Body Work and Psychotherapy

By David L. Ruettiger

Originally published in Massage & Bodywork magazine, February/March 2005.
Copyright 2005. Associated Bodywork and Massage Professionals. All rights reserved.

Some years ago, I wrote an article for the New York State Society for Medical Massage Therapists titled “Counseling Psychology and Massage Therapy.”1 Rereading it recently, I realized I had more to say about the connection between the fields of bodywork and psychotherapy. Both practices are deeply involved in the therapeutic relationship and have much in common. The emerging field of somatic psychology has much to teach us.

I decided to research the possibilities of finding graduate level training combining the healing aspects of both disciplines. Similar to the Reese’s peanut butter cups commercial of peanut butter colliding with chocolate, it appears this same phenomenon has happened in academia in somatic psychology. This is a relatively new field and new therapists are emerging to start their practices.* For the most part, it appears that psychotherapists engage in talk therapy, while bodyworkers engage in touch therapy. As the mind and body can no longer be separated in healthy, healing relationships, neither can touch and talk. It is time for a new paradigm? Can we do both?

The Body’s Dialogue
In his book, The Body in Psychotherapy, Don Hanlon Johnson describes his Rolfing experience with Ed Maupin, a clinical psychologist educated at the University of Chicago. “His manipulations felt more
like an intense human dialogue,”2 Hanlon wires. Bodyworkers often develop somatic intuitive abilities achieving an energetic intimacy with their clients.3 This professional maturation is akin to counselors honing their listening and empathic skills.

In addition, bodyworkers can affect changes in body structure through soft tissue manipulations and various other techniques, but their role is much more complex than that of a “mechanic.” Many bodyworkers have, or will, face a client’s emotional release on the massage table as a result of the somatic work being done. Yet, most are not trained as counselors.

Conversely, counselors are not trained as bodyworkers either, but they can affect changes in attitude and, therefore, behavior through their various skills of listening and responding. In fact, effective listening is one of the counselor’s more effective tools. Responding is also a learned skill in knowing what, if anything, to say and how to say it. Counselors see the release of emotions as a goal.

For the bodyworker and counselor, I define emotional release as previously unexpressed emotions coming to the surface in various forms such as weeping, feelings of anger, laughing, etc. The two therapists may deal with the client’s emotional state differently, but their goals are identical. The person coming to bodywork is usually seeking relief from a physical complaint or stress. Part of the insight process is the person’s ability to see her own personal mind-body connection.4 These same issues hold true in the psychotherapeutic relationship.

When massage therapists gather together, the topic of discussion, other than technique differentials, is often tissue issues. Tissue memory is thought to be the remembrance, or holding, of trauma in the connective tissues.5,6 Bodyworkers often unlock the hypotonic structures and release the memory held there. The body remembers everything that has happened to it. Imagine the body as a tape recorder: The therapist pushes the play button and acts as a witness to the sounds, sights, and feelings expressed. A good example is reflected in the bodyworker whose clients are survivors of sexual abuse and trauma.7 What better way for the client who has disassociated from her own body to reconnect than in this safe touch environment?8 If only bodyworkers had the skills and training of psychotherapy, I believe the healing potential of these precious moments could be augmented for our clients.

Mutual Goals
In order to understand what benefits each field can offer, it is necessary to become aware of their respective goals. Once we know the goals, we can appreciate and decide if we are able to utilize them in the best interests of our mutual clients. I like the imagery that goals have in sports and children’s games, where the goal is seen as a safe place. Ensuring safety is a basic requirement to both disciplines, as is trust-building. Another way to look at our common goals is to examine our intentions, or that which determines the direction of our goals. The intention of the bodyworker and the counselor are very similar as they relate to their respective clients. Both intend for the continued or restored health and well-being through stress reduction and insight.

There is no doubt that bodywork has direct psychological and physical benefits.9 The physical effects of massage are well-documented, whether they be mechanical or reflexive. Mechanical effects on the muscular, cardiovascular, and integumentary systems are most obvious with muscle softening, increased blood flow, and skin elasticity to mention just a few. The reflex effects of massage are more indirect, yet all the systems of the body are affected. Breathing slows. Lymph moves. Elimination of wastes occurs. Digestion clears. Joints move more freely. The nervous system is also affected: Parasympathetic systems are stimulated toward relaxation, and the neural-gating mechanisms are affected to reduce pain.10

The emotional and mental effects of bodywork are equally well-documented, however, less understood. As neuro and somatic psychologies, as well as other sciences come into the light, there will be a fuller, scientific understanding of the emotional/mental benefits that bodyworkers repeatedly encounter.

A common feeling after massage is one of mental clarity and alertness. This is also true after counseling. The insight of “Aha, now I understand” is one shared by both psychotherapist and bodyworker. Applied research in the use of human touch and the many benefits of massage continue to be documented by Tiffany Field, Ph.D., and associates at The Touch Research Institute at the University of Miami. Mental alertness is a common goal in sports massage. Short sessions, with a speed and technique different than regular table massage, are used to increase cardiovascular and joint mobility and prepare the athlete. Muscles are relaxed and ready for their full contractile and elastic natures. It is likely that mental alertness and clarity are related to increased blood flow to the brain and sensory stimulation.

Similarly, reduced stress and anxiety are common goals of both fields. One has only to see the incredible success of seated chair massage in the workplace to witness the benefits of even minimal bodywork, where sessions average 8 to 20 minutes per employee.

It is through the relaxation response that insight occurs. The activation of the parasympathetic nervous system and release of endorphins are thought to occur in massage therapy.11 When the mind and body mobilize in fear or rage, however, the sympathetic division of the autonomic nervous system is engaged and the heart pounds, among other symptoms. Obtaining a generalized feeling of well-being is another mutual goal, as is a positive outlook on life. As endorphins are released, pain and stress decrease, and the upgraded image and feeling replaces the previously negative experience. The insight of a client in psychotherapy serves to help gather the resources necessary to behave differently. The similar body integration of massage therapy at this time is fundamental to the client’s improvement.

I have often advocated the training of massage therapists and bodyworkers to include fundamental counseling skills and am heartened to see many schools beginning to include this type of programming into their academic areas of study. However, the institutions teaching psychotherapy appear to be more reticent in any endorsement of psychotherapists touching clients in any way, except through verbal interchange. I am happy to see this archaic view of human interaction changing. The California Institute of Integral Studies in San Francisco requires applicants to their somatic psychology program to have massage therapy training. Bodyworkers can be trained in simple counseling skills. Psychotherapists can be trained in simple touching skills. As professionals, we exist for the benefit of enhancing the healing process of our clients, using all the available tools we can acquire. I believe we can respect our mutual scopes of practice while enhancing our ability to make a real difference in the lives of our clients.

*For the purposes of this article, the words bodyworker and massage therapist are interchangeable, as are the words counselor and psychotherapist.

David L. Ruettiger holds a master’s degree in counseling and
guidance, and is a certified massage therapist. He’s pursuing an
additional master’s degree in somatic psychotherapy. He can be
contacted at drudy9191@netzero.net.

References
1 Ruettiger, D. Counseling Psychology and Massage Therapy. New York State Society for Medical Massage Therapists Quarterly. 1998 June.
2 Johnson, D.H., and Grand, I.J. Inquiries in The Body in Psychotherapy Somatic Psych. California Institute of Integral Studies. Berkeley, CA: North Atlantic Books, 1998: 2.
3 Benjamin, B., and Sohnen-Moe,C. The Ethics of Touch. Tucson, AZ: SMA Inc., 2003: 30.
4 Rattray, F., and Ludwig, L. Clinical Massage Therapy: Understanding Assessing and Treating over 70 Conditions. Toronto, ON: Talus Incorporated, 2000: 15-16
5 Upledger, J. E. and Vredevoogd. Craniosacral Therapy. Seattle, WA: Eastland Press, 1983.
6 Barral, J.P., and Mercier, P. Visceral Manipulation. Seattle, WA: Eastland Press, 1988.
7 Eckberg, M. Shock Trauma: Case Study of a Survivor of Political Torture. The Body in Psychotherapy. Berkeley: North Atlantic Books,1997:17-39.
8 Benjamin, B. Massage and bodywork with survivors of abuse. Massage Therapy Journal. 1995 Fall:12-15.
9 Beck, M.F. Theory and Practice of Therapeutic Massage 3rd ed. Albany, NY: Milady Publishing,
1999: 242.
10 Tappan, F.M. and Benjamin, P. J. Healing Massage Techniques: Classic, Holistic, and Emerging Methods. 3rd ed. Stamford, CT: Appleton & Lange, 1998: 34.
11 Kaard, B., andTostinbo, O. Increase in plasma beta endorphins in a connective tissue massage. General Pharmacology. 1989 20(4):487-489.


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