NOTES ON A SESSION – 12/9/2013

I periodically remember, way after the fact, that it could be useful for any of us to share the details of our sessions. Each session is such a fascinating integration of art, intuition, critical thinking, applied science, touch experiments, careful observations of client response, and moment-to-moment refinements as we see what may be working best and what not.  This morning I thought a session from yesterday would be a good one to describe while it was still fresh in my mind!

This was with a young woman of about 50 who is doing well in her life. Her complaints were some chronic pain and a feeling of instability in her right mid-thorax and some recent tension in the front of her left thigh.  She talked also about her need to be more assertive in relationships regarding her needs and wants.  I asked what work she wanted and she requested a session combining some Deep Massage with Zero Balancing.

I reminded her that in some sessions I may use pressure that can be intense – as I remember my own Rolfing sessions to be years ago. And she said she generally preferred deeper pressure. I was thinking, mostly intuiting, since she was quite open, that a little more pressure than usual might provide even deeper benefit. I also suggested that if she felt more aligned in her structure and energy, it might support her feeling more strength to be assertive – might feel a clear and stronger connection of heart, voice and mind – helping her have clearer channel to speak from both her heart and mind.  Also, since she is a bit kyphotic, I thought getting deeper relaxation in the back and greater length through the front of the torso might facilitate her feeling more connected in the upper body and relieving leg tension might help her feel more supported through her legs, not with her back’s tension.

She announced at the beginning of the session that she needed to be done in about 45 minutes!  Normally I work for a full hour, so I felt the need to stay economical and focused through the whole session to get everything planned done in 45 minutes.

We began working down the back with Deep Massage, down the erectors.  I started easy and, in successive passes, deeper and deeper, particularly in the mid-thorax and on the sacrum, which often enjoys more attention than most therapists give it. Briefly released the low back.  Then I began to work on the lower and mid thorax.  I started on the left side first as I find it more effective usually to work the less affected side first.  I worked from T12 up slowly to T1 using a broad slow deep effleurage largely with my forearm.  Then, moving to the right side where there was more tension, I slowed down considerably and added more pressure to the work, checking in regularly to make sure she felt it was good, not hurting.  I had her actively engage her breathing at some points to release some of the ribs with forceful, thorough exhales. The combined tissue work and breathing yielded some deep relaxation and I felt we were on our way.

Now we worked with levator scapula and then the posterior neck.  I found expected tension levels, nothing remarkable and helped the tensions, when found, relax with direct pressure – I call it “melting”. The main surprise in the neck what that the left side of her atlas seemed shifted to the left, or perhaps there was more fibrous tissue there so I spent extra time melting near the transverse process of the atlas and gently coaxed it to move into a more central position.  After the neck work, I helped, with fists down the entire back, integrate her feelings of increased relaxation and length in the neck, to be felt, as we proceeded down the back, as relaxation and length from the occiput through the entire back, down to the bottom of the sacrum.

I could have now worked down the back of the pelvis and legs, but I decided to continue the work on the upper body and to begin integrating Zero Balancing. So she turned over into lying supine, and I evaluated her neck movements – flexion, extension, side-bending, etc.  No particular restrictions. I did some fulcrums, called in ZB “half moon vectors,” through the neck, combining gentle traction with additional vectors up and to either side, while working with the soft tissues, sweeping from SCM all the way around to the spinous processes.  I then slowly did deep circular friction on the whole scalp, enjoying imagining that her mind was relaxing, as it so often does with work on the cranium.

We had been proceeding not fast but at a good clip so far.  Now it occurred to me that it might be relevant to do a longer fulcrum called the head-heart fulcrum.  This involves putting in a half-moon vector through the neck and simultaneously laying a hand on the sternum, adding a feeling of connection by gently tractioning the head hand superiorly and the sternal hand inferiorly, without moving, and holding those tensions to encourage the feeling of connection. This seemed to work well.  By this point in the session, her facial expressions were indicating she was enjoying the work and that she was going into yet deeper relaxation, that place where relaxation begins to turn into the experience of inner peace and easy, yet deep self-exploration (at least I hoped so!). She said the session was going great, so I was also feeling confident and happy with how it was going.

I asked for permission to work with her abdomen and did some easy work there, then continued with a lifting, moving fulcrum on the medial ribcage and sternum.  This was done slowly, giving her optimum time and helpful pressure to help reposition the ribcage.  I had my second hand on the back.  As I helped lift up the front of the ribcage with one hand, I did a kind of slow racking deep effleurage downward with my fingers on the back, gently encouraging the posterior ribs to settle back down, not to be pulled up and “rounding” over into kyphosis.  This seemed to help.  Then I did a deep stroke out pectoralis major on each side. As I did so, I noticed some tension and fibrosity around the coracoid processes. So often with thoracic kyphosis, pectoralis minor may be tight and pulling the coracoid process anteriorly.  So we did additional work releasing pectoralis minor using active movement up and down while I worked up and down just beneath the coracoid processes.

Finally, for the upper body, I did a bit of work on the arms and hands.  Finding the hands to be rather cold, I added a little work warming up the hands with some gentle petrissages and a Zero Balancing arm fulcrum which encourages, with careful tractions and rotations, a feeling of relaxation to flow through the shoulder girdle, arms and hands.

Now to the lower body!  On the right leg, I used some hip fulcrums, introducing gentle traction and rotation into the hip.  I added, with my second hand, work into some tension in the low back, sacrum and back of the pelvis.  Then I drew my fingers down the side of the thigh and lower leg. I worked similarly with the left leg where she had reported tension. However, I decided that, to help her release the left leg more fully, I would work down, especially the iliotibial band, more slowly.  Actually I started melting into the side of the pelvis first, did feel more tension in that left gluteus medius and around the greater trochanter, I worked into that gently.  Then I began to work down the i.t. band  aka gall bladder meridian.  I would move with some depth about an inch, then I would hold that tension and briefly stop moving, then I would begin a little deep movement again, then pause again, and so on.  It took about a minute to go down the i.t. band in this manner. I was imagining that for her, time was beginning and then standing still and then beginning and standing still and all the while, she might be feeling that she had all the time in the world to completely release the tension she’d been experiencing.

I then added a bit of work down the side of the fibula and with the feet, ending with half moon vectors through the feet and through the whole body.

Then I checked in.  We were nearing the end of the session – was there anywhere she wanted additional attention? She indicated she felt very complete.  So I left the room.

I felt very pleased with all that we did and in a very efficient manner in a short time. After she had dressed, we checked in and she was obviously standing much more upright. She was very happy with the session and found it remarkable how much we were able to accomplish in a short period of time. She mentioned that a number of moments there were quite incredible, especially how she felt with the work down the left i.t. band – she said there was lots of structural engagement but also “lots of energetic clearing happening right down to the bone marrow.” We agreed this had been a very successful session.

Every session, more or less, re-affirms for me, how wonderful and profound our art and science is.  How grateful I am that to have found a life work that I find ever intriguing and rewarding and is so appreciated by its receivers.  If you are a therapist (or a client) of massage/bodywork, I know you know what I mean!