resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
July, 2011, Vol. 11, Issue 07
The Inside-Out Paradigm: The Intake Interview
By Dale G. Alexander, LMT, MA, PhD
"The appointment begins when the client makes the call."1 This phrase, spoken by Dr. Richard MacDonald, DO, 25 years ago, was a turning point in my comprehension of just how important the initial interview with a client is both over the phone and in the office.It is the beginning of a healing contract that might last for a few appointments or for many years. This article will detail the basics of what has served me to assist my clients.
Over the 31 years of my clinical massage therapy practice specializing in chronic ailments, the problems that clients present are increasingly complex, layered and continue to inspire me to explore the "many dimensions of healing." To date, I still do all of my telephone interviews with prospective clients.
Initially, I seek to gather information about how committed they are to their healing, whether we are beginning with a third person trust based on a personal or professional referral or not. In addition, whether they have ever felt injured or misunderstood by other health related practitioners.
The emotionality conveyed by the tone of their voice generally is my best guide. When their voice tone is loud, demanding or commanding, I often ask whether they are scared, hearing impaired, or have been mistreated by other health related practitioners. I give them a chance to start over. I endeavor to keep this initial call to 10 -20 minutes. I give myself permission to encourage that they see a physician before seeing me, if they haven't already. I often refer prospective clients to other alternative health practitioners.
People committed to their healing consistently inquire first about your confidence to assist them and will add additional special circumstances and needs second, once they have established whether or not they sense you have the competence and experience to help them.
When prospective clients place their initial emphasis on money or time convenience for them, this is a flag to me that they are wanting professional care, but only if it meets their conditions. When someone calls to make an appointment for someone else, another flag goes up. Yes, there truly are people that busy, including me at times, but it stills says something about how they run their life including how they drive themselves. I typically book the appointment with the caveat that the named client will call me before the appointment so I may personally interview them.
When a client is looking for a named style of massage or bodywork, I ask them to describe their ongoing difficulties. The nature of what I do along the continuum of bodywork skills has become rather broad such that it no longer fits a specific label. When they ask me whether I have ever worked with their polysyllabic medical difficulty, I am specifically honest as to whether I have or not. And, if not, I request that they educate me. This might seem paradoxical yet it demonstrates from the beginning that I am willing to learn from them. I want to create healing partnerships where they are the star character of their own movie. I'm the hired help.
The Key To The Interview
The key intention of the initial "office interview" is for me to engage the person fully as a human being as well as a practitioner. I endeavor to gather a gestalt of how they see their problem and to assist their perception to include the internal functioning of their bodies and the potential influence of their mental habits and emotional fluctuations. This means I rarely listen to long stories anymore and correspondingly infer that I do not endeavor to convince them of anything. They have the choice to move forward, as do I.
When presented with a vague description of what is bothering them such as, "I have so little energy" or a more psychological inference such as anxiety or depression, I ask them an existential question, "what do you sense is your life purpose?" The turbulence related to identity consolidation in the midst of exquisite life transitions has an enormous influence on our human physiology. Examples of such transitions include the death of a loved one, a job loss, a relational break-up or a financial crisis, among many others.
When presented with a series of physical complaints, I often ask a layered question first. What have you been told about your problems, what do you believe is the root cause, and do you feel as though your mortality is threatened by it? This latter phrase is crucial to include because it flushes out people who really are scared that something has been missed in their medical care and that they might indeed be in serious trouble.
I ask questions to fit the person as I experience them. That is why I don't use standard written questionnaires. However, there is a philosophy and a method to how I ask questions. At the physical level, I seek to discover the earliest sign or symptom that has the longest history as this has assisted me most often to unravel what is happening within their physiology, accreted trauma or might be an indicator of a genetic link or deficit/defect. At the cognitive level, my job is to assist them to connect the dots between the events of their lives and to unhook from the ones that are acting as a drag on their healing. Assisting clients to find their way toward acceptance and/or forgiveness is still a higher octave of our work. We are all challenged to reconcile the difficult transitions of our lives. And, by assisting clients to connect the dots within their lives empowers their capacity to prevent future difficulties.
The following 10 questions and their time line will often trigger a light bulb for them, as well as myself:
Just yesterday, a prospective client with an identified aortic valve regurgitation responded to the flu question by saying that when he does have the flu it was most often of a respiratory variety and that it would last a week to ten days. He had not made the connection between his valvular regurgitation and how this might have extended his illnesses in the past. Such subtle yet revealing information allowed me to orient my skills to relieve the pressure within his chest to allow his heart more ease to do its crucial job.
Interspersed with, or following these questions, I go through the history of their organ systems quickly to ascertain any dysfunction or repetition of illnesses in their lives. I also will ask the same question in a different way if I instinctively am drawn to it. With a recent client who came to me with a rare form of cancer, we had identified that notwithstanding the official diagnosis, she had the beginnings of diabetes that once confirmed by her internist, has begun to radically change her life for the better. Improving a client's quality of life is perhaps our profession's highest service.
Another key to an effective interview is to personalize it. Be more vulnerable than your client.3 Invite a healing contract and define what this means to you while altering your language to include their sense of such a contract. Accept that they will not be able to give you a complete physical history because much of it has been compartmentalized or repressed. During your first appointment, the real opportunity is for both you and your client to decide whether you wish to move forward working together.
People have a tendency to get sick or to injure themselves as a way for their physiology to discharge its excess tension and thereby to rebalance itself. When a client reports a pristine medical history without either, I become quite curious. Typically, there is something they have forgotten or repressed which eventually comes to light over a series of sessions. And occasionally, what emerges is that they have had severe allergic reactions to one thing or another. Again, this is when I refer clients back to their physicians.
Part of our role as massage therapists is to be part of our clients' early detection team. The mathematical normal curve does allow for exceptional individuals to experience amazing health yet, as we age, the probabilities increasingly point to cardiopulmonary, cancer or orthopedic difficulties. In having followed my local newspaper for 15 years, the age of death so often occurs between 50 and 65, which is within the 40 - 70 demographic of those people who most often seek our care. We have a responsibility to assist them to discern those personal events which often signal something is amiss from the "inside-out."
Chronic ailments often have an accreted history involving multiple minor and major traumas underlying a recent physical event or might be the "canary in the coal mine" of the organ systems endeavoring to signal that something deep inside is in need of attention and care. Those chronic problems that seem to have no related physical event associated to their onset are the ones we need to be especially encouraging to our clients to seek consultation with their physicians.
The purpose of this column currently continues to be oriented toward assisting you to understand the "Waves of Aging," their most common origins, and their progressions that fly under the radar of typical medical detection, especially when clients present with chronic somatic ailments.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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