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Massage Today
April, 2001, Vol. 01, Issue 04

Touch and Rapport

By Keith Eric Grant, PhD, NCTMB

There go my people. I must hurry and catch them, for I am their leader

- Mahatma Ghandi.

The Path of Touch Unfolding

Facilitation, like true leadership, is paradoxical in that it often requires us to chase after those supposedly being led.

Within such facilitation, there is a deep appreciation for the abilities and resources of the client, and an acknowledgement that the full outgrowth of the interaction will only become apparent as it unfolds. It is an orientation that obliges us to be flexible in our attitudes and approaches.

Depending on our therapeutic orientation, we may approach a client from a sensory-driven perspective of finding and gently releasing areas of unconscious holding and restriction. More formally, we might take the orthopedic perspective of assessing painful lesions stemming from structural and functional dysfunctions, then proceeding to systematically alleviate them. In any approach, having our interventions take hold often requires a change in body perceptions and use from our clients. I am particularly struck by Deane Juhan's (Job's Body) comments about massage opening a window for the client toward a new, less strained way of experiencing their body, and by his repeated emphasis on the importance of bodywork as client re-education:

Practiced touch can not only deliver a collection of sensory impressions, but it can also impart those impressions in such a way as to convey a smoother style, a larger repertoire, a greater flexibility, and a finer appropriateness to our movements. It can help us to learn - in ways that our upbringing did not - a whole new manner of sensing and behaving. It can help us to learn to more accurately assess our condition, to identify and resolve stress, to reverse vicious circles, to move towards health rather than toward increasing involvement with our infirmities. It can help us to establish the new sensory engrams and master the new conditioned responses that are necessary for successfully breaking out of our ingrained patterns and our compulsions.

Beyond what Juhan provides, there are several paths along which we can delve into underlying mechanisms and clinical experience. Pain researcher Ron Melzack continues on from the gate theory of pain (Melzack and Wall) in considering the neurological basis and implications of phantom limb pain. He conjectures that we possess an inherent neurological analog of our physical bodies . This analog system, he theorizes, can independently generate perceptions of pain until it is reorganized by new coherent sensory input, such as that provided by bodywork.

A second perspective is provided by psychologist E. L. Rossi's review of the new field of psychoneuroimmunology. In The Psychobiology of Mind-Body Healing, Rossi discusses research indicating that stress on the nervous system produces chemical messengers that have profound effects on immune system functioning. In providing a supportive emotional environment and nurturing touch, we address the effects these neurochemical systems have on perceptions of pain and quality of embodiment.

Choreographer Eric Franklin (Dynamic Alignment through Imagery) is one of a line of dance movement instructors who have achieved their results working with the interrelations of imagery, body use, and neuromuscular patterning. These dance educators have noted the role our mental imagery plays in organizing the neuromuscular patterns that facilitate the ease or strain of our posture and conscious movements. We have only to think of movement or conflict and our body has responded, beyond the speed of our conscious thoughts. Just imagining a movement or a posture causes the body to activate muscles and to integrate optimal pathways towards that vision. Our positive body images can act to alleviate tension that results in unnecessary limitations and wear as equally as our negative body images can limit our effective use of space and increase the effort of our movements. We begin to understand the wisdom behind Juhan's assertions that bodywork can add new possibilities to a client's world of embodiment.

The Dance of Rapport

Psychiatrist Milton H. Erickson was notable for his abiding faith that, apart from unnecessarily limiting beliefs and lack of experience, clients possess all the resources they need to live full and rewarding lives. Starting from an attitude of accepting and utilizing the client's worldview and abilities, Erickson was a master at providing the needed experience and flexibility that allowed positive changes to evolve naturally for his clients. Neuro-Linguistic Programming originators John Grinder and Richard Bandler similarly stress the importance of pacing and leading. Pacing is a process of acknowledging and matching a client's current experience in a manner to establish rapport. If we attempt to lead without rapport, our efforts will fall short. Likewise, if we limit ourselves just to pacing, we lose the opportunity to effect positive change.

Part of the skill of pacing is simply to be fully present with our clients. To promote this skill, I teach my students a simple yet unexpectedly profound exercise; actively pacing a supine client's breathing with a hand on their anterior torso while staying conscious and present to observe subtle changes in their appearance and position. It is hard to over emphasize the emotional impact of such quiet presence and support in a culture in which it is so rarely encountered. This exercise draws on our skill at pacing and leading our clients in their perception and use of space, effort, and time. These are ways of organizing our embodiment that are used by dance instructors such as Constance Schrader (A Sense of Dance). I find they provide useful frameworks for understanding a client's body image and use. Each can be further refined, such as dividing time into tempo, beat and rhythm.

When we work on people, we act to increase the ease and comfort with which they inhabit their body. Amid the gentle stretching of fascia and facilitation of muscles, we send countless sensory signals throughout their nervous system. We focus intently on them, pacing, nurturing and supporting their emotional needs. In so doing, we provide them with a new sense of themselves as embodied human beings.

Click here for previous articles by Keith Eric Grant, PhD, NCTMB.


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