Practicality - Practical Bodywork

Touchy Topic Tuesday: How To Solve A Problem

“No problem can be solved at the same level of consciousness which created it.”–Albert Einstein

Last week we discussed the effects of scarcity on the brain’s ability to think. The more pressing and immediate our problems, the less bandwidth we have available for coping with them. This holds true for money problems, relationship problems, time problems and health problems. We get so wrapped up in a negative feedback loop that we enter a ‘stress tunnel,’ where we can only see the terror before us, and lose our capacity for long-range planning.

So, with thanks to Jeanna Gabellini, my lovely business coach, I present an all-purpose strategy for solving problems.

1. Notice that you have a problem.

The reason denial is such a common coping strategy is that it keeps things comfortably familiar. If you have no problems, there’s nothing you have to change. Moreover, if you ‘admit’ you have a problem, that’s tantamount to placing blame, which as we know is of the devil.

So if you can go so far as to say to yourself, “hmmm, there seems to be a problem here,” without attaching a value judgement to it, you have already taken a major step toward solving it.

2. Study the parameters of the problem.

If you have financial problems, sit down and look at your accounts. If you are ill and/or in pain, contemplate your own mortality. If you’re on the verge of divorce, look over the brink. If you’re operating on a permanent time deficit, borrow an hour from all your pressing commitments and do nothing.

This will be scary. It will induce panic, despair, and the desire to consume copious amounts of alcohol. Stick with those feelings. Have a good long talk with them and hear what they have to say. Let them scream and cry and rage until they’re done.

Why this works: Your negative emotions are only parasitic entities when you try to sweep them under the rug. When you stop trying to evade them, they burn themselves out, reveal themselves to be illusory, or just start boring you to tears.

3. Notice what beliefs you have around this problem.

If you are anything like me, you could write a book-length essay entitled “Why I Am So Screwed.” Boil it down to the essence. Describe, to your intellectual and emotional satisfaction, why it is impossible to solve this problem.

Why this works: Our beliefs determine our actions. Most of the time, our minds are operating under a set of assumptions which were formulated before we were seven years old. Trying to solve a problem by handing it over to a seven-year-old’s id pretty much guarantees sub-optimal results.

4. Quiet your mind.

For some people, this involves visualizations about stuffing your problems into a bloated weather balloon and watching it float away. For others, rigorous Zen meditation is the only way to go.

You might get some respite from mental chatter by going for a five-mile run, or watching George Carlin clips, or putting on the Bee Gees and imitating John Travolta until you spot the neighbors gawping and laughing their a***s off.

Do whatever works for you. It doesn’t have to be perfect. You merely aim to create a perceptible gap in your mental landscape.

Why this works: Your brain has access to amazing resources, once you clear some bandwidth.

5. Open up to a shift in perspective.

For those of you who are very smart, this will not be easy. You must consider the possibility that you–or your seven-year-old id–might be wrong. For many of us, this is scarier than Step 2.

On the other hand, there COULD be a solution to this impossible, miserable, soul-scorching problem. That would be really nice.

So just entertain the possibility.

Why this works: See the quote from Albert Einstein, above.

6. Ask your newly quiet, open mind some specific questions.

Tailor your questions in a way which allows for fabulous things to happen. For example, instead of asking “Why am I always broke?” try asking “How can we easily double our household income this year?” Or, “How can I best experience passion and romance in my life this week?”

Why this works: That clear bandwidth in your brain needs to focus itself on coming up with the most efficient solution to your problem. It can’t do this if it is grinding away upon irrelevant concerns. Therefore, ask questions that you really want to know the answers to.

7. Listen for the answer.

Your mind may present you with an image, a single sentence, or a detailed set of instructions. Write down whatever comes, without editing and without judging. If nothing comes, go about your day and check in later.

Effective solutions will not be emotionally charged. If your mind presents you with an answer that feels angry, judgmental, anxious, fearful, contemptuous, or cruel, this is your seven-year-old id talking. Pat your seven-year-old self on the head and go for another walk.

8. Act upon information received.

Lots of people skip this part, and then wonder why nothing ever changes. It’s the reason why people get addicted to psychics and Tarot cards. They’re looking for an answer that doesn’t require action on their part.

A good answer to a problem may not look like anything you recognize. It may not seem to be addressing the problem at all. It will, however, be sensible (or at least innocuous), and feel like a nice thing to do at the moment.

Why this works: Taking small, sensible actions that feel nice are the ONLY way to implement sustained changes. If a proposed action makes you feel bad, you won’t take it, at least not consistently. Thus it is not a solution to your problem, no matter how rational it appears.

9. Rinse and repeat.

If you get in the habit of using this process, you will not only get better at clearing your bandwidth, you’ll be able to continually tweak your actions according to your situation. You’ll discover new opportunities because your mind will be clear enough to notice and act upon them.

What kinds of mind-clearing and problem-solving techniques work for you? Please leave your insights in the comments!

Big Healthcare and Cheesecake

I always get a little giddy when a new article by Atul Gawande appears. The latest, in which he compares the quality control and cost efficiency at the Cheesecake Factory with that of Big Healthcare, does not disappoint:

The neurologist, after giving her a two-minute exam, suggested tests that had already been done and wrote a prescription that he admitted was of doubtful benefit. Luz’s family seemed to encounter this kind of disorganization, imprecision, and waste wherever his mother went for help.

“It is unbelievable to me that they would not manage this better,” Luz said. I asked him what he would do if he were the manager of a neurology unit or a cardiology clinic. “I don’t know anything about medicine,” he said. But when I pressed he thought for a moment, and said, “This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.”

This is not at all the normal way of doing things in medicine.

I’d strongly recommend that you go read the whole thing. There are so many things to discuss that it’s hard for me to pick one. But in answer to the biggest and most obvious question–why aren’t best practices standardized in modern healthcare?–I offer this theory: Because doctors, by and large, are smart and ambitious people. And smart, ambitious people vigorously resist rule by committee.

That is not at all what Gawande or the Cheesecake Factory are suggesting. But in order for best practices to be evaluated and implemented within a large, complex system, communication has to be far more nuanced and, ironically, less hierarchical than has ever been the case in human history. One of the more fascinating parts of the article is his description of a successful interaction between a remote monitoring facility and a suspicious doctor:

Half an hour later, Hayes called Mr. Karlage’s nurse again. She hadn’t received the orders. For all the millions of dollars of technology spent on the I.C.U. command center, this is where the plug meets the socket. The fundamental question in medicine is: Who is in charge? With the opening of the command center, Steward was trying to change the answer—it gave the remote doctors the authority to issue orders as well. The idea was that they could help when a unit doctor got too busy and fell behind, and that’s what Hayes chose to believe had happened. He entered the orders into the computer. In a conflict, however, the on-site physician has the final say. So Hayes texted the St. Anne’s doctor, informing him of the changes and asking if he’d let him know if he disagreed.

Hayes received no reply. No “thanks” or “got it” or “O.K.” After midnight, though, the unit doctor pressed the video call button and his face flashed onto Hayes’s screen. Hayes braced for a confrontation. Instead, the doctor said, “So I’ve got this other patient and I wanted to get your opinion.”

Hayes suppressed a smile. “Sure,” he said.

When he signed off, he seemed ready to high-five someone. “He called us,” he marvelled. The command center was gaining credibility.

Notice: this is not an authoritarian system. This is negotiation by persuasion, using facts, mutual respect, and good manners.

Woo hoo.

What to Do When You Can’t DO Anything

As many of you know, my brother-in-law, Leif, is currently battling a rare form of cancer called mantle cell lymphoma. He’s young, formidably strong and has one of the healthiest lifestyles of anyone I know. We went up to Maine to visit him last week.

It’s impossible to describe what it’s like to watch someone you love go through a terrible experience. As far too many of us already know, cancer treatment is not only brutal, but chronic; it just goes on and on. Coping with chronic is qualitatively different from coping with a crisis, like getting hit by a bus; getting hit by a bus has a narrative arc that you can move through. Getting cancer is like setting up house in the middle of a freeway.

Most of us, of course, want to be able to walk into a crisis and fix it. Feeling helpless in the face of suffering is thus one of the most difficult states of mind we endure. So what can we do about that? Here are a few suggestions.

• Never underestimate the healing value of mundane service. Wash dishes, clean floors, do laundry, run errands, cook a healthy meal. These tasks are particularly helpful by virtue of the fact that they are infinitely renewable, and can be done without thinking too hard.

• Just be around. Send notes, send gifts, make phone calls. They’re appreciated.

• Don’t say, “If there’s anything I can do, give me a call!” Instead say, “Would it be helpful if I brought a meal, did laundry?” People under stress are often too overwhelmed to be proactive in asking for help. Use your common sense, double-check, and listen to the answers.

• Meditate. Here is Ken Wilber:

…Foremost among these practices is the one known as tonglen, which means “taking and sending.” The practice is as follows:

In meditation, picture or visualize someone you know and love who is going through much suffering–an illness, a loss, depression, pain, anxiety, fear. As you breathe in, imagine all of that person’s suffering–in the form of dark, black, smokelike, tarlike, thick, and heavy clouds–entering your nostrils and traveling down into your heart. Hold that suffering in your heart. Then, on the outbreath, take all of your peace, freedom, health, goodness, and virtue, and send it out to the person in the form of healing, liberating light. Imagine that they take it all in, and feel completely free, released, and happy. Do that for several breaths. Then imagine the town that person is in, and, on the inbreath, take in all of the suffering of that town, and send back all of your health and happiness to everyone in it. Then do that for the entire, state, then the entire country, the entire planet, the universe. You are taking in all the suffering of beings everywhere and sending them back health and happiness and virtue.

When people are first introduced to this practice, their reactions are usually strong, visceral, and negative. Mine were. Take that black tar into me? Are you kidding? What if I actually get sick? This is insane, dangerous! When Kalu first gave us these tonglen instructions, a woman stood up in the audience of about one hundred people and said what virtually everybody there was thinking:

“But what if I am doing this with someone who is really sick, and I start to get that sickness myself?”

Without hesitating Kalu said, “You should think, Oh good! It’s working!”

…

A strange thing begins to happen when one practices tonglen for any length of time. First of all, nobody actually gets sick. Rather, you find that you stop recoiling in the face of suffering, both yours and others’. You stop running from pain, and instead find that you can begin to transform it by simply being willing to take it into yourself and then release it. The real changes start to happen in you, by the simple willingness to get your ego-protecting tendencies out of the way.

–Ken Wilber, ‘Grace and Grit,’ 247-49

This doesn’t have to be a big dogmatic deal. You don’t have to let anyone know you’re doing it. It’s a practice that may help you to be more present, less anxious, and less visibly freaked out. Lots of us want to ‘be strong’ for our loved ones, but what does that mean? Stoicism? False cheer? Pretending nothing’s wrong?

Tonglen meditation can help you stop ‘doing’ and move into ‘being,’ which is where authentic connection lives.

The You-ness of Rolfing

Theresa Zordan is an expert Rolfer and visionary blogger from Denver, CO who graciously offered to swap guest posts with Practical Bodywork. We are pleased as punch to have her.

It may be hard to believe, but sometimes I forget about Rolfing and how helpful it can be. It’s especially hard to believe considering I am a Rolfer. This is what I do all day, every day. But you see, I have this weird thing in my brain about Rolfing: I think it can help just about everything, for just about everyone. Except me.

Someone tells me how their knee’s been bothering them; I think to myself, “I can help with that.” Someone tells me how they feel out of whack and off kilter; I think to myself, “I can help with that.” Someone tells me how they get headaches a few times a week; I think to myself, “I can help with that.” Someone’s freaking out about work and their house and their boyfriend; I think to myself, “I can help with that.” Then, I break my toe, sprain my shoulder, get emotionally wrapped up into a giant-multi-colored-extra-knotted ball of string and I think to myself, “Whatever am I going to do?!? Who could possibly help me with this!?!”

And so, last week, I found myself with said broken toe (my first broken bone!), and sprained shoulder (thanks for nothing, yoga), and emotional ball of knots and I finally (finally!!!) remembered that Rolfing might be able to help me. So, I called up my bud, Dave Sheldon, a Rolfer in Boulder, and asked if he could fit me in. He said yes and I walked into his office with a laundry list of complaints. It was one of those sessions (do you do this?) where you go in, planning to mention just those two or three things that are really bothering you, and by the time you’re five minutes into the session you’ve listed 23 things instead. “AND my roommate’s dog is driving me crazy! AND my sister’s coming to visit next week and it’s stressing me out! AND my sacrum feels all wonky! AND I’ve been wearing flip-flops for two weeks now and I’m sick of it, but I can’t wear any other shoes without my toe hurting and I can’t exactly walk into the bank barefoot, can I?” And so on, and so forth.

Then, the funniest (and at the same time the most natural) thing happened. I got on the table and closed my eyes, and Dave started working. All of a sudden, it felt like all these layers were falling away from me. Like I’d been wearing a suit made out of 23 layers of tissue paper. So light that I hadn’t thought to take it off, but enough that it was affecting the way I looked and that rustling noise was really getting to me. And one by one, Dave gently cut each layer away, and let it fall to the ground. Some layers were wrapped tightly around my foot, keeping it stable, but I didn’t need those anymore. Some of them were wrapped all around my shoulder, all the way down to my wrist and around my ribs and spine. I didn’t need those anymore either. Most of them were wrapped around my heart, or my solar plexus, or my throat, or my head, getting me caught up in unnecessary worry and fear and distress. I didn’t need a single one of those tissue paper layers.

And I realized there, on the table, why it was that I fell in love with Rolfing in the first place. Dave wasn’t taking away anything that I needed, or anything that was inherently me. And he wasn’t adding anything to me, either. He was simply uncovering the real me, and giving me permission for that to be enough. I didn’t need any of this tissue paper to make me stable or pretty or to cover anything up. I was perfectly me, without all that other stuff. He was reminding my shoulder and my toe that they already knew how to recover from an injury quickly and with ease. He was reminding me that worry and fear were good intuitive signals to listen to, but there was no reason to walk around spinning in them all day. And the greatest part was that he did all that without saying a word. He worked with the physical tissues and the energetic patterns and gently unwound them until there I was, just the way I should be. And when I came from that centered, more-me sort of place, I realized, my sister and I had shared a house (and usually a bedroom) for 16 1/2 years. We could probably figure out 3 days just fine. Oh, and my sacrum felt better, too.

It was funny. When I walked into his office, I didn’t feel like someone other than myself. But when I walked out…the change was drastic and clear. I’d walked in like a papier-mâché doll of myself and walked out as me. And that right there is some good shit, yo.

–Theresa Zordan, Rolfer extraordinaire

So How The Hell Do We Do That???

As some of my wise friends point out, changing the face of healthcare is a quixotic proposition. It’s all very well to saythat your doctor should be prescribing more massage than painkillers, that insurance should cover it, and that everyone should be insured.

But as we all know, our broken healthcare system makes far more money by selling drugs and high-intervention treatments to sick people than by investing in low-intervention therapies that keep them well. Too many people have their livelihoods bound up in the status quo. It’s not just difficult to get a man to understand something, when his salary depends upon his not understanding it; it may well be impossible. Upton Sinclair was an optimist.

So where do we start?

This is funny. Ha. Ha.First of all, like the global economy, our healthcare system is grossly overbalanced. Premiums are rising faster than our ability to pay for insurance, high rates of unemployment mean that more and more people are getting pushed out of employer-funded healthcare, and an aging population is using up more and more healthcare resources. Those who still have jobs and insurance are able to remain in denial, but the system as it stands is unsustainable.

Second, our society is changing in some fundamental ways. Communication is infinitely easier, faster and more varied than at any time in history. There are a lot of smart, underemployed people with time on their hands, and highly sophisticated communications devices in those hands.

As the healthcare system slowly collapses under its own weight, there’s a lot more motive and opportunity for alternative practitioners to set up shop, and for desperate and disillusioned clients to try them. Due to the lack of a cohesive, non-exploitive alternative system (Massage Envy: even the name is bad karma), alternative healthcare practitioners have to be entrepreneurs, if they want to earn a decent living. And good entrepreneurs know that you live or die by the number and quality of your relationships.

Because of these factors, there’s a lot more scope for new healthcare paradigms gaining influence and visibility through lateral connections, like network marketing, rather than the top-down corporate capitalism model, which requires huge investments up front.

Therefore, Bucky Fuller’s ‘better model’ is building itself as we speak. As people lose their insurance, or see their premiums rise, they’re forced to take responsibility for their own health. As network marketing reaches more and more people, they will be savvier about how they choose a practitioner, and what healing modalities work for them.

At the same time, Big Healthcare is trying to save costs by cutting payments to practitioners. Mainstream healthcare practitioners will have less and less incentive to hitch their wagons to a system which is giving them less and less, and more incentive to look around for another model.

And there it will be. People like Atul Gawande are out there backing up their common sense advice with research and documentation. Practitioners who collaborate, develop skills and market effectively will have a wider range of influence over cultural thinking about healthcare. And people getting screwed by an insane system will have both the motive and means (through relentless communcation) for demanding change.

Any questions?

Vision for the Future of Healthcare

‘Winter and Spring,’ stained glass by Judith Schaecter, 30″ x 38″, judithschaecter.com

Wouldn’t it be amazing if:

• You could go to your doctor with severe pain, and she would write you a prescription for a course of massage therapy and other bodywork, which not only blissed you out, but solved your problem without the nasty side effects of drugs?

• Your massage therapist could refer you to the top specialist in the area for whatever issue you had, from varicose veins to systemic nerve pain?

• Hospitals felt like wellness centers, complete with fountains, lovely smells, spa-like decor, fresh organic meals, your favorite media on tap, natural light, and a virtual dearth of harsh fluorescent lighting, scary sounds, sinister smells, andsimilarities to an Argentinian torture chamber?

• Wellness centers were jam-packed with practitioners who not only knew how to work miracles, but knew when to send you to someone else for the best possible treatment?

• You’d be hard put to tell the difference between a doctor’s office waiting room and the atrium of a high-level resort spa?

• Insurance covered all of this, and everybody?

Impossible, you say? Crazy? Hubristic to the max?

Yes, possibly.

But this is the vision for Practical Bodywork that gets me out of bed every day. In my mind, I see that atrium, with the fountain, and stained glass by Judith Schaecter set into the walls. I see my favorite clients pouring in and receiving all the love and joy they’ve come to expect. I see practitioners who like and respect one another, working together to create the best health outcomes for every client. I see everybody earning a living wage with health insurance.

During the last year I’ve been taking a crash course in business development–marketing, networking, accounting, and management–a DIY MBA, if you will. I’m surprised to note that I’m loving it. The business world has, seemingly, greater scope for idealism than the art world ever did–more leverage, more autonomy, more community engagement, and more practical influence. Also more money.

Practical Bodywork is still at the very beginning of this journey. We’re moving along at a pace that may not set the world on fire, but won’t kill us, either. We’re beginning the search for office space, which will one day hold that fountain and fabulous art, as well as many other amazing health care practitioners. We’ve got a bookkeeper and an editor, a project development advisor and a business coach, and may qualify for a loan sooner than we thought we could.

We have also, on a joyful, visionary whim, applied for a small business grant. You can help us qualify. Just go here, search for Practical Bodywork in Philadelphia, and vote. No donations required. Love!

After the Fall

Recently a new client, Susie M., booked a four-session package sight unseen. “When I read about your ankle, I knew you were the one for me,” she said.

Susie sprained, and possibly broke, her right ankle four years ago. There was some confusion as to whether there was a bone chip floating around in there or not; what was certain was that she hadn’t been able to work out since. The ankle was chronically swollen and painful even after four years of treatment, including physical therapy and six months of myofascial release. Doctors had given her steroid injections to ease the swelling, but these did nothing but cause burn marks at the injection site.

As soon as I started work, I noticed that the anatomy train leading from her swollen ankle, up the right peroneal compartment, threading through her hip, and crossing the body to her left shoulder was bunched, knotted and compressed. There were so many adhesions in her right peroneals that I suspected the swelling was almost entirely a result of impaired circulation. Muscles and fascia don’t operate independently of the circulatory system; if they are compressed, they’re compressing everything around them.

After her first session, Susie declared, “I think you released more in one session than happened in six months of myofascial release.” She reported sharp pains in her left leg, hip and groin during the next few days, but on her next visit the swelling in the right ankle was 80% gone. She kept coming regularly as things unwound, and every week there was a different issue to confront, but ankle pain was not one of them. After four years, she was able to go back to the gym.

This re-confirms a long-held observation – that if one part of your body is injured, the trauma doesn’t just stay in one place. The body quickly redistributes strain to deal with it, but once the original injury heals, your body is still out of balance. This imbalance can then create a whole host of other problems unless it is addressed.

(“Confusion,” oil on linen, 36″x 48″, 2008 by Stephanie Lee Jackson, www.stephart.com

Physician Heal Thyself

Piriformis_muscle

Image via Wikipedia

–guest post by Sujatha Ramakrishna, M.D.

Having a family full of doctors can be such a mixed blessing. Most physicians are aware of the pitfalls of being related to someone who knows way too much about every little ache or cough.

When I was a fourth-year medical student interviewing for residency positions in psychiatry, I met up with the department chair at UT Southwestern in Dallas, whose wife was also a physician. I guess he must have gotten bored with the usual interview questions, or perhaps he took one look at my transcript and decided there was no way was he accepting me into his program, because the discussion took a personal turn.

He asked me what it was like having two physicians for parents, and hinted that certain issues had arisen over the years with his own children. My response was simply, “Well, when I was a kid, and I got sick, they either didn’t care at all … or they totally freaked out.” He just about died laughing at that one. It must have sounded incredibly familiar to him. Perhaps that answer meant that I would have gotten accepted into his program after all.

Now I am a grown-up shrink, and I still have a family full of doctors who provide ample advice, both solicited and unsolicited, for every ailment imaginable.

A few months ago, I got up quickly after sitting in an awkward position on the edge of my couch, and I thought that my right leg was asleep. Well, walking it off, of course, was the solution. Only … whoops! I had foot drop. For those of you who don’t know, this means that when you try to walk your toes drag the ground. Flashback to those med school classes, trying to remember what that meant. Was I having a stroke? A compressed nerve? Hysterical paralysis?

Med school was 20 years ago, as was my last neurology rotation, so of course I had no idea. But I knew that Google would save me … hmm … “damage to the peroneal nerve.” Ok, that sounded reasonable.

But wait, it wasn’t so simple. I also started having twinges under my right seat bone, with radiating pain down the back of my thigh and around to the front of my lower leg. Not good. I had to cancel a trip to Texas, because I had been planning to drive but couldn’t sit for that long.

That’s when all hell broke loose.

My mom the family practitioner called me up, and suggested all sorts of narcotics and muscle relaxants that I could take. She said that if I came down to Texas my sister the radiologist would get me a free MRI. My cousin the orthopedic surgeon asked me if I had back pain, and wanted to know the positional nature of the symptoms.

My aunt the pathologist told me that the real problem was that I needed to acquire more padding on my ass, and suggested having a mojito to get that process started ASAP. As a side note here, one of the really wonderful things about belonging to an Indian family is that you get updates on how much weight you have gained or lost every time you see them, even if the scale says that you haven’t gone up or down 2-3 pounds in the last five years.

My uncle the vascular surgeon, after having a few scotches at that same gathering, started off with a recommendation for a nerve removal, assuring me that yes he had done neurosurgery rotations back in the 1970s (!) and finished with the brilliant idea that a total leg amputation would be a more permanent solution and also earn him more money.

My father the emergency room physician had the most practical advice of all, which was simply, “Don’t drive to Texas.” Words to live by.

Fortunately, another cousin of mine and her husband are physical therapists. I showed them where it hurt, and they immediately said, “Aha! Piriformis!” I said, “What???” We either hadn’t learned about that one in anatomy class, or I had forgotten. More likely than not the latter.

Basically, the problem was a tight muscle which was compressing the nerve. They showed me a stretch that would relieve the tightness — sitting on the floor with my knees bent, crossing the right leg over the left, and using my left hand to pull my right knee towards my left shoulder.

Soon the party at my cousin’s house turned into a mini-yoga class for everyone, which was hilarious but also more therapeutic than any advice that I had received from any of the physicians. I did the stretches that they showed me every morning, and I haven’t had a problem with that nerve since then.

Obviously I am lucky to have such a caring family, and their intentions were nothing but the best. But this story is a great example of how maybe we doctors are too quick to turn to pills, diagnostic equipment, and the knife in every situation. When those things are not indicated, we have few other resources to fall back on.

Back in the old days, doctors didn’t have all the fancy tests that we have now, so they had to spend a lot more time listening to and observing the patient in order to make their diagnosis. You might even say that the close personal relationships which they had with their patients were their best diagnostic and therapeutic tools. We could all use a lot more of that these days.

When Stress Is The Problem

How many holistic healing practitioners have you encountered who piously urge you to ‘eliminate stress’? You’re not ‘living the life’ unless you’re ‘free from stress’!

Just makes you want to smack ‘em.

Because stress happens. If your life is entirely free from stress, you’re either a sociopath or you’re dead. You can eat healthy, exercise, meditate, get counseling, get a better job, live a ‘soul-centered life,’ and you are still no more immune to death, disease, anxiety, uncertainty, and sudden traumatic upheavals than anyone else. A huge problem with New Age evangelists is that they try to use their beliefs, habits and mantras as talismans against evil–if I just chant ‘Love is Everywhere’ often enough, everyone will love me and nobody will ever die!

Recently, dear friends, I left my day job to run my business full-time. In the space of two and a half months I came down with two colds, an ear infection, and lower back spasms that lasted two weeks. Luckily, I do not believe that ‘psychosomatic’ means ‘it’s all in your head, so just Think Good Thoughts!’ I have a realistic understanding of the mind-body connection, which dictates that emotional stress can lead to a less-effective immune system and a hyperactive nervous system, and there’s not always an easy way around it. So I followed my own advice, put my daughter in the stroller and walked for miles and miles. In a little while, the colds, ear infection and spasms cleared up, and I continued evangelizing. ;-)

So I prefer to talk about ‘stress management techniques’ rather than ‘living a stress-free life.’ That way, when you smash into one of life’s brick walls, you say to yourself, “Ah! A brick wall! Let me mix myself an iced tea while consulting a map,” instead of, “OMG! This wasn’t supposed to happen! I must be a Bad Person! Commence self-flagellation, or flagellation of others!”

I could go off on many Prescriptions for Life, since I’ve been signing up for a whole lot of holistic mailing lists lately, but in order to restrict myself to my purported area of expertise, I will confine myself to a few Tips for Stress-Induced Lower Back Pain.

When it’s in the acute stages, try to sleep on your back with a bolster under your knees, and a rolled-up towel behind your neck. This keeps your spine in a neutral position, and allows the spasming muscles to get over their freakout with a minimum of interference.
Hydrate. Drink a ton of ice water, lemon water, iced tea and diluted fruit juice. You can intersperse this with strong liquor (great muscle relaxant!) as long as you adhere to the ‘rinse cycle’ principle; one virgin cranberry seltzer for every alcoholic drink you consume.
Take it one day at a time. Walk as much as you can. Sit on a yoga ball and bounce; this loosens your hip flexors, which are key in stabilizing your lower back.
Get a massage! It won’t fix the pain right away, but it will address the spasming muscles, and send your brain into a theta-wave state which will reduce your stress reactions in the longer term.
Go to a yoga class, once the pain is less acute. Yoga will balance your body all over, releasing restrictions far from the area of pain which may be contributing to it.
Tylenol won’t kill you if you take a couple. Just don’t make a long-term habit of it.

When to See a Doctor

Know your anatomy!You wouldn’t think people would ever get their massage therapist confused with their M.D., would you? You’d be surprised.It’s touching and flattering, how often I am asked for my input on potentially serious medical conditions. Possibly this is due to the fact that 1) I see a lot of people in varying degrees of pain, uncertainty and confusion, 2) I ask probing questions, 3) listen to the answers, and 4) read continually. Finding news of effective treatments for the conditions that plague my clients is one of my joys. I learn as much from them as they learn from me.

However, it ought to be staggeringly obvious that I am not a doctor. Massage and bodywork can be excellentsupplemental treatments for all manner of ills, but they should never be a substitute for comprehensive medical attention. When you have a diagnosis, I’m happy to tailor your session to support your treatment plan, but I know my limits. Here are some of the symptoms that will cause me to refer you for a check-up before I’ll see you again.

You have areas of unexplained hypersensitivity, or severe numbness. Since I work on a lot of people, I’m familiar with the range of pain sensitivities in healthy people. If you’re flinching when I touch you lightly in a place that shouldn’t hurt, if you have no feeling in a major limb, or if you insist that I ‘go harder’ when I’m working deeply in an area which should be sensitive, I want you thoroughly checked by a neurologist.
You have severe constipation over a long period of time. I once had a client who wanted two-and-a-half hour sessions to address her chronic constipation, but who categorically refused to see a doctor about it. “What could a doctor do?” she asked me, seemingly rhetorically. “Check you for diverticular disease and colorectal cancer,” was my response. It would be irresponsible of me to continue treatment until these possibilities have been ruled out.
You have unexplained swelling or bloating in your extremities. “It will go away on its own,” is often what my clients report hearing from their doctors. But if the swelling has no obvious cause, I think you should be tested forheart, liver or kidney problems.
You have a suspicious-looking mole on your back. One minor service I provide for my clients is keeping an eye on areas of the body that they don’t normally see. Most people know to visit a dermatologist if they have anirregular mole that changes appearance; if you’ve got one on your back, I always ask if you’ve had it looked at.
You suddenly start having migraines. Many of my clients have suffered from migraines for years; they find that regular massage can reduce the frequency and severity of their episodes. But if you’ve never had a migraine before, you should see a doctor before getting a massage.

A doctor’s job is often to do triage in an emergency; my job, as I see it, is not to ‘fix’ a problem, but to facilitate healing over the long term. Massage is less like a drug and more like a tonic–it stimulates the immune system, the parasympathetic nervous system, the endocrine system and the musculoskeletal system to balance and repair themselves. The subtle connections among seemingly disparate systems and processes fascinate me. My clients never have to worry that they’ll bore me, telling me their aches, pains, worries, triumphs, or last night’s bizarre dream. But they also know that they can count on me for the occasional blast of common sense.