Mary Ann Foster: A new client came to me for massage: a feisty, older woman. During the intake process, I asked her what kind of massage she liked, and she related an experience she didn’t like: “It started out OK, but just as I was drifting off into deep relaxation, the therapist startled me by telling me to take a deep breath. I snapped back, ‘Take your own d__n breath! I’m trying to relax.’”
Mary Kathleen Rose: Ah, yes. Sometimes our good intentions to help people can actually interfere with the process. In the 1980s, we learned a number of breathing techniques to use in massage. They were designed to help the client relax chronic holding patterns, feel greater harmony in the body, and even to access unresolved emotions. I recall other breathing techniques used independently of hands-on bodywork, such as expressive sounding and primal screaming.
MAF: My throat gets raspy just thinking about it. My relationship to breathing really improved from practicing yoga and other movement modalities that stress self-awareness. Breath awareness can be a great resource in massage, since awareness is the first step to change.
MKR: A number of years of ago, I made an interesting discovery. I noticed a client breathing shallowly, then realized that I, too, was breathing shallowly. By focusing for a moment on breathing fully and deeply myself, I noticed that, magically, the client’s breathing also deepened, and she relaxed.
MAF: Yes, we can always trust that if we breathe easy, so will our clients. The body, in its natural wisdom, will breathe itself, if we can just get out of way. This is a good thing, because if we had to consciously direct our breathing all day, we’d drop from exhaustion.
MKR: A healthy lifestyle offers many ways to optimize healthy breathing, such as slowing down, getting regular exercise, and even singing.
MAF: Yet faulty breathing patterns contribute to the postural problems and chronic pains that many of our clients experience. How can we help them breathe more effortlessly without interrupting the flow of a massage?
MKR: First of all, we can help the client get into a comfortable position where she or he can breathe most easily. For many people, face cradles restrict breathing, creating respiratory congestion. By optimizing use of the seated, side-lying, and supine positions, the client can breathe more easily. Putting a pillow or towel under the head in the supine or side-lying positions can help open the respiratory passages.
MAF: I like to focus on the rhythmic motion of the diaphragm muscle itself, because it is the prime mover in respiration. One way to do this is simply place the hands on the lower ribs and invite lateral expansion. I also teach my clients a basic stress management technique they can practice anywhere. I ask them to breathe easy and on each exhalation allow the weight of the body to sink down into the ground and through the earth.
MKR: In contrast, when we ask clients to take a deep breath, they bring in more oxygen, which can increase sympathetic tone. This can be stimulating rather than relaxing, and in the extreme, can lead to hyperventilation.
MAF: Indeed. Hyperventilation causes blood gas imbalances, leading to symptoms of dizziness, chilling, and/or involuntary muscle spasms. Deep ventilation can conjure up dramatic emotional reactions that some people mistakenly tout as having psychotherapeutic effects. Instructing a client to focus on deep breathing can also increase anxiety in an already tense person.
MKR: Here’s an exercise to help you connect with your client by noticing and following their breath. Have the client sit upright in a chair. Stand behind the person and place the palms of your hands lightly on the thickest part of the trapezius muscle at the top of the shoulders. Maintain the contact, noticing the movement created by the person’s inhalations and exhalations. Listen to the breath with the palms of your hands, lightening your contact with the inhalation, and adding some pressure with the exhalation. Follow this connection through three to four cycles of the breath.
MAF: That’s so simple and yet so profound. Touching and connecting to clients this way, noticing and following their natural respiratory rhythms, builds deep trust and empathy. They know, albeit unconsciously, that we’re listening and paying close attention to them.
Mary Kathleen Rose, BA, CMT, teaches wellness education and massage in medical settings, advocating self-care of the caregiver. She is the author of Comfort Touch: Massage for the Elderly and the Ill (Lippincott Williams & Wilkins, 2009). www.comforttouch.com.
Mary Ann Foster, BA, CMT, specializes
in movement education for massage, teaches experiential kinesiology at the Boulder College of Massage School, and is the author of Somatic Patterning: How to Improve
Posture and Movement and Ease Pain (Educational Movement Systems Press,
2004) www.emspress.com