Issue link: https://www.massageandbodyworkdigital.com/i/1464088
science. This way you are making it clear you are in the same boat as your clients—a neophyte eager to understand—which will make your client feel less judged or ignorant. Balachandran is blunt about acknowledging the shortcomings of manual therapy with our clients: "Pain education should make them understand that 'pain does not mean harm.' Most of our current treatments based on the structural-pathology model may provide temporary pain relief, but pain explained based on our current model only helps to heighten fear of pain and anxiety in the patient." 19 You can introduce the enormous influence of the brain and nervous system, taking care to avoid any hint of that dangerous "it's all in your head" notion by continuing to acknowledge their own experience. As we try to talk with our clients about this more complex understanding of pain, we must also seek to learn from them at the same time. We must never be dismissive of their pain. (Especially because there is a good chance they have already been dismissed by their doctor, or multiple doctors, in their attempt to find help.) We must ask questions and listen with grace, and in so doing we empower them as we educate them. Along the way, it is crucial to admit you don't know everything. Resist the temptation to be the expert, to tell your client what is wrong with them—that is what gets us into trouble in the first place. I find that once a client sees me as an ally, the therapeutic possibilities expand. Either during the session or between our sessions, I can offer simple suggestions for them to experiment with in their daily life: anything from ways to be more cognizant of their breathing, to shifting positions periodically at their desk, to a simple stretch before bed. The goal here is not to find the answer—to not prescribe the magic bullet that will make them feel better. Instead, my goal is to encourage an attitude of exploration. The brutality of pain is that it instills a sense of fixity. What begins as a warning signal, a protective mechanism, can grow rigid. We see this physically, as people limit their movements to avoid the possibility of pain. We also see this emotionally, in the narratives people tell about their bodies: "My neck is always a mess." "I am a terrible sleeper." "I never ." (Sound familiar?) Barry Boyce, the founding editor of Mindful, writes, "So often we have a single solid label for our pain and we interpret what it means. We can begin to construct storylines of worst-case scenarios or self- loathing." 20 In the face of this rigidity, we want to offer the possibility of pliability, both physically and emotionally. So while we must always acknowledge, and never minimize, the client's experience, we also don't need to catastrophize along with our clients. We can make our treatment room a space where clients can explore their pain rather than simply reject it. We can listen without judgment and suggest simple ways to shift. Encouraging mindful awareness— simply noticing, without judgment, exactly what you are thinking and feeling with each breath—can help our clients unlock from their rigid narratives: "Many people are surprised by what happens when they bring attention to physical discomforts in this way. Often they notice that pain sensations are not solid, but pulse and change from moment to moment, and sometimes pass without any special action on our part." 21 52 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 2 The possibilities are so numerous that you can experiment with making small shifts in all aspects of your practice, from the lights and sounds in your treatment room to the way you ask intake questions to the particular strokes you do and how you do them. As we cultivate an awareness of the present moment, there is no need to be relentlessly optimistic or upbeat. (That chronic pain client of yours will not appreciate you blithely insisting that the world is beautiful and everything is going to be fine.) Instead, be yourself. Know that pain is always present, but believe that change is always possible, that we can continue to grow, and that we can continue to expand our narratives. THE NEXT STEPS T he author Sebene Selassie, a four- time cancer survivor, describes a day in which her postsurgical pain forced her to, as she puts it, "slow down, rest, recuperate." The result was revelatory: "I began to appreciate the opportunity bestowed by discomfort. It was precisely the aches upon waking that drew me into this attentiveness, into a somatic practice I don't often prioritize, into movements I rarely explore, into the joy of sensation. The pain itself was an opening to well-being. I was filled with wonder at the possible intimacy between pain and gratitude." 22 We have no choice but to experience pain. So let's reframe our relationship with it. Let's seek instead some version of Selassie's "possible intimacy." What if, instead of aspiring to a life that is free of pain, we aspired to a life that is full of pliability. In the brief time we get to inhabit these marvelous bodies of ours, let's not aim toward perfection, an aspiration that will always leave us and our clients disappointed. Instead, let's acknowledge that pain, tension, and stress are inevitable—and necessary—