resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Apple Takes a Bite Out of Research
The more than 700 million iPhone users have just been given the opportunity to "do their part to advance medical research."
If Your Pro-Chiropractic Governor Resigned, Would You Be Prepared?
John Kitzhaber, MD, recently re-elected to a historic fourth term as Oregon governor, has resigned among alleged ethics violations by his fiancée' and first lady, Cylvia Hayes. I developed a personal friendship with John and consider him a good friend.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
Make Every Day Mother's Day
May is a special month for many reasons. After a long, harsh winter, spring is at last in full swing. Memorial Day helps us honor those who have fought and fallen in the name of freedom.
News in Brief
Dr. Frank Nicchi Receives Award at ACC-RAC; Sherman College Expands International Influence.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Talking to Patients About Medial Branch Neurotomy (Part 2)
Even when lumbar facet denervation (medial branch neurotomy) is successful, relief is rarely complete or permanent. Smuck, et al., reviewed 16 articles and found the average duration of >50 percent pain relief for an initial procedure was nine months.
Applauding a Legacy of Leadership
Founding Palmer West President, John Miller, DC, HCD (Hon.), FICA (Hon.), a 1954 graduate of Palmer College of Chiropractic, passed away March 8, 2015 at age 83.
Functional Impingement of the Hip (Part 2): Rehab Exercises
I find functionally impinged hips that don't move properly on so many of my patients. (See part 1 of this article for a description of the condition.)
Teach Your Patients About External Healing Applications
Since the skin is the body's largest organ, and is able to respond to both internal and external stimulations, communicate sensations to the brain, protect the body, breathe and even excrete toxins, it can be an excellent source of healing.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Trouble in the Wellness Waters?
Call me old-fashioned, paranoid or just old, but I do remember graduating from chiropractic college in the late '70s in the midst of the Wilk v AMA lawsuit.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Compassion and Compassion Fatigue: Balancing Your Emotions in the Treatment Room
I entered massage therapy to serve others, and oncology massage therapy because of how deeply that service affected me. In general, massage therapists enter the profession because we care: about people as a whole and in particular about their health and well-being.
But, could caring end up hurting or draining us?
Those of us helping professions — nurses, doctors, social workers, chaplains, massage therapists, and more — can be strongly affected by working with clients experiencing trauma in the form of a health crisis. This strain can happen as a result of working with one particular client, or it can be a cumulative pile-on of a number of different emotionally difficult cases.
There is a lot of discussion and not much agreement out there about the exact meaning of the terms "compassion," "empathy," "compassion fatigue," and "burnout." We'll lump them together under "being deeply affected by a client's experience."
Deeply Affected by a Client's Experience
Whatever we call it, it's important to look at any hard-hitting emotional toll on ourselves when we care for people experiencing pain, trauma, mortality, and suffering. Imagine you are seeing a particular client diagnosed with advanced cancer, and she shares with you how hard and emotional her treatment is, how she is too fatigued to play with her children, and how, most of all, she is terrified of dying before she gets to see them grow up.
That's all just from what your conversations. During the hands-on session, you learn about the physical pain in her hands and feet, the restricted movement from past surgery or radiation, and the ongoing wear of chemotherapy on her hair and skin. You know these things intimately as your hands touch her body in a full hour of time. This intimacy can challenge the separation we need — or think we need — between ourselves and our own fears of cancer, mortality, pain, and suffering.
So our knee-jerk reaction to this might be, "How can I protect myself? How can I establish good boundaries like we were taught to do in massage school?" We don't want to feel our clients' emotional pain and distress, so we might rush to put up strong dividers between "us" and "them."
When our clients represent our worst fears, and we spend a huge amount of effort to protect ourselves from those fears, our lives and our work can suffer. Here, the discussion typically turns to the boundaries we must have for this protection. Healthy boundaries can help us manage our own emotional well-being, but it's worth discussing what those boundaries should look like. The boundaries in my own work that have been most important are regarding self-care, rather than separation or protection from clients' experiences.
Taking on My Own Suffering, Not Others
My first lesson in this came from Irene Smith, more than twenty years ago. Irene is a longtime massage therapist, educator, and author. She founded Service Through Touch, serving people with HIV in the San Francisco Bay area in the 1980's. She has gone on to teach us much about massage in illness and at end of life, and maintains her blog and schedule at www.everflowing.org.
Irene said, "I don't believe that we take on another human being's suffering. I believe that what happens is that we find ourselves in an experience that simply opens us up to our suffering."
With her words and instruction, Irene taught me that, while I might think I am absorbing my client's expressed or unexpressed pain, in reality, the situation is provoking my own pain. If I follow her guidance, I can learn much about my old losses, current fears, and the human condition in general. As I've learned about myself, I've become more present with others.
With this lesson, my relationship to compassion began evolving. I have learned important lessons from several teachers about joining with people and separating from people during hard experiences.
Many Teachers on Compassion
Lauren Muser Cates, an oncology massage therapist and educator, has some more passionate wisdom for us in her blog post, "Boundaries, Schmoundaries." She suggests that instead of putting up walls to try to keep ourselves "safe" and "protected," which can leave us feeling empty, we should work with staying open to others' experiences and ourselves. Lauren tells us that boundaries have their place in the practicalities of massage therapy — scope of practice, payment, set hours, and so on — but "When it comes to emotion and our essential humanness, boundaries, as they've been taught to us, are a myth."
Additional teachers came to me a couple of years ago, when I put together a series of webinars on hospital-based massage therapy (HBMT). I sought out several people who had HBMT programs in place for years, looking for their wisdom on program development, longevity, and the practicalities of making massage work in the hospital. In the process, I interviewed and recorded people from five HBMT programs: Paula Gardiner, MD; SatSiri Sumler, LMT; Carolyn Tague, LMT; Briane Pinkson, LMT; and Karen Armstrong, LMT, about their HBMT work.
When participants in the conference asked these people about the emotional impact of their work, a common theme emerged. The panelists spoke to the importance of some sort of contemplative practice — often yoga or meditation — in maintaining balance and resilience. Self-care was mentioned, of course, but with a particular emphasis on reflection and stillness. I heard their message loud and clear.
More recently, I have come to know the work of Joan Halifax, PhD, founder of the Upaya Institute and Zen Center in Santa Fe. She has worked and been present in end of life care for decades. She has shared important wisdom about compassion through her writing, speaking, and teaching.
In particular, I remember her stating once that true compassion can be enlivening, not draining. She, too, underscores the need for a contemplative practice, so that the mind can be resilient when challenged by pain and suffering. For those of us looking for "everyday compassion for everyday use," she has developed the "G.R.A.C.E." method of cultivating compassion.
These are some of the teachers I have encountered along the way of my own calling in oncology massage, but one more is worth mentioning: myself. I am glad to be able to count myself on my list of teachers. From meeting myself and listening closely, I become better able to be with my own feelings and vulnerability. Lived in more presence, my life is teaching me to feel whole in my own pain and suffering, and to be more present with the pain, suffering, and wholeness of others.
It's also teaching me how that wholeness looks in practice. In fact, in this very column, years ago, I shared my own list of self-care measures. Little has changed over the years on that practical little list. If you read that column and substitute "hula-hooping" for "skating" as my preferred physical outlet, plus add "meditation," the column will be entirely up-to-date for 2015.
Test Your Compassion Fatigue
Because wholeness comes with awareness, I am a fan of most anything that helps us ask the right questions. Once can test one's own compassion satisfaction, compassion fatigue, and burnout levels at many different websites, but one of my favorites is the Professional Quality of Life Scale at the Compassion Fatigue Awareness Project.
The inherent emotional aspects of our profession, those same aspects that may have drawn us toward populations such as oncology massage, hospice and palliative work, can make things like boundaries, presence, and compassion a messy affair. There is rich wisdom to be learned in this messiness, if we choose to pay attention.