What have you learned about dissociation? - massage and bodywork professionals2024-03-29T00:32:01Zhttps://massageprofessionals.com/forum/topics/what-have-you-learned-about?commentId=2887274%3AComment%3A192223&feed=yes&xn_auth=noThanks to Daniel for posting…tag:massageprofessionals.com,2011-07-28:2887274:Comment:1961072011-07-28T19:26:33.876ZTherese Schwartzhttps://massageprofessionals.com/profile/ThereseSchwartz
<p>Thanks to Daniel for posting the link to the definition. Like Stephen I think I had a misconception about dissociation and I'm really glad we are having this discussion!</p>
<p> </p>
<p>Rick, your work sounds fascinating! I thought I'd be done with taking Upledger CranioSacral courses after SomatoEmotional Release 2 because I didn't think my clients would need me to take more than that to get them somewhere good. I was wrong, and will be taking the 2 remaining classes! The focus of them…</p>
<p>Thanks to Daniel for posting the link to the definition. Like Stephen I think I had a misconception about dissociation and I'm really glad we are having this discussion!</p>
<p> </p>
<p>Rick, your work sounds fascinating! I thought I'd be done with taking Upledger CranioSacral courses after SomatoEmotional Release 2 because I didn't think my clients would need me to take more than that to get them somewhere good. I was wrong, and will be taking the 2 remaining classes! The focus of them is to have the therapists work on each other so that we "can bring better therapists to the table". I heard somewhere that we can only get people as far as we have gotten in our own personal growth. So I work really hard on myself as well.</p>
<p> </p>
<p>Stephen, one I can hear you say "it should be "have got in our own personal growth"! :) Decades later I'm still confused on that particular grammatical construct having got/gotten it wrong on both sides of the Atlantic! OK seriously now, the sensory deprivation tanks make me queasy just thinking about them. I'm fairly sure that I would be quite traumatized by being in one. But then I'm one of the childhood abuse people who has issues with many aspects related to dissociation (well, it used to be a lot worse. I've worked hard!).</p> Rick,
this is of great intere…tag:massageprofessionals.com,2011-07-28:2887274:Comment:1957072011-07-28T09:06:31.589ZStephen Jeffreyhttps://massageprofessionals.com/profile/StephenJeffrey
<p>Rick,</p>
<p>this is of great interest, have you any more links or articles you can guide us to ?</p>
<p>Flotation tank therapy was very trendy a while back, was there any problems with dissociation and psychotic episodes given the conditions when inside the tank? (if I'm completely off track with this then I apologise) <br></br><br></br><cite>Rick Rosen said:</cite></p>
<blockquote><div><p>Stephen,</p>
<p>Thanks for that acknowledgement. I started out as a massage therapist in 1978, and soon…</p>
</div>
</blockquote>
<p>Rick,</p>
<p>this is of great interest, have you any more links or articles you can guide us to ?</p>
<p>Flotation tank therapy was very trendy a while back, was there any problems with dissociation and psychotic episodes given the conditions when inside the tank? (if I'm completely off track with this then I apologise) <br/><br/><cite>Rick Rosen said:</cite></p>
<blockquote><div><p>Stephen,</p>
<p>Thanks for that acknowledgement. I started out as a massage therapist in 1978, and soon crossed paths with Ron Kurtz, a pioneer in the area of body-centered psychotherapy. His work became known as Hakomi Therapy, <a target="_blank" rel="nofollow" href="http://www.ronkurtzhakomi.com">which continues today</a>. (Kurtz passed away in January of this year). After my initial training with Kurtz, I went back to school and earned a master's degree in psychology from West Georgia College, which had a strong Humanistic Psychology emphasis in the department.</p>
<p>In both private practice and teaching, I've always held a focus on the interrelationship of body, mind, emotions and energy.</p>
<p>This discussion thread is important, in that it brings attention to the therapist's ongoing responsibility to not only track and attend to the state of the client's experience, but also their own. Michael Shea, PhD, a noted scholar and clinician in our field who has published books on Somatic Psychology and Biodynamic Craniosacral Therapy, suggests the "80/20" guideline: that the practitioner maintains about 80% of attention on their own present-centered experience during the session, and the other 20% on the client. While this may seem counter-intuitive, it's based on findings that it is the psychosomatic state of the therapist that is the most powerful factor in influencing the client's well-being and healing process.</p>
<p>When I hear anecdotal stories about therapists "going unconscious" and grinding out too many sessions in a day, or allowing distractions to regularly divert their focus, it suggests that our field still has a long way to go to bring a truly healing framework to the client-therapist relationship.</p>
</div>
</blockquote> Stephen,
Thanks for that ackn…tag:massageprofessionals.com,2011-07-26:2887274:Comment:1947292011-07-26T23:19:42.660ZRick Rosenhttps://massageprofessionals.com/profile/RickRosen
<p>Stephen,</p>
<p>Thanks for that acknowledgement. I started out as a massage therapist in 1978, and soon crossed paths with Ron Kurtz, a pioneer in the area of body-centered psychotherapy. His work became known as Hakomi Therapy, <a href="http://www.ronkurtzhakomi.com" target="_blank">which continues today</a>. (Kurtz passed away in January of this year). After my initial training with Kurtz, I went back to school and earned a master's degree in psychology from West Georgia College, which had…</p>
<p>Stephen,</p>
<p>Thanks for that acknowledgement. I started out as a massage therapist in 1978, and soon crossed paths with Ron Kurtz, a pioneer in the area of body-centered psychotherapy. His work became known as Hakomi Therapy, <a href="http://www.ronkurtzhakomi.com" target="_blank">which continues today</a>. (Kurtz passed away in January of this year). After my initial training with Kurtz, I went back to school and earned a master's degree in psychology from West Georgia College, which had a strong Humanistic Psychology emphasis in the department.</p>
<p>In both private practice and teaching, I've always held a focus on the interrelationship of body, mind, emotions and energy.</p>
<p>This discussion thread is important, in that it brings attention to the therapist's ongoing responsibility to not only track and attend to the state of the client's experience, but also their own. Michael Shea, PhD, a noted scholar and clinician in our field who has published books on Somatic Psychology and Biodynamic Craniosacral Therapy, suggests the "80/20" guideline: that the practitioner maintains about 80% of attention on their own present-centered experience during the session, and the other 20% on the client. While this may seem counter-intuitive, it's based on findings that it is the psychosomatic state of the therapist that is the most powerful factor in influencing the client's well-being and healing process.</p>
<p>When I hear anecdotal stories about therapists "going unconscious" and grinding out too many sessions in a day, or allowing distractions to regularly divert their focus, it suggests that our field still has a long way to go to bring a truly healing framework to the client-therapist relationship.</p> Hi Rick
you seem to have put…tag:massageprofessionals.com,2011-07-26:2887274:Comment:1949122011-07-26T22:58:55.862ZStephen Jeffreyhttps://massageprofessionals.com/profile/StephenJeffrey
<p><br></br>Hi Rick</p>
<p>you seem to have put the phenomena and definition together very well, was this part of your massge training or something learnt whilst in another profession.?</p>
<p> </p>
<p>You say</p>
<p><em>When the therapist notices the client is no longer "present" -- different from that soft, drifty-kind of state that is common among massage clients -- the therapist should pause their hands-on work, and check in with the client. If the client seems detached from their bodily…</em></p>
<p><br/>Hi Rick</p>
<p>you seem to have put the phenomena and definition together very well, was this part of your massge training or something learnt whilst in another profession.?</p>
<p> </p>
<p>You say</p>
<p><em>When the therapist notices the client is no longer "present" -- different from that soft, drifty-kind of state that is common among massage clients -- the therapist should pause their hands-on work, and check in with the client. If the client seems detached from their bodily experience, is having difficult communicating, looks pale, or is otherwise "not there", the therapist should take time to gently bring the client's attention back into their body, into eye contact with the therapist, and into a normal, full breathing pattern.</em></p>
<p>How often in your sessions has this happened to you<em>?</em></p>
<p>As massage therapists we are taught many manual skills that are learnt in a purely physical way. The concentration on technique/stance/pressure etc often keeps us too focused on physical aspects, when in fact, many a satifactory resolution to pain is because we have correctly (all be it unintentionally) engaged/freed the mind. </p>
<p>regards steve </p>
<p> </p>
<p> <br/><cite>Rick Rosen said:</cite></p>
<blockquote><div><p>Dissociation is a real phenomena, and massage therapists need to pay attention to the state of their client <span style="text-decoration: underline;">at all times</span>. We are treating a person in a real-time process, not just massaging soft tissue. With that said, I agree with Laura that massage therapists should not engage in counseling or processing a client's dissociative experiences. At the same time, it's not as simple as just letting the client "come back" into their body at the end of a massage/bodywork session.</p>
<p>Dissociation can be mild and insignificant, like when a client drifts into a semi-sleep state. It can also be more pronounced or even extreme. It is not beneficial for a strongly-dissociated client to continue to receive massage, as they are not able to adequately take in or process the somatic input. In some cases, continued touch while dissociated can drive trauma deeper into the soma. A client in this state may not even be able to communicate their experience or their needs to the therapist. At that point, the massage is no longer producing therapeutic benefits.</p>
<p>When the therapist notices the client is no longer "present" -- different from that soft, drifty-kind of state that is common among massage clients -- the therapist should pause their hands-on work, and check in with the client. If the client seems detached from their bodily experience, is having difficult communicating, looks pale, or is otherwise "not there", the therapist should take time to gently bring the client's attention back into their body, into eye contact with the therapist, and into a normal, full breathing pattern.</p>
<p>Once the client is able to make the shift back in and is stable there, the therapist should ask the client if they want to continue the massage session (as originally scripted at the beginning), modify the remainder of the session, or end the session. A one-time occurrence may not be a cause for alarm (unless it's serious), but any kind of <span style="text-decoration: underline;">repeating pattern</span> of dissociation is a strong indication for a referral to an appropriate mental health professional who is experienced in working with this phenomenon. Finding and treating the source of dissociation is out of the scope of practice for massage and bodywork therapy.</p>
<p>By the way, I'd pay money to see Laura "counseling" clients in a show like Dr. Phil. ;-)</p>
<p> </p>
<p>Rick Rosen, MA, LMBT</p>
</div>
</blockquote> I think we ought to do a skit…tag:massageprofessionals.com,2011-07-26:2887274:Comment:1938752011-07-26T09:35:50.672ZLaura Allenhttps://massageprofessionals.com/profile/LauraAllen
I think we ought to do a skit at the AFMTE. I'll be Dr. Phil and you can be my patient! LOL<br></br>
<br></br>
<cite>Rick Rosen said:</cite><br />
<blockquote cite="http://www.massageprofessionals.com/forum/topics/what-have-you-learned-about#2887274Comment192218"><div><p>Dissociation is a real phenomena, and massage therapists need to pay attention to the state of their client <span style="text-decoration: underline;">at all times</span>. We are treating a person in a real-time process, not just massaging…</p>
</div>
</blockquote>
I think we ought to do a skit at the AFMTE. I'll be Dr. Phil and you can be my patient! LOL<br/>
<br/>
<cite>Rick Rosen said:</cite><br />
<blockquote cite="http://www.massageprofessionals.com/forum/topics/what-have-you-learned-about#2887274Comment192218"><div><p>Dissociation is a real phenomena, and massage therapists need to pay attention to the state of their client <span style="text-decoration: underline;">at all times</span>. We are treating a person in a real-time process, not just massaging soft tissue. With that said, I agree with Laura that massage therapists should not engage in counseling or processing a client's dissociative experiences. At the same time, it's not as simple as just letting the client "come back" into their body at the end of a massage/bodywork session.</p>
<p>Dissociation can be mild and insignificant, like when a client drifts into a semi-sleep state. It can also be more pronounced or even extreme. It is not beneficial for a strongly-dissociated client to continue to receive massage, as they are not able to adequately take in or process the somatic input. In some cases, continued touch while dissociated can drive trauma deeper into the soma. A client in this state may not even be able to communicate their experience or their needs to the therapist. At that point, the massage is no longer producing therapeutic benefits.</p>
<p>When the therapist notices the client is no longer "present" -- different from that soft, drifty-kind of state that is common among massage clients -- the therapist should pause their hands-on work, and check in with the client. If the client seems detached from their bodily experience, is having difficult communicating, looks pale, or is otherwise "not there", the therapist should take time to gently bring the client's attention back into their body, into eye contact with the therapist, and into a normal, full breathing pattern.</p>
<p>Once the client is able to make the shift back in and is stable there, the therapist should ask the client if they want to continue the massage session (as originally scripted at the beginning), modify the remainder of the session, or end the session. A one-time occurrence may not be a cause for alarm (unless it's serious), but any kind of <span style="text-decoration: underline;">repeating pattern</span> of dissociation is a strong indication for a referral to an appropriate mental health professional who is experienced in working with this phenomenon. Finding and treating the source of dissociation is out of the scope of practice for massage and bodywork therapy.</p>
<p>By the way, I'd pay money to see Laura "counseling" clients in a show like Dr. Phil. ;-)</p>
<p> </p>
<p>Rick Rosen, MA, LMBT</p>
</div>
</blockquote> I think of this topic mostly…tag:massageprofessionals.com,2011-07-23:2887274:Comment:1935072011-07-23T13:45:31.589ZLee Edelberghttps://massageprofessionals.com/profile/LeeEdelberg
<p>I think of this topic mostly in relation to physical and/or sexual abuse, often from childhood. My social service oriented friends and colleagues tell me that this type of abuse occurs in almost epidemic proportions, and they say that the majority of victims are women. </p>
<p>So I try to be aware that the client on the table could be harboring some very deep trauma that could be triggered unexpectedly, with dissociation being one line of defense.</p>
<p> </p>
<p>On a much more mundane…</p>
<p>I think of this topic mostly in relation to physical and/or sexual abuse, often from childhood. My social service oriented friends and colleagues tell me that this type of abuse occurs in almost epidemic proportions, and they say that the majority of victims are women. </p>
<p>So I try to be aware that the client on the table could be harboring some very deep trauma that could be triggered unexpectedly, with dissociation being one line of defense.</p>
<p> </p>
<p>On a much more mundane level, I figure that our mind can't keep track of every bit of trauma and pain it's experienced, so it shuts things off to be able to deal with the here and now. Part of my focus in a session is to gently bring awareness to the various parts of a persons' body so their healing mechanisms can kick in.</p> Hi Daniel
thanks for this def…tag:massageprofessionals.com,2011-07-23:2887274:Comment:1930332011-07-23T08:40:17.018ZStephen Jeffreyhttps://massageprofessionals.com/profile/StephenJeffrey
<p>Hi Daniel</p>
<p>thanks for this definition, did I use the term incorrectly on another thread when trying to explain how it is possible for a therapist to palpate and know (by experience) that the condition of the tissues as palpated should be feeling very tender or even extreamly painfull. But the client reports no pain?????</p>
<p>Is this wrong to use this terminology or is this indeed a form of dissociation. ?????? <br></br><br></br><cite>Daniel Cohen said:</cite></p>
<blockquote><div><p>I was…</p>
</div>
</blockquote>
<p>Hi Daniel</p>
<p>thanks for this definition, did I use the term incorrectly on another thread when trying to explain how it is possible for a therapist to palpate and know (by experience) that the condition of the tissues as palpated should be feeling very tender or even extreamly painfull. But the client reports no pain?????</p>
<p>Is this wrong to use this terminology or is this indeed a form of dissociation. ?????? <br/><br/><cite>Daniel Cohen said:</cite></p>
<blockquote><div><p>I was not familiar with the term. But after looking it up I can say I've found this with a few clients. I agree with the view that specifically treating this is beyond the scope of our profession. However, what we do, as others have pointed out can be a trigger. We can be there, which may be enough. How it comes into play during massage for trauma victims, I believe, should be part of the core massage therapist education.</p>
<p><a target="_blank" rel="nofollow" href="http://en.wikipedia.org/wiki/Dissociation">The definition</a></p>
</div>
</blockquote> ~
I second this. I can hea…tag:massageprofessionals.com,2011-07-22:2887274:Comment:1922232011-07-22T14:56:38.925ZLas Vegas Massage In Summerlinhttps://massageprofessionals.com/profile/las_vegas_massage_in_summerlin
<p>~</p>
<p> </p>
<p>I second this. I can hear her now, "Bless your heart." :-)</p>
<p> </p>
<p>Kris</p>
<p><br/><br/><cite>Rick Rosen said:</cite></p>
<blockquote><div><p>By the way, I'd pay money to see Laura "counseling" clients in a show like Dr. Phil. ;-)</p>
<p> </p>
<p>Rick Rosen, MA, LMBT</p>
</div>
</blockquote>
<p>~</p>
<p> </p>
<p>I second this. I can hear her now, "Bless your heart." :-)</p>
<p> </p>
<p>Kris</p>
<p><br/><br/><cite>Rick Rosen said:</cite></p>
<blockquote><div><p>By the way, I'd pay money to see Laura "counseling" clients in a show like Dr. Phil. ;-)</p>
<p> </p>
<p>Rick Rosen, MA, LMBT</p>
</div>
</blockquote> I was not familiar with the t…tag:massageprofessionals.com,2011-07-22:2887274:Comment:1923062011-07-22T14:21:53.640ZDaniel Cohenhttps://massageprofessionals.com/profile/DanielCohen
<p>I was not familiar with the term. But after looking it up I can say I've found this with a few clients. I agree with the view that specifically treating this is beyond the scope of our profession. However, what we do, as others have pointed out can be a trigger. We can be there, which may be enough. How it comes into play during massage for trauma victims, I believe, should be part of the core massage therapist education.…</p>
<p></p>
<p>I was not familiar with the term. But after looking it up I can say I've found this with a few clients. I agree with the view that specifically treating this is beyond the scope of our profession. However, what we do, as others have pointed out can be a trigger. We can be there, which may be enough. How it comes into play during massage for trauma victims, I believe, should be part of the core massage therapist education.</p>
<p><a href="http://en.wikipedia.org/wiki/Dissociation" target="_blank">The definition</a></p> Dissociation is a real phenom…tag:massageprofessionals.com,2011-07-22:2887274:Comment:1922182011-07-22T13:44:22.553ZRick Rosenhttps://massageprofessionals.com/profile/RickRosen
<p>Dissociation is a real phenomena, and massage therapists need to pay attention to the state of their client <span style="text-decoration: underline;">at all times</span>. We are treating a person in a real-time process, not just massaging soft tissue. With that said, I agree with Laura that massage therapists should not engage in counseling or processing a client's dissociative experiences. At the same time, it's not as simple as just letting the client "come back" into their body at the end…</p>
<p>Dissociation is a real phenomena, and massage therapists need to pay attention to the state of their client <span style="text-decoration: underline;">at all times</span>. We are treating a person in a real-time process, not just massaging soft tissue. With that said, I agree with Laura that massage therapists should not engage in counseling or processing a client's dissociative experiences. At the same time, it's not as simple as just letting the client "come back" into their body at the end of a massage/bodywork session.</p>
<p>Dissociation can be mild and insignificant, like when a client drifts into a semi-sleep state. It can also be more pronounced or even extreme. It is not beneficial for a strongly-dissociated client to continue to receive massage, as they are not able to adequately take in or process the somatic input. In some cases, continued touch while dissociated can drive trauma deeper into the soma. A client in this state may not even be able to communicate their experience or their needs to the therapist. At that point, the massage is no longer producing therapeutic benefits.</p>
<p>When the therapist notices the client is no longer "present" -- different from that soft, drifty-kind of state that is common among massage clients -- the therapist should pause their hands-on work, and check in with the client. If the client seems detached from their bodily experience, is having difficult communicating, looks pale, or is otherwise "not there", the therapist should take time to gently bring the client's attention back into their body, into eye contact with the therapist, and into a normal, full breathing pattern.</p>
<p>Once the client is able to make the shift back in and is stable there, the therapist should ask the client if they want to continue the massage session (as originally scripted at the beginning), modify the remainder of the session, or end the session. A one-time occurrence may not be a cause for alarm (unless it's serious), but any kind of <span style="text-decoration: underline;">repeating pattern</span> of dissociation is a strong indication for a referral to an appropriate mental health professional who is experienced in working with this phenomenon. Finding and treating the source of dissociation is out of the scope of practice for massage and bodywork therapy.</p>
<p>By the way, I'd pay money to see Laura "counseling" clients in a show like Dr. Phil. ;-)</p>
<p> </p>
<p>Rick Rosen, MA, LMBT</p>