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Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
March, 2014, Vol. 14, Issue 03
Ending the Energy Debate
By David Lauterstein, RMT
There have been many recent online discussions in our field about "energy" and the role it may or may not play in our work and education. Many people have noted regretfully that some of the discussions have given rise to divisiveness somewhat uncharacteristic in our field.Partly, this may be a function of "social" media. When it comes to sorting out emotions, it is not a very effective medium. This reminds us that, unlike massage and the world of "high touch" in which compassion is the rule, the Internet and the world of "high tech" is not a very effective context for resolving difficult emotions.
What everyone does appear to agree on is enhancing the quality of education and therapists. It may be helpful to look at what role "energy" may or may not play in improving massage education and in therapy. First, we need to know what we are talking about. What does energy mean? Importantly, it is a word for which there is more than one definition. The definitions of "energy" refer to two quite different things – a quality of action and a physical phenomenon.
Here is the definition from the free online dictionary:
The first two definitions are more subjective and refer to the world of experience and a quality of action. The second two definitions are more objective, referring to measurable physical phenomena described by science. As we look at the energetic aspect of massage and bodywork, let's keep these varying definitions in mind.
We can note in the beginning that the energetic aspect of massage refers more to the quality of action and touch, than to the scientific, objective definition. Is massage "energy work?" If we mean by energy work, pure energy work done off-the-body, it is fairly easy to say "no." Massage involves touching the body and often is defined expressly as soft tissue manipulation in textbooks and in many state laws.
Is there an energetic aspect to touch therapy done on-the-body? Using the quality of action definitions above, we can say "yes." The quality of our touch may be considered energetic. Quantifiable aspects such as pressure may be measured, but the energetic aspect is more subjectively experienced.
We need to remember that massage can (and should) be objectively studied, but it is experienced subjectively by the client. Clients are interested in feeling better, in having more pleasure, less pain, more relaxation and more energy. Using the first two definitions we see these are subjective goals, facilitated by both the structural and energetic clarity with which we engage the tissues and the nervous system of the body.
Where both the pro- and anti-energy camps get in trouble is when they leap to the objective definitions of energy. The pro-energy folks wish to see the energy aspect of massage and bodywork as objectively existing, like electricity or magnetism. While these may be intriguing metaphors for the energetic aspect of our work, there is little if any proof that the energy spoken of by some massage therapists and bodyworkers exists objectively. Again and again, we need to return to the fact that the energetic aspect refers most directly to subjective experience. This makes it no less real, our experience is real – but like thought and emotion, like love – you can't find it under a microscope.
Now the elusiveness of how to describe subjective/energetic experience has given rise to various terminologies. Some people are attracted to a particular language describing the energetic aspect because that was what they were taught or they find those concepts and vocabularies illuminating of their own experience as receivers and as givers. Some people find helpful the languages of chi or meridians, prana, kundalini, chakras, bio-energy, élan vital, psychology or phenomenology, etc. Some people prefer language referring primarily to the nervous and endocrine systems, seeing the experience of energy largely as a projection of the brain.
How can and should we reflect these varying views in our education? No one is saying this should a mandatory part of basic curricula, however, there are some ways various educators may choose in a balanced way to cover this topic.
We may cover some of energetic aspects of massage and bodywork in our history classes. Asian concepts linking up energy and anatomy have played a role in the history of massage. The "humours" in medieval medicine; the assumption of links between the spiritual and physical aspects of health; the energetic understandings of psychology and, most recently, psychoneuroimmunology – any or all of these may be helpful in producing students with a fuller picture of our work and its roots in the history of manual and mind-body therapy.
We can note that many modalities explicitly integrate structural and energetic work – zero balancing, deep massage, some forms of myofascial release. And many more assume this is what's happening – shiatsu, Thai massage, rolfing, etc.
We should cover how conscious and unconscious beliefs affect health. Chronic mindsets and chronic emotional conditions can exacerbate or even cause a variety of tension-syndromes. The placebo effect is powerful. Ted Kaptchuk, author and acupuncturist and colleagues mostly from Harvard have created a "Program in Placebo Studies and the Therapeutic Encounter." It is equally important for students to also understand the nocebo effect – the harm that can be caused by uncaring healthcare that may evoke negative feelings in the client. Placebo and nocebo effects of course may be considered as within the realm of the energetics of touch.
In looking at assessment skills and the therapeutic relationship, it is important that we consider posture, movement, and the energetics that may underlie those. We may agree on what we should not do:
We should not talk to clients about their "energy." Diagnosis, whether structural or energetic, is not within our scope of practice. When a massage therapist or bodyworker talks to the client about their energy, they are way beyond the boundaries of massage (and basic etiquette) and quite likely to evoke the nocebo affect by verbally attributing certain energy characteristics to a client.
We should be conscious that when we are touching people, it is a contact which is more than just physical. This means we need to take responsibility for the energetic as well physical effects of our interaction and touch. We need to recognize that we are touching both structure and energy.
Massage is an art and a science. We depend on research and scientific knowledge to enable us to work effectively with our clients. At the same time, every session is a person-to-person, moment-to-moment improvisation that calls for a subtle sensitivity to the medium we are working with. In the case of massage/bodywork, our medium is the most complex and sensitive life form known to exist. Of course, we need art and science. Of course, we need to know this person is a profound integration of structure and energy, tissue and issues, and to be sensitive to what is both objectively true and subjectively experienced.
To argue for or against either the structural or energetic perspective is like arguing which of your two eyes you ought to see out of. By honoring both what research and what subjective experiences teach us, we arrive at the highest quality of touch, education and therapeutic benefit. Without science, without a respect for knowledge and structure, we lose our commitment to truth; without art, without a respect for subjective, energetic experience, we lose our commitment to the soul and beauty of our work. We see better and more truly with both eyes.
David Lauterstein is Co-Director of Lauterstein-Conway Massage School in Austin, Texas. He is author of "The Deep Massage Book" and "Putting the Soul Back in the Body." David has been inducted into the Massage Therapy Hall of Fame, received AMTA's Jerome Perlinski Teacher of the Year Award, and in 2013, was recognized as "Educator of the Year" by the Alliance for Massage Therapy Education. For more info, visit www.TLCschool.com.
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