May 31, 2005
Massage: The Missing Link in Addiction Treatment |
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People in the early stages of addiction recovery often experience an uncomfortable gap between their body and mind. Therapeutic massage can bridge that gap, and is a powerful adjunct treatment in the addiction and recovery process.
Substance abuse is a major public health problem. According to the National Institute of Drug Abuse, substance abuse costs our nation more than $484 billion per year. This includes costs related to crime, medical care, treatment, social welfare programs, and time lost from work.
Comprehensive treatment for the addicted individual is the key to turning this health crisis around. In the October 2003 edition of Counselor, The Magazine for Addiction Professionals, Joni Kosakoski, BSN, RN, CARN gives us the fuel to propel massage therapists into the realm of drug and alcohol treatment. In her article “Massage: Hands Down, a Treatment for Addiction”, Kosakoski gives us a clear and concise analysis of massage’s benefits for this population and its place in addiction treatment.
Incorporating massage into a substance abuse program is advantageous in all of the stages of quitting an addiction: withdrawal, detoxification and abstinence. The physical, emotional and spiritual components of recovery all can be directly benefited by the healing power of therapeutic touch. The nurturing contact of massage utilizes skin as the translator of the therapist’s intent. Skin, the largest sensory organ in our body, is our primary sense for connecting information from our external surroundings to our internal environment.
The Touch Research Institute in Miami, Florida has performed scientific research documenting the physiological effects of massage on the body. Kosakoski reminds us of some of their findings on massage such as decreased pain, diminished autoimmune response, enhanced immune response, and increased alertness and performance. These effects appear to be related to massage’s ability to reduce cortisol, a stress hormone, as reported by the Touch Research Institute in 2003. Several of the Touch Research Institute’s studies positively document the ability of massage to decrease anxiety, depression, agitation, and cravings.
In order to understand the connection between massage therapy and its benefit in addiction treatment, Kosakoski explains the neurological biochemistry of addiction: “Much attention has been directed to the mesolimbic reward system, the so-called ‘pleasure pathway’ of the brain. The area is activated in part by the release of the neurotransmitter dopamine, the chemical messenger responsible for making us feel good when we engage in any pleasurable activity. It is well known that dopamine is significantly involved in addiction and that dopamine levels are lower than average during the withdrawal process and into early recovery until brain chemistry normalizes.”
In 1998, the Touch Research Institute published the findings that a regular massage regimen produced long-term results of increasing dopamine levels. The fact that massage naturally increases dopamine levels, and decreases cortisol levels makes it a perfect addition to a standard detoxification program.
The neurochemistry of an addict takes time to get back into balance, so massage treatments after the initial detoxification phase is crucial. When a person uses a substance to feel good, his/her body stops manufacturing its own “feel good” chemicals, (endorphins), and the substance takes over that task. Therefore, when a person quits using an abused substance, they lose their source of feeling good. Since it takes time for the body to start manufacturing its own endorphins again, this is a challenging interim to endure. This interim is the recovering addict’s most vulnerable time to relapse.
In the 1989 edition of General Pharmacology, Kaada and Torsteinbo of Norway reported on study results that massage therapy increased the amount of beta-endorphins in the blood by 16 percent. The release of endorphins during a massage allows the recipient to feel normal, even fantastic, without the aid of a drug. This can be a powerful, even life-changing experience for the client.
On a physical level, the circulation that occurs with massage is also a desired occurrence during the detoxification process. Therapeutic massage’s invigoration of blood and lymphatic fluid allows for a more efficient exchange of oxygen rich nutrition into the body’s tissues, and the delivery of toxic waste products out of the body’s tissues. Kosakoski adds that “All systems of the body function more efficiently with improved circulation and a reduction in tension of the soft tissues and musculature…”
On an emotional level, part of an addict’s recovery process is learning to identify and manage the triggers that cause them to desire escape. Regular massage sessions can aid the client’s awareness of his or her own body, including where and when tension exists. Being conscious of these patterns is a step toward recognizing one’s own resistance, which can lead to healthfully addressing emotions associated with cravings and stress. In addition Kosakoski says that “Emotional release can commonly occur with massage, which provides a safe, non-threatening opportunity to begin the process of recovering long-buried emotions and memories.”
On a spiritual level, the deep relaxation of a massage can provide a still inner place for the recipient to connect with themselves. Being grounded, centered and fully present can be experienced when receiving therapeutic touch from a grounded, centered and fully present practitioner. A recovering addict has a whole new world opened to them when they acknowledge that they can simultaneously be anchored, present, feel good and be substance-free. As Kosakoski explains, “To allow oneself to surrender to the practitioner’s hands — to breathe fully and easily, to acknowledge and receive the gifts of nurturing, surrender and relaxation ….is an invaluable addition to the newly recovering person’s repertoire of relapse-prevention skills.”
Massage has the unique ability to affect all of our layers of being — from the spiritual plane all the way up to and including our body’s chemical composition. In the process of abandoning an addiction, these many parts of ourselves become fragmented. It is merely a matter of time before all addiction and recovery treatment programs recognize massage’s ability to mend the mind-body connection. When that happens, therapeutic massage will be integrated into addiction treatment, and clients will be optimally prepared to succeed in their recovery.
Posted by Nicole at 12:18 PM
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A Smart Way to Practice: Cooperative Marketing |
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A massage therapist can promote his/her practice in a myriad of ways. While word-of-mouth is the way most practitioners build their clientele, it is definitely not the most effective. At first glance, a joint marketing venture may sound like an intimidating concept, but it’s actually very simple and, even better, it’s cheap.
Many believe that starting a massage practice from scratch can require a commitment of about three to five years before steady profits roll in. The typical mantra of a massage therapist can go something like this: “If I help people, they will come.” Marketing used to seem like a foreign notion reserved for corporate suits forcing themselves on the unsuspecting public. In the June 2005 issue of Massage Today, Colleen (Steigerwald) Holloway, LMT shared a marketing gem in the article “Practice Management 101: Better Than Word-of-Mouth Marketing”.
In this article, Holloway points out the deficiency of word-of-mouth advertising. She reminds us that “People who have a bad experience with a service will tell between six to 10 people. Bad news travels quickly, and people love to complain and receive sympathy… Conversely, people who have a good experience with a service will tell only one or two people, and often only when it happens to come up in conversation.”
A viable solution to the inequality of word-of-mouth referrals is a joint marketing venture (JMV). A JMV is a partnership with another service-oriented business. The two businesses endorse each other with testimonial letters to their customers. This is such an effective way to reach new people because they are getting a recommendation from someone they already know and trust. The best news of all, is that a JMV is easy, effective and very inexpensive.
Holloway describes three simple steps to getting your new marketing plan underway. The first step is to find your JMV partner. The best way to find a partner is to make a list of your current clients who own a small service-oriented business with an established clientele. Out of that list, chose your most satisfied and loyal clients. If you don’t have appropriate clientele to choose from, approach your relatives, neighbors and friends that own a business. Once a partner is chosen, and they agree to enter a JMV with you, you can move on to Step Two.
In Holloway’s article, a clear guide is given for the next step, which is writing the endorsement letter. In the first paragraph of this letter, Holloway says to explain the problem you need to be solved. This could be anything from recurring low back pain (if your partner is a chiropractor), a challenge in figuring out taxes (if your partner is an accountant), to a catastrophe involving a toilet (if your partner is a plumber). In the next paragraph, Holloway says to write a strong testament attributing your partner’s service as the solution to your problem. The testament could be “Jo’s Plumbing Service came to my rescue right away. They quickly fixed my toilet, offered great suggestions to prevent the problem from recurring and they even helped me clean my flooded home.” In the final paragraph, offer a call to action. This is an incentive for the reader to contact the business being endorsed. The example of a call to action given by Holloway in this article is “Dr. Jones is such a terrific chiropractor that when I told him I was going to spread the word about him to all of my clients, he offered to give each of my clients a free initial examination. That’s a $60 value! ... Call him today at (555) 555-1212, and tell him I sent you.”
The final step that Holloway gives is to implement your joint marketing venture. Have your partner write an equally persuasive endorsement letter praising you and your massage practice, including a compelling call to action offer. Agree on an equal amount of clients for you and your partner to send the respective letters out to, and you are well on your way to expanding your practice.
When implementing a joint marketing venture, a business owner has nothing to lose. The investment is only the cost of stationary and stamps. Holloway shows that marketing does not have to be contrived and uncomfortable. While you may still believe that “If I help them, they will come,” you also now know that you can accelerate this process and have your phone ringing right away with even more new clients interested in your services. With this simple and effective way to network and educate people about the benefits of massage, you will find it isn’t necessary to wait five years before developing a steady stream of new clients.
Posted by Nicole at 12:16 PM
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The New Food Pyramid Reflects a Growing Consciousness |
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The U.S. Department of Agriculture has finally abandoned the “one size fits all” theory of consumption. Combined with an emphasis on exercise, the new Food Pyramid has us heading in the right direction.
After 13 years, the U.S. government’s “Food Pyramid” was recently updated. Todd Zwillich reports on it for WebMD Medical News in an article entitled New Food Pyramid Gets Personal published on April 19, 2005.
Mr. Zwillich writes that “Officials say they once again hope to make the revamped pyramid, now decorated with a series of colored bands representing food groups, a fixture in schools, doctors’ offices, and health clinics throughout the nation. They also hope that a new emphasis on exercise and moderate eating will finally help make a dent in America’s obesity epidemic, now affecting more than one-third of adults and nearly one-fifth of teens.”
The revised pyramid includes two important new features: the emphasis on exercise as a precursor to health and the flexibility to personalize the new guidelines for each individual.
The new pyramid depicts steps on the side with an image of a person climbing the stairs. This stresses the value to our health of combining physical activity with eating a balanced diet. As our technology advances, the propensity toward a sedentary lifestyle increases. The creators of this new image should be applauded for attempting to bring physical activity to the forefront of our consciousness.
The other exciting change is that one set of recommendations is no longer applicable to everyone. Zwillich reports that it’s designed to help individuals plan their dietary intake based on their age, sex and level of daily physical activity. It is official: Our government has embraced the fact that as individuals, we have individual needs, which is truly a breakthrough. Zwillich gives the following example:
A 55-year-old female who exercises less than 30 minutes a day is told to consume 1,600 calories per day in a diet consisting of 5 ounces of grains, 3.5 ounces of fruits and vegetables, 3 cups of milk and dairy products, and 5 ounces of meat and beans. For a man of the same age and exercise level, the site calls for a diet limited to 2,000 calories per day.
This is of great advantage over the old pyramid, where the number of servings, not serving size was outlined. Now we have 12 different pyramids representing the different nutritional needs for every person. As described above, each individual pyramid gives guidelines for the specific number of cups of each food category to be consumed each day. The dilemma of how to showcase all of this information on one chart was resolved with current technology — the internet. The website, www.mypyramid.gov, gives visitors the option of entering their age, sex and physical activity level to view their very own customized pyramid.
The Food Pyramid improvements bring us closer to creating a healthier population. Very much in line with many healthcare practitioner’s perspectives, the 2005 Food Pyramid places an importance on physical activity and personalized nutritional needs. The popularization of these concepts will permeate mainstream thought. As these new guidelines are taught to our children, we will see a more healthful society materialize.
Posted by Nicole at 12:13 PM
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May 12, 2005
Proof that Laughing Does a Body Good |
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Finally - scientific proof that laughter reduces the risk of cardiovascular disease. University of Maryland medical researchers demonstrate that vasodilation, and its medical benefits, increase significantly following a good laugh.
In 1979, a groundbreaking book by Dr. Norman Cousins was published, Anatomy of an Illness. In this book, Dr. Cousins described how watching hilarious Marx Brother movies helped him recover from the painful disease, ankylosing spondylitis. He was so thrilled about the effects of laughter and humor that he spent the last 10 years of his life doing clinical research at UCLA Medical School and established the Humor Task Force. Dr. Cousins' work eventually led to the field of psychoneuroimmunology (PNI), a new science hanging on to the edge of medical acceptance. PNI is now a field of medical research that attributes aspects of both the psyche and the nervous system as having a measurable influence on the body's immune system.
The impact of Cousins' work has evolved (over the past 25 years) to the point where research documenting the power of our emotions on the physical body is acceptable. Fast forward to the Scientific Session of the American College of Cardiology on March 7, 2005 in Orlando, Florida. At this session, the University of Maryland Medical Center presented results of a study proving that positive emotion has a positive effect on cardiovascular health. Their results were published online at the University of Maryland School of Medicine's website.
We now know that laughter and positive emotion help blood vessels function better. The inner lining of blood vessels (the endothelium) has a powerful effect on blood vessel tone, regulates blood flow and, in general, plays an important role in cardiovascular disease development. When the endothelium dilates, blood flow is increased - and when it constricts, blood flow is decreased. The principal investigator of this study, Michael Miller, M.D. is the director of preventive cardiology at the University of Maryland Medical Center and associate professor of medicine at the University of Maryland School of Medicine. Dr. Miller claims that "the endothelium is the first line in the development of atherosclerosis or hardening of the arteries, so, given the results of our study, it is conceivable that laughing may be important to maintain a healthy endothelium, and reduce the risk of cardiovascular disease."
This study measured the cardiovascular effects from viewing 30 minute segments of emotion provoking film. They used clips from a movie that caused mental stress, "Saving Private Ryan" (DreamWorks, 1998) and clips from a movie that was humorous, "King Pin" (MGM, 1996). Blood vessel reactivity was measured before and after watching the movies. The findings were that blood vessels dilated following watching a funny movie (increasing in diameter 22%), and that blood vessels constricted following watching a stressful movie (decreasing in diameter 35%). The subjects of this study were non-smokers with healthy cardiovascular systems. The good health of the volunteers removes study bias, lending itself to be respected, reproducible and to contain reliable conclusions.
These results go a long way in supporting Cousins' earlier findings, and in confirming that laughter does a body good. "The magnitude of change we saw in the endothelium is similar to the benefit we might see with aerobic activity, but without the aches, pains and muscle tension associated with exercise," says Dr. Miller. "We don't recommend that you laugh and not exercise, but we do recommend that you try to laugh on a regular basis. Thirty minutes of exercise three times a week, and 15 minutes of laughter on a daily basis is probably good for the vascular system."
Perhaps we'll see a new movement in healthcare, taking the phrase "laughter is the best medicine" to a clinical level. Some people have been quick to catch on, as laughter clinics spring up in hospitals and laughter clubs make a nationwide debut. Most bodyworkers already know that positive emotion and relaxation have far reaching holistic health benefits - except now there is scientific data to back it up.
Posted by Nicole at 05:56 PM
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The Epitome of 'Practice What You Preach' for Massage Therapists |
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As massage therapists, we are familiar with what constitutes a healthy lifestyle. We recommend these applications all the time. But how easy is it to get caught in the hubbub of life, and ignore our own health? A massage therapist shares his story, and encourages us to stay conscious of our body and the environment that we function in.
Common sense dictates that a therapist can only give to their client what is present within themselves. This can present a challenge to many bodyworkers, because many of us are so tuned in to "caretaking" that we neglect our own self care. It can become routine to skip a daily meditation, wolf down a fast food burger and speed through traffic to get to the spa - where eight back to back clients await your services. The "caretaker syndrome" describes the pitfall of putting others needs before our own and often leads to burnout or illness.
In the May 2005 issue of Acupuncture Today, Certified Massage Therapist David J. Razo shares his life changing experience in an article entitled "A Lesson Learned the Hard Way: Caring for Patients Means Caring for Yourself". In this article, Mr. Razo describes his emotional journey as his dangerously high blood pressure (220/120) landed him a trip to an emergency room and subsequent hospital admission.
Mr. Razo's predominant reflection was on simultaneously fostering the health and well-being of himself and that of his clients. In observing the environment of the hospital and noting its impact, the idea that everything one is surrounded with contributes to the healing process really hit home. His awareness of the used alcohol swabs littering the floor, the institutionalized bluish-green wall color and the burials at the cemetery just outside his window escalated to a broader understanding of the effect a healing environment has on the immune system.
A new zest for creating a healing space was compounded by the admission that he was good at giving advice and poor at following it. In all of this reflection, it became apparent that he had allowed all of the healthful lifestyle habits (the very ones he suggests to his clients) erode. In keeping a busy schedule, being hurried became his norm. Stopping to smell the roses, exercise or eat a healthful meal were just words that he repeated to help others - they were no longer a part of who he was. This groove is easy for any healthcare practitioner to fall into. It requires constant self checking to ensure that the inner self is not only heard, but being joyfully nurtured.
Mr. Razo recovered from his chest pain and high blood pressure scare, and is now successfully managing his health. According to Mr. Razo, "...that TLC we nourish our patients with also needs to be directed toward us...take the time to quiet your mind and feel the wind brush past your face." Wise words from a bodyworker recovering from the "caretaker syndrome."
Posted by Nicole at 05:54 PM
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Educate Your Clients About Electric Massagers |
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Properly trained massage therapists know to avoid the carotid artery with direct, vigorous and/or repetitive massage. Handheld electric massagers are sold everyday to the public, and many of those customers don’t read the accompanying directions. Make sure your clients know about the danger of these products in the neck region.
Handheld electric massagers are widely available and seldom used with caution. These massagers are a big business, and can be found almost anywhere -- from a high-end retail chain, to a nook in a neighborhood pharmacy and occasionally in the back of a novelty shop. People predominantly seek these devices out for self relief of stressed, tensed and achy muscles. These products traditionally come with a user's manual that gives basic safety guidelines typical for electrical devices. The manual may also recommend keeping the unit moving, cautioning against holding it in one location for an extended amount of time. Unfortunately, manuals are rarely read cover to cover -- and if they are, consumers tend to take safety guidelines with a grain of salt, meaning, appropriate caution is seldom exercised. Perhaps the litigious nature of our culture has resulted in our callousness toward safety measures, assuming that hazards are overstated to protect the issuer from frivolous negligence lawsuits. It can take a horror story, either personalized or newsworthy, to clue people in to the validity of a safety caution.
A case report entitled "Carotid Dissection Associated with a Handheld Electric Massager" by Arthur C. Grant, MD, PhD and Norman Wang, MD posted by WebMD's Medscape on 2/1/05, was published by the Southern Medical Journal in 2004. This report serves the purpose of a horror story, by bringing our awareness to the appropriate use and safety of electrical massaging devices.
This report is about a 38-year-old woman with a history of migraine headaches and smoking cigarettes for 15 years. She had a right-sided headache with pain extending down into her neck. Over-the-counter pain relievers offered her no help, and after a few days of pain, a friend of hers helped her massage the painful area, using a handheld electric massager on her neck for about 20 minutes. The area on which she focused was just below the angle of the jaw, over the sternocleidomastoid muscle. Five days after the neck massage, this woman had dysarthria (a speech disorder in which the pronunciation is unclear, yet the linguistic content and meaning are normal) and severe left-sided hemiparesis (paralysis). Medical tests confirmed the cause to be an internal carotid artery dissection resulting in a massive ischemic stroke.
A universal misconception about pain is that "no matter where it is, if it hurts, keep rubbing and manipulating it until it feels better." In doing just that, a relatively young woman with no major stroke risk factors suffered from a disabling stroke. Apparently, the warnings to be careful with massage in the area near the carotid artery (lateral neck), and to keep a massaging device in constant movement are serious warnings with significant consequences. This sad account is best served as a caution to anyone using a handheld electric massager, to educate our clients on the proper use of these devices and to impact businesses advertising and packaging these massagers. Instead of a graphic image of a massager being used on the neck, a big red X through such an image might just send a powerful enough message. In the meantime, protect your friends and clients by educating them on this danger, to prevent this type of report from becoming a personal horror story.
Posted by Nicole at 05:52 PM
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