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Dimensions of Holistic Massage
Beyond the Nuts and Bolts of Swedish

By Linda G. Means

Originally published in Massage Bodywork magazine, November/December 2009. Copyright 2009. Associated Bodywork and Massage Professionals. All rights reserved.

For modern-day massage therapists, the concept of holistic massage may seem very 21st century. Yet, for millennia, healing bodywork was intended to balance the physical, emotional, mental, energetic, and spiritual bodies. Just as ancient medical bodies of knowledge incorporated a multi-dimensional model, ancient massage practices also addressed the holistic organism.

When Swedish massage was developed in 19th-century Europe, the Swedish focus on soft tissue manipulation of the physical body probably helped massage therapists gain acceptance in the physically oriented allopathic medical community.

In the late 20th century, as American massage schools began to include a variety of energetic healing modalities in the curriculum, the massage community began a return to its holistic roots. Swedish massage is still often regarded primarily as a physical practice. Let's take a look at a 21st-century model of Swedish massage that provides for a holistic approach.

A holistic massage session employs a variety of strategies to work specifically with the client's physical, emotional, mental, energetic, and spiritual needs. Deep relaxation and effective therapeutic results occur most readily when the client's and therapist's mental activity is quieted, when clear energy flow is facilitated, and when the client feels 100 percent safe, comfortable, and nurtured.


The Mental Body
Herbert Benson, MD, began to study the phenomenon he calls the "relaxation response" in the 1970s. Benson found that in addition to the "fight-or-flight" response--the physiological manifestation of stress--there is a diametrically opposite physiological response that relieves the effects of stress. Benson describes the relaxation response as "a natural and innate protective mechanism against 'overstress,' which allows us to turn off harmful bodily effects [and which] brings on bodily changes that decrease heart rate, lower metabolism, decrease the rate of breathing, and bring the body back into what is probably a healthier balance."1 These effects may account for many of the diverse medical benefits that have been measured in clinical studies of massage therapy for various medical conditions. However, this result is not achieved solely by physical manipulation of soft tissue. If we can help to induce the relaxation response during massage treatments, every massage can be deeply relaxing and deeply therapeutic because of the therapeutic benefits of the relaxation response.

The relaxation response occurs when mental activity is slowed to a quiet, relaxed state. This is the state generally associated with the practices of meditation and yoga. In this state, the electromagnetic waves of the brain slow to a frequency of 8-12 hertz (Hz), which is called an alpha wave state. The alpha wave frequency is also associated with parasympathetic nervous system dominance and hypnotic trance states. Hypnotic trance is a state in which the organism is receptive to suggestions for positive change, so the client's healing intention may be fulfilled more readily in this state.

As part of a massage session, we can use specific strategies to subdue various types of mental busyness that prevent the slow brain wave frequencies associated with relaxation.

"Monkey mind" is the Buddhist term for the usual walking-around kind of mental activity that occurs during most of our waking hours. Monkey mind is characterized as an endless stream of thoughts about anything and everything. Monkey mind produces a beta brain wave state (greater than 12 Hz) that prevents the relaxation response. We can help the client reduce monkey-mind thought streams by providing relaxing input for them to focus on, especially at the start of the session:

- Consider using music as foreground sound instead of background sound. Enchanting melodies with gorgeous instrumentation and lots of movement and suspense can captivate the client mentally, drawing her attention away from whatever was on her mind before she got on the table. Some music is specially formulated to induce alpha waves.
- A stroke or movement that is highly soothing and unexpected may attract the client's attention and help her focus on the pleasurable feelings in her body. Gentle rocking is very nurturing, and according to shiatsu teacher Carl Dubitsky, extended rhythmic oscillation slows brain waves.2 Whole-body rocking under the sheet can provide a compelling and comforting start to a massage. Slow, hypnotic rhythms drummed into the body may also capture the attention, as well as slow down brain waves.

"Worry mind" refers to thought patterns that carry concerns about the bodywork session itself. If your client has had painful massage experiences in the past, you can relieve worry mind with reassurances that you do not want to cause pain, and by checking in occasionally to be sure the client is comfortable. This lets the client feel safe, allowing them to let go of this fear mentally. If your client mentions a specific body area that needs attention during the intake, he may continue to worry about that area until he feels your attention there. If a client tells his therapist that his lower back is killing him and the therapist doesn't even touch that area for the first 40 minutes of the session, he may lie on the table wondering if he was heard, or whether he should say something again, and his attention may stay focused on that discomfort until it is attended to. As a therapist, you can relieve this worry thought pattern by beginning the session on that part of the body. Similarly, if a therapist has the habit of only visiting each body part once during a massage session, the client may feel disappointed after the therapist covers up the worrisome area. By returning frequently during the session to the area of concern, you can help the client feel that the attention there is never-ending.

"Tracking mind" is the phenomenon of noticing where the therapist is working and anticipating what she will do next. This mental activity is especially likely if you do the same massage routine during every session, or do the same massage sequence on the right and left sides of the body during one session: "OK, now she's going to flex the ankle, then she rotates and tractions each toe ... yep, there's the first toe...second toe...next toe...next one..." You can defeat tracking mind by working in a way that is unpredictable. If the work cannot be tracked, tracking mind gives up thinking about it. You can also deter tracking mind by continuing one lovely, soothing stroke or movement for a ridiculously long time: "That feels great but I know she's almost done, she only does that four times ... wow, she's still doing it ... wow, that feels so good, and it just goes on and on ..." Eventually the mind surrenders the expectation that the good feeling should stop soon, and relaxes into pure pleasure.

"Social mind" comes into play when the client feels an obligation to be engaged conversationally with the therapist, which is not relaxing neurologically. The brain activity involved in chatting generates beta brain waves, which then prevents slower frequencies. You can encourage clients to enjoy therapeutic silence by addressing this in your literature or intake process, and by not allowing yourself to be drawn into chatting during a session. I sometimes respond to a client's chatty questions by saying, very softly, "I'd love to talk to you about that later. Let's take a couple of deep breaths right now." Conversation about what is happening during the session is sometimes necessary, of course, and keeps the attention focused on the bodywork happening in the present.

Recent scientific discoveries in neuroplasticity have demonstrated that the human brain has tremendous capacity to change its patterns, even in adulthood. Brain reorganization occurs in response to repeated new patterns. According to Sharon Begley, author of Train Your Mind, Change Your Brain, "The actions we take can literally expand or contract different regions of the brain, pour more juice into quiet circuits, and damp down activity in buzzing ones."3 In this regard, if our clients experience slow brain wave states for extended periods of time during massage sessions, this may also stimulate their brains to adopt new, healthier patterns. We can help our clients begin to develop the brain patterns and health benefits of trained meditators.


The Emotional Body
By providing an emotional sanctuary during the massage session, we can help the client relax deeply and let go of emotional armoring which may be associated with health issues. Emotional openness comes from a feeling of being nurtured, accepted, listened to, and appreciated. We can gain the client's emotional confidence in many ways--before, during, and after the treatment session.

Before The Massage
Remember that the session really begins at the moment the client walks through the door, at the first contact with you and your environment. Do you welcome the client warmly? Do you call him by name as he enters your space? Are you glad to see him? Does the client experience your full attention from the time you greet him? Try to get your treatment room set up completely before greeting the client so that after you turn your attention to him, you have no need to take it away to light candles or close the window blinds.

A thorough intake discussion assures the client you are taking all of her concerns into account. Even a regular weekly client needs to know you are basing today's session on what her needs are today, and that you are listening attentively to fully understand those needs. Asking clarification questions about the client's issues or repeating what the client has told you indicates that you are truly engaged with the client's concerns.

The intake discussion also provides an opportunity to reassure the client that the treatment will be a safe experience. In order to surrender fully to a state of deep relaxation, the client needs to believe that the therapist will not hurt her during the massage session. We can frame the client's expectations for the session by saying up front that we do not intend to cause pain or discomfort, because the body tenses up in response to pain. You can ask your client to let you know if anything feels uncomfortable in any way so that you can adjust the work to suit her. This indicates that you welcome feedback during a session, without regarding it as criticism or complaint, helping the client to release any fear of the therapist. When we clearly convey the intention of providing client-centered massage instead of therapist-centered work, the client feels secure in knowing her needs will be met fully. When a client says, "Do whatever you like," I respond with, "I'd like to do whatever you would like!" My friend Annette Sand tells her clients, "It's all about you!"

During The Massage
Imagine the feeling of sore muscles that have been aching for touch. Then imagine that exquisite feeling of relief when a caring therapist makes the first soothing contact with those needy muscles. Activate your own emotional body, fill your hands with the feeling of "help is here," and pour that feeling into your client's body. This engages the client's emotional body, as well as the physical body, creating strong emotional harmony between therapist and client. Peggy Horan, massage teacher at the Esalen Institute, describes the experience of emotional harmony in this way: "I loved that the work was received on deep levels, way beneath the skin, closer to the soul, where clients experience their sense of real self, their feelings, and their emotional home inside their body."4

As you work, the quality of your touch informs the client as to how carefully you are listening to the body to detect the perfect level of work. The emotional body does not feel safe with touch that feels aggressive, reckless, or inattentive; we recoil from people who scare us or cause us pain. When deep-tissue work is done slowly and attentively, the client's body intelligence detects your sensitivity to what is happening beneath your hands. Deep compression done too quickly or automatically can blow past the point of resistance and cause pain, which may also blow the client's feeling of emotional security and increase her fear and resistance toward your work.
Checking in with the client about the comfort level of pressure, temperature, how far to take a particular stretch, etc., demonstrates that you are actively engaged in trying to adapt the work to accommodate all of your client's needs as they arise during the session.


After The Massage
Even if you feel time-pressured in your work schedule, you can create the feeling of lingering in the client's field after the treatment session ends. Try leaving the feeling of your touch on the client by releasing your final contact so gently and gradually that the client still feels you there after you are gone. Allow even just a minute or two after the session to bask with the client in his state of joy and pleasure, and to allow your client the opportunity to express his feelings and experiences in private with you. Remind your client that the body will continue to respond and unwind over the next couple of days, to help him carry the effects of the session home with him.


The Energetic Body
A Swedish massage session can be designed to clear energy blockages and induce a strong flow of energy throughout the body, which moves all physiological processes back toward normal. Energy blockages are associated with muscle tension, pain, inflammation, and physical discomforts which we are trying to relieve during the session. Swedish massage techniques frequently help release these blockages. Neuromuscular techniques, for instance, may help a muscle release tension; now the excess energy that was released from that muscle needs to be dispersed to fully relieve the client's symptoms and promote total healing. We can accomplish this by clearing the energy pathway leading from that area through the limbs that connect to that area. In the case of neck tension, for example, after releasing the neck we can stimulate energy flow through massage work on the scalp, shoulders, arms, and hands to enable the released energy to flow freely out of the neck. Tension released from the lower back can be directed out of that area via the hips, legs, and feet, and also via the upper back, shoulders, arms, and hands. Joint mobilization helps release energy blockages; long stretches that traction the whole length of the body help stimulate energy flow through the longitudinal meridians.

Our choice of music also influences the energetic effectiveness of bodywork. Yin bodywork uses deep, quiet touch to relieve anxiety and other excess energy imbalances. Quiet, unstructured music provides a good energetic complement to yin therapy. Yang bodywork uses rhythmic movement to stimulate energy flow and address deficient energy conditions. Rhythmic, moving music supports the therapeutic energy of yang bodywork.

Most massage sessions benefit from a combination of these energetic approaches, so it is useful to choose a music playlist that alternates between yin and yang energetic blueprints, creating a holistic energetic arc for the session. You can customize the music specifically for each session through your observation of the client's energetic profile. If a client shows indications of an excess energy disorder, such as anxiety, you may want to use predominantly yin music, particularly at the start of the session, interspersed with some yang work to promote overall energy flow. For a deficient energy disorder, such as fatigue, predominantly yang music may be more therapeutically effective, with yin music used strategically for quiet moments such as deep tissue work, or slow work on sensitive areas like the belly, neck, and face.

Vibrational resonance refers to changes in the frequency of an energy field in response to an external energetic stimulus. Resonance results in vibrational synchronization between two energy fields. As therapists, we can create in ourselves a healthy, balanced vibrational field for the client to harmonize with, by approaching the client in a calm, relaxed, centered, grounded state. When we work with a quiet mind, focused on our connection with the client, our brain waves slow down and provide a relaxed vibrational target for the client's brain frequencies. When we work with gratitude and compassion, the client's emotional field resonates with our joyful, loving state. These are not metaphorical constructs, they are actual vibrational manifestations of our experience, which can transfer to the client through our close, extended contact during a massage session.

In their book Soul Medicine, Norman Shealy and Dawson Church describe calm, emotional states as one of the characteristics of a master healer: "Healers...who regularly induce feelings of peace and tranquility in themselves--and have a spiritual practice focusing on love and compassion--are more likely to enter the kind of physiological state associated with healing ... A master healer, in the healing state, is typically tranquil inside, even if their outer actions are animated."5


The Physical Body
Working holistically on the physical body entails addressing the body as a whole unit, instead of a collection of parts. The arm does not end at the wrist--it continues energetically and psychologically through the fingertips. The leg does not end at the upper thigh--it continues over the hip and into the lower back. If we uncover one leg, work on it in isolation as far as the upper thigh, cover it back up again, and don't return, we are telling the leg that it is a separate entity. By physically connecting the leg with the hip, the back, the arm, the opposite leg, we awaken the body's memories of how everything is connected and works together. By returning to the leg again and again during the session, we remind the leg again and again that it is part of the whole organism.


The Spiritual Body
Compassion is the hallmark of the spirituality of massage. Our clients feel our compassion, as well as the nurturing and attention in our hands, or the absence of it. If you engage in your practice as sacred work, your client's spirit will respond with gratitude and healing.

The groundbreaking work of Masaru Emoto demonstrates the physical effects of love healing. Emoto's photographs of crystals formed in water treated with compassion and gratitude provide visible evidence of the transformational power of love. Given that the human body is composed of more than 70 percent water, it is clear that the compassionate touch of a spiritually-oriented massage therapist can potentially induce the state of vibrant, radiant wholeness seen in Emoto's crystals. As Emoto says, "If we fill our lives with love and gratitude, this consciousness will become a wonderful power that will spread throughout the world."6 In our role as massage therapists, we are given a license to touch people with kindness. We are indeed the lucky ones to have the job of guiding clients into a space of peace, relief, and contentment. Your gratitude for your work may be the key to your success as a health care provider.

The holistic massage approach heals more than just tight muscles. Holistic massage guides the client, and the therapist, into a place of wholeness, connection, communion, and bliss--a place where the client feels loved and listened to, allowing them to access the body's deep intelligence to release limitations and old patterns, and allowing muscle tension to fall away naturally.

Linda G. Means, PhD, CMT, is a certified Esalen Massage therapist, energy healer, holistic healing coach, massage teacher, and writer. Her holistic massage work is infused with yoga, Brazilian Spiritist healing, and traditional Chinese medicine. To contact her, visit www.peacehope.com.

NOTES
1. Herbert Benson, The Relaxation Response (New York: Harper Collins, 2000), 56.
2. Carl Dubitsky, Bodywork Shiatsu (Rochester, VT: Healing Arts Press, 1997), 101.
3. Sharon Begley, Train Your Mind, Change Your Brain (New York: Ballentine Books, 2007), 8.
4. Peggy Morrison Horan, Connecting Through Touch (Oakland, CA: New Harbinger Publications, Inc., 2007), 4.
5. Norman Shealy and Dawson Church, Soul Medicine (Santa Rosa, California: Elite Books, 2006), 92.
6. Masaru Emoto, The Hidden Messages in Water (New York: Atria Books, 2001), 146.




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