When I receive bodywork - most notably acupuncture and massage, my therapists  remark on how loudly my body speaks.  They say that it almost seems like my body is yelling sometimes - "I want you to focus here! I want you do do that!"  And when they check in about what they think the bossy body is saying, it's almost always something I am thinking while I'm on the treatment table.   The health providers that I trust and stick with for the long term,  joke about my very "bossy" body. These excellent practitioners are not intimidated by the prolific non-verbal and sometimes out-loud verbal directions that help them focus better on helping me. And vice versa, when they say my body is "bossy",  I take it as a compliment - a bossy body is one that knows what it likes and needs.

My acupuncturist, Polly, often finds herself in the middle of a session puzzling why she is putting in so many needles or why she is leaving them to "cook" for so long or so deep, then she realizes - "oh its Marian" and she can relax.  She remembers that my body happens to like all that focused sensation and takes it's sweet time to process it.

And last time I went to my bodyworker, Katharine, she started telling me how "they" were telling her not to push so hard on my belly to give it relief.  At first I thought she was talking about her spirit guides -  she has told me that she talks intuitively to a bunch of exotic healing entities. But when I asked her point blank who she was talking to in regards to my body, she admitted she was conversing with my intestines.

Its not just nonverbal, mystical, intuitive messages that make up the way my body communicates, I can also use my mouth to flat out say what I want.  It is not uncommon for me to request, "Could you apply kneading or jostling so that my pain has somewhere to go, instead of pushing down on it?  I don't like the way that I feel with static force.  It feels like that kind of pressure traps the pain in my body."   (I have been teaching, writing about and applying massage for so long that I can be very specific in my requests.) Good health practitioners are grateful for my specificity.  They realize that my bossiness actually makes their job easier. They don't have to wonder what is the right thing to do. They don't have to pretend that they can intuit what I want when I am right there clarifying everything for them. They don't get caught up in their own ego.

I love my bossy body.  I revel in its voice.  For many years that voice was muted by confusion over my medically unexplained chronic pain and the prescriptions that I poured into my system to drown out the intractable hurt.  I didn't understand at all at any level, conscious or not, what could help me climb out of that morass.  I was at the mercy of therapists who didn't care how I wanted to be treated and who proclaimed conflicting diagnoses and treatments.  Heck, one local PT known around town for her "intuitive" bodywork met me and then arranged my body on the table like Jesus up on the cross.  She then started yelling at me "There, there!! you are a martyr!".  (Needless to say, the dramatics didn't help me and I didn't return.) Over years of dealing with personalities and agendas in alternative health that tried to boss me around just because I was sick, I learned that developing my own bossy body is a good thing.

So now I am so grateful for my beautiful mixed up crazy "bossy body" and any help it wants to share..

Calibration
A good health provider can model caring by the way they calibrate the modality that they practice.  Here are examples of how a therapist can hone your self-care, drawn from two of the modalities that I most rely on: Massage Therapy and Qigong/Tai chi.

Massage
    Massage therapists use touch to shine a spotlight on places of dis-ease, but more importantly, to shine the light of awareness on places of “ease” in your body. After a series of sessions your ability to feel and take refuge in places that feel good increases. Those body regions of refuge expand after repeated sessions, while areas of discomfort become less intense and smaller as they diffuse and are absorbed into healthier tissues. The most effective massage therapists will never make you grimace through painful pressure. They know that you are far more likely to experience longer lasting and quicker acting results when they massage right up to the edge of tension without forcing past. This technique establishes awareness and the possibility of release without increasing tension, strain and pain. After experiencing the ease with a professional, you may find that you can get in touch with your body in a new way using your own hands. You may even be able to feel the knots melting underneath your hands, or your own energy pulsing beneath your fingers, as it releases. And you may want to reinforce this knowledge by having your therapist give you a good working over. Let this become your once-a-month, twice-a-month or weekly treat to take care of yourself.

Qigong/Tai chi
    Qigong/Tai chi is a movement meditation enhanced with imagery. At its most basic level, Qigong is a practice of following  the continuously changing sense of life force energy as it moves through you. Self-practice reinforced with weekly or biweekly group practice/classes are ideal to build Qi (energy) and one’s connection with self, others, and nature. A good Qigong coach teaches and encourages you with this loving practice.
    The word master, as in “Qigong Master” is somewhat intimidating – it implies a lineage that has been passed down and teachings that cannot be adjusted in any way. However, Qigong literally means “energy work” (Qi = energy and gong = work, so we’re actually learn to “gong our Qi”). This energy work is an iterative process, and naturally changes over time by the people who put it in to practice. The best Qigong coaches or tai chi instructors encourage students to develop a solo practice that meets their individual needs.
    For example, when I practice the pose “Carry tiger to the mountain” and feel the incredible release in my body as my hands reach up to release my burden/the tiger’s spirit into the sky, that body sensation is how I understand the form.  The pose “Holding up two mountains” is honed to my exact needs when I feel just how much to extend my arms in order to express “right place, right time”.
    I am not the first to adapt Chinese movement forms for personal needs. The Yang family adapted Tai chi to reflect a health generating form from the twisting, powerful Tai Chi movements expressed by the Chen family. Qigong and Tai chi were the original Chinese medicines, before acupuncture, before herbs. Movement practice doesn’t depend on any outside substance or procedures– just an increasing trust of one's own body and how it wants to move.

Compassion
Once you have chosen therapeutic modalities to support your unique needs, what else does taking care mean? In colloquial language, “take care” is often used to mean “WATCH OUT!!!” Sometimes when you leave on an airplane, friends and family cry out: “Take care!” They really mean: “Take care not to get killed on the airplane! Take care not to get hijacked!” However, taking care is so much more than a warning. Taking care can be like the soft brush of a mother’s hand on your cheek. Say to yourself: “There, there, I know it hurts, but I am here for you.” You can be your own best friend on the journey towards wellness.

Most of us are nicer to everyone else than we are to ourselves. When we practice accompanying ourselves with love and kindness throughout the day, whether things go well or not, it can translate into all sorts of benefits, some tangible, some not. This loving practice can build a resiliency to carry us through to the next thing in our lives.

Taking care of yourself compassionately can be the intentional path to try the next step proposed by a practitioner even if it seems scary or strange. Taking care can involve following through on exercises or lifestyle changes that support the healthier you. And taking care can be giving yourself a break when you are sick of only eating rice and vegetables every day and decide to splurge on a piece of chocolate for a special occasion!

Communication
Taking care is not blindly letting a therapist dictate significant lifestyle changes. Patients are not empowered when a doctor simply hands out a bunch of pills, although sometimes medications can be a necessary jump start towards wellness. Similarly, people don’t feel stronger when handed out a bunch of prescriptions of what they have to do – for example, lots of exercises or food restrictions without consideration of how to implement the lifestyle changes in real life. No one can live on kale salad and mushrooms alone or 3-6 hard hours of cardio every day—unless it gives them joy.

In my mind, dogged adherence to rules is little better than downing a bunch of drugs. Asking hard questions of my practitioners about how I can do what I am asked to do makes me feel stronger. Communication is empowering.

Choice
Last but not least, taking care involves exercising choice. The power of expectation and choice is illustrated by one of my favorite research studies, ever. Kalauokalani, D. et. al. (1) studied 135 patients randomized to receive either massage or acupuncture as treatment for low back pain. Before being assigned to either group, participants were asked to describe their expectations regarding the helpfulness of each treatment on a 1 to 10 scale. Patients who expected that massage would help more than acupuncture were more likely to feel better with massage, and vice versa. General expectations about getting well did not effect how well patients recovered. This study demonstrates the importance of selecting how you care for yourself.

In summary, taking care involves lots of “ vitamin C's" :

• Calibration or fine-tuning knowledge about your body,
• Compassion and self-kindness,
• Communication,
• Choice

The last "C" is for Continue.  Continue to apply any and all Competencies you gain.

(1) Lessons from a Trial of Acupuncture and Massage for Low Back Pain, Kalauokalani, D., Cherkin, D.C., Sherman, K.J., Koepsell, T.D. and Deyo, R.A. SPINE volume 26, Number 13, pp. 1418-1424 (2001)

Sometime when people hear that I am a massage therapist, they try to bargain for a lesser fee.  They want to see how cheaply I will sell my services, and they will brag about how they got massages for $39, $49, $59 at Massage Envy or through Groupon. My dear client, Jeanne, who greatly appreciates seasoned professional touch, encouraged me to blog about the value of excellent medical massage.

So here you go, why I believe professional massage therapists should be fairly compensated for our skill and expertise and why massage for medically complex people is not comparable to a standard rub down. The basic points I will be making are these:

I DON'T CHARGE $39 FOR MASSAGE BECAUSE -

• I love my profession and I value my work.

• I have pride in my status as a woman in business

• Deep relaxation and healing requires experience and integrity

• Medical massage is an advanced manual therapy practice.

• Providing complex medical issues require additional sensitivity, experience, education and strong critical thinking skills

I'd like to discuss each of these points ....

I love my profession.  Every time I teach a group of licensed massage therapists (LMT's), I realize how they can be some of the most giving human professionals- dedicated to personal growth and healing, That is why I cannot in good conscience support a mentality that devalues practitioners and the profession. Do you know that massage factories packaging 'massage in a box" typically keep half (or more) of the fees you pay? Most bodyworkers last only a few years in the industry because of injuries and burnout? I cover this more in my book; Body Mechanics and Self Care Manual).

One can only do a limited number of deep tissue, rehab. oriented, and medical massages in a day and maintain the highest quality. At $39 and often less per hour, with no benefits, like retirement and health care, sick leave and vacation, self respecting massage therapists cannot support ourselves and our families and suffer severe burnout. Unfortunately, LMT's who work under these conditions are not always able to maintain a high standard of service. Clients might not feel the massage is helpful. This is a negative reflection on the profession. You can see what a few former customers of a typical 'warehouse massage factory have to say about their experiences by visiting http://www.ripoffreport.com/reports/directory/massage-envy.

I have pride in my status as a woman in business.   Most women are in business for themselves so they can be in control of their income and lifestyle goals.  Yet women as a whole still earn less than men. In fact, women’s-to-men’s earning ratio has been in the 80-81% range since 2004.  One reason women in business are still earning less than men is that female entrepreneurs and business owners sometimes doubt our value and self-worth, and that is reflected into business fees or prices. My dream can quickly fall to the wayside if I don't charge what I am worth. Nobody wants to work with someone who doubts herself enough to undercut services.

I want to model how it is possible to make a good life providing good service to others - making others feel better, healthier, more empowered.  I want my son to see that it is possible to make a living doing something meaningful, and doing it with integrity. I want him to see his mom make it doing work that she loves.

Deep relaxation and healing requires safety and trust that can only be supported my someone who knows what to do from experience and integrity. I have taught in massage schools since 1992, and you will not believe what I encountered in classrooms.  Some students go into massage school to work out personal demons and try to hurt others physically or are sexually inappropriate.  There is pressure to pass these so-called therapists onto the community. And although I always fought to keep the massage environment safe and professional, sometimes I lost the battle. 

Comparing my bodywork to a novice who has just gotten out of massage school is like comparing apples to oranges.  The heart of a good LMT is seasoned and honed as she lives a full human life and adds to her clinical experience each year.  My clients appreciate the superior service that comes from 20+ years in the field. In the end, they understand that by paying a fair price for excellent bodywork, we both win. My hands successfully solve complex problems for them that confound less tested therapists.

Medical massage is an advanced manual therapy practice. Just like doctors have residencies to develop special areas of expertise, I have training and experience far beyond the basics. I am nationally certified and have logged over 2000 hours in advanced trainings. I have put in many years perfecting specialized manual tools - craniosacral, myofascial, lymphatic, visceral  and qigong therapy.  Each advanced modality adds a new approach and options to my toolbox to help my clients heal. I know how to touch people who hurt.   http://www.marianwolfedixon.com/massage.html

Complex medical issues require additional sensitivity, experience, education and strong critical thinking skills.
Massage therapists with training in evidence-based medicine are few and far between.  The greatest gift of my post graduate Research Fellowship in Complementary Medicine is the learning how to read critically what works for the most people, what is replicable, and what is safe. but not only can I analyze the aggregate, I understand how to adapt my work to benefit you.  I also can weigh whether alternate therapies may enhance bodywork or be a better solution in certain cases  I know how to touch people who hurt. I know how to titrate treatments to adapt to medications or upcoming procedures.  I know how to treat multiple complaints, such as people living with cancer who are plagued with insomnia or digestive issues.

You don't have to take my word about this.  See what clients are saying about me.

A final word - if you really want to get a $39 massage from me, take advantage of my refer a friend offer. 
Thanks for listening -