require every client to be in therapy, just those who are interested in pursuing somato-emotional integration. I’ve got clients who are coming for general stress and relaxation, who come for pregnancy, and I don’t require that. If at any point our work is going in a direction that I feel as though that would be appropriate, I do ask it then….”
Do you make yourself available emotionally when memories and emotions surface for clients, and at what point do you refer out?
Osborne-Sheets: “When, within the exploration that we’re doing, memories and feelings come up, I am available. How I work with that is: I stay with the bodily experience of that memory or that feeling so that I help to hold up ‘the mirror,’ so to speak, to that individual of what their body is saying about this in terms of what movement it wants to make.
“I focus on a real observation of their bodily experience and allow the body to have its say, to let it speak, if there are words that need to be spoken, or if it’s movements, or if it’s body postures to express something that wasn’t able to be expressed at the time….
“Within the context that I am working I am usually in communication with a psychotherapist, if that kind of thing surfaces within the context of our work, allowing that bodily expression if appropriate, even though it is a reflection of an emotional state.
“Because I’m usually already working with a psychotherapist, I usually don’t have to refer out. However, I do sometimes discontinue bodywork temporarily, or sometimes for a long amount of time, if the individual is having difficulty coming back to a grounded, everyday reality. That’s saying to me that they’re overwhelmed by the amount of information that’s coming up, that there’s too much for them to assimilate….”
Describe the integrative body therapy that you provide for these clients.
Osborne-Sheets: “What I provide is an experience of touch that is to the bone deep but very gentle so that it’s not invasive. It’s on the borderline of pleasurable, yet there’s an intensity level that says, ‘hmmm, something’s stirring here’ but, at the same time, it feels good.
“Combined with that, I use omni-directional and rhythmic movement that helps the neuromuscular system not be boxed into its repetitive patterns. Those together provide a physical experience of being profoundly attended to without any pressure to particularly do anything. Within that context, self-awareness is more likely to occur.”
How do you go about providing safety for incest survivors?
Osborne-Sheets: “I don’t require an incest survivor or any of my clients to tell any more than they volunteer. I provide for a sense of privacy in that way. I offer a lot of options in terms of how one will be touched or where one will be touched.
“I ask all my clients, whether I know they are an incest survivor or not, if there are parts of their bodies that they are uncomfortable with having touched. I offer the option of remaining seated and fully clothed, and numerous gradations between that and being undressed on a table. I request feedback regularly from a client on what they’re experiencing, and on their comfort level with what I’m doing.
“If, in fact, I know that someone is an incest survivor, I state very clearly that I will not touch them in any sexual way, and, if there is any way in which I touch them that they perceive as sexual, that’s not my intent. There is a profound range of what kinds of touches can be perceived as sexual to people.
“For any of my clients, I am committed to a level of confidentiality in not revealing their work in any way. I think one of the other ways in which I offer a level of protection to incest survivors is that I don’t see that as their identity. Whatever brought a person into my room, I try to initially look at them with a more encompassing viewpoint.”
How can deep tissue sculpting be helpful to women with eating disorders, as mentioned in your book, Deep Tissue Sculpting?
Osborne-Sheets: “My hands-on work is very much a blend deep tissue work simultaneously with movement. The two of them together work the most magic, but it creates a kind of paying attention that requires for many people a shift in consciousness, a shift into an internal awareness.
“For people with eating disorders oftentimes that internal awareness is asleep or shut off in some kind of way. The work is non-invasive, because it’s gentle and nurturing as well as demanding. For many people, their eating disorder is part of a defense mechanism and a protection system and so this kind of touch doesn’t further fortify that defense system. In fact it kind of renders that defense system a little obsolete.
“There’s an ability to drop some of that defensiveness and be more able to pay attention on a physical and an emotional level….Because of the structural paradigm with which I am working, there is much more body organization. Rather than their bodies feeling so difficult for them, they begin to feel more comfortable within that body, more pleasure within their kinesthetic sense. That just leads them to more pleasure in their body from a positive perspective, and that then leads them into behaviors that are going to tend to help them to develop their internal self-worth and their sense of the positive that comes from the body….
What was the most challenging case you have encountered, and how did you address it?
Osborne-Sheets: “Well, first I’ll give an example of what I considered in some ways to be a failure story. I think it’s important that we all recognize that we aren’t successful with everyone and often times you only hear the success stories.
“I had a client who was sent to me by his psychologist who on a physical level had irritable bowel syndrome and panic attacks and managed to maintain his job, but the rest of his life was pretty nonexistent because of the level of anxiety that he experienced.
“I saw him weekly for a number of months, and I was seldom able to keep his awareness in his body for longer than three minutes at a time in all that time. We were not able to successfully bring him to enough awareness of his body that he could even learn any breathing techniques to reduce the panic attacks. He had the most staunchly defended body that I ever had the pleasure to work with.
“When I was working my best, I was able to continue to focus my awareness on him and work with him with the faith that perhaps some part of him was in fact there and that at some point it would awaken, and he would remember maybe even all of this that had happened. I never got to witness any of that happen. When I was not working at my best, of course, I was feeling like I hadn’t done things right or that I was very ego-involved in the outcome of the sessions.
“On a more successful note, I had a woman who had a multiple personality disorder and had some physical problems with her neck and shoulders. It was very challenging to work with. She had only a single split so that there were two individuals inside her, but they had a different body manifestation… Once I felt what she felt like in each personality, I could feel her shift. I got so I could tell she was shifting on me on the table. It was very challenging to organize this woman’s body because in fact there were two people’s bodies that I was working on.
“What I did was stay focused on the body, enabling her to be able to compare for herself and observe her two bodies. She started being able to find ways to not be so different. Now, I don’t take credit for the healing of this woman. I take credit for a part. She had a most glorious spirit and maybe no matter what she would have done she’d have healed herself because she had that kind of soul.”
Can you recall your most rewarding healing experience?
Osborne-Sheets: “You know it’s interesting, because I’d say a good 90 percent of the time I have a rewarded feeling every time I work with someone. The word ‘reward’ implicates some sort of something that happens at the end of a goal having been reached with some sort of goal orientation to it. The places where I’ve been the most rewarded have been the places in which I haven’t been focused on a goal, focused on a reward, and especially not focused on it in terms of what it means as to who I am or how effective I am or any of those kinds of things. The most reward generally comes when I am the least personally involved and the most empathetically involved. That’s probably true for most practitioners, I would guess.”
What excites you about your work?
Osborne-Sheets: “It’s never the same. Never. There’s a freshness and an aliveness and, in a sense, a contribution to my own spirituality in that my intention has to be to stay current on a moment-by-moment basis with what’s happening. I can’t assume or expect that anything’s going to be the same….
“The combination of science and artistry excites me. You cannot do this work, and do it well, with either one of those pieces. You can do fine intuitive work or fine technical work but to really do fine work, you must have both….
“The more I develop my intuitive side, the more I’m able to truly see the way in which paired muscles work. That excites me. I guess both sides of my brain feel satisfied by it.
“I am very excited by the very concrete contribution that hands-on touch makes to individual lives, to our society and to the planet. I think it makes a phenomenal change in people’s lives that affects politics, economics and culture….”
What advice do you have for those practicing in the field?
Osborne-Sheets: “Pursue some type of internal discipline….1 would also encourage our profession to see what touch truly is. Touch is a part of human existence, it’s a part of family life, and it’s a part of the family….
“For bodywork to be an integral part of our society is appropriate, as is whatever contribution each of us can make to have our work be a part of rather than separate from society.”
In your opinion, how can massage therapists and bodyworkers bring further legitimization to their work in the medical and insurance arenas?
Osborne-Sheets: “I think the most important thing for us to recognize is that higher standards of education are crucial. I happen to think that the best way to accomplish this is through the tiered concept of a structure, such as how the nursing profession presents itself….
“I would hope that we would pursue means to validate the benefits of our work more extensively than they have been. I would hope that would be a priority for us as individuals and of our professional organizations.
“I think that the power of massage therapy as an educational tool is equally important, its role as part of self-awareness and understanding of ourselves is as important….”
What is your vision of the future for bodyworkers in the next 10 years?
Osborne-Sheets: “As I understand the cycles of health care, I think that we’re on an upswing in that cycle, which provides a kind of window of opportunity for us right now. When I first started doing bodywork, it was definitely an upstream swim.
“I think we’re on that upswing and I think over the next 10 years we will enjoy increasing public awareness of the benefits, public acceptance and a continued decrease in the association of our work with prostitution and quackery kinds of activities.
“Unless we have a serious economic collapse, I think that we will be able in the next 10 years to establish enough of a foundation for our profession that most of us will be able to make a reasonable living doing work that we love and that makes a significant contribution….”
Thank you, Carole.
Health Maintenance – Preventive Care for Hands and Bodies
ArticlesBy Carole Osborne-Sheets
Massage & Bodywork, July/August 2008, p 74
As a continuing education teacher working with practitioners from many different schools, I’ve commiserated with the pain and frustration of poor body and hand care. Carpal tunnel, tendonitis, and thoracic outlet syndrome are far too common in our profession. Chronic back, neck, and shoulder pain shorten many a lucrative career. Most of this is preventable, and here’s how.
My 33-year career in bodywork has offered me many lessons. One I learned quickly, in fact in my first two years, was to attend to my own body use and maintenance. When a vague thumb and shoulder achiness began to temper my beginner’s zeal, I discovered how to prevent it from becoming chronically painful. As I learned more efficient use of my body weight with balanced alignment, those problems diminished. After that incident, body use and care became an integral part of my daily routine and of every instructional program I have developed subsequently. Now I celebrate both my own successful and relatively pain-free career, as well as those of the practitioners I have trained.
Care, development, and protection of your hands and body are crucial for effectiveness and career longevity, no matter which bodywork or massage specialty you practice. Because of the stress of sustained pressures, practitioners of deep tissue, neuromuscular, structural integration, and other body therapies need to be especially mindful of:
Body Alignment and Weight Shift
Table Size and Height
Endurance, focus, receptivity, relaxation, and strength in the hands result from effective use of the entire body. Proper table width and height are the first requirements to achieve efficient, stress-free body alignment. A 27″–30″ wide table will usually allow the client adequate room, while enabling most practitioners to shift their weight over the table without excessive leaning and strain to their backs. Choose a narrower table if you are short; however, you may then need side extensions or some other measure to accommodate larger clients’ arms.
Most practitioners work best with their table height adjusted so that, when standing erect and arms hanging loosely at the side, the tabletop touches between knuckles and wrist. This height encourages and allows for use of the lower body for pressure and weight shifting. It prevents the need for extreme knee bending or for muscling technique from the upper body. Of course, modify this rule for your body shape. When working with side-lying clients, the higher end of this range allows for the more horizontal weight shift involved. When working with heavier clients or using a contoured body cushion or other client positioners, adapt by lowering table settings.
Stance and Weight Shift
Think of your body’s center of gravity (in the lower abdomen) as a flashlight aimed as directly as possible at the structure you want to touch. Aligning your spine, with no excessive curvatures, rotations, or twists (especially of the lumbar and cervical areas), is crucial in minimizing stress and avoiding injury. Lengthen your entire spine, but maintain gentle curvatures. Lengthen your lower spine by imagining a weight attached to your coccyx, drawing it toward the ground. To lengthen the upper spine, imagine a hook at the crown of your head attached to the sky.
To get lower, bend at your hip joints or knees. Do not from your waist, which can strain your lower back. Notice and correct any collapse or side-bending of your head or torso. Look downward when you need to locate structures and monitor client reaction, then realign your head on your spine, reestablishing a gentle cervical curvature with your chin gently tucked in. In summary, weight shifting from the lower body is more efficient and comfortable (image 1). Upper body “muscling” of technique usually creates pectoral girdle and spinal collapse and pain (image 2).
Avoid side-bending head and upper body when clients are side-lying (image 3).
With balanced alignment, and the table at the proper width and height, you are ready to perform your technique, whether it will be a compression into a trigger point, effleurage, kneading, a passive joint movement, or a slow, melting deep-tissue sculpt. Gather your weight into your rear leg, emptying your front leg of weight, but allowing it to remain relaxed, resting on the floor. Initiate and maintain momentum by pushing into the ground with the rear leg, but do not lock that knee in doing so. Direct your weight into your working tool, and avoid loading your front leg, which should remain empty, relaxed, and free to step if needed. Increase pressure by pressing into the ground and lean more heavily onto your tool; lighten it by shifting subtly back into the rear leg. Release your pressure by regathering your weight into the rear leg. With each technique applied, push from the back leg into the area being compressed or stroked. Accomplish movements (such as many traction stretches) away from the client’s body and return effleurage by similarly shifting weight from front foot to back foot. Start traction moves with weight forward, then shift gradually to the rear leg (image 4).
For procedures (such as petrissage or some lomi lomi strokes) that require you to squarely face the side of the table, a “horse riding” stance is more efficient. In this stance, your feet are parallel to each other, at least as far apart as your shoulders’ width, and your knees are flexed. Weight shifting between the feet should power your arms for techniques. Allow your torso to rotate around your lower abdomen much like a washing machine agitator moves.
When working in a seated position, plant your feet firmly on the floor. In this position, the actual weight shifts must result from your ischial tuberosities pressing into the stool or chair, thereby, functioning as the feet do when standing. Of course, always maintain spinal alignment with the head erect, and relax your shoulder girdle. Effective seated body use involves relaxed, erect alignment (image 5). Sustained side-bending and hunched shoulders can create both practitioner and client pain (image 6).
Upper Body Alignment
Relax all unnecessary contraction of the pectoral girdle muscles so that your shoulders remain down, balanced horizontally on the torso. Avoid hunching and anterior rounding of the shoulders when applying techniques. Pay particular attention to releasing excess tension in your levator scapulae, rhomboids, supraspinatus, and trapezius. Your biceps, deltoids, latissimus dorsi, pectoralis major, trapezius, and triceps will not be overused if you use your body weight efficiently to create pressure, rather than pushing from your arms. To stabilize your shoulder and scapulothoracic joints as you shift your weight into your client’s body, balance the functions of the serratus anterior/rhomboids and the latissimus dorsi/upper trapezius, along with the humeral stabilizers (i.e., infraspinatus, subscapularis, and teres minor).
When the forearm or elbow is used, only the contraction of the elbow flexors is necessary; keep the forearm, hand, and wrist relaxed. Stabilize the shoulder and scapulothoracic joints in an open, balanced position, avoiding excessive humeral adduction or abduction, and let your shifted body weight be the source of pressure. Apply no pressure from the head, other hand, or the shoulder and back muscles. This will avoid strain to your upper extremity. You will also prevent possible injuries, such as bursitis, neuritis, rotator cuff syndrome, and tennis elbow. Relaxed arm, hand, and shoulder positions deliver deep, sensitive pressure (image 7).
Joint Protection
Avoid wrist hyperextension and overuse of the heel of the hand by effleuraging with soft-fisted knuckles whenever possible (image 8).
Excessive pressure on your fingertips, particularly on the thumbs, can hyperextend or hyperflex the metacarpal-phalangeal joint. The resulting ligament strain and stretching can cause instability, pain, and swelling in the affected joints. Avoid these problems by bracing or supporting your fingers and hands to create additional protection for the joints sustaining the greatest pressures. For example, the fisted hand can brace behind your thumb, or your other hand can act as a splint for the phalangeal joints when fingertip pressure is required.
Use one hand to apply pressure while the other stabilizes the working fingers (image 9).
Exclusive and/or improper use of any tool—but especially the fingertips, heel of the hand, or thumbs—can result in joint-structure damage. Reserve these tools for small areas, specific, definition-type work, and thinner, less-tense muscles. By regularly using alternative tools such as your elbows, forearms, and knuckles, you can sensitize them to nearly as fine a receptivity as your fingertips. Vary which tool you use throughout each session. Since the structure of the elbow and fisted hand are more capable of sustaining deep pressure without threat to joint integrity, use these tools for deepest pressures whenever possible. Carpal tunnel syndrome, irritation and inflammation of the joint capsule, osteoarthritis, and strained ligaments are all probable results of using one tool more than others or attempting to release large masses of muscle with smaller tools such as thumbs or fingertips. Fists are effective tools for denser muscles and when needing deeper pressures (image 10).
Developing Hand Strength
Proper alignment and balance of your pectoral girdle as it sustains much of your body weight is difficult without adequate upper body strength. Maintain a regular program of exercise, weight training, or other activities that target strength and flexibility in these muscles: biceps, latissimus dorsi, rhomboids, shoulder joint stabilizers, trapezius, triceps, and, most importantly, the serratus anterior. The serratus provide critical downward rotation of the scapula, stabilizing it and the rest of your shoulder girdle against the posterior driving force you create when leaning your body weight to massage.
Most practitioners can easily incorporate daily push-ups to develop a foundation of pectoral girdle strength. If you cannot do a full push-up, then work toward that goal with progressively more strenuous push-up variations. Start by doing push-aways (image 11):
Pectoral girdle strengthening begins with push-aways and progresses to full push-ups.
Increasing Body Energy: A Tai Chi Exercise
Protect and strengthen your hands by increasing overall body energy and by learning to direct that energy through your hands. Traditional Asian disciplines such as tai chi chuan and qigong are notable for their effect in developing the body’s vital energy (chi). If experienced teachers in these arts are unavailable, video instruction can be helpful. Here’s a basic exercise from tai chi that you can do daily to generate more energy:
Regular Maintenance
As you already know, clip and file your nails regularly, and keep your hands clean, smooth, and free of calluses and rough spots. Protect your hands with gloves when gardening, using harsh cleaners, or doing manual labor. In addition, self-massage of your hands is invaluable for keeping them free of tension. Use deep, melting compressions of the muscles down to the bone; eliminate trigger points; and wring and strip any accumulated tension from your hands and forearms daily or, at least, weekly.
Use post-event sports massage techniques for any stressed areas of the arms, hands, and pectoral girdle. Increase and clarify energy flow in your hands by regularly and systematically sculpting and stripping each fingertip, including anterior, posterior, and nail surfaces.
Attentive care of your hands is as crucial for effectiveness and vitality of your trade as is advanced or specialized skill enhancement. Avoid debilitating injuries and discomfort by maintaining proper body alignment and extra support for your joints; increasing core, pectoral girdle and hand strength; using a variety of tools; and maintaining your hands regularly. You’ll likely have a longer, more pain-free career as a result.
[minti_divider style=”1″ icon=”” margin=”60px 0px 60px 0px”]
Carole Osborne-Sheets is the author of and Pre- and Perinatal Massage Therapy, and a contributor to the upcoming textbook Teaching Massage Therapy, as well as numerous other publications. She is the 2008 recipient of the AMTA Jerome Perlinski National Teacher of the Year Award. The work outlined in this article is adapted from portions of the author’s textbook Deep Tissue Sculpting.
For these and other books, click here.
For information about her certification program, Pre- and Perinatal Massage Therapy, and other hands-on workshops, click here.
Carole Osborne’s 2008 AMTA National Teacher of the Year Acceptance Speech
ArticlesThank you, Kristen.
And I mean the sincerest of thank yous to the entire AMTA– from the National Board Members, to the Council of Schools and the Nominating Committee, and to individual AMTA members. Thank you for acknowledging my life’s work and the passion and commitment with which I pursue it. I am deeply honored to be named this year’s Jerome Perlinski National Teacher of the Year Award winner. I join a distinguished group of educators, represented unofficially today by the 2005 winner, my friend and colleague, Ruth Werner. And now, today, I have the additional pleasure and honor of interacting with you, my colleagues in the teaching of the somatic arts and sciences.
Give me another minute or two for publically thanking a few more folks, then I have some thoughts and feelings about teaching that I’d like to share with you. We’ll probably have some time for you to ask me your questions as well.
Thanking all who have contributed to my development as a teacher would be unacceptably lengthy; however, I must deeply thank, as a group:
Do you know what this award means to me? I am a fervent defender both of the artistry and science of our work. My receiving this award, at THIS time in our profession’s development, renews my hope that we will continue to value both intuition and intelligence as we train therapists for today’s challenging, changing and exciting possibilities.
And what is the official meaning of this award? It honors the memory of Jerome Perlinski, an extraordinary educator and much beloved Council of schools leader. He is remembered for his recognition of others’ gifts and talents and his ability to bring out their best. He helped raise training standards, improve teaching methods and educate massage practitioners about the importance of ethical, professional behaviors. When colleagues remember Jerome, they use words like inspired, passionate, motivating, principled, and exceptional. Aren’t those traits towards which we all aspire as teachers? I liked to think that I have these qualities. Receiving this award tells me that my colleagues see some of them in me as well.
I certainly do feel inspired. Someone once said “The noblest of professions is that of teacher.” Think about that. When you see your students’ progress, “getting it,” don’t we think “yes, he is getting it!” We might give ourselves a self- congratulatory “pat” on the back for investing time in that student, but what we are INSPIRED by is actually THEIR successes, in spite of or perhaps because of their difficulties. 34 years into teaching, I still delight in the rediscovery of body and mind made by students as they take the journey to become a MT. Teaching people how to make others feel better, more loved, more in touch with their inner self- how great is that!?
I am passionate about my work. It gives me great pleasure and greater satisfaction. I have always liked to get my hands and feet in the mud. In the same manner that children like to run through puddles and play in the mud, I delight in the sensations of my fingers probing, helping to release tension, and unify energy. Considering that we come from the dust and go back to the dust, teaching massage therapy keeps my hands in the mud of the human flesh, my heart open, and all the while demanding that my head analyze, categorize and synthesize= a great juxtaposition. The confluence of spiritual and material in our work is very energizing to me too. As a teacher, I am able to zealously pursue a spiritual mission through a vocational means. Jerome Perlinski was principled. Here’s a few of my principles as a teacher that I invite you to considering adopting too: teaching comes from experience and wisdom, not just information. Inspired teaching only comes when one is being oneself, not trying to be a Xerox of another teacher or role model. I also subscribe to the old African proverb “It takes a village to teach a child.” Instruction is not just an individual pursuit. The community of learners– teacher and students– is as important as the content of the course. So in my teaching, I attend to the web of relationships in each classroom, and use it to support each individual’s learning.
Another principle: be consistent in observing and inquiring to find out where a student is in her understanding of the course content. Meet students where THEY are, then take them in assimilable steps from there to where they need to be.
A few others: Quality massage therapy education offers a balance of artistry and science, left and right brain understanding. MT teaching involves content and feeling. Embrace and support that balance.
Want to motivate your students? Make eye contact with them. Looking directly at your students, individually, conveys respect, interest, and personalized care in instruction. It’s one of the most effective ways I find to reach a student.
For me the ultimate reward or experience is when teaching comes full circle. That is, when the teacher learns from the student and in essence the roles reverse. In almost every Pre- and Perinatal MT course that I teach, there’s at least one student with a maternity healthcare background. I usually learn a new treatment, hear an inspiring story of maternal or medical achievement, or have my perspective widened when they share their experiences. I have a great love of books. I love to hold them, turn the pages, and run my fingers through the text. Quite naturally, I’m very tactile, even as a reader. I have a burgeoning stack of books to read, many recommended by students. Two favorites, Ina May’s Guide to Childbirth and Birthing from Within, were students’ recommendations to me.
I was recently deeply satisfied while co-teaching with a mentee of mine with whom I have spent about 8 years in developing her skills. She led a group discussion with warmth and a firm, but gentle control. She contributed observations to students, recognizing difficulties and achievements that I was missing. She explained concepts so clearly and fully, saying that she had embodied my teachings, I found myself wondering, “How insightful and clear! Did I teach her that?!” Certainly she has taken what she learned from me, and has gone beyond.
Last month I helped a former student and teaching assistant close her very successful practice of over 20 years. In the aftermath of an auto accident, she is unable to sustain a full time practice. I witnessed her gratitude for her years of teaching and doing massage therapy, her acceptance of the end of her career, and the grace with which she completed her time with her clients. What an inspiration in how to let go, move on, and embrace change!
So here’s my deepest motivation for teaching massage therapy: In the early 70s, I taught personal and spiritual growth seminars that were too esoteric, seeming to have no practical application for the students. As I developed my own bodywork skills, I understood that teaching therapeutic massage and bodywork would convey a spiritual message: Humanity is One Spirit, while giving students a livelihood. MT is a career of “right livelihood,” earning a living while serving others. Some students might come initially just to be able to hang out their shingle, but many find along the way the spiritual foundation and truths inherent, and their lives, and all those they touch are transformed.
And transformation, on a worldwide scale, is what we need to become a more peaceful world. When a shooter goes rampant, someone explodes himself in a marketplace, entire villages are ethnically cleansed, or a young woman is reported raped, I get solace and hope from knowing that each new massage therapist’s touch offers the antithesis: an experience of connection and nurturing that has the potential to eventually activate a more widespread knowledge of Unity and cultivate harmony and joy. I invite you to become similarly motivated.
So let me conclude with the example of one of my mentor teachers. My tai chi teacher, 90 something year old Abraham Liu, has been a role model since 1975. He teaches by example, with wit, grace, and intelligence. A master, he never is condescending, interacts individually with his students, and he lives and practices what he teaches. He relishes learning from other masters, and he reads extensively. He teaches with the warmth and wisdom of a kind grandfather, the sparkly eyes of a toddler in full exploration, and the patience of water flowing over rocks, sure in the knowledge that even a granite boulder will eventually be grains of sand. He is humble and accomplished. “Ah, Grasshopper, someday you will understand.”
With this award, I add Jerome Perlinski as a role model, and I invite you to as well. I wish you all the best as you seek inspiration and success as a teacher. May you have at least as much joy, satisfaction, and peace as I have had as a teacher.
Thanks for interacting with me, and for making the connections you have at this event. I’ll wait around afterwards a bit if you have anything else you’d like to address with me.
Carole Osborne – 2008
AMTA National Teacher of the Year with Ruth Werner, author of A Massage Therapist’s Guide to Pathology, and 2005 Teacher of the Year
Colleagues, Eugenie Newton (left) & Marjeanne Estes, celebrate with Carole at the 2008 AMTA National Teacher of the Year Ceremony.
Nurturing your Mind, Body & Spirit
ArticlesAs massage therapists, the amount of physical and emotional energy that we put out can be very demanding at times. We know we need to take the time to fuel the energy we so easily give away. Like many of you, it’s a balance I’ve struggled to find in my 21 years as a massage therapist … but I’m getting better.
Read entire article
Supporting Pregnancy with Massage Therapy
Articlesby Carole Osborne
Nurturing touch during pregnancy, labor, and the postpartum period is not a new concept. Cultural and anthropological studies reveal that massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ healthcare. 1 Studies indicate that most of the more peaceful cultures use touch prominently during pregnancy and early childhood. 2 Midwives, who for centuries have provided maternity care, have highly developed hands-on skills.
Current research on the benefits of touch is providing a contemporary basis for its reintroduction in many technological societies, including the United States. Scientists have found that rats restricted from cutaneous self stimulation had poorly developed placentas and 50% less mammary gland development. Their litters were often ill, stillborn, or died shortly after birth due to poor mothering skills. 3 Pregnant women massaged twice weekly for 5 weekly for 5 weeks experienced less anxiety, leg and back pain. They reported better sleep and improved moods, and their labors had fewer complications, including less premature births. 4Studies show that when women received nurturing touch during later pregnancy they touch their babies more frequently and lovingly. 5 During labor the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labor and number of complications, interventions, medications, and Cesareans. 6
Why Pregnancy Massage Therapy?
Profound local and systemic changes in a woman’s physiology occur as a result of conception and the process of labor. Changes during pregnancy span the psychological, physiological, spiritual, and social realms, according to Carole Osborne, author of Pre- and Perinatal Massage Therapy and maternity massage therapy specialist since 1980. “Massage therapy can help a woman approach her due date with less anxiety, as well as less physical discomfort,” says Osborne.
A typical session performed by a therapist specializing in pre- and perinatal massage therapy, can address pregnancy’s various physical challenges: edema, postural changes, and pain in the lower back, pelvis, or hips. Swedish massage may facilitate gestation by supporting cardiac function, placental and mammary development, 7 and increasing cellular respiration. It also reduces edema and contributes to sympathetic nervous system sedation. 8 Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints and myofascial structures, especially the sacroiliac and lumbosacral joints, lumbar spine, hips, and pelvic musculature. 9 Structural balancing and postural reeducation reduce neck and back pain caused by improper posture and strain to the uterine ligaments. “Prenatal massage therapy also can facilitate ease of labor by preparing the muscles for release and support during childbirth,” according to Osborne.
“Beyond these physical effects, an effective prenatal massage therapy session provides emotional support,” says Osborne. In the safe care of a focused, nurturing therapist, many women unburden their worries, fears, and other anxieties about childbearing. She believes that bodywork helps the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively. “Laboring women whose partners learned and provided basic massage strokes to their backs and legs had shorter, less complicated labors. 10 Imagine the benefits generated by the skilled hands of a trained touch specialist!”
The Postpartum Period
Beginning with the baby’s birth, a new mother must cope with more changes. She is typically only 10 to 12 pounds lighter, yet she is still maintaining her body with an anterior weight load posture. The massage practitioner can facilitate proprioceptive reprogramming to gently return the body to its pre-pregnancy state, to alleviate pain, and to bring about a renewed sense of body and self.
As a specialist in postpartum work, Osborne focuses on repositioning the pelvis and repatterning overall body use. Postpartum massage sessions can restore functional muscle use in the lumbar spine area, as well as strengthen and increase tonus in the abdominal musculature stretched and separated by pregnancy. Additionally, the overtaxed, hypotoned iliopsoas muscle functions can be improved. Upper back muscles which now support larger breasts and the carried infant’s weight need work to reduce strain, and to help maintain flexibility despite the physical stresses of infant feeding and care. For post-Cesarean mothers, specific therapeutic techniques also can reduce scar tissue formation 11 and facilitate the healing of the incision and related soft tissue areas, as well as support the somato-emotional integration of her childbearing experience.
Pre- & Perinatal Massage Therapy Education
To safely massage pregnant, laboring and postpartum women, Osborne feels that it is imperative that practitioners be knowledgeable about normal pre- and perinatal physiology, high risk factors, and complications of pregnancy. “Many of these conditions necessitate adaptations and consultation with physicians and/or midwives prior to sessions. Various techniques and methodologies must be modified or eliminated, depending on the individual and the trimester of pregnancy,” according to Osborne.
“Somatic practitioners will find reliable detailed, research based protocols and contraindications in Pre- and Perinatal Massage Therapy, and in my home study course based on that text,” says Osborne. For those seeking comprehensive hands-on training and certification as a maternity massage specialist, she recommends her 32 hour workshop.
“My Pre- & Perinatal Massage Therapy book and training programs developed from 27 years as a somatic practitioner and educator and 22 years of specialization in maternity and infant massage,” says Osborne. “Our students benefit from our continually expanding body of knowledge, research, clinical experience, and consultations with other perinatal health care providers.”
“Our instructors offer somatic therapists a safe and comprehensive approach to pregnancy, labor, and postpartum massage therapy. We also encourage an empathetic, non-judgmental attitude in supporting women’s ‘pregnant feelings’. These certification workshops include over 80 techniques specifically adapted for pre- and perinatal needs, and the practical marketing strategies, ethics, and skills to elicit collaboration with other perinatal specialists and to build a successful pre- and perinatal massage therapy practice.”
Application has been made to the Scottish Massage Therapy Association and the Guild of Complementary Practitioners for continuing professional development (CPD) points. Carole Osborne is approved by numerous American associations and agencies. She is approved by the National Certification Board for Therapeutic Massage and Bodywork as a continuing education provider (32 category A units: workshops include two ethics hours). Her workshops and staff are also approved by the Florida Board of Massage, California Board of Registered Nursing, and International Childbirth Educators Association; meet current American Massage Therapy Association continuing education standards; can be used for Associated Bodywork and Massage Professionals membership; and can be used for continuing education credit with Doulas of North America.
The Pre- & Perinatal Massage Therapy certification workshop is Carole’s expansion and refinement of the original Bodywork for the Childbearing Year® training which she co-created and taught from 1980-1996. Since 1980 she has trained over 4,000 massage and perinatal specialists throughout the United States, Canada, and Scotland. Her first textbook, Deep Tissue Sculpting, is an established professional text. Click here to order a book or to learn more about other workshops by Body Therapy Education.
Carole Osborne is the author of and Pre- and Perinatal Massage Therapy, and a contributor to the upcoming textbook Teaching Massage Therapy, as well as numerous other publications. She is the 2008 recipient of the AMTA Jerome Perlinski National Teacher of the Year Award. The work outlined in this article is adapted from portions of the author’s textbook Deep Tissue Sculpting.
Footnotes
Survivors of Childhood Sexual Abuse and Therapeutic Massage
ArticlesContribution by Carole Osborne to When Survivors Give Birth by Penny Simkin and Phyllis Kraus, published 2004
Traumatic birth experiences and sexual abuse assault a woman’s body as well as her emotions. When both tissues and feelings need to heal, bodyworkers and massage therapists can be ideal facilitators. They specialize in touch methodologies combined with education of their clients on the structure and function of the affected body parts. Their professional skills increase their clients’ awareness and understanding of the connection between their feeling states, memories, and physical experience.
Appropriate bodywork helps pregnant survivors in these ways.
Women with a traumatic touch history often cope by numbing themselves. They have steeled themselves against pain and humiliation to the point where they continually shut out much physical awareness. To armor effectively, such a woman clenches her jaw and throat and freezes her diaphragm to diminish both breath and feeling. Tension in other muscles, especially in the chest, inner thighs, abdomen, and pelvic floor often complete her defense. Relaxation of these areas can be extremely difficult for such a defended woman.
Bodyworkers skilled in working with abuse survivors can gently and patiently help decrease this muscle tension and improve overall relaxation ability. The one-on-one nature of body therapy is ideal for individualized breathing instruction while coaxing chronically tight respirator muscles to ease their grip. Appropriate deep tissue and other therapeutic techniques melt painful pelvic and let tension. This can be especially helpful with fearful women who are unintentionally resistant to vaginal exams or anxious about birth’s inherent “letting go.”
Consciously directed bodywork helps reacquaint the woman with her body. Modulations in depth, direction, duration, rhythm, speed, and intensity of touch create a rich influx of information and corresponding responses and awareness. This heightens her perception and stimulates new body understanding and awareness. In this safe environment for self-exploration, the bodywork client can gradually rediscover numb, neglected, or tense body areas. As they work together, the client can practice distinguishing what she experiences as positive and negative touch. Because the client controls the pace and nature of the work, she can alter the experience, stopping altogether if desired. This also helps to improve her ability to communicate her awareness and feelings.
Some survivors, rather than numbing themselves to their pain and hurt feelings, become hypersensitive to touch and exhibit a low tolerance to pain. During bodywork or massage, such clients sometimes flash back to traumatic events that flood them with piercingly intense memories, body sensations and feelings. Productive processing of this type of experience requires a practitioner who can help to defuse these memories by assisting the woman in staying with her sensations while encouraging emotional expression. Active resolution can begin to come when unsaid words and sounds or decades-old gestures and actions slip out. After the feeling and sensation states normalize, touch and dialogue are critical to help the client assimilate the intense experience.
Lessons learned in this type of somato-emotional integration directly improve women’s birthing experiences. Discharged of some of their traumatic energy, such memories have a less present impact, improving both baby’s and mother’s prenatal and birthing outcomes. Their resolution also helps women to anticipate and recognize threatening or negative triggers and to develop skills for avoiding or responding to those situations in new, more empowering ways.
Reva Rubin, RN, former nursing professor, has documented her conclusions about the positive impact of appropriate touch during pregnancy. From extensive clinical observation, she has concluded that those women who receive warm, responsive, supportive physical contact prenatally and during labor tend to interact with their infants similarly. Positive physical contact, therefore, might facilitate disruption of the repeating abusive cycles so prevalent in the families of the sexually abused.
Many abuse survivors appreciate bodywork alone or as an adjunct to other forms of counseling. For best results, pregnant women and their healthcare providers should seek a practitioner who is educated and experienced in trauma survivors’ special needs. In addition, comprehensive training in the safety concerns of prenatal massage therapy is also essential. To help the woman or care provider to choose, they should ask practitioners for a resume, including their education and experience, professional references, and/or a consultation prior to beginning therapy to ensure a feeling of safety and confidence with that individual.
Pediatric Massage
ArticlesFeature Article in Massage Therapy Canada, Winter 2002
by Linda Hickey, RMT
Forget the quiet, babbling brook music, scented flickering candles and a peaceful calm descending in the room and bring in the children!
Touch, along its full spectrum is a universal communication of attention and nurturing care. The new parent’s loving caress as they get to know their baby, mothers rubbing the backs of her troubled children, to the therapist’s focused attention to treating an injured athlete’s knee, all lie along the continuum. The intention is always to be nurturing, be it the person, the nervous system or the tissues.
For the therapist considering pediatric massage, there is also a full spectrum of avenues to explore.
Toddler Years
Attempting to work in traditional ways with toddlers will be challenging. It is the developmental task of this wonderful age group to move away, using their new motor skills to explore the world with the parent as a safe harbor to return to for reassurance and support. Touch can be given when they initiate and for only as long as they determine, which is not always ideal with the constraints of a clinical setting.
Developing a range of resources like interesting hand toys, movement games and music may help momentarily, but it is more likely that we would be using a doll to demonstrate technique for the parents to try to integrate into their child’s daily routines. It is helpful if your teaching doll for this age group is size and appearance appropriate, i.e. a “big” boy or girl. In this way you may be able to engage a child in playing with you and be able to access brief hands-on moments to assess and then instruct the parents who will likely always be more successful in their massage than you.
Childhood Years
Once a child has mastered the full range of motor and exploration skills and has developed the language they need for satisfying communication of their needs, they transform into the massage therapist’s dream. Attention and focus is primarily to voice, making creative and elaborate story telling the therapist’s greatest tool for her accompanying hands.
Acting out on the child’s body imaginary dragons, unicorns or even a variety of weather patterns – whatever engages the child’s imagination and attention- becomes the backdrop for the massage. With this age group we can be true to our primary focus of facilitating parents’ comfort and skills with massage and work directly with children, giving them the benefit of our direct attention simultaneously.
Last spring one of my regular clients approached me with concern of her five-year-old son’s over-activity and tendency to anxiety. She hoped massage might calm him, but she needed help with figuring out what and how to do this at home.
While his mother watched quietly from the sidelines, I perched up on the table with John. Over the course of four half-our sessions, we created an ongoing narrative of the adventures of Pete and Pot, two prehistoric stegosaurus creatures and their good friend Sam, the saber-toothed tiger. John enthusiastically helped me tell the story. He kept the names straight, while my hands acted out on his truck and legs, the actions of stomping across the tundra and moving quietly towards the prey.
In the moments that we were discussing the finer details of what would happen next, my hands were busily yet quietly engaged in calming, centering, deep-breath encouraging strokes that his mother would mentally note and imitate at home. In this family, the continuing saga has become the framework for some calm and centering time as needed throughout the day and before bed.
Integrating instructions for parents with treatment requires some practice. It is not unlike that childhood game of patting your head and rubbing your tummy at the same time.
HINTS TO ASSIST IN YOUR PRACTICE
Adapt your positioning: Become comfortable working in a variety of positions. Supported side lying, supine, and semi-reclined work best with children to facilitate communication with words and eye contact. Do not rule out massaging in any other position of sitting, standing, in your lap on the table or under the table. The trick is to get your hands on wherever the child feels comfortable and gradually work toward a more traditional table position.
Adapt your time: More frequent, shorter treatments work best. Thirty minutes is usually more than enough time to be in a focused session with a child and their attention span.
Adapt your pressure: Create a couple of feedback strategies, geared to age, for your young client to use in reporting what feels right for them. Most children after three years or so will be able to use the stoplight words: green means go ahead, it feels great; yellow means caution, it feels like it might change suddenly; and red always means STOP. Another strategy may be more simply describe “light as a butterfly, heavy as an elephant or Just Right,” a variation of the Three Bears story that most children know. Be prepared for children to test out the control they have in directing the pressure of their massage. They need to know that they can trust you to listen, and then they can focus in on the experience of the massage. Know that the amount of pressure will always be right therapeutically for the moment, for the tissues themselves and for the child’s personal sense of body and experience ownership and control.
The experience of controlling what is done to their bodies becomes particularly important in working with children who are chronically ill or disabled. For children whose life experience is filled with occasions of adults doing things to them, sometimes painfully, without their permission or in spite of their protests, imagine what an affirming experience massage could be for them when our hands not only feel good, but we work WITH them rather than doing TO them.
Work with parents: Working with the parents in the room watching requires some preparation. Be clear in your communication with parents that your attention will be with the child for the time that you are together. Ask parents to observe quietly until the end of the session at which time you can discuss what you did, answer questions and give directions. It is difficult for a parent to not get involved, especially if their child appears to be uncooperative. If this is the case, assure the family that you are comfortable handling the situation and that you will request their support if you feel you need it. There may be times when children need more support from their parents in the treatment sessions and this too needs to be accommodated. I have worked successfully with families and children though I never touched the child.
I have a realistic child-sized rag doll, Annie, that becomes my child who has come for a massage and Annie and I interact as if she were real, acting out what it is I want the parent to do and the child to do.
There are endless, fun ways to bring massage to families and children. I have arranged special birthday packages when the child of a regular adult client comes for a massage, gets to choose, mix and take home their special massage oil blend with a birthday card. For special celebrations I have led Family Massage classes where children learn how to massage their parents’ feet and backs, always a popular event!
There is yet another purpose of bridging the worlds of massage and children. Massage therapists in fact share an important common dream with families everywhere in that we too wish for a more nurturing, less violent world for future children. Our massage is the way in which we work toward that future.
Positioning Concerns for Prenatal Massage Therapy
ArticlesAdapted from Pre-and Perinatal Massage Therapy by Carole Osborne
The question most practitioners consider first when contemplating massaging pregnant women is how to accommodate that ripe belly. Safety, comfort and therapeutic effectiveness affect both prone and supine positions during pregnancy. These same considerations point favorably to working with expectant women while they lie on their side.
Prone Positioning Restrictions
While stomach sleeping may be a safe, comfortable resting position, once sufficient pressure is applied for an effective massage this is no longer a reliably comfortable and safe position. Prone positioning on a flat therapy table can exert strain on the lumbar, pelvic, and uterine structures. Prone positioning shortens posterior musculature; compresses and anteriorly displaces the lumbar vertebra and lumbosacral junction; rotates the sacroiliac joints; and increases strain on the sacrouterine ligaments. Prone position, particularly in later pregnancy, often aggravates the causes of many women’s back discomfort.
Pillows or specialized equipment that is marketed for pregnant clients can mitigate these problems, but neither pillow props, body cushions, pregnancy pillows, most on-site massage chairs, nor tables with cut-out ovals completely solve the problematic aspects of prone positioning. These alternatives can either (1) further strain posterior structures and the taxed uterine ligaments, or (2) create increased intrauterine pressure, particularly when you apply sufficient pressure to address the posterior structures therapeutically.
In most uncomplicated, low-risk pregnancies, some increase in intrauterine pressure is acceptable. Additionally, during the first 13 weeks the anterior iliac spines usually protect the uterus from increased pressure. Use the prone position in the first trimester, but keep in mind that avoiding increased intrauterine pressure is of particular relevance when there are placental abnormalities, or a higher risk of such conditions. Be cautious if there is heightened concern about fetal blood supply or uterine competence. Women diagnosed with these conditions are often uninformed about their impact on receiving massage therapy. Some of these problems go undetected until screening tests are performed, or until bleeding, cramping, or other overt signs of problems have occurred to warrant further diagnosis. Prone positioning, even in the first trimester, can be problematic when the embryo is larger than normal, with twins or other multiples, and when the mother is obese. Use sidelying and semi-reclined positions after the first trimester with all pregnant clients to avoid the risk of excessive intrauterine pressure.
Some other considerations: Prone positioning exerts pressure on sensitive, enlarged breasts. Because of increased mucous production and the inadvisability of using alleviating medications, many women become unacceptably congested in prone position. Some women are uneasy with “lying on their baby.” Finally, the confines of face cradles often hamper verbal and emotional sharing.
For the comfort and safety of the pregnant woman, eliminate the prone position after the first 13 weeks, regardless of your or the client’s perception or preferences in this regard. Use caution and make reasonable adaptation for its use in the first trimester.
Supine Positioning Guidelines
Prenatal supine positioning also involves safety considerations. In this position the weighty uterus rests against the inferior vena cava. Extended compression of the vena cava will result in low maternal blood pressure and decreased maternal and fetal circulation (supine hypotensive syndrome). Some women report uneasiness, dizziness, shortness of breath, or other discomforts when lying flat on their backs, although others seem entirely content; however, with or without notable negative effects, decreased fetal circulation occurs, particularly if the placenta is embedded posteriorly.
Some healthcare providers advise never lying supine, primarily when there is increased concern about fetal oxygenation. Though it appears safe throughout pregnancy for most women receiving massage therapy to lie on their backs briefly, for a two to five minute maximum, always follow these instructions when present. In second and third trimesters, be prudent and take mitigating measures for more extended anterior work. Options in early pregnancy include use of pillow support under the right side of the torso to shift uterine weight toward the left. After 22 weeks, elevate the torso to a semireclined angle of 45°-75°. Use the sidelying position as both a prone and supine alternative.
Sidelying Positioning
For all of the reasons above, sidelying (lateral recumbent) position offers maximum safety and comfort throughout all pregnancies. When sufficiently supported by pillows, bolsters, and/or cushions, most women can relax in this position. Sidelying minimizes strain on any of the uterine ligaments or on the musculoskeletal structures. It prevents increased intrauterine pressure, increased sinus pressure, and it tends to encourage somato-emotional integration. Physicians and midwives recommend the sidelying position to help ensure placental and fetal circulation when complications occur and in many high risk pregnancies. The left sidelying position allows maximum maternal cardiac functioning and fetal oxygenation, though most pregnancies are perfectly safe with mom on either their left or right side. The safest position for prenatal massage thereapy is the sidelying position, regardless of possible inconvenience to or preference of the practitioner.
Here are the basics of comfortable and safe sidelying positioning: Use several sizes of firm and soft pillows, a long body pillow, and/or a contoured bodyCushion. Support the woman’s head so that her cervical spine is aligned with her torso, and not hyperextended or sidebent. Use sufficient support to accommodate the space between the acromioclavicular joint and the head so that her shoulder is not uncomfortably compressed beneath her upper torso weight.
Tuck a small foam wedge or pillow, approximately eight inches square and two to four inches thick, under her abdomen near the pubic bone to support the uterus and prevent uterine ligament and lumbar strain. Place another similarly-sized pillow under her waist to support the lumbar spine if her hip and waist proportions are markedly different. Provide an additional pillow to support her upper arm, relieving pressure on tender breasts and preventing anterior torso rotation.
Extend her bottom leg, and position it on the table posterior to the other leg to avoid restriction of venous flow. For the uppermost leg, place supports of sufficient height and density to maintain a horizontal line between hip, knee and ankle, and to moderately flex this hip and knee. This will prevent strain on the sacroiliac joints and the lumbar spine, and anterior rolling of her torso. Proper leg height also mechanically assists in the reduction of leg edema, and provides relief from painful varicose veins.
The almost fetal sideling position offers psychological comfort for most pregnant women. Nestled comfortably on her side, she may feel more able to talk about her excitement, and her concerns, without the obstruction of a face cradle, as when prone, or the confrontational effect of talking face-to-face, as when supine.
The next time you have a pregnant client, you now have a basic overview of why, when, and how to position her. You may also want to learn more prenatal physiology, how to adapt your work for pregnancy’s demands, and specific prenatal therapeutic massage and bodywork techniques.
Carole Osborne-Sheets is the author of and Pre- and Perinatal Massage Therapy, and a contributor to the upcoming textbook Teaching Massage Therapy, as well as numerous other publications. The work outlined in this article is adapted from portions of the author’s textbook.
An Interview with Carole Osborne (BC Practitioner)
ArticlesThis 1998 interview with Carole offers insight into the history and development of her work and its context in the midwifery and research fields.
This is the first of two interviews by Isobel McDonald with women who are leaders in the field of women’s health during the childbearing year.
View article (PDF)
In the Earlier Years: A 1993 Interview
ArticlesFirst Published in Massage Magazine, Nov/Dec 1993, Issue 46, 44-52
Melissa B. Mower, author and interviewer
My first real introduction to Carole came in February 1991 just after I had written a comprehensive article for this magazine about the development of a national certification examination for massage therapists and bodyworkers. When I sought her opinion on the piece as an editorial advisory board member of magazine, Carole criticized some aspects of the article.
We had a long discussion about the article, and while we basically agreed to disagree on some of the issues, we were able to openly speak our minds and maintain mutual respect for one another.
This was the foundation for our professional relationship. Since then, we have continued to communicate warmly, and I have been able to rely on her candor on other subjects as well.
In order to better understand what Carole’s work was all about, I asked if she would be willing to give me a mini-session. She took nothing for granted of me as a client. Her work was done with a sparing amount of oil as I lay face up in a room lit by the natural light of the windows. She explained that much of her bodywork is done face up, primarily because it’s easier for her to monitor the breath and that for most people, especially if emotional processing is involved, lying on one’s back is more comfortable.
A lot of her work involved deep holding with movement. It felt as though each part of me was being embraced and hugged. At times it seemed as though she was probing the depths of my soul, though her touch was never invasive or in any way felt threatening. She encouraged my breathing and free movement by simply and frequently saying “yes.” My comfort was of primary importance. It was wonderful session, one that instilled a sense of peace.
As a person and a professional, Carole embodies sensitivity with strength, compassion with caring, as well as empathy and enthusiasm with little ego involvement or judgment. She’s a delight to be with and to learn from.
I understand you were inspired toward bodywork through a group, called Arica. Would you tell us about that?
Osborne-Sheets: “Arica offered me a distillation, so to speak, of many of the traditions around the world of development of enlightenment and consciousness practices and had a very heavy emphasis on body-related methods.
“It is a school that relied a lot on Tai Chi and Tai Chi-type exercises, a lot of movement, meditation and some bodywork. It had a sense and a psychology of the body and of the psyche that truly acknowledged what seemed to me to be the truth – that we had a physical part of ourselves and an emotional part of ourselves and there was something intellectual that was there as well. Uniting all of that was a sense of spirit or life force or soul….Arica was extremely important in reconnecting me with my Source.”
How do you feel your psychological and consciousness background has benefited your current practice?
Osborne-Sheets: “What I have gotten from the theories of the psyche from Arica, and the Jungian theory of an internal male inside each of us women and an internal female inside each man…is that balance is achieved as you move freely between those two sides….
“When I first was introduced to the idea of yin and yang energies from the Eastern cultures, it was the first time I heard a theory that coincided with what my perception of what reality was….All of this affords me as a practitioner a relatively easy non-judgmental stance because I can see both sides, and I believe that both sides are valid. That means that I can give my clients a tremendous amount of permission to be.”
You advocate that physical and emotional balance is crucial for a therapist to accomplish his or her work. How do you maintain balance?
Osborne-Sheets: “My most consistent practice has been in Tai Chi. One of my purposes in coming to San Diego was to study Tai Chi, and I have continued to do that, studying under Abraham Liu. I do a lot of writing and journaling and emotional clearing on my own….
“One of the ways that I maintain emotional balance is that I experience myself and I think of myself in relationship to my clients as almost a neutral element that just provides some sort of environment.
“When I think I am going to fix someone or that I am going to help someone, I find it is emotionally unsettling. It depletes me, and I don’t generally do a very good job at fixing or helping someone….My family life helps me keep perspective that bodywork is not the only thing in life and makes a big difference.”
Describe the work that you do and what makes it unique.
Osborne-Sheets: “There are two aspects to the work that I do. One of the things that I do is somato-emotional integration. I work with people to explore what the relationship is between their physical tension and their emotional tension. I do that through using a very firm but gentle and deep pressure called deep tissue sculpting, done simultaneously with passive joint movements that are rhythmic and very gentle, for the most part.
“That sets up an environment that, if someone is interested, they tend to be able to feel and understand and have an ability to explore: What is my body saying? How does that relate to what my emotions are? What are my belief structures? In what ways am I unable to move freely in my body, feelings, or mind structure?
“I think what is perhaps unique about my work is that I don’t have an agenda with a client. It is not my idea that what we would do should have to create an emotional release or that there would be some kind of catharsis.
“I frame what I am doing as an exploration and often times those things happen… The second part of my work is work with women during the childbearing year, focusing on their pregnancy, the birth of their babies, their birth as a mother, and their interaction with their babies afterward, using the same techniques in working with people who are exploring their emotions, and also utilizing a number of other techniques.
“The approach that my (now former) business partner, Kate Jordan, and I have in this kind of work is unique in that while we are technically and medically very attentive, there is not exclusivity. It is equally as important as providing a place this mother can feel that she can talk about some of the fears she has, for example.
“The uniqueness of the deep tissue work that I do and that I teach lies in my feeling that I don’t feel benefit in creating pain in my clients. The work I do is not painful, at least not predominantly painful; it can be very intense, and I work very deeply, but I take the time that it takes biomechanically to enter into a body and enter in slowly enough so that it is not painful or invasive. I think many forms of deep tissue work and myofascial work can be very aggressive and painful for some people. I know that a lot of people accomplish some very wonderful results from that kind of work, but it is just not my style.
“One of the things that I think is unique about my touch is the way in which I combine a constant pressure and omni-directional movement. As far as I know I haven’t run across anyone who combines technique in that kind of way….
You were a co-founder of IPSB, formerly the Institute of Psycho-Structural Balancing. Do you still utilize the psycho-structural balancing approach that the school was founded upon?
Osborne-Sheets: “Yes. My apprenticeship training with Ed Maupin was and continues to be profoundly impactful, although the focus of my work is not structurally oriented. Ed, a psychologist, was one of the first few students Ida Rolf trained in structural integration.
“The wisdom and the genius of Ida Rolf, as Ed conveyed it to me, continues to be a foundation for my understanding of the structure of the body. That coincides with the Tai Chi principles of grounding through to the earth, and at the same time extending up to the heavens that you accomplish through alignment of the spine. On a physical level those structural parameters are the basis of my work. The psychological orientation is a ‘well, what does that mean in terms of what this person feels and what this person believes and how they perceive themselves and how they interact with the world?”‘
How would you say your work has evolved?
Osborne-Sheets: “My view of the structure is still based in that sense of alignment but instead of seeing a shoulder that is higher than another one, for example, what I now see is an expression of where someone is in their structure and in their emotions….
“When studying [Milton] Trager’s work, and in having lively discussions with him about how one could combine deep tissue work and passive joint movement, I gained a tremendous amount arguing each of our perspectives about that.
“I had the opportunity to work in an osteopathic physician’s office, and I learned strain/counterstrain work, some muscle energy work, myofascial release, and just the osteopathic perspective on health and disease. While I am not practicing craniosacral work, my sense of the body changed tremendously through taking a [John] Upledger course.
“Movement wise, I have been greatly influenced by a woman named Emilie Conrad-Da’oud. The focus of her workshops is rather eclectic and esoteric in some ways. They focus on micromovement, cellular movement.
“Her work is called continuum movement, and I’ve always combined some form of movement with whatever deep tissue work I do. Focusing internally on that level of movement has really enriched my work.
“I’ve learned a tremendous amount from Kate. When Kate and I began collaborating on the childbearing year class, I learned a very different and complementary approach to the body….
“I’ve got an amalgam of influences. Throughout all of it there has been the steady precision of pressure, holding pressure. That is what I started with in my own self-explorations before doing anything that you might call massage. That has been the stable center from which all sorts of other things have been added. Also the attention to the client’s emotions through the body has been consistent throughout. This amalgam is what I continue to teach in my courses at IPSB.”
What evaluation techniques do you utilize in assessing a new client?
Osborne-Sheets: “I use a lot of visual cues including my sense of vertical alignment, horizontal planes, of structure and the balance of fascial planes. I also evaluate visually for places where the body feels empty or where the body feels full or where there is a feeling of a lack of vitality. That is a visual impression that comes when I soft focus my eyes, when I let my eyes go and see without focusing on anything.
“Also, a lot of my assessment is in the words that I hear. I get a lot from what someone says to me, not just the words themselves and the choices of words, but also from the tone and the expression, what isn’t said….
“Maybe even more importantly than those two, I assess kinesthetically. I assess with omni-directional movement in the form of gentle rocking and shaking movements that help me to feel where the body is not moving, generally a place where there is some myofascial restriction…”
How would you say that massage therapists can better develop their abilities to read the areas of tension and then evaluate a client?
Osborne-Sheets: “I think probably the first thing I’d say would be to gain an internal understanding of the kinesiology and the way the structure is intended to be. Have some sort of paradigm for evaluating the structure…. Understand how bodies move, what are the components of gait, and how does one erect the spine.
“The second thing would be to develop the ability to see individuals without a preconceived idea of who they are or what they are….
“It seems to me that one of the best ways for a therapist to be able to assess is to truly commit themselves to some type of internal discipline that provides for clarity of mind, appropriate use of the body, and attention to the essence of things….”
What kind of issues come up for clients who are adult children of alcoholics or incest survivors, and how can practitioners be prepared to deal with them?
Osborne-Sheets: “The kinds of issues that will frequently come up are, first of all, body awarenesses that can be alarming or unexpected because there hasn’t been attention paid to the body.
“There needs to be ability on the practitioner’s part to stay with the client, stay with whatever intensity level the client is experiencing. The best way to do that is to stay in touch with one’s own breathing and to monitor what is happening with the client’s breath. It is the simplest and yet the most profound indicator and connection between what the body is experiencing and what the feelings are saying.
“I think it’s important for therapists to realize that just being with someone is profoundly therapeutic…What it requires of the practitioner is an ability to be with (the client) and to recognize and own when you are uncomfortable being with and, at least, have a recommendation of someone who you know who can be with (the client).”
Do you recommend that these clients also seek individual counseling?
Osborne-Sheets: “Absolutely….I have a tremendous amount of respect for what psychotherapists and counselors are able to do. I see us as complementary, neither one better than the other. We probably are the same profession and just don’t know it. Our tool is just different. As bodyworkers I think we grasp the soul through the flesh, and they grasp the soul more through word and through thought….
“Until training programs substantially prepare bodyworkers for the emotional aspects of the work, I think it’s an ethical imperative that we only work in a way that is respectful of the limitations of what our training and our abilities are….
“I don’t require every client to be in therapy, just those who are interested in pursuing somato-emotional integration. I’ve got clients who are coming for general stress and relaxation, who come for pregnancy, and I don’t require that. If at any point our work is going in a direction that I feel as though that would be appropriate, I do ask it then….”
Do you make yourself available emotionally when memories and emotions surface for clients, and at what point do you refer out?
Osborne-Sheets: “When, within the exploration that we’re doing, memories and feelings come up, I am available. How I work with that is: I stay with the bodily experience of that memory or that feeling so that I help to hold up ‘the mirror,’ so to speak, to that individual of what their body is saying about this in terms of what movement it wants to make.
“I focus on a real observation of their bodily experience and allow the body to have its say, to let it speak, if there are words that need to be spoken, or if it’s movements, or if it’s body postures to express something that wasn’t able to be expressed at the time….
“Within the context that I am working I am usually in communication with a psychotherapist, if that kind of thing surfaces within the context of our work, allowing that bodily expression if appropriate, even though it is a reflection of an emotional state.
“Because I’m usually already working with a psychotherapist, I usually don’t have to refer out. However, I do sometimes discontinue bodywork temporarily, or sometimes for a long amount of time, if the individual is having difficulty coming back to a grounded, everyday reality. That’s saying to me that they’re overwhelmed by the amount of information that’s coming up, that there’s too much for them to assimilate….”
Describe the integrative body therapy that you provide for these clients.
Osborne-Sheets: “What I provide is an experience of touch that is to the bone deep but very gentle so that it’s not invasive. It’s on the borderline of pleasurable, yet there’s an intensity level that says, ‘hmmm, something’s stirring here’ but, at the same time, it feels good.
“Combined with that, I use omni-directional and rhythmic movement that helps the neuromuscular system not be boxed into its repetitive patterns. Those together provide a physical experience of being profoundly attended to without any pressure to particularly do anything. Within that context, self-awareness is more likely to occur.”
How do you go about providing safety for incest survivors?
Osborne-Sheets: “I don’t require an incest survivor or any of my clients to tell any more than they volunteer. I provide for a sense of privacy in that way. I offer a lot of options in terms of how one will be touched or where one will be touched.
“I ask all my clients, whether I know they are an incest survivor or not, if there are parts of their bodies that they are uncomfortable with having touched. I offer the option of remaining seated and fully clothed, and numerous gradations between that and being undressed on a table. I request feedback regularly from a client on what they’re experiencing, and on their comfort level with what I’m doing.
“If, in fact, I know that someone is an incest survivor, I state very clearly that I will not touch them in any sexual way, and, if there is any way in which I touch them that they perceive as sexual, that’s not my intent. There is a profound range of what kinds of touches can be perceived as sexual to people.
“For any of my clients, I am committed to a level of confidentiality in not revealing their work in any way. I think one of the other ways in which I offer a level of protection to incest survivors is that I don’t see that as their identity. Whatever brought a person into my room, I try to initially look at them with a more encompassing viewpoint.”
How can deep tissue sculpting be helpful to women with eating disorders, as mentioned in your book, Deep Tissue Sculpting?
Osborne-Sheets: “My hands-on work is very much a blend deep tissue work simultaneously with movement. The two of them together work the most magic, but it creates a kind of paying attention that requires for many people a shift in consciousness, a shift into an internal awareness.
“For people with eating disorders oftentimes that internal awareness is asleep or shut off in some kind of way. The work is non-invasive, because it’s gentle and nurturing as well as demanding. For many people, their eating disorder is part of a defense mechanism and a protection system and so this kind of touch doesn’t further fortify that defense system. In fact it kind of renders that defense system a little obsolete.
“There’s an ability to drop some of that defensiveness and be more able to pay attention on a physical and an emotional level….Because of the structural paradigm with which I am working, there is much more body organization. Rather than their bodies feeling so difficult for them, they begin to feel more comfortable within that body, more pleasure within their kinesthetic sense. That just leads them to more pleasure in their body from a positive perspective, and that then leads them into behaviors that are going to tend to help them to develop their internal self-worth and their sense of the positive that comes from the body….
What was the most challenging case you have encountered, and how did you address it?
Osborne-Sheets: “Well, first I’ll give an example of what I considered in some ways to be a failure story. I think it’s important that we all recognize that we aren’t successful with everyone and often times you only hear the success stories.
“I had a client who was sent to me by his psychologist who on a physical level had irritable bowel syndrome and panic attacks and managed to maintain his job, but the rest of his life was pretty nonexistent because of the level of anxiety that he experienced.
“I saw him weekly for a number of months, and I was seldom able to keep his awareness in his body for longer than three minutes at a time in all that time. We were not able to successfully bring him to enough awareness of his body that he could even learn any breathing techniques to reduce the panic attacks. He had the most staunchly defended body that I ever had the pleasure to work with.
“When I was working my best, I was able to continue to focus my awareness on him and work with him with the faith that perhaps some part of him was in fact there and that at some point it would awaken, and he would remember maybe even all of this that had happened. I never got to witness any of that happen. When I was not working at my best, of course, I was feeling like I hadn’t done things right or that I was very ego-involved in the outcome of the sessions.
“On a more successful note, I had a woman who had a multiple personality disorder and had some physical problems with her neck and shoulders. It was very challenging to work with. She had only a single split so that there were two individuals inside her, but they had a different body manifestation… Once I felt what she felt like in each personality, I could feel her shift. I got so I could tell she was shifting on me on the table. It was very challenging to organize this woman’s body because in fact there were two people’s bodies that I was working on.
“What I did was stay focused on the body, enabling her to be able to compare for herself and observe her two bodies. She started being able to find ways to not be so different. Now, I don’t take credit for the healing of this woman. I take credit for a part. She had a most glorious spirit and maybe no matter what she would have done she’d have healed herself because she had that kind of soul.”
Can you recall your most rewarding healing experience?
Osborne-Sheets: “You know it’s interesting, because I’d say a good 90 percent of the time I have a rewarded feeling every time I work with someone. The word ‘reward’ implicates some sort of something that happens at the end of a goal having been reached with some sort of goal orientation to it. The places where I’ve been the most rewarded have been the places in which I haven’t been focused on a goal, focused on a reward, and especially not focused on it in terms of what it means as to who I am or how effective I am or any of those kinds of things. The most reward generally comes when I am the least personally involved and the most empathetically involved. That’s probably true for most practitioners, I would guess.”
What excites you about your work?
Osborne-Sheets: “It’s never the same. Never. There’s a freshness and an aliveness and, in a sense, a contribution to my own spirituality in that my intention has to be to stay current on a moment-by-moment basis with what’s happening. I can’t assume or expect that anything’s going to be the same….
“The combination of science and artistry excites me. You cannot do this work, and do it well, with either one of those pieces. You can do fine intuitive work or fine technical work but to really do fine work, you must have both….
“The more I develop my intuitive side, the more I’m able to truly see the way in which paired muscles work. That excites me. I guess both sides of my brain feel satisfied by it.
“I am very excited by the very concrete contribution that hands-on touch makes to individual lives, to our society and to the planet. I think it makes a phenomenal change in people’s lives that affects politics, economics and culture….”
What advice do you have for those practicing in the field?
Osborne-Sheets: “Pursue some type of internal discipline….1 would also encourage our profession to see what touch truly is. Touch is a part of human existence, it’s a part of family life, and it’s a part of the family….
“For bodywork to be an integral part of our society is appropriate, as is whatever contribution each of us can make to have our work be a part of rather than separate from society.”
In your opinion, how can massage therapists and bodyworkers bring further legitimization to their work in the medical and insurance arenas?
Osborne-Sheets: “I think the most important thing for us to recognize is that higher standards of education are crucial. I happen to think that the best way to accomplish this is through the tiered concept of a structure, such as how the nursing profession presents itself….
“I would hope that we would pursue means to validate the benefits of our work more extensively than they have been. I would hope that would be a priority for us as individuals and of our professional organizations.
“I think that the power of massage therapy as an educational tool is equally important, its role as part of self-awareness and understanding of ourselves is as important….”
What is your vision of the future for bodyworkers in the next 10 years?
Osborne-Sheets: “As I understand the cycles of health care, I think that we’re on an upswing in that cycle, which provides a kind of window of opportunity for us right now. When I first started doing bodywork, it was definitely an upstream swim.
“I think we’re on that upswing and I think over the next 10 years we will enjoy increasing public awareness of the benefits, public acceptance and a continued decrease in the association of our work with prostitution and quackery kinds of activities.
“Unless we have a serious economic collapse, I think that we will be able in the next 10 years to establish enough of a foundation for our profession that most of us will be able to make a reasonable living doing work that we love and that makes a significant contribution….”
Thank you, Carole.
Healing Touch for ACA’s
ArticlesNurturing touch is a natural part of a healthy, functioning family unit; however, the children of alcoholic and other dysfunctional families often grow up experiencing primarily abusive touch, such as violent beatings, sexual abuse, and/or neglect, both physical and emotional. Therapeutic massage and bodywork can provide a safe context for healing from these types of early traumatic experiences. Although published in 1989, this article’s overview of somato-emotional integration still offers direction to today’s practitioners.
View article (PDF)