Don’t assume that I know anything, or that we agree on anything. The word research carries certain assumptions for you and me, and it calls up certain images in our minds. It puts a fence around our discussion that prevents us from getting anywhere new. So we need to cast the word aside for a moment and look at some bigger things: the power of language, the forces of money and prestige, and the responsibilities of being a healer.
Let’s begin with gratitude. I am a bodyworker, and my job involves sitting in a quiet room where people come to visit me. They talk about their lives and bodies, share their healing processes, and create a beautiful trust between us. I begin the rhythm of my session, so familiar and yet always so different, and I get to watch amazing changes unfold. I see my hands moving like those of my massage teachers. I recall the fierce patience in their eyes as they transmitted to me what was once given to them. I look around my treatment room and can’t believe my luck for finding such work.
Could a person be so enthralled with his job and yet desire more? Well, I do. I want more from the bodywork profession, and I suspect that you do, too. I want more longevity, more respect, better compensation, and better results. This yearning is not in spite of my gratitude; it flows from it. How can my sessions be so difficult to describe to a physician? How can such obvious benefits remain obscure to the millions of folks out there with sore backs, chronic stress, and collapsed posture? My knuckles are looking a bit swollen today, so I must ask: why not a swollen savings account to match?
Courtroom or Classroom?
When we think of science in the practice of massage, we often think “proof.” We see things happen in our practice, and then we wait impatiently for science to catch up and confirm it. For example: it is entirely obvious to me that massage therapy can help reduce headache pain. I see it work in nearly every case, and I’m basically waiting for the courtroom to prove me right. But as long as I fixate on pure vindication, I never get to the questions that could actually refine my bodywork practice: What about the type of headache? Duration of relief? Anatomical focus? Mechanism of action? Modality of massage? Combination with other therapies? When science becomes a tool of leverage to me, it loses its potential to teach me anything.
Besides its numbing effect, waiting for proof is tedious. I learned this in high school, where bibliographies replaced bullies as my main stressor. Research was something I did in order to win arguments and avoid reprisal. If that’s all that science can offer, no thanks—I’d rather just focus on my bodywork. Leave the research to the researchers, and the Internet debates to those without dinner plans.
The “courtroom” view of science goes way beyond massage and health care: with lazy news coverage, political fabrications, malpractice litigation, and commercial greed, we’ve all built up a cynical fixation on being proven right. But proof is about as far from most science as touchdowns are from tennis. “Scientific knowledge is in perpetual evolution; it finds itself changed from one day to the next,” says psychologist and philosopher Jean Piaget.1 Proof for the scientist is at best a sort of North Star; a beacon that gives direction, but can never be reached.
The Language of Integration
Science is born of constant disagreement. Everyone jockeys for authority, and everyone is eventually guaranteed defeat. Even before skeptics try to shoot others down, they endure their own strongest critiques. In the deadpanned words of naturopath, osteopath, and acupuncturist Leon Chaitow, “It’s a bit of an ego-stripper.”2
You would think this to be a pointless exercise, and yet people keep contributing. Almost like expert gardeners, they respond to defeat by making a closer observation of things. They refine their methods, go to conferences, and collect opinions. Sometimes (not always) they even befriend their adversaries; they may oppose each other on one level, but they also care deeply about building something together. Science is propelled by these antagonisms, just as our muscles hold us aloft in precise opposition.
This is a cultural fact that often creates confusion for bodyworkers. If another massage therapist said to me, “Hey, you’re full of it. Your beliefs are wrong,” I am likely to smile and stop talking to him or her. But to a scientist, this little jab is the beginning of a conversation and not the end. In fact, science constructs all its communities to facilitate high-quality argument. Health-care research scientist, author, and educator Martha Menard calls science “a social activity ... [that] takes place via human interaction, through informal communication among colleagues, more formal presentations and discussions at conferences, and publication of completed findings in peer-reviewed journals.”3
Paper by paper, conference by conference, we become more connected. We generate a common way of describing phenomena, asking questions, and interpreting results. It allows practitioners of disparate modalities to collaborate effectively in client care, and gives the public a way to understand our work. John Weeks, editor of The Integrator blog, calls evidence “the language of integration.”4
Bodyworkers, being staunch individualists, may bristle at such collectivism. Our history is filled with geniuses who swam against the mainstream. Were Ida Rolf and Milton Trager concerned with generating a common language?
Of course they were! Otherwise they would not have taught. And here’s the thing about the “mainstream” in modern health care: it can only be seen from a distance. If you went looking for it, you’d find only a loose coalition of beliefs that we’re not currently arguing about. Massage and bodywork are now popular practices,5 and so it’s time for us to come down from the mountains. It’s not always comfortable to contend with skepticism, but we win something profound from engagement: a deepening of our practice, and a more satisfying way to speak to others.
Research is About Now
If science is an evolving culture and language, then research is the primary method. It means thinking carefully, trying things out, looking openly at results, and then trying again. Just as the best bodyworkers listen carefully for what doesn’t work, the best researchers have cultivated an endurance in the face of failure. Both are in this for the long haul.
Sounds great, you might say, but the long haul is not what’s happening this week. Is this stuff really worth your attention? Yes. Bodywork research is not about far-off benefits or someday differences. It’s about the daily realities of your practice—things you can identify right now that affect your life. Following are five reasons why research matters and why it’s a vital part of our profession.
1. Money
Research is ultimately about resource allocation. It’s how folks in the general public make decisions about where to spend their health-care dollars. It’s how insurance companies decide whether to reimburse for massage therapy treatments and how much to reimburse. It’s how state and federal regulators decide what counts as health care and what counts as luxury. It’s how massage schools ultimately decide what’s worth including in limited curriculum space, and how other health-care professionals decide whom to take seriously as colleagues.
Many of us begin with big aspirations for our earnings and career stability in massage practice. Then the inevitable snags come: the clients don’t show up as regularly as expected, the insurers haggle on what counts as necessary care, and the employers are not universally abundant. So we learn to hustle and scrounge, and we accept that the field of bodywork just doesn’t pay that well.
Wait a minute—what? Think for a moment about what you do. About the responsibility that, like it or not, people bestow on you. Think about the physical demands and mental focus that it takes to be an excellent massage therapist. Now think about your paycheck. Maybe you didn’t get into this line of work because of the money, but I’ll tell you what: many folks get out because of better money elsewhere.
When we feel underpaid, we’re likely to blame our direct employer, or the local market, or we just blame ourselves. How about looking at the overall valuation of massage therapy? What about the fact that almost none of the benefits you see on a daily basis have been meaningfully studied in research literature? Massage is a seriously unstable career for many people, partially because they have no leverage to charge on par with the benefit they provide.
I don’t know how quickly or completely the research world can elevate our earnings, but I can tell you this: no one else but you and me are going to drive that reality into being.
2. Grace
You’re working too hard. You know it. Have you ever written a long email to a curious client, when you could have linked them to a research study? Have you ever felt like you’re doing the same massage 10 times in a row? Have you ever tried to defend an insurance claim, or educate an unruly client, or connect with a doctor, and felt at a loss for words? Each of these could be much easier with a healthy relationship to research.
Find one good massage research study. Read it on your lunch break. I guarantee that your afternoon massages will start looking different. Your hands will be smarter even when your brain is confused. The charting language will flow more easily, and the professional referrals will spring up from mutual interests instead of desperate ploys. You will be surprised that you are not alone in your ideas, and that the path of professional growth is laid with treasure if you would only look to the ground.
3. Beauty
Bodywork is a deeply beautiful practice, full of rich traditions, lifelong learning, rewarding apprenticeships, and long hours of delving into mysterious patterns. Science has these same beauties, and—believe it or not—many scientists have similar motivations as massage therapists. They want to do work that helps people. They are curious, insightful, and artistic in their ministrations.
When I sink my fingers into a dense whirlpool of fascia, or when I float my hand on the rib cage as a wave of breath rises and falls, or when I feel the aliveness of taut bands twitching, I feel the exact same quiet precision, the same moments of contemplation, and the same respect for a well-asked question. Science transforms the body from a hunk of meat to a humming orchestra or a hushed landscape. Beauty in bodywork happens in those moments when I let go of what I think it should be and observe what it is.
4. Progress
Admit it—aren’t you tired of having the same conversations? Or the same dumb turf wars between health-care professions, or between bodywork specialties? Are you cool with the fact that in 2012 you (or your colleagues) are still getting sexual solicitation? What if nothing changed in 10 years’ time?
We all live with the most ridiculous nuisances, and we act like we are powerless to change them. Last year, I was told I shouldn’t use the term range of motion because in New York State they’re required to call it range of movement. The reason being that the former term is considered joint manipulation, and the latter is just swaying your body while holding a limb. This was a court decision. Are you kidding me?
The only reason we have to deal with this stuff is because we’re playing someone else’s game. I have deep respect for the bodyworkers who tirelessly stepped up, year after year, and gave me a better career. But if we want to stop fighting for scraps, the game itself has got to change. It won’t change with client education or with clever marketing. Research is the way to do that, and not someone else’s research, but ours.
5. Integrity
There were some fundamental principles that drew you into bodywork. You believe in what you do, and you believe that the world is full of people who would benefit immensely from your work if only they knew what it could do for them. Oh well, you say. If they don’t call you up, it’s their loss.
True enough. You can only do so much in a day. But if you really care about reducing suffering, then your job includes making sure that your work is better understood for the next generation of bodyworkers.
This means speaking up when you disagree with someone, and it also means opening up to criticism. It means saying what you believe, and it means admitting when you don’t know. It means simultaneously celebrating your curiosity and cultivating your discernment.
This dualism is the key to expanding the reach of your ideas. There is immense strength in seeking out the opposite perspective. If you think massage is effective in some situations, then ask yourself when it’s not effective. If you think massage can relieve pain, then ask yourself when it might cause pain. Have you ever wondered what a trigger point really is? A fascial adhesion? What’s really behind your decision to move from one spot to the next? Can you even describe it to yourself?
Let’s begin
Research in massage and bodywork is not about pursuing special training or gobbling up a ton of facts. It’s about speaking up when it’s time to speak up, and listening when it’s time to listen. If we really care about what we do, then we need to plunge into the big mysteries, slog through semantic confusion, and do our part to advance the conversation happening all around us.
Notes
1. Jean Piaget, “Genetic Epistemology” (lecture, Columbia University, New York, New York, 1968).
2. Leon Chaitow, “Writing for Publication” (presentation, Highlighting Massage Therapy in Research conference, Albuquerque, New Mexico, September 26, 2005).
3. M.B. Menard, Making Sense of Research: A Guide to Research Literacy for Complementary Practitioners (Toronto, Ontario: Curties-Overzet Publications, 2003).
4. John Weeks, personal conversation with the author, 2010.
5. Associated Bodywork & Massage Professionals, “ABMP Fact Sheet,” accessed February 2012, www.massagetherapy.com/media/metrics_massage_clients.php.
Michael Hamm, LMP, CCST, is a teacher of anatomy, research literacy, and neurofascial bodywork. He serves on the Massage Therapy Foundation (MTF) Board of Trustees and was the winner of the MTF’s 2005 Student Case Report Contest. Contact him at mike.hamm@gmail.com or www.neurofascia.com.
Both of these opportunities will put you in direct conversations with the research community and transform your career. If you want to witness the leading edge of our profession, these are the places to be.