By Bruce A. Hopkins
Originally published in Massage Bodywork magazine, February/March 2007. Copyright 2007. Associated Bodywork and Massage Professionals. All rights reserved.
My massage story begins in 1918. A three-year-old girl resented her new baby brother and wished he were dead. A few days later the baby was dead. The girl didn't know about the 1918 flu--she thought she had killed her brother. Fast-forward twenty-four years to 1942: this very same girl--now a woman--had her first child, a boy, and her long repressed guilt came flooding back. As she struggled with her feelings, her child was fed and clothed, but was touch deprived. Jump another fifty-four years to 1996. The boy, now a man, spiraled into depression as his business approached bankruptcy and his marriage came unglued. His recovery began with a polarity therapist who gently coaxed his disassociated body and mind back together. The therapist then passed him on to a massage practitioner.
I am the man in this story. At my first massage therapy appointment I found myself on a different planet. I reacted to massage the way I imagine people do to their first hit of crack cocaine. I was no sooner off the table than I was counting the hours to the next session. I craved the touch--it was truly an addiction. I went every week for more than two years. There was no such thing as enough.
Finally, the developmental synapses I had not closed as a child snapped shut. The addiction was gone. Massage was now a wonderful way to spend an hour and a half. Amazingly enough, I drifted away from massage as I pulled my business back together and my wife and I began to rebuild our marriage.
Shortly thereafter, in 1998, I was diagnosed with chronic lymphocytic leukemia, a slow-moving, incurable, and inexorable decline in the immune system. In shock, I turned to our cancer community center for support. I found a few others there who had similar indolent diseases and many who were fighting aggressive and dangerous cancers. A Calling
Not knowing what was next, I decided to sell my then-thriving business. I learned of a program at our church for people contemplating retirement. The program began with grief work, accepting that some dreams are never to be accomplished. We internalized that retirement means loss of a social group and, for some, loss of power, perks, and even of identity. We moved on to looking back over our lives, sorting out our deepest values, the ones instilled in us over the years by our parents, teachers, and mentors. Then we spent time looking at the world around us to find our greatest needs. Finally, the minister defined a calling as the place where your deepest values meet your world's greatest needs. My calling came into laser sharp focus--to bring the healing power of massage to others struggling with cancer.
When I asked others at the cancer community center, "How are you?" the answer often was, "I can't relax/sleep/eat. I'm stressed/bone weary/constipated/fuzzy-headed/nauseous/anxious/scared/ worried/numb. I hurt/ache/burn/tingle/itch/
prickle. I'm sad/depressed/obsessed with cancer. I feel helpless. My body betrayed me. I feel estranged from others/disconnected/isolated. After surgery I'm disfigured/pulled/twisted/scarred. I can't leave the couch/don't look forward to anything/have no control over my life. I feel like a piece of meat caught in the medical machine."
I thought to myself that someone needs to focus on the patient, to help him reconnect with himself, to retrieve and reunite his scattered body, mind, and soul. Then many of these other issues would improve, and some would go away entirely.
I knew what I was to do. I went looking for a massage program with no-nonsense requirements and warm heart. When I arrived at Maine's Downeast School of Massage, a cosmic door opened. I knew I was home. It was a year of sheer joy. I hadn't cracked a textbook in more than thirty years. Anatomy was a real challenge. At age sixty, I was older than my three youngest classmates together. They became my honorary granddaughters. I knew why I wanted to know what I was being taught. I discovered that my sixty-year-old fingers and thumbs were already shot. I had to figure out how to work without them. My classmates dubbed me the man with the golden elbow.
Before graduation I learned about Gayle MacDonald, a woman who taught about massage and cancer at Oregon Health Science University in Portland. When I called her, she told me about an in-hospital program for seven students in Mesa, Arizona. I told her my story and she accepted me on the spot. In Arizona, we studied and worked in the hospital. I massaged patients after surgery, during chemotherapy, after radiation therapy, and in the bone marrow transplant unit. The Slow Lane
Now I have a private practice and I am as busy as I want to be. My practice differs from the usual in several ways. I am retired and only work part time, but I try to give my clients the gift of time. I block two hours for each appointment with seventy-five minutes on the table. I have new clients mail the paperwork in advance so there is time to listen to their cancer stories. Every client reminds me of the adage "Healing does not take place in the fast lane."
A sign on my desk says, "The healing power of massage should be available to everyone dealing with cancer. I ask only that you pay in proportion to your resources and in proportion to the benefits you receive. Suggested fees are 'so-and-so.' Please pay less if this is beyond your means. Thank you for paying more if you are moved to support this work." Some do pay much less; some pay considerably more. It works, but I have to remember to trust the universe.
I only seek cancer patients and their families as clients: however, I take others who seek me out. If I have a cancellation, I donate the session to an organization that can send someone who would otherwise never discover massage. If the client offers to pay me, I suggest they make a donation to the organization instead.
I can't do deep work because of my hands, but it doesn't matter. Deep work stimulates the sympathetic nervous system. People with cancer have enough fight or flight going on without my adding to it. They need the relaxation response to heal. A lomi-lomi technique that utilizes very slow moving and very heavy forearm pressure over a large area is the perfect complement to light work. Namaste
In my experience, most massage sessions end with "Thank you" and "Take your time," all of which is code for "The session is over. Ready or not, you now need to take responsibility for not falling asleep and for getting off the table." That would create a serious disconnect after the client and I have spent seventy-five minutes seeking a state of profound relaxation.
So I've chosen to close my sessions differently. Namaste is the Hindu salutation meaning, "The part of God that lives in me acknowledges and honors the part of God that lives in you." At the end of the massage, I step back, pause, say, "Namaste" softly and sit down where the client can see my feet under the face cradle. I sit and hold the sacred space the client and I have created until the client is ready to return. If she drifts off, I gently 'rattle the dishes.' When she rouses we may exchange a few words, sometimes more than a few, and when the client dismisses me, I leave. My clients agree that this is a holistic and satisfying end to the massage experience.Meaning of Massage
Ihave asked clients to verbalize what massage means to them. Here's what they said:
- "All through my diagnosis and treatment, the only time someone touched me and it didn't hurt was on the massage table. It was like an oasis in the desert."
- "I scheduled massage a day or two before each chemo. That way my mind and body were looking forward to the massage, not focused on the chemo."
- "I was so sick from concurrent chemo and radiation, massage was the only place where I felt in control and could help myself."
- "I not only felt relief from the taxing effects of chemo and the debilitating muscle/bone ache, I ended up feeling an overwhelming sense of peace."
- And best of all, from the table, a few minutes after my "Namaste"--"Does anyone have a right to feel this good?" Fight the Good Fight
Most people with cancer are so busy with the physical demands of surgery, chemo, and radiation they do their emotional and spiritual work in bits and pieces, if at all. I have been fortunate to have had several years to do that work. When my dragon finally comes out of the cave, I hope to fight the good fight and to finally yield with grace. As my midterm exam was making peace with the dragon, I became a hospice volunteer. Another massage therapist volunteer and I developed a program to teach hospice volunteers how to safely massage their clients, with hopes of expanding the program to other hospice organizations. (We are quite a team, a recovering Type-A executive and a burned-out homicide detective.) I visualize the touch of my mentors' hands, passing through my hands and passing through the hands of the hospice volunteers to communicate and commune with people for whom touch is the only language left.
A difficult part of working with cancer patients is, quite simply, that some of them may die. Alicia was a long-term client. I worked with her all through her chemo and radiation for breast cancer. Some months after treatment, she was back in the hospital with metastases to the brain. After several tries at curative therapies she decided to go home. Her husband called and asked if I would give her a massage every day until she died. Over the next three days she became less and less responsive, while periodically becoming very agitated. Each day massage brought her peaceful sleep. On the fourth day she was unresponsive and her breathing was a death rattle. As I worked, I was sure that a deep and distant part of her knew I was there. She died peacefully a short time later. It was a transcendent experience to stand at the gateway between life and death.The Power of Touch
While in Arizona, I was assigned to massage a woman who was to receive packed platelets. Her platelet count was so low she was forbidden to brush her teeth because she might bleed out. The only safe massage was to gently move the hair on her skin with a little oil. I found her in a hospital bed in a corner of the infusion room. I could see the anxiety on her face and on her heart rate and blood pressure monitors. After the nurses started the infusion, I pulled the curtain and started to massage her face and scalp, arms and hands, lower legs and feet, and finally, her back. I could feel her become progressively more relaxed and I could see the change in both monitors. By the time I reached the middle of her back, she was sound asleep. What a demonstration of the power of touch and what a demonstration that often less is truly more.
A year later, I was speaking to a leukemia/lymphoma support group. The facilitator was a hospital oncology social worker. Talking with her I remembered Arizona. Perhaps we could replicate the concept, have volunteer therapists massage cancer patients during their chemo. Long story short, we now have fifteen volunteer massage therapists with cancer training who staff the infusion room daily on a rotating basis. Every patient can choose to have massage. The response from patients and medical staff has been overwhelming. The department head reported in wonderment that one patient now says she looks forward to coming to the hospital on chemo day.
Originally I conceived of this as a personal project, but soon realized it made sense to start a program that would continue after my immune system had declined to the point that it was no longer safe for me to be in the hospital. I visualize the massage camel's nose under the hospital tent. First the infusion room and patients and caregivers waiting for oncologist appointments. Then chair massage breaks, instead of coffee breaks for nursing staff. A hospital-provided space for half-price regular massage for staff. Massage of oncology inpatients. Ultimately, hospital-wide fee for service massage of patients and their families. We have made a small beginning with the potential to improve the journey for thousands of patients and their family members. Applications
If I could have chosen not to have chronic lymphocytic leukemia, I certainly would have. But I didn't get the choice. And I am profoundly grateful for the many blessings that diagnosis brought me--including massage.
I used to live in my head. Now when I am working, I am caught up in sensory experience--the soft light, the music, the waterfall. My movements are tai chi, originating from my center. Sensations come through my fingers and palms, thenar eminences, power pads, and the outsides of my elbows. I am immersed in the feel of cream, fabric, hair, cool skin, warm skin, and the anatomy wonderland under skin. For me, massage is meditation. In seventy-five minutes I may spend seventy totally focused on the experience. Time stands still on both sides of the table. When I'm finished, I sit still and I'm completely at peace. I am often overwhelmed with gratitude for the moment, for the oneness of life, for the work I am privileged to do. I feel truly blessed.
I have never been able to draw, sing, or play an instrument. Poetry and dancing come only with great effort. But I have found a powerful creative impulse deep inside. I have touch equivalents for color and texture, harmony and discord, silence and thunder, overture, melody, and reprise. I have a powerful need to express myself, to communicate through touch. For me, doing massage is like composing a symphony to be heard only one time, by just one person, and then lost forever.
Between the dark ages and the Renaissance, the alchemists were the philosophers and physical scientists of the age. They spent a great deal of energy in search of the philosopher's stone, the touch of which could reputedly change lead to gold. Massage is truly my philosopher's stone. Massage changes our own fears, worries, pain, and losses into the desire and the energy to serve others similarly burdened--lead to gold. Massage changes our clients' anxiety to peace, pain to pleasure, estrangement to connection, helplessness to control, lead to gold. Massage extends the touch of one hand to the touch of hundreds of hearts. The effects ripple out, on and on. We'll never know of all the people we touch in remarkable ways. Bruce A. Hopkins, LMT, lives and practices in Portland, Maine. For more information, visit www.mettamassagetherapy.com.