Asian Bodywork Therapy, Part II

Marma Therapy, Thai Massage, and Insight Bodywork

By Kondañña (Barry) Kapke

Originally published in Massage & Bodywork magazine, December/January 2005.

Previously, we examined the American Organization of Bodywork Therapies of Asia’s (AOBTA) definition of Asian Bodywork Therapy (ABT) using three styles of bodywork — amma, shiatsu, and Jin Shin Jyutsu (October/November 2004, page 114). It was suggested that Asian Bodywork Therapies share three common criteria: They treat the whole human being through the agency of manual contact; they have a basis in Traditional Chinese Medicine (TCM) principles and assessment; and they use traditional Asian techniques and protocols to bring about balance. Here, we will look at three forms — marma massage, Thai massage, and Insight Bodywork — that are organized around a paradigm other than TCM.

Marma Therapy

One of the basic characteristics of ABT is its focus on energetic anatomy and physiology. With this comes the understanding that the free and harmonious flow of energy is necessary to health. Disruptions to that flow will inevitably result in disharmony and disease.

Ayurveda, literally the “science of life,” is the traditional mind-body medicine of India, and in the yogic and ayurvedic view of energetic anatomy, there are three types of energy centers: chakras, of which there are seven major energy centers; nadis, or energy channels, of which there are 14 major channels; and marmas, or energetic points, of which there are 107. Marmas, which literally mean “sensitive” or “vulnerable” zones, are similar in some ways to the acupoints of TCM, but involve larger areas of the body. Some suggest that TCM adapted many aspects of marma therapy. Through manipulation of marmas by way of massage (abhyanga), acupressure (mardana), aromatherapy, pranic healing, herbs, bloodletting, marmapuncture, and heat, prana (life energy) can be directed to remove blockages and stimulate energy flow.

Marmas may be categorized into two broad classes: lethal and therapeutic. Lethal marmas are vulnerable sites where force or damage may cause serious injury, unconsciousness, or death. Warriors of ancient India, and even the horses and elephants that carried them into battle, wore body armor called varma to protect these vulnerable points. The knowledge of marmas and the mastery of the pranic force associated with marmas was central to martial arts, the highest form of which was called Marma Adi. As a natural consequence to the martial applications of marma science came the necessity for Varma Chikitsa, or marma therapy. Therapeutic marmas can be used to direct prana for health and transformation as well as to cure injury and disease.

Mapped out centuries ago in the Sushruta Samhita,1 there are 22 marmas on the lower extremities, 22 on the arms, 12 on the abdomen and chest, 14 on the back, and 37 on the neck and head. Marmas range in size from one-half anguli2 to four anguli, or the breadth of a fist. Smaller marmas can be called points, but the larger marmas correspond to a zone or region. There are major marmas that correlate to the seven spinal chakras, internal organs have marma points, and joints may potentially be marma regions. In addition to the 107 classical marmas, each individual will also have their own unique marmas relative to their age, build, weight, posture, behavior, and diet. The entire skin surface of the body can be thought of as the 108th marma, conjoining all the other marmas.

Marma massage is one method of helping to balance the three biological humors, or doshas, that exist in every person. All ayurvedic therapies that work on the prana in some way, including marma massage, seek to harmonize its functions, primarily through the tridosha — vatta, pitta, and kapha. “Dosha” literally means “that which will imbalance” and the three doshas are the primary factors behind both health and disease. They regulate our internal climate through their ever-changing interactions of movement (vatta), heat (pitta), and moisture (kapha). According to David Frawley, one of the leading ayurvedic physicians, “Health consists of the timely development and harmonious interaction of the three doshas. Disease is caused by their imbalances, excesses, and inappropriate movements.”3

Marma therapy is the most direct way to harmonize the prana in the body. Abhyanga utilizes not only massage techniques, but also the medicinal properties of oils, herbs, and aromas, whereas mardana focuses on the application of finger or thumb pressure to marmas. Since marmas are sensitive points, gentle pressure is used, primarily with the thumb, which projects the main pranic energy of the hand. Clockwise motion is stimulating and is indicated when tonification or strengthening the internal organs and tissues is desired. Counterclockwise movement is beneficial for sedating excess doshas, dispersing blocked energy, and for detoxification. Massaging the whole body opens marma energy and prepares the ground for the most effective treatment of specific marmas. However, individual marmas can also be massaged by themselves as a quick treatment.

Thai Massage

Thai massage, one branch of traditional Thai medicine, has been practiced to heal the body and spirit and to maintain health, vitality, and flexibility for more than 2,500 years. There are four pillars of traditional medicine in Thailand: herbal medicine, nutritional medicine and food cures, spiritual practice, and manual medicine or massage. Jivaka Kumar Bhaccha, an ayurvedic doctor and personal physician to the Buddha, is revered as the father and patron saint of Thai medicine. The Thai credit him with the development of Thai massage and refer to him as Shivago Komarpai, or simply Shivago. With roots in ayurveda and yoga, and steeped in Buddhadharma, Thai massage is known as Nuad Bo’Rarn, which literally means “ancient massage.”

Thai massage developed within Buddhist monasteries, or wats, and was practiced by monks and nuns. Nuad (massage) not only relieved aches and pains, but it also helped the monastics sit for long periods of time in meditation. Richard Gold, an acupuncturist and Thai massage instructor, says, “Nuad Bo’Rarn is considered to be a form of meditative practice, with benefit to the recipient as well as the practitioner. The practitioner endeavors to work in a state of mindfulness, concentrated and present in every breath, each moment. Every movement, every procedure, every breath, every posture, and every position is an opportunity for the practitioner to achieve clear intent and mindfulness.”4

Thai massage is sacred bodywork and puts into practical application the philosophy and values of the spiritual path. For the most part, monks and nuns no longer practice Thai massage. However, the emphasis on Thai massage as a meditative art and an expression of metta (unconditional love) remains. “It is in the spirit of love and humility,” Gold continues, “that the practitioner approaches the healing session. The practitioner prays for guidance and wisdom to serve at the highest levels possible. The hope is to relieve human suffering. There is no one right way to accomplish this endless task. Practitioners simply and honestly apply their skills and knowledge to the best of their abilities without attachment to the results.”5

When the Burmese destroyed Ayuthaya, Thailand’s second capitol, in 1767, most of the medical texts were destroyed. To help preserve the tradition of massage, King Rama III in 1832 ordered the monks at the royal monastery in Bangkok (now referred to as Wat Pho) to carve medical teachings into the stone walls. These 60 plaques depict the energy channels of the body — 30 of the front of the body and 30 of the back — along with descriptions of treatment protocols for working the marmas along these pathways.

In Thai medical theory, influenced strongly by ayurveda, life energy or prana circulates through energetic channels called “sen.” Of the 72,000 nadis, Thai massage is primarily concerned with 10 major pathways. The 10 sen essentially connect the abdominal region around the navel to the sensory and excretory orifices. This area, referred to as “hara” in Japanese and “dan tien” in Chinese, is the physiological, emotional, and energetic core and is the domain of the dosha Vata.

Central to the therapeutic focus of Thai massage is the concept of Wind. In the ayurvedic paradigm, Wind is the dosha Vata (or “Lom,” in Thai). Wind is the most important of the doshas, and thus is a focus for massage, because Vata sets the other doshas in motion, and it assists in regulating their functions. The slow rhythmic presses and deep compressions of Thai massage are intended to facilitate the correct movement and presence of Wind in the body and to release the Wind from places where it has become trapped or stagnant. Stretches are designed to free Wind that has become lodged in the joints. “Stopping the blood,” a signature technique in Nuad Thai, is called “opening the Wind” in the Thai language.

Thai massage is performed on a mat on the floor with the client in loose clothing to permit ease of movement. The Thai massage therapist utilizes hands, feet, forearms, and knees to apply pressure to the sen and to stretch, balance, and energize the recipient’s body. A traditional massage session will last from two to three hours, slowly preparing the tissues and encouraging the flow of prana before moving the body mindfully, gently, and gradually into deep stretches and yoga-like postures. Thai massage emphasizes the mind-body connection and not only is effective in the treatment of physical disharmonies, but also emotional and spiritual disorders.

Insight Bodywork

Insight Bodywork (IB) is an eclectic style of somatic bodywork that germinated from the cross-fertilized influences of shiatsu, Thai massage, Breema,6 and Buddhadharma. It has roots reaching deeply into these traditions and yet cannot be said to belong to any one of them.

Insight Bodywork is a floor-based energy work, although it is a very physical and movement-based form, mobilizing almost every joint in the body and working the channels and marmas/acupoints through stretches and applied pressure with hands and feet. Despite hands and feet being the primary tools, it is a style that makes creative use of multiple points of contact, where potentially every part of the body can be an instrument for the application of pressure or for making connection. Building on and expanding the movement vocabularies of Nuad Thai and Breema, IB brings nurturing support to the body and emotions through cradling, brushing, and holds in a seamless flow that has intimacy, safety, immediacy, and playful spontaneity.

The Buddha was often said to be the Master Physician, providing the cure (liberation) from suffering and the causes of suffering. Many of the tools and skills of the path to awakening can also be tremendously helpful in the healing relationship. IB cultivates the Brahma Viharas — metta, or unconditional love; karuna, or compassion; mudita, or vicarious joy; upekkha, or equanimity — as healing intentions and as mind states that conduce to an immediate and profound shift in energy and consciousness. Other tools such as the use of visualization, sound (mantra), gestures (mudra), postures (asana), and ritual may also be called on to unblock obstruction in body, mind, and spirit.

Drawing from the paradigm of Traditional Chinese Medicine, Insight Bodywork seeks to harmonize the flow of Qi through the tissues, channels, and organs, and, from ayurveda, to balance the chakras, the tridosha, and the intersection of body and consciousness. It is work that directs mindfulness and intention to unraveling the causes of suffering and is a sacred journey of discovery and insight.

These three styles draw in whole or in part from the ayurvedic model of medicine. Certainly there are similarities between TCM and ayurvedic models, but also significant differences. Can two very different theoretical constructs of health and disease coexist comfortably under the rubric of Asian Bodywork Therapy?

The AOBTA definition of ABT provides a useful framework. However, I believe it is too clearly slanted toward the TCM model, which is but one medical paradigm within Asia. Furthermore, it seems evident that contemporary forms, not originating in Asia, such as Insight Bodywork and Breema Bodywork, operate as Asian Bodywork Therapies, too. It is my hope that the umbrella of Asian Bodywork Therapy can embrace and shelter not just bodywork forms that are organized around TCM principles and assessment, but also those organized around ayurvedic, Buddhist, and Taoist approaches to health and disease. I see the uniting quality of Asian bodywork not to be its geographic origin or affiliation but its focus on energetic anatomy and the paths to harmony and balance. To embrace ayurvedic therapies, Dharma medicine, and TCM-based forms as Asian Bodywork Therapies can only enrich, not diminish. As our profession grows and defines itself, this is a conversation of which I hope to hear more.