4.) KP: Are there certain types of conditions or injuries that myofascial therapy would not be appropriate for?
Beth: Yes, if someone has a really recent injury, I probably would encourage them to rest a bit before coming in. But, in general, it’s pretty rare for me to have to screen someone out, because there’s usually something I can do that will be safe and helpful. It’s more common for me to get a sense from someone’s interview that I can help them with the soft tissue injury they are bringing, but I can’t tell how much will be a soft tissue component only, versus something else, that needs a different kind of practitioner. Or, it there may be something systemic going on, where they will have to get their hormone levels balanced in order to fully heal. Quite often what will happen is that I’ll invite a client for a session or two, and I’ll get them on the table and be able to tell if they’re responding or not responding. That will give me more information about what else may be going on in their bodies.
Also, there are certain basic contraindications to massage. For example, if somebody has phlebitis, you want to be careful with that. If someone has heart issues, there are certain trigger points that you want to avoid.
KP: So, you are assessing all of those components when you meet with them initially, from both the interview, along with the feedback you’re getting directly from the bodywork, and according to this, if you feel a supplemental or alternative intervention is needed, you might provide that recommendation to the client?
Beth: Yes, for some people, I’m kind of the primary person they come to, but for a lot of people, I’m just part of a team.
KP: That’s great and something that does seem different from your average massage service. I think that for a lot of people, the idea of bodywork is getting a massage while you are on vacation, but it sounds like your work is more complex and that you have a lot of good resources to draw on which can be helpful to people.
Beth: Yes, and I feel pretty lucky, my practice is more made up of people who don’t see it as a luxury. It’s unfortunate that costs can be prohibitive to people receiving the bodywork they need. I do what I can with a sliding scale, or sometimes barter, but I wish that I could be more accessible because I’m limited to people that can afford my rates.
KP: I hear what you’re saying, that people are coming to you, for this kind of service out of necessity. It’s not recreational, it’s therapeutic.
The other piece that I want to learn more about is attachment. I have a lot of people who come on a regular basis and clearly the relationship itself is a big part of what’s helpful to them. My work is in some ways most suited to working with attachment trauma because touch and even rhythm and a certain kind of sensitivity or attunement can access directly some very tender systems.
Understanding all of this better is new territory for me.I’m very careful with scope of practice, but I’m also coming from a place where I’m recognizing that I already have been working with this.
KP: Right, so the reality is that you’ve already been working with this material connected to trauma, but through the Somatic Experiencing training, you’re now getting that deeper understanding of what’s going on and how best to work with it.
Beth: Having the nomenclature, having the understanding of the biological and psychological systems, so that if I see something in an interaction or in someone’s body, I can recognize it and have a context for it; that’s really helpful.
KP: I’m glad you’re bringing up this piece related to trauma and exploring it more as a bodyworker…clearly it’s an integral component to healing. As a psychotherapist, I certainly have quite bit of awareness of trauma, and unfortunately, it seems that the majority of people have experienced some kind of trauma, whether it’s more subtle or more dramatic. And, awareness of the attachment issue, that is so important…I have yet to meet a client or person who has had the perfect attachment experience. (laughter)
Beth: Yeah, I know, there are all of those attachment studies that say something like 85% of people are securely attached and everyone I talk to says that is just not true.
KP: Yeah, I think that perhaps that’s putting the bar too low. So, as you talk about this, I just think it’s great that all of this is on the forefront of your mind.
Beth: Well, not with everybody, but with enough people that it feels important. I’ve had a lot of people who come for one thing and then something happens and I refer them to psychotherapy. And, then it’s becomes a team effort. I always really love working with people who are already in counseling because they are more open to the deeper layers of what can happen on the table and then what happens on the table they can bring into their psychotherapy. That often works really well.
And, there’s a lot of flexibility to shift gears as needed, sometimes just working on a soothing massage, sometimes focusing on structural changes, and sometimes, it’s the emotional pieces. We’re working with how to deal with and understand all of it.
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