Issue link: https://www.massageandbodyworkdigital.com/i/885423
therapeutic presence, as it helps us hone in on the most helpful engagement. Let's explore how to expand your palpatory sense, learning what information the client is showing us when we touch with the least amount of disturbance or invasiveness, keeping our hands relaxed and alert to receive the most input possible. This noninvasive approach will make any bodywork modality more effective. TRADITIONAL PALPATION AND THE "FIX-IT" MENTALITY We are trained to palpate within a medical model. We are taught how to feel for certain qualities such as a tense, tight area that could mean scar tissue, a soft boggy feel representing swelling, heat for inflammation, or the hard end- feel of a braced joint. All these ways of palpating provide useful information. Note that all are in search of discovering specific pieces of information. We go in, literally, with a plan and an idea of what we will find. This is a model of being the expert in the room, looking for what's wrong and devising a plan to remedy it. We carry that mentality into the session. As bodyworkers, many of us are trained with the following way of approaching our business: greet the client, listen to their concerns, settle them on the table, do an assessment in a way that's comfortable and familiar to the therapist, and then set about remediating the stuck places, or what's been deemed wrong. Hopefully there is a check- in along the way: gauging comfort for the client, and how well their body is accepting the changes the therapist is trying to bring about by measuring against the initial assessment. This approach can create good change for our clients; however, we only get what we're looking for, and that means we can only find what we already know. We also limit avenues for change to those that address the problem we've identified. Whether "light touch" or "deep tissue," the focus is on seeking out and doing. The major downside of looking for problems is that it is easy to override the client's system because we have an agenda. The opposite of that would be to touch with the intention of finding out what information can come into our hands, instead of what our hands can go in and find. What we find may be surprising, like noticing a sore knee is actually helped most by releasing the opposite shoulder rather than working on a tight set of quads. We may also find what's going right in the body and learn that bolstering what's going right rather than trying to find and fix what's going wrong may be just what's needed. As much as we focus on pain and dysfunction in bodywork, we know that if our client can come to us, and even most of the time when the client is unable to come to us and we go to them, there's more going right in the body than going wrong. This is true even for clients who are ill, but a simple example of this would be a client complaining of neck pain. Perhaps we find that their neck and torso are stiff and resistant to touch, but their feet are very open to being worked, and that the client begins to relax and enjoy touch at their feet. This client may be best served by working the feet thoroughly, and then expanding work into other areas of the body that can also experience these calming, pleasurable sensations. You may be surprised that their neck releases without any work there at all. It's good to remind ourselves that when we focus on what's wrong, we are aligned with the part of the client that wants to change (see "Cultivating Neutrality: Grow Your Therapeutic Presence," Massage & Bodywork, November/December 2014). We have no room to see how the pattern is serving the client and whether it is in their best interest to go in with the intention of correcting back to "normal" or "proper" alignment. In sessions like these, often clients' bodies either resist or give in. There is greater likelihood of missing the source of the issue, and only changing the compensations. When we take away compensations that are working for the client, we've done them a disservice. And as we are sure you've seen, often those compensations come right back, and we're left with a client who says, "It felt better for a bit, and then started hurting again." When you can keep your hands curious and open to new information, outcomes improve. This openness can be especially useful with clients who don't improve despite all your orthopedic tests or amazing protocols of wonderful techniques. If outcomes are baffling or less than ideal, consider taking in more information and following what you find, rather than coming up with a plan and attempting to fix what's wrong. A PALPATION MODEL Craniosacral therapy (CST) is based in noninvasive touch, so it provides an effective model for this session approach. In the CST paradigm, we become a mirror for our clients, so clients can feel themselves more than our intervention. This can be especially important for folks who are already in sensory overload. And since many people in acute and chronic pain are in sensory overload, this can be a large percentage of the clients you see. As in other forms of bodywork, trust is vital for the CST practitioner: first we must trust that the client's body is smart and communicating with us. Then, we must trust the communication our hands 54 m a s s a g e & b o d y w o r k n o v e m b e r / d e c e m b e r 2 0 1 7