When You Can Object

Most of us, I reckon, have some opening spiel with our clients about letting us know if they don't like something we're doing. Mine goes like this. It's usually the last thing I say: the client's on the table, all covered up with the sheet & blanket. I've laid hands on their back. I lean down a bit and say, “If anything I do makes you uncomfortable, for any reason, tell me right away.” They make some little sound of acknowledgment, or a little nod. I go on, to drive it home, “Don't lie there thinking, God, I hope he stops doing that pretty soon. Just tell me.”

In other words, the answer to “when can you object?” is clean, simple, and categorical. Any time.

This is important. It's on my mind because I found myself reiterating it recently, with a client I've seen many times. Because it's easy for a sense that one shouldn't object to grow up, maybe even especially inside of an ongoing therapeutic relationship.

It got me thinking about various reasons you might decide you couldn't object. Here's three:

He knows what he's doing, and I'm here to avail myself of his expertise. A client of mine once said, when I was checking whether something was OK, “You're the boss!” and was, maybe, surprised by the forcefulness of my response. I said “No, you are the boss. You're hiring me, and you're the expert on your own sensations. I am not the boss.” I don't want any vagueness about that at all. The client is the boss, by virtue of paying me, and they're the owner of their body, by inalienable right. I refuse to be the boss of anyone else's body.

I haven't objected to this before, so I have no right to now. I don't know how common this is, but I sometimes worry about it. What okay one time might not be another. There are places that are sensitive and vulnerable, by nature, by culture, or by personal history. Every therapist knows this, and approaches them cautiously if at all: the abdomen, the inner thighs, the inside of the upper arms are common ones, but it can be practically anywhere. I've had clients who could not stand to have their feet worked, or to have their ears touched. There are certain positionings that for one individual or another are too much: I know someone for whom, due to old trauma, lying on her side for a massage nearly always brings tears. The first time we work a delicate area or reposition you, we usually check in ahead of time, and are alert for signs of discomfort while we work. But after we've decided it's okay, we may not be watching out, even though we know these things shift. You should always object if you're not liking it. It may take a while for you to figure out you don't like something, after all. And you don't have to object for all time. It is perfectly legitimate to say “Oh, not the calves, not today.” And it's still legitimate, even if you really liked the calves last week. That was then.

I can't object without impugning his motives. You may be thinking: I know he's not trying to grope me, I know this is my own discomfort and comes from my own history, so I shouldn't lay this old baggage on him.” This is nonsense. Saying “I'm not comfortable with this touch” is not an accusation, and no legitimate therapist would ever take it as one. If you do think your therapist is trying to grope you, rather than just objecting, you should end the session and go inform the state massage board. We don't want those people in the business. But if you're unsure, the best way to make sure is to say, clearly, “I'm not comfortable being touched there.” Any legitimate professional will stop at once, and be grateful for the feedback. They may explain why they were doing that particular move in that particular way, and they may ask for clarification about where “there” is, which is fine: but if they try to convince you that you should be comfortable with it, or try to keep doing it, red flags should be sprouting before your eyes like crocuses in Spring. Those are not professional responses.

I'm sure there's lots more reasons why you might think you shouldn't object, but this is one of those few questions that has a simple, clear, straight-edged answer. When can you object? Any time. You don't need a reason, or a precedent, or a principle. You can just say, “I don't want to be touched there,” or “I don't want to be in that position,” or “I don't want to be touched that way.” And if objecting doesn't feel entirely comfortable or natural to you, it may be all the more important to do it. You might even just want to practice – object to something even if you are comfortable with it. You can just cheerfully say, “I don't want my stomach touched.” And – without being offended, or asking for justification, or being perturbed in any way, I will simply not touch your stomach.

Of course, we will (hopefully) have asked you in the intake interview if there's any areas you want us to avoid, or any place you don't like to be touched. When I'm asking I usually add some examples: “Face? Feet? Abdomen? Glutes?” But you don't always know ahead of time, and before the first massage you don't really have any idea what my touch is going to be like. Even if you like heavy work on your feet, you might hate a light touch there. When you realize that I might actually do light tapotement (drumming) on your belly – I've been known to do it, it's a standard in tui na massage – you might decide in a hurry that it's not the touch you want there. You don't sign away your right to control how you're touched by signing the intake form!

Any time. And sooner rather than later, please. The massage doesn't work if you're not comfortable.

Why I Do That Parent Special

Okay, so I'm not a big HuffPo fan in general, but this article by Una LaMarche, How To Be a Perfect Parent in 5 Easy Steps... or Probably Never was so funny and so true. Here's step 5:

5. "If Mama Ain't Happy Ain't Nobody Happy" Sounds Like a Tyler Perry Movie But Is Also Totally True
All of the organic, fair-trade, pasture-raised artisanal Play-Doh and 800-count recycled hemp crib sheets in the world won't matter if you as a parent don't feel at least reasonably happy and cared for. This means taking time -- by force if necessary! -- to eat, sleep, and do things that matter to you, whether that's work or crappy reality TV or a manicure or a spin class. If you find yourself flailing, and contemplating buying Brooke Shields' "Down Came the Rain" for Amazon overnight delivery, as I did, get help. See a therapist, get meds if necessary. Or just schedule a night out with friends when you can bitch about your problems and get tipsy and feel like a free person again. Whatever gets you to a better place. Your happiness matters. It matters just as much as your child's happiness, because your child's happiness depends on you. Everything depends on you. NO PRESSURE OR ANYTHING, JESUS.

Which is why I do that massage for parents of kids under Four special. Those first few years are hell on wheels.

How my Mother Saved my Life

Last year I was riding my bike up a narrow street, with cars parked on either hand. Suddenly a car door popped open, right in my path. Too late to swerve. I clenched the brakes, hit the door, and flew off the bike.

A moment later I was on my feet, fifteen yards down the road, jolted but perfectly fine. According to bystanders, I had flown over the door, gone headfirst toward the pavement, done an elegant shoulder-roll, and come up on my feet, and trotted to a stop. “That was pretty impressive,” said one of them. The onlookers seemed more shaken than I was.

A nice bruise developed on my hip: I think I slammed it against one of my handle-bars on my way off the bike. But no other injuries: not a scratch, not a scrape.

I was absurdly fortunate. People get killed that way. All I remember of my flight is seeing the pavement coming and ducking my head. A “tick” as my helmet tapped the ground, and then being on my feet. But it was familiar. I'd done it before, somewhere, sometime... when?

It was months later that it suddenly came to me: gymnastics. Grade school. I was always terrible at sports, in grade school, with the single odd exception of gymnastics, which I had some talent for. My mother had even taken me to extra gymnastics lessons, somewhere: I had a single vivid memory of mastering forward flips off a springboard, in a place that is otherwise unfamiliar to me: floor mats, sweat, sour dust, the leather handle of the horse, chalk on the uneven bars. Forty some years ago, I had learned what to do when hurtling headfirst at the ground. Duck your head, give way with the foremost shoulder, and let the roll happen. If you're still moving too fast when you come out, let another roll happen.

What strikes me now is that my body remembered what I had learned forty years before, called it up in a flash, and used it, while my conscious mind had so thoroughly lost the memory that it took months to find it again.

Thanks, Mom. I doubt I was properly grateful at the time!

I think there's two obvious lessons here: one is, see to it that your kids do some gymnastics, formally or informally; and the other is, what your body learns in scary circumstances, it doesn't soon forget.

Posture and Deskwork

Clients often tell me they're working on their posture. I'm a massage therapist, right? I'm supposed to approve of people minding their alignment: sitting in perfect, harmonious balance, with their arms in the exact neutral position. So they're surprised, possibly a little hurt, when I say, “There's nothing wrong with your posture. Forget about it.”

I'm rather abrupt because 1) worrying about your posture ups your stress and will tend to make the problem worse, 2) people virtually never change their posture, whether they worry about it or not, and 3) it draws energy and attention away from the real problem. The problem is not how you're sitting, the problem is how much you're sitting. And the answer is to get the hell out of the chair and do something, whenever you can. Really get up, and move around. Go jog around the parking lot a couple times. Lie down on the floor for five minutes, pulling your knees up to your chest a couple times. Waggle and twist.

If your workplace culture frowns on this, then shame on them. But do whatever you have to do. Sneak out to the stairwell. Jog in a bathroom stall. Slip out to your car and lie down in the back seat: if someone sees you, pretend you're looking for your phone. Whatever. No amount of exquisitely balancing your head on your neck, and centering your rib cage above your pelvis, and positioning your arms on or off the arms of the chair, is going to change the fact that sitting for even a few hours doing desk work is damned bad for you, and that sitting for nine or ten hours is even worse. If you're doing that, and then going home and spending five more hours doing the same, as your leisure relaxation, then God help you.

A stand up desk won't help much either. Even one that adjusts so you can either sit or stand probably won't make a lot of difference. Again: it's not how you do it, it's the fact that you are doing it. To work with a screen and keyboard means that you're holding most of your body rigid while you do fine motor work with your eyes and fingers. Doing this for hours at a time makes demands on your body that it's not designed to meet. The problem is not your alignment, or your level of enlightenment, or your emotional maturity: it's that you're stressing your body beyond its design tolerances.

Most corporate ergonomic interventions begin with the assumption that a person should be able to sit doing deskwork for forty or fifty hours per week: companies that employ people to do it are understandably reluctant to question this assumption. But if you want a nice long working life with a happy neck and back, you had better question it. I see people every week whose neck and back pain has rendered them unable to work. Young people, some of them: thirty- and forty-year-olds. Don't join them. Get out of the chair and away from the desk.

Massage is wonderful. I highly recommend it. And it will even help somewhat. But there's no way that even twice-weekly massage – more than most people can afford – will offset what a day spent mostly at deskwork is going to do to you. You need to get serious: realize that you're challenging your body to do something very difficult for it, and bring your ingenuity to bear on mitigating and relieving its hardships.

Further reading:

Feldenkrais-trained Todd Hargrove's wonderful set of posts on posture.

A great essay on sedentary workplace survival: Paul Ingraham's piece on “microbreaking."

Moving Happily

This is an interesting article, about some research into mortality rates and the ability to stand up easily:

http://vitals.nbcnews.com/_news/2012/12/13/15870881-can-you-do-this-simple-sitting-test-predicts-longevity

I haven't had a chance to look at the research itself, but the simplicity of this test appeals to me, as compared to the tests that are more favored by medical people. Controlling your blood lipids or your blood pressure or your heart rate is tricky, a bit difficult for the layman to measure properly, and generally discouraging. But trying to keep, or regain, your ability to get up off the floor without using your hands, elbows, or knees? That's pretty straightforward and cuts a lot of crap.

I don't link to this because I'm perfect myself at it! I'd score eight out ten on their test: I can rise confidently from sitting on the floor without using my hands or elbows, but I can't even imagine doing it without one knee. Not without losing fifty pounds, anyway. I don't know what I weigh (I haven't weighed myself in years), but I imagine it's 220 pounds. or so. I can't figure out how to get my center of gravity up that first foot or so without rocking up onto a knee. But I can do that, fluidly and easily, and from there, it's a piece of cake.

Now it is. In my forties, I couldn't have done it without at least one hand, and probably two knees. I'm much stronger now than I was then, more flexible, and my balance is better. I intend to keep all these capacities as long as I can, and never to relinquish the firm friendship I now have with the floor. I take to the floor almost any time I have a chance, without looking too odd. I really do not want to become one of those people who totters along in perpetual vertical, perching on high chairs, unable to get up and down. I love the ground, to go easily into a deep squat, to roll readily and smoothly onto my stomach or my back. And I don't do weights or training or formal yoga or anything; the closest thing I do to what modern people call “exercise” is ride my bicycle into my breakfast place, or into work, a few times a week.

But I do what kids do: I try stuff. I challenge myself all the time, silly challenges. Can I crawl over the couch without using my arms? Can I hop up the short steps to the basement on one foot? When I'm riding the train, and hanging onto those rails I hang my bike from – and which are so enchantingly like monkey bars – can I haul myself up, surreptitiously, so that my feet are dangling, without anyone noticing? When you weigh as much as I do, this is no mean feat.

The thing about all my silly challenges is, that they actually have to do with moving myself around, in ways that I might actually need to do, sometime. If you like lifting weights and doing stuff with machines, that's great, but the real point of exercise is being able to move yourself, even if you're injured or stuck or thrown into some terribly awkward position. And if you're willing to be silly, your own body has all the weight and resistance you could ever want, even if you're not as hefty as I am.

The other day a client told me, “I'm so grateful for your advice last time.” I couldn't remember what I'd said, so she filled me in: “you said, 'find some way to move during the day that makes you happy.' That's just been so important to me.”

This body. It's such a marvelous thing, and the more battered and time-worn the more wonderful, really. You can always try things. You don't need to be an athlete, or a yogi, or a gym rat. You can just crawl happily around the house, dance on any limbs that still work, see if you can step on every third flower on the carpet. Scuttle like a crab. Roll over in bed without using your arms. Whatever. What I don't like about the American Way of Exercise is its damned grimness, repetitiveness, and solemnity, and its emphasis on trying to make your body and yourself be like some ideal. Forget that. Get on the floor with the kids and just horse around. Put on some music and dance. Move happily. Treat your body like the wonderful, unexpected, and delightful gift that it is.

Earning My Keep

“There's a time during your massages,” said a client with MS, “when I'm completely without pain. It's amazing, because that never happens. Not even on the pain meds. I get to remember what it's like.”

Then she added ruefully, “It ends exactly when you start working on my calf.” A perennial problem area, lots of spasms. Her point, I think, was that this area was so bad that the pain was insuperable there. But I remembered that moment too: it was the moment when I became anxious that I was just giving a fluffy superficial massage, and reckoned I should do some real work and fix something. Earn my keep. I had shifted then from extremely light work – just stroking, really – to work that, though most clients would still find it irritatingly light, was identifiably massage.

A blunder, I think. My guess, in the light of what we're learning these days about persistent pain, is that any minimal improvement I may have induced in the calf will have been trivial compared to the benefit of walking her nervous system through the experience of being without pain. That's the important thing I have to offer. Valuable in itself, in the moment, and probably the most effective intervention I can make in her hyperalgesia. The next time I get anxious about earning my keep, I hope I remember that. I'm not a body repairman: I'm someone who talks to nervous systems. That's my job, and I'd do better to stick to it.

Pause

The backs of my hands in her flanks, rolling over, slowly, until my palms settle on the back of the hips, on the rises of the iliac crest: one of those places that call out for the palms; they fit there, like a sleepy child's head fits between shoulder and breast. I come to a complete stop.

Disengage cleanly, says David Lauterstein, often. Nothing worse than a handshake that just sort of indistinctly peters out. Shake and be done. And usually I agree with him. But sometimes I stop like this, for two or three full breaths. Sometimes the absence is a presence; sometimes the drumstick that doesn't fall is more audible and important than the one that does.