Pure of Heart Massage by Joshin Yamada

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Again I am incredibly tardy in adding to these letters, which I now realize were a kind of blog before blogs became blogs. The big change in direction I feel now is twofold. One is a desire to work more closely with fibromyalgia sufferers and the other is to serve overweight people better. I also feel like it is important to discuss the role of the client and boundaries in massage.

I have had the fortune of getting to work with clients with fibromyalgia almost since the beginning of getting my license, but I oftentimes felt that I didn't know enough to really help. As part of my 2007 renewal of my massage license, I took A Somatic Approach to Relieving the Pain of Fibromyalgia, a 16 hour continuing education course. I loved the course. I had taken courses on fibromyalgia before but felt they were vague and unscientific. This course was different.

The course began by talking about how fibromyalgia is a complex disease with physiological components. There is an imbalance of neurotransmitters that affect the client. Fibromyalgia is marked by a deficit of serotonin as well as a surplus of Substance P. Serotonin carries pleasurable relaxing signals in the nervous system, and substance P transmits signals of pain. So fibromyalgia sufferers feel extra pain while feeling less good signals and having trouble sleeping as well.

That scientific basis alone made me feel like I had a better way to start approaching patients with fibromyalgia, but the course also provided a series of passive neuromuscular facilitation stretches to specifically work the 18 diagnostic points of fibromyalgia sufferers. There were also active, resistive stretches provided, too.

Armed with this knowledge, I feel I have been able to perform better, more specific massages on my patients with fibromyalgia. I have been very encouraged by the response I have seen from working weekly with these people. I want to share this work with more people who have fibromyalgia, and plan on emhpasizing that speciality when I next do any advertising on Craig's List.

In the same vein of stepping up to serve the world, a friend has recently asked me to emphasize a new direction. She knows me well enough to know that I have grown up fat, and dealt with society's stigma towards overweight people. Also she knows that I don't share that attitude, and instead think of ways to promote self acceptance/size acceptance. I enjoyed taking a class at Portland State University about Body Image/Size acceptance issues.

I believe that massage is good for everyone, not only for the relaxing aspects of it, but I believe it can be especially good for anyone with poor blood circulation because it promotes the movement of waste fluids in the body; for anyone with high blood pressue because it reduces blood pressure temporarily; and for anyone who is susceptible to getting sick often because it increases the white blood cell count in the immune system.

I myself felt really shy about getting a massage. On the first day of massage classes, the teacher told us to partner up. One person would cradle the head of the person lying down on the table. I felt such tremendous fear that my head was really heavy that I broke out in a sweat. I worried that the weight of my head would make the other person's wrists hurt- a rather silly fear since just about everyone's head weighs the same. In the following week, undressing and allowing strangers (who quickly became close friends) was scary, too.

In general, putting yourself in the position of going to a strange place, relinquishing yourself of your clothes, and then letting someone touch you feels extremely vulnerable. If you multiply that by the factor of feeling unaccepted by society for being overweight, the strain can feel unbearable. I want right now to allay those feelings for anyone coming to see me. You have my word that I won't judge you negatively for your physical body.

This makes a good segue into my last point. I have had the experience (too many times) of leaving a client in the massage room to change and get ready, and when I come back, they are lying naked on top of the sheets. This serves as a good reminder to me that massage is a unique situation in many people's lives. All the aforementioned factors that can leave you feeling vulnerable are in place, and I think that sometimes makes people feel they cannot speak up or make themselves more comfortable.

As the therapist who is standing there working, it's easy to forget that many clients won't feel comfortable speaking up about being scared, or the level of pressure that they want. I want all my clients to know that they are always in control of their massage, and that I am there to serve them. It is completely acceptable, and even desirable to me, that a client be vocal about their preferences. Please don't be shy about asking for more pressure, or telling me when a certain move is uncomfortable. And conversely, don't be shy about making noises when something feels good. I follow my teacher's advice, which is if someone tells me something feels good, I will linger just a bit more leisurely in that great spot. Clients seem to really love this, so I am extra happy when that magic happens.

Well I look forward to working on your health with you in the future.

copyright © 2007 by Joshin Yamada