Massage Therapy Body of Knowledge

Comment

Comment by Mike Hinkle on October 5, 2009 at 12:15pm

Hi Carl,

Your words:

"This BOK is not so much about mastering a skill but recognizing boundaries of a scope of practice."

However, the problem as I see it is that if it is not done properly it can negatively affect not only thouse who practice within the scope of Swedish or use Swedish are part of what they do but instead the entire bodywork field.

Carl, now you are seeing it. This is not about Swedish, Asian or energy work. It's about licensed massage therapists. There are parameters that affect all therapists. Most therapists, starting out, have no idea which direction they will head towards in the profession. They simply want to learn it all, well at least a little of everything. How else will they know if they'll like it?

No where in this BOK does it say you must "master" anything, as you say above. I know you want to make this a (us vs them) with the discussion of Swedish vs Asian/Medical. It has nothing to do with this.

I understand how energy workewrs have concerns and I have them as well. But I will do something to address those concerns and not repudiate the profession's efforts to organize. I have seen nothing that would keep Reiki or any energy workers from continuing as they presently are.

Bert is right, I agree with you about a lot of what you say, but some things, not!

Comment by Bert Davich on October 5, 2009 at 12:15pm

Beautifully said Carl,
That is exactly what I have been trying to say. The BOK should initially be about standards of practice for touch therapy and should include all types of practice and modalities. That should be the FIRST order of business for the BOK. Until that is completed, anything else is premature as 'anything else' should be done with consideration for an established standard of practice, which has not been completed.

It is my hope that instead of trying to throw together a BOK to meet some arbitrary deadline, the BOK group would slow down and concentrate on and complete a standards of practice in a mindful way. The 'volunteers' need to relinquish their desire to be the ones to complete this mission while they are in control or prepare for the long haul to do it in a mindful way.

Comment by Carl W. Brown on October 5, 2009 at 11:16am

I believe that the measure of an expert is that they have a clear understanding of what they do not know. It seems that if MTs do harm it is often working outside of there scope of practice such as advising a person that may contradict a doctor’s advise. While is should be clear that to we not be telling people not to get flu shots or what ever, the issues becomes less clear when if deals with mental issues. People often talk about problems of have emotional shifts then we work on them. Most MTs are not properly trained to have a clear understanding of where what they are doing shift into non-professional psychology or how to direct people to get help when they need it. This BOK is not so much about mastering a skill but recognizing boundaries of a scope of practice.
I see some people playing with fire but explicitly provoking emotional outbursts or adding coaching to what they do.
Then there is the issue that licensing laws often prohibit mixing touch with psychology so what do you do with people who need the combination. I have attended Somatic Experiencing training sessions and can appreciate the power of the work. I also majored in psychology and understand some of the pitfalls of untrained practitioners.

Comment by Bert Davich on October 4, 2009 at 9:38pm

Carl, I agree with you on much of what you say, with some exceptions, like your statements "I don’t believe that written tests will work but that does not mean that they cannot be tested" and "It is like Reiki. I feel it from some people and not others. However since it is undirected energy I don’t know that it can be tested"

As a Reiki trained therapist I dispute that the energy is 'undirected'. The Energy does not come from the practitioner, but is directed through the practitioner to the recipient.

Again the problem is who is going to do the testing and what standards are going to be applied to a medium that cannot be quantitatively be described?

Regarding your computer consulting work, it might surprise you to know that I did the computer mathematical simulations for a game that was introduced into a Las Vegas Casino in the 1080's that was scrutinized by the gaming control board's consultants and passed muster. I also did simulations on "Pai Gow" for a casino that was 'concerned' about the percentage of hold on the game. I have no degrees or qualifications that qualify me to have done this, but I was proven correct both times.

My point here is that when we are dealing with energy work which is something that cannot be quantified (as simulations can be) further regulation by individuals who do not understand what they are regulating would impede proper practice and innovation. Period

Comment by Carl W. Brown on October 4, 2009 at 2:04pm

I did not get involved in the BOK originally because I do not do Swedish work and feel that it should be developed by thouse who do because they understand it better than I. However, the problem as I see it is that if it is not done properly it can negatively affect not only thouse who practice within the scope of Swedish or use Swedish are part of what they do but instead the entire bodywork field.

I have had a bit of experience including 6 years as chairman of the Independent Computer Consultants Association professional standards and ethics committee. It was doing that work that I discovered the importance of a standards of practice. I was also chairman of a committee that worked on the standards for the predecessor to the USB bus. I have also served on committees ranging form the Orinda Transportation committee to the Unicode standards organization.

I worked with computers for 40 years where the function of programming is to understand and model a problem or situation. With bad modeling and the program produces bad information even if the data is good.

A good example that most people can understand is when I was doing disaster recover planning for Levi Strauss part of what I did was develop scenarios to test our plan. We would go though exercises to test the plan, note what when wrong and correct the plan. One of my earthquake scenarios very closely matched the Loma Preita quake that came 8 years later. I predicted the cypress structure collapse and even that exact point that the Bay Bridge would collapse. However I made a mistake and thought that because the downtown area was fed by several power grids that power would be restored quickly. However I had neglected to consider that every high-rise building in each area had to be inspected floor by floor before they could reconnect power to the grid. The other parts of the plan works great but it took days to get power back to the computer center and many of the offices. Fortunately, they at a backup center near Dallas but it would have been better to have pushed to add a backup generator for the facility.

While I don’t think misunderstandings will be as bad as burning witches thinking they caused the plague, but the current standards add material that is inappropriate. Teaching thinks like energy to people who will not use it is a waste of time and money as is teaching anatomy and physiology they MTs will forget. It is a better use of time and money to focus on making them better professionals.

If we address a standard they we would like to see rather than just focusing on harm, we could include things like evidence based practice that can later serve as a way of integrating further training and modalities.

Like the plan I helped develop for Levi, the solutions were unique to Levi’s business. This BOK cannot be applied to all forms of massage and bodywork. The BOK not only has to be complete for the modality but cost effective as well. There were things we could have added to Levi’s plan but were not cost effective. It has to be enough but not too much.

I think different modalities will also need different types of testing. For example I envision testing things like Asian but checking to see that one can come up with consistent assessments and they others can “feel” the changes they you have done. Personally I have felt when some other practitioners work on my patients. They leave “fingerprints”. I have had acupuncture and have not felt anything nor gotten any benefit but I have had sessions where I can feel the difference energetically. While I have not benefited I have seen concrete results in other patients. I don’t believe that written tests will work but that does not mean that they cannot be tested.

It is like Reiki. I feel it from some people and not others. However since it is undirected energy I don’t know that it can be tested.

Comment by Darcy Neibaur on October 3, 2009 at 11:19pm

Hey Guys,

Thank you so much for your in depth sharing on the MTBOK First Draft. I have tryly enjoyed reading your comments. You have all brought out food for thought. I have a printed copy here that I am reading through and hopefully will finish soon.

Comment by Bert Davich on October 3, 2009 at 10:53pm

Thank you for your comments and for starting this discussion which has enlightened me in ways I did not expect at the time I joined. Hearing how others process and and define what we do is a growth process in itself.

I do know that modalities can be combined successfully, including therapeutic massage and energy work because I have experienced great results doing that. A 90 minute session of 'hard core' structural work without a break can be overwhelming to a client. The 'in between' work that facilitates a client to reach parasympathetic mode is a major factor in in successful treatment. Knowing what 'in between' work any given client needs to facilitate entry into that mode is truly an art which I strive to develop further every time I lay hands on a client. Sometimes it may be a a few strokes of slow effleurage, other times it may be Reiki or a light energetic touch. In my experience, combining energy and structural work has resulted in the best outcome time after time. However, there is no way to quantify that except to see and hear the client response, which would be considered subjective.

Comment by Carl W. Brown on October 3, 2009 at 8:27pm

Bert, much of what we do is art. It is interesting that while one may think of orthopedic bodywork as objective because it focuses on a detailed anatomical model, it too requires years to learn. Like energy work it is a learning process that does not test well nor fits into a traditional learning system. The Lauren Berry work which was developed by a person who combined what he learned at the Alameda morgue with structural engineering learned at UC requires the type of learning where the student is the best judge of what they learn. One can take the same class again and learn new things. Learning the muscle what it does, where it is and what it is called is just the start. You learn how the muscle thinks of itself, and the body’s feeling of the muscle. What if feels like healthy and when it has issues. Even how it feels in different people. I was told that it takes at least 10 years to learn and much of it comes from working with your mentor on their clients.

I mentioned spa work because even though it does not focus on heath issues it is something with fairly standard requirements. It is ironic because the word spa comes from “sanus per aquam” or Latin for health through water.

Comment by Bert Davich on October 3, 2009 at 5:27pm

Carl,
Your statement that you think of acupressure as the modality to use pressure point in the same fashion as acupuncture without needles is exactly my point. That is the 'original theory' and does not take into account the evolution of "finger pressure". The expertise you associate with acupressure is applicable to acupuncture which takes 10 years of study/mentoring to master and would still be not be quantifiable. I personally would not let a someone with a few months of training in acupuncture stick needles in me. Acupressure does not require the same level of expertise to be used effectively. Go to 3 different acupressure and acupuncturists and get their exact chi flow evaluation. If they are identical I will retract what I said. Who is going to determine that a therapist can accurately read the pulse and determine chi flow. Determining chi flow is not an objective science. It is an art. When you say a therapist should learn each modality 'completely' you assume there is a finite amount of knowledge associated with each "modality" and ignore the overlaps which are infinite as well as new innovations introduced by pioneers. You also seek to quantify the ability of a therapist to connect to the energetic field of the client, which is not quantifiable. It would behoove you to re-think your position on energy related work which by nature is not quantifiable. I respect the position of others on this issue, but have a problem when they seek to quantify an un-quantifiable art and force their position on everyone else.

Regarding Spa's and their 'amenities', they are a business model that is based on 'pampering', not on healing those in need and should be approached with that in mind.

You stated "there may be issues where experts disagree" and that is exactly my point! Who decides which experts are "right" and get their position written in stone. Setting standards of practice should be simple non-partisan non-modality standards that can be applied to any touch therapy without defining specific modalities that can or cannot be applied in specific situations. ESPECIALLY energy related work which cannot be measured, compared or quantified objectively.

Comment by Carl W. Brown on October 3, 2009 at 3:38pm

I don’t think BOKs lead to modality compartmentalization but rather insure that if you learn a modality that you do so completely within the scope of the modality. I think the better therapists take from what they learn and make it their own. However they should learn each modality completely.

I think of acupressure as the modality to use pressure point in the same fashion as acupuncture without needles. It requires that a person take pulse examine the tongue etc. to determine chi flow problems. Shiatsu may be dependent on acupressure or an overlapping modality. I am not the expert here.

There may be issues where experts disagree. Is CST crainopathy, Upledger or biodynamic? Even within Swedish there are differences. Do you include all the spa amenities such as mud wraps, hydrotherapy etc. It makes sense if you are standardizing people to work in the spas. However another approach is to set standards and then add an extra BOK for spa certification.

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