Positioning for a Chair Massage Without a Massage Chair

I love to introduce people to massage. I have massaged people in restaurants, on airplanes, at dinner parties and even outdoors in parks. When I go to visit my family on the East Coast, I consider it my pleasure to gift them with massage.

If I want to do a thorough job of it, I like to give a complete upper body massage. But what if I don’t have my massage chair handy? This 3-minute video demonstrates how to position massage recipients over a table top so that they are comfortable and you are able to access all parts with ease.

Of course, the other option for my family was to finally buy a massage chair that stays on the East Coast permanently.

Viewing Massage Through a Holonic Lens

One of the critical topics in the massage community is how to define and label what we do. How we define massage influences how we market our services, how we regulate them and how we educate new people coming into our profession.

Like the classic tale of the blind men trying to describe an elephant, how we define massage, to a great extent, depends on where we are standing. Massage is a very big elephant with many facets. So, when we talk about massage, at the least, we need to talk about where we are standing so we can also frame the limits of each perspective and how it relates to every other perspective.

Since 1998, I have been a student of integral theory, which presumes that every perspective is true but partial. The integral approach thus allows for an infinite number of perspectives while, at the same time, providing a framework that allows us to carefully examine and map, in this case, all dimensions of massage.

This article is the first in a series that will analyze massage from a wide range of perspectives using the integral framework. Each analysis will define a lens through which to consider the rich tapestry of massage. The first lens I will use is called the holonic perspective.

The holonic lens defines that every aspect of existence is at once both a whole and a part—a “holon.” Writer/philosopher Arthur Koestler coined the term holon in 1967 and called the hierarchical ordering of any sequence of whole/parts a holarchy.

For example, a human holon is composed of many organ parts. Each organ holon is composed of cells; each cell is composed of molecules; molecules are composed of atoms; atoms of particles and so on. This article is a holarchy starting with letters that make words that make sentences that make paragraphs that make the article.

Each fundamental holon can stand on its own but, when combined with other holons, more complex, more significant holons emerge. That is to say, a holon is not merely the sum of its parts. Each holon transcends and includes the previous structures. While a cell is composed of molecules, it also transcends cells to form a higher functioning, more complex structure.

This concept is imbedded in the origins of the Holistic Health movement that emerged in the 1970s. That movement was a reaction to the reductionism dominant in the specialization of mainstream medicine for most of the 20th century that treated only parts of people, not the whole person. Indeed, one of the reasons I was drawn to massage and bodywork forty years ago was the fact that its resurgence was driven by people committed to a holistic understanding of the body/mind.

There are many holarchies we can study in massage. I will give two examples in this article, one that looks at the physical, objective exterior of massage and one that considers an interior, subjective perspective. In future articles other holonic analyses will emerge.

A Massage Exterior

A complete professional massage holon is composed of a series of sequences or protocols applied to various parts of the body. Which sequences are selected (location) and how much time we spend on each part and in what order (choreography) has a lot to do with how we define any particular massage.

For example, foot reflexology, chair massage, Indian head massage, sports massage, remedial massage, and full-body Swedish or acupressure massage each select their locations and arrange their choreography very differently.

Each holonic sequence in a massage is a composition of various techniques that can be categorized into dozens of variations on compression, friction, stroking, holding, kneading, lifting, movement and mobilization, percussion, and vibration. These techniques and sequences, combined with a clearly defined intention and/or theoretical framework and/or worldview is what defines a particular massage modality.

Finally, every technique holon is composed of touch. Professional massage is a physical connection to and through the skin of the recipient. Most of the time this is done by the hands of the practitioner but can also include the intermediary of massage tools manipulated by the practitioner.

So, to summarize this analysis of massage we could say that fundamental to all massage is touch. But the particular kind of touch in a massage is not casual, accidental or spontaneous. Rather it is the trained touch of definable techniques. These techniques, in turn, compose the sequences that, informed by specific intentions, create what we call a massage.

A Massage Interior

One subjective (interior) analysis of another holarchy inherent to massage might point to the fact that every massage is fundamentally a relationship holon.

While there are many kinds of relationships (e.g. mathematical, organizational, mechanical), in massage the relationship is interpersonal, i.e. between two people.

Within the universe of all possible interpersonal relationships, massage is not a parental relationship or a friendship, but I would suggest it falls in the category of service relationships.

The kind of service that we provide, as noted in the first section, is fundamentally touch which, by definition, means that this service is one that requires physical intimacy.

So, we could summarize this point of view by saying that massage is subjectively experienced as an intimate, interpersonal, service relationship.

Practical Value

These two holarchies point to the internal and external constructions of a massage. Understanding that fundamentally massage is objectively about touch and subjectively about intimacy is critical to the health and growth of our profession. While these should be our primary areas of expertise, by and large, both of these aspects have been increasingly relegated to the shadows of our profession.

With the transformation of “massage” into “massage therapy” we have left behind the philosophical roots of the holistic health tradition.

Consequently an ever-increasing number of students are allowed to graduate from massage programs without knowing how to give and receive touch nor deal with the intimacy inherent in a touch relationship.

The latest striking example of touch-denying in our profession comes from the two surveys currently circulating in the industry—the FSMTB Job Task Analysis Survey and the companion Entry Level Analysis Project. Both are part of the attempt to define entry-level skills for our profession. Between the two, the word “touch” appears exactly one time. Of course the term “intimacy” does not appear at all.

Our refusal as a profession to embrace touch and the intimacy it represents by sterilizing it under the guise of massage therapy is clearly leading us down an unnecessarily self-limiting path. [See the related article Moving from Acceptability to Accessibility.] Our virtual culture is increasingly debilitated by the lack of authentic human validation and connection. We hold an answer literally in the palm of our hands. Let’s give people what they crave.

The Canyon Ranch Think Tank

Have you every wondered why the National Certification Board of Therapeutic Massage and Bodywork (NCBTMB) has such an awkward name? What’s with that business of “Therapeutic Massage and Bodywork?” Couldn’t they have stopped after the word “Massage?”

You can credit a fascinating but mostly forgotten piece of massage history, The Canyon Ranch Think Tank, for making certain that “Bodywork” was included in the name.

Canyon Ranch, located in Tucson, AZ, was one of the first of a new generation of high end spas in the late 1980s  looking to transform the image of “fat farms” into “wellness centers.” Founded by Mel and Enid Zuckerman in 1979, within ten years it was a recognized innovator in the spa industry and was spreading its message of wellness and integrative health through its non-profit arm, the Canyon Ranch Foundation.

It was this foundation that brought together a group of 13 independent bodywork leaders for four days in September of 1989 “to explore issues critical to the emerging bodywork professions. They were to examine some of the unifying characteristics of touch professionals, and the objective of this particular meeting was to study and contribute to the evolution of the core terminology.”

What this came to mean for the participants was a search for “THE WORD,” an umbrella term under which all skilled touch professions could unify. After hours of intense discussion, the word settled on was, you guessed it, “Bodywork.”

Interestingly, at that time, there were only three serious contenders: “bodywork,” “massage,” and “touch therapy.” Significant in its absence was the term “massage therapy” which, arguably, could be said to have actually won the terminology battle, at least within the mainstream massage community.

Indeed, probably the only specific impact the Think Tank actually had was making certain that the NCBTMB, whose development was spearheaded by a number of Canyon Ranch participants, included the term “bodywork” in its name. I have always used “bodywork” as my meta-term for all touch modalities and still thinks it makes the most sense.

If you are interested in reading the full report, including the formal definition of “bodywork,” you can download a PDF here.

If you would like to read more about why “massage therapy” dominates the terminology in our industry today, check out this related article.

Haptics: The Science of Touch

Last week I saw a commercial for the new Cadillac XTS that featured an innovative touch technology called the Safety Alert Seat. The system sends vibrating pulses to drivers through the seat cushion if they drift out of their lane without a turn signal activated or if there is threat from the front or rear, such as when backing blind out of a parking space.

“It’s akin to someone tapping on your shoulder in a crowd to get your attention,” said, General Motors Active Safety Technical Fellow Raymond Kiefer. “Using the tactile sense to communicate crash threat direction provides an effective and intuitive way to cut through the clutter of visual and auditory sensory information that drivers routinely experience.”

Cool!

Chart comparing Massage to Haptic research

Number of annual peer-reviewed research papers.
Source: EBSCOhost

This technology had been developed in a field of touch research that I have been following for the past 15 years called “haptics,” derived from the Greek word meaning “pertaining to the sense of touch.” Thus, if you are studying touch, you are studying haptics.

Since the only thing that all 100+ modalities of massage and bodywork have in common is that they are all based on touch, it would seem only natural that the massage industry would have a close association with the folks doing haptic research. Unfortunately, that is not the case. Even the recently published groundbreaking textbook on massage therapy research (Massage Therapy: Integrating Research and Practice) makes no mention of haptic research.

As noted in the accompanying chart, annual research in massage has actually leveled off in the past five years while annual haptic research surpassed massage research ten years ago and continues to grow steadily each year.

Who is doing haptics research?

There are scores of companies developing products based on haptics research. Many do their own research and others partner with academic institutions such as:

Disney Research is an example of a major corporation investing in touch research: Surround Haptics – Immersive Tactile Experiences

Why are they doing haptic research?

Most research in haptics has focused on extending the human ability to reach, explore, grasp, manipulate and get feedback from the world around us. Applications can be found in robotics, prosthetics, remote medicine and surgery, hazardous environments, manufacturing, communications and education.

Closer to home, the phone vibrating in your pocket and the joystick on your gaming console are both a result of haptics research.

In the future, haptics will become an essential aspect of virtual human interaction in such arenas as business meetings and classrooms. Sound waves are being studied for their ability to mimic touch making virtual handshakes within the realm of possibility.

How is this important to massage?

Since massage and haptics have never interfaced with one another, at first glance, they may not appear to have much in common. But that is definitely not the case. Here are some reasons why we should be working together.

Defining touch

One of the outcomes of haptics research has been to define the discreet constituents of touch mechanics (movement, friction control, vibration, contact force, pressure, duration) and to develop models for discriminating texture, softness, ridgidity, temperature, moisture, shape, proprioception/orientation and weight/heft.

All of these components are critical to massage and thus essential to informed massage education, practice, evolution and research.

Standardizing touch

A serious flaw in virtually all massage research to date is the lack of standardized protocols. “Subjects received ten-minutes of massage to the lower back,” is not a particularly useful sentence in a massage research paper because it is difficult, if not impossible, to duplicate.

We need to define a common vocabulary of touch far beyond effluerage, petrissage and tapotement. Iris Burman and Sandy Friedland made an attempt in their book TouchAbilities: Essential Connections, but far more refinement is required.

One of the reasons that I feel fortunate that my massage modality is Japanese acupressure is because there is a built in precision to the acupressure points, the channels they lie upon and the techniques that are used to stimulate them. I am a big fan of quality control in massage, so I also teach chair massage as one would a martial art, that is through “Katas,” highly choreographed sequences of techniques, point locations and body mechanics. The kata model is one of the few in massage that allows for high standardization of protocols.

Touch tools

As haptics has defined the parameters and functions of touch, out of necessity the field has also had to develop tools that apply and measure each aspect of touch. These tools can obviously be used by massage researchers to apply standardized touch, measure touch or used as controls in touch research.

The biology of touch

Haptics is as interested in the anatomy and neurophysiology of touch as is massage and they have the money to pay for functional MRIs. We need to be monitoring their work, sharing information and cross-fertilizing our fields.

The psychology of touch

Research into how haptic aspects affect the psychology of gaming (the thrill of driving on that racetrack), computer shopping (where you can feel the texture of the skirt you are viewing on your monitor), and mutual virtual touching continues to expand. Investigating the psychology of touch is in its infancy and the massage industry needs to be accessing research and resources wherever we can.

Massage is poor; commerce is rich

The massage industry has suffered from an inferiority complex (fighting a negative public perception) and consequent lack of imagination for decades. Because of our fear of embracing touch (see related article), we have allowed commercial interests outside of the profession to charge ahead with a touch research agenda that is almost totally off the radar of the massage industry.

The massage industry should be in the middle of all touch research, not standing on the sidelines. It is time to take off the blinders and begin dialoging and collaborating with the commercial and academic interests who are spending millions of dollars researching touch.

Let’s get in the driver’s seat, folks!

Introducing Touch

Whenever I am in an unfamiliar room, full of people I don’t know, my shy parts come out. I feel isolated, vulnerable and fearful and immediately begin looking for the nearest exit.

However, I also know that the best thing to do is to force myself to go up to someone in the room and introduce myself. Once I have made a connection with another person, my shy parts start to relax and my more social parts start to take charge.

For many people about to get the first massage of their life from a stranger, often in a strange environment, the situation is many times more scarier. These are the people we often encounter when doing chair massage.

That’s why it is crucial that the massage practitioner takes the initiative to quickly make new customers feel welcome. I walk toward the customer with my hand extended, greet the customer by name and introduce myself while shaking their hand. Then I lead them to my massage chair.

The handshake is important because it is the first step in our physical touch relationship and, for most people, a handshake represents safe touch. Stepping forward first is a way to let them know that you resonate with their vulnerability and are willing to step into their space, before they step into yours.

There is generally a lot of verbal interaction that goes on in the first 60 seconds of that relationship. Most importantly I want to know about the customer’s previous experience with professional touch. “Have you ever had a massage before?”, “Have you ever had a chair massage?”, “Have you ever had an acupressure massage?” are all questions that will give valuable information as to their comfort level with touch.

Secondarily, with new customers I want to always ask for and receive permission to touch specific parts of their bodies. “I am going to work on your shoulders, arms, upper back, lower back, neck and scalp.”

As I mention each body part I touch the same area on myself. I find that helps slow me down and not make the introduction sound so much like a rote recitation while, at the same time, giving customers two sensory pathways through which to absorb what I am telling them. Remember, these folks are often nervous and overwhelmed. My job is to help them gain a sense of control. I do this by clearly outlining the structure and content of our relationship.

After I have described where I am going to be touching, I ask them if there is anyplace in their upper body where I need to be cautious, where they have aches, pains, strains, cuts bruises, rashes, injuries, surgeries or the like.

This is their cue to inform me of any musculoskeletal issues that I need to know about, but also the point at which they can ask me not to touch certain areas of their body, if they choose. The most common area that people mention not wanting touched is their hair or scalp.

After I have asked for and received permission to touch specific parts of their body, next I need to know how to touch those parts. Since I do traditional Japanese massage on a sequence of acupressure points, for me that mostly means making certain that my touch pressure be appropriate.

I always verbally give customers permission to give me feedback about my pressure. “If at any time during the massage anything feels uncomfortable, you will let me know, all right?” After getting their assent, I also tell them, “You are going to be in charge of the amount of pressure that I use. When I start working on the acupressure points, I am going to ask you for feedback about the pressure.”

This is an important piece. It is not enough to give people explicit permission to give you feedback; you must also make them practice giving you feedback so they will know you are serious about having them control their experience.

When I start working on the first line of acupressure points, I ask something like, “How’s the pressure? Would you like more, less or should I keep it about the same?” It is important to frame it as a question so that your customers are forced to commit to a response and take responsibility for their bodies.

Many people are so out of touch with their bodies that they have no frame of reference from which to respond. Or, since they perceive you as the “expert,” customers sometimes believe that you have some magic ability to know what the perfect pressure will be for their body.

Thus, I may add any of the following explanations to the mix for further clarification:

“The pressure doesn’t have to hurt to be effective.”

“We are looking for enough pressure so that your body want to go, “Ahhh…” but not so much pressure that it wants to go, “Ow!!”

“Any amount of pressure will activate circulation in the area.”

“It is not a no pain, no gain situation.”

“This massage is not supposed to hurt. It is supposed to make you feel better, not worse.”

And, as my friend Ken Bridgman notes: “Unlike Bill Clinton, I can’t feel your pain, so you are going to have to tell me if it hurts.”

Here are a couple of other notes about solidifying the touch relationship during a massage.

  • For new customers, depending on the length of the chair massage, I will ask for feedback about pressure 2 to 5 times during a massage.
  • Anytime I get feedback from a customer I always thank the person for letting me know.
  • If I get the pressure wrong on one side of the body, I always ask for feedback when I get to the same section on the other side of the body.

If you have any other suggestions about how to make people comfortable receiving touch from a stranger during a chair massage, leave a comment below.