The Regulated Therapist: Why Your Nervous System is Your Most Important Clinical Tool

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The Regulated Therapist: Why Your Nervous System is Your Most Important Clinical Tool

Hi everyone and welcome, really excited to have everyone here. We already had 60 plus
people in the waiting room to get this started. So there's a lot of attraction to this topic,
a lot of excitement. So we'll get started in a moment here. We'll be about a few minutes
of our housekeeping as I like to call it. But with that, let's kind of get into those
housekeeping items to let people roll in, to get started. I like to push everyone towards
the chat feature. So why not everyone kind of click in or type in where you're located,
where you're logging in from. It's kind of a fun way to get started. This is a very community-based
event. So we want to make sure that it starts there. So I'm going to look over here. I see
South Carolina, Hawaii, Oregon, Arizona, Minnesota. Well, welcome everyone. It's so cool to see. And so
now you guys know where the chat is. So definitely check in there, connect with us, ask your questions,
etc. We'll be monitoring throughout. So if you're not familiar with me, my name is Lizzie and I work
with Massage Magazine Insurance Plus. And this is our webinar series called In Session. I'm really
excited to be your co-host today and introduce you to our guest host for this topic. So let's talk
about myth really quick. This is Massage Therapy Therapist Appreciation Week. So that's a week
full of giveaways, a week full of free CEs like this one, a week free of just education and
connection. So definitely I hope all of you have taken advantage of all the different things in
there. And if not, go check back at our different webinars, go check back at all the different
resources because this event is put on for you. And then of course, don't forget to look into our
liability insurance. We provide US-based massage therapists, bodywork professionals,
Reiki practitioners coverage. And we don't just stop there. We also offer a wide range of exclusive
member benefits, including 50 free CE credit hours with Neil Asher, which is who we are speaking with
today, one of the providers. So let's get into today's topic. So just really quick, this is
being recorded. So you will be able to go and watch this back. So if you're joining, watching the
recording, hello and welcome. In addition, we will email this to you guys with all of the
information on how to register those two CEs, two free CEs. All righty. So today's topic is
the regulated therapist, while your nervous system is your most important clinical tool.
Please join me in welcoming Josh Williams, a visionary and nervous system information
informed bodywork and founder of the touch code method with a BS in exercise science, a doctoral
candidacy in occupational therapy at Hawaii Pacific University. And over two decades as a
licensed massage therapist in Oregon and Hawaii, Josh is also a certified health and wellness coach.
His expertise spans exercise physiology, cardiac rehab, luxury resort spas, and his concierge
bodywork studio in Bend, Oregon. Josh's innovative touch code method blends biomechanics,
manual therapy, and nervous system science for humans and horses. Welcome, Josh. We're really
excited to have you today. And thank you all for joining this webinar in the incision series,
but also massage therapist appreciation week. So with that, I'll drop some links in the chat.
And I'm going to pass it over to Josh from here. Thank you.
All right. Thank you, Lizzy. And thank you, Shannon and everybody, MMIP. Thanks for the
welcomes in the chats to really appreciate that. It was really cool seeing where you were all
tuning in from. It's like all over the country. And massage appreciation week. I mean, come on,
this is great. I appreciate the work you guys do. I'm so grateful to be here because I've been in
this field for 25 years. And I've got a big heart for massage therapists. I really believe in the
work we do. I mean, you guys are in it. You've went to school for it. You do it on a daily basis.
But when you step back and kind of look at it, like from the outside, it's like, wow, you guys,
you deal with people in one to one environment, hands on 60 to 90 minutes. I just couldn't think
of a more important work to do, especially in the world today. So big appreciation to all of you.
Thank you for tuning in. I hope that my intention for this is just hopefully to give you something
that you can use. A lot of information is already available and a lot of the things that I'm going
to share with you today are things that I need to work on. And for those of you that already know
a lot of this stuff, I hope it's just a reminder and maybe an inspiration to revisit it.
And what we're going to talk about, let me get my slide shared here. Bear with me for one sec.
There we go. Okay. So we're going to talk about the regulated therapist and why your nervous system
is your most important clinical tool. And I want to say right from the beginning,
this isn't going to be a webinar about being perfect. It's not a webinar about being
some, you know, floating, serene, fully optimized wellness guru. This is about real practice,
real bodies. It's about you. It's about me, real therapists. And ultimately, it's the real cost
of doing meaningful work with our hands. So thanks for being here. And let's, let's get into it.
So I don't know about you, but sometimes I feel reticent to like tune into self care topics.
You know, and I want to share you, like, we're not going to be talking about my nicer candles.
I'm not going to tell you to journal more. I'm not going to tell you essential oils are going to fix
your burnout, you know, even if it's like Bhutan cypress or blue chamomile or whatever it is.
And we're not going to talk about just being more grateful and practicing your attitude harder.
I'm definitely not going to tell you you just got to say no more and work on your boundaries.
Um, or, you know, take a bubble bath and that's going to solve everything.
So we're not going to talk about bubble baths today. You know, and hey, I love all that stuff.
I mean, don't get me wrong. I'm not saying that stuff isn't awesome. I love it. Sign me up all
day long for Bhutan cypress and bubble baths. But there's, there's an element to self care
and this topic of provider burnout that can sometimes kind of gaslight the human experience.
You guys know what I'm talking about? Like we have a job to do and sometimes our lives
don't just hit the pause button so we can do that. You might have kids at home and you know,
you might have relationship challenges. You might be having health problems, you know,
whatever is going on. I mean, let's not even talk about the news today. So
there's a lot more to self care than just like telling you to do better.
And I don't believe that self care is indulgent. And I hope to share a perspective with you all
here today that it's more about professional self advocacy.
And the thing is, you know, everybody here, why I'm so glad to be invited to share this
on massage therapy appreciation week is your hands have held so much.
People you work with are in pain. Maybe they're in recovery. Maybe they're dealing with grief.
Everybody's dealing with stress. I've worked on people battling cancer. I've worked on their
spouses, you know, stroke survivors who are learning to adjust to a life where suddenly they
don't have use of half of their body and they're depending on caregivers. The grief of empty
nesters, you know, doesn't always have to be this, this hardcore disease and loss. Like I said,
two or three kids go off to college and life last year. And I honestly didn't really get the
empty nest grief until then and like, let me tell you, that's a real thing. First responders
work with firefighters and paramedics who have seen things that frankly, I don't know how they
how they're able to shed that. Health care providers, other nurses, other massage therapists,
you know, the burnout rates are so high in those professions. And, you know, I just want to remind
you, we don't just provide a service. We step into room. We create meaningful,
lasting impact for others. You're become a part of somebody's story. And ultimately,
what you all are are frontline nervous system workers. You do work that really matters. And
in a world that's becoming increasingly screen based, AI mediated, everything's becoming so automated,
the distraction, all the stuff you guys know I'm talking about.
What we're doing is not becoming less relevant. You know, it's been a lot of talk about AI
replacing jobs. And it's fascinating topic. I kind of, I told my wife one of my guilty
pleasures is kind of futurist podcasts. And I think it's fascinating. But the work we do,
it's hands on. As things get more and more roboticized and AI-ified, it's almost like the work we
do becomes a more of a rare commodity. And I think something that's much more needed because
skilled, present, human touch, it's just even more essential as we kind of enter this world that's
less and less embodied every day. So, and ultimately, what that means for us here today is that
protecting the person who delivers that, it's not optional. It's not a luxury. It's essential. And
and look, this idea is inspired 100% by Audrey Lord, a writer, activist, and she reframed self
care and honors the luxury but as an act of self preservation. It's an act of radical resistance
to a world that's kind of moving the other direction. And for people like you that are doing
demanding service-oriented work and often in systems that don't protect you, it matters more
than ever. So, here's what we're going to talk about today. This is what you're going to walk
away with. In addition to your two CEUs, we're going to talk about why the nervous system matters,
why your state matters. State means like your regulation state and how it actually affects outcomes.
And I'm not just going to talk about it as an abstract idea or the kind of wellness language
that we might use with our clients. I'm going to talk to you about some real science. I'm going
to describe it as an authentic clinical variable. The second that we're going to talk about three
specific rituals you can use before, during, and between sessions. I'm going to keep it simple,
that stuff that you can make your own. I know a lot of you are already experts in this.
Like I said, hopefully this is a reminder, maybe just a little reframe or a little different way
to look at things. It helps make it fresh and something that hopefully you'll revisit if you're
not already doing it. I know over the years I've done massage of sometimes I really lean into these
things and other times I don't even think twice about it. So, I really think it matters.
Then lastly, we're going to talk about practical stuff, load management. We're going to talk about
body mechanics, but I'm going to give you a perspective that's not just telling you
to use your body weight and get off your thumbs. I got some other ideas about that that I'm going
to share with you and hopefully it'll just help you protect your career ultimately.
And look, I want you guys to make this your own. Like you, you guys are artists,
you're healers, you're visionaries, you're impacting him in lives on a daily basis.
You don't need to do anything I say. I want you to make this all your own because you're
the experts of your own life. And there's a lot of research on learning. A lot of what we learn
today, most of it we're going to forget over 80%. Actually, it's kind of depressing to think about
it. But this is a method that's been proven to help you. And if you got a notepad, this is a good
way to take notes. You can make little categories, free association, making drawings. If you just
have ideas, might have nothing to do with what I'm talking about, but write it down because those
are the connections that's happening in your brain that makes this stick. And it's going to
help you make it your own. Because this isn't just about getting CEUs, right? Like this is stuff you
can hopefully really use. And I'm not going to personally test any of you. So just let any
test anxiety go away and make this your own. So the first thing is just think what? You know,
what the heck am I talking about in your words? Like, how would you describe it?
If somebody, you know, if you're talking to your other massage therapist's friend later this
afternoon, like, what do we just talk about? Always think about how you can rephrase things in your
own words. And then even more intimately to you, so what? Why does it matter to you specifically?
You know, we all have lies behind what we do. And they're deep, they're powerful, they're
incredibly personal. See if you can find threads to your own why. And then now what? Let's get
out of theory and let's like, what can we really do? Like, what's actually something I can do like
this afternoon, like tomorrow, next session. Okay, so let's start, let's start with the thing
that nobody really likes to talk about in our field. And it's what, what it actually costs us to do
this work. All right, I mean, let me just describe, let me describe someone. Tell me if you know them.
See if any of these people sound familiar to you. Somebody who works through pain,
because canceling sessions means losing income, they can't spare. Somebody who doesn't have
real transitions between sessions, maybe enough time for water, sometimes even hold,
have to hold it, you know, because they didn't have time to get to the bathroom.
Or someone just says, I'm fine. I want to know the therapist or friend asked you're doing,
because going into the truth would be way too heavy. Or someone that carries the emotional
residue of one client section directly into the next without really even realizing it.
Someone that markets warmth and healing and empathy and presence while running on fumes behind the
scenes. Or somebody uses willpower and caffeine just to get through the day.
And somebody that really loves what they do, like truly loves it, dream come true to do this work.
But in the background, are quietly wondering how many more years they can do it.
I mean, all of these were me at different times, just to let the cat out of the bag.
And also, no judgment on any of these. I can relate to each one of these statements.
So I didn't put anything here that I couldn't actually say myself.
Um, you know, then there's the classic, like giving great advice to clients about self-care.
You know, boundaries, nervous system support will not having followed that advice in months.
So I don't think that's just like the traits of a burned out therapist. It's definitely not weakness.
It's somebody that really cares, but just is not protecting their capacity.
So we as we are ultimately health care providers, you know, we're working in healing environments.
We have to honor our, we have to honor the work we do by protecting ourselves, you know.
And here's the problem, right? I don't think most of us woke up one morning and wanted to become
martyrs to hustle culture. I know I certainly did it.
A lot of this, it's trained into us. A lot of it's economic. A lot of it is cultural.
A lot of it is just simply survival. You know, hustle culture is always telling us to optimize
harder. We have to earn our rest, to push through pain. And ultimately, our value is in our output
and how that output creates inputs, right? In terms of careers.
So when you become your own kind of best friend and self-advocate in your healing journey so that
you can help others, it's more about protecting your capacity. Regulation is one of your operational
skills, primary skill, hopefully. I'm going to make an argument for that today. It's about staying
human. It's about staying real, trying to lead with your values, even when it's really hard.
And ultimately, the value is not in what you do. It's literally who you are, like you are the value.
So if hustle culture treats you like a machine that needs optimizing,
the self-advocacy is going to treat you like a human that needs protecting.
And again, as someone who spent plenty of time being exhibit A for the hustle culture column,
I just want to say no judgment here. I'm just kind of framing what we all know is to be true
in the world here. So let's get to it. What are we talking about here today when I'm talking
about nervous system, talking about state, all this stuff? For so many years, I thought pushing
through was professionalism. I started in my early 20s. I'd do sometimes six to eight
massages a day because I was in the spa industry in Hawaii. And we would work holidays. We'd do
sometimes 21 days straight. They forced you to take a break after 21 days.
And I did that for years, evolved as we do in a different practice environments. And even after
having my own practice in my own office here in Oregon, there was a point where I was super burned
out. And I actually started not enjoying the profession. I wanted to break. I needed to get
off the wheel. And I was really lucky. My wife works with horses. She's a therapist. She does
psychotherapy with horses. She was a horse trainer before that. We're not particularly privileged
people in many ways, but we did have access to horses. And I started doing equine body work.
And that helped me kind of revisit this profession that I love so much and reinvigorated my passion
for it. And the main thing that it taught me was that our nervous system state is everything.
And I didn't enter it knowing that at all. Like I started with this very performance mindset.
Often people watch you when you're doing work on their horses. So it kind of felt
performative at times just to be really transparent with you. And there was this one horse named Lola,
L-O-L-A. And I'm sorry to get a picture of her for you on the slide. She's a really sweet horse.
And she was like not having anything that I would do. Like I could not find a way to work with her
that was working. And it didn't matter how hard I tried. I mean, I literally was breaking a sweat
and sessions. I was trying what I thought were advanced techniques and integrative concepts
where I thought were so innovative and awesome. And she just wasn't having it. And that literally
came a point where I realized that she was just in an activated like sympathetic nervous system
state. And just like humans, she can't listen to or respond to anything when they're in that state
because it's a survival state of mine. And the great thing about working with horses, if any of you
ever get a chance to try that, please do or let us know in the chat if you already do work with
horses. I'd love to hear from you. Is that they are just like this giant nervous system.
And they are nervous system first species. Part of it is because they're prey animals,
part of it's because they live in a herd culture. They really lean on their nervous system in
ways that are very palpable and very alive in their system. I believe we as humans do as well,
we just have developed a culture in a society that has kind of put that in the back drop,
you know, somatic understanding and nervous system regulation has kind of been pushed aside
for all those like hustle culture reasons we talked about earlier. And it wasn't until I slowed
down and really actually did almost nothing that she started to relax and accept just my presence.
And that's when I realized that like working harder was not required to do better work. And then
hopefully that sounds really simple to a lot of you. For me, that was kind of like I couldn't
believe it. I thought it was all about technique and training and education and effort. So that
was really freeing to know that. And I think that this whole idea of protecting our capacity is so
important. The next question is what exactly are we protecting or what is actually happening
between the nervous systems like your client's nervous system and you in a session. And
at least for myself, why did nobody explain this more clearly in massage school? You know,
we talked a lot about contraindications and techniques and stuff. Personally, we didn't talk a lot about
this thing. And what is this thing? Well, technically, I'm going to just give you a little bit of science
here because I want to back this up. I want to make sure I'm giving you stuff that really works.
This doesn't just sound nice or feel good. This has been proven to work. And what we call this
is therapeutic alliance in the research. In occupational therapy, they call it therapeutic
use of self, which I love that term. I love both terms. Therapeutic alliance, that's beautiful,
right? So this is really I think at the edge of this nervous system science, like what really is
happening? What are we really protecting? And to just explain this slide a little bit,
because I know it's it's kind of like alliance outcome correlation. Most of us don't walk around
talking, talking about these kind of terms. So let me translate the point. There was a study way
back when, you know, there was a point where we didn't know aspirin thin blood, right? There was a
point where that was new information. And they were doing a big study for heart disease. And
they were trying to understand if aspirin could help people not develop blood clots,
because there was some evidence that it did. So they did this huge, I mean, it was one of the
biggest funded studies and history of medicine at that time. This is a long time ago, decades and
decades ago, I think it was like in the 60s. So they did this huge study. And during the study,
they started seeing the evidence. And that R equals O two, that's the outcome correlation
coefficient. It's a pretty small number compared to the ones up above, which are 0.28 to 0.30.
Well, that was big enough that they had to cut this study short, you know, millions and millions
on the line, thousands and thousands of participants. So many researchers and doctors managing it was
a huge study. They had to cut it short because that that outcome correlation was so significant that
it was going to be unethical to continue giving people like fake aspirin, right? The sugar cube
thing that they were probably giving them. Because what if they had a heart attack during the study
and they could have given them a medicine that worked? So similarly, we've done some research on
this thing called therapeutic alliance. And that's just you being a human being with another human
being. That's not you using all the awesome skills that you've trained and developed. It's not you
deciphering complex biomechanical patterns and unwinding them in real time. That's just you
connecting with another human in a way that makes them feel seen and heard. And it's 10 times higher
than the aspirin. And it's one of the most stable things across medicine that they have found over
the years over 295 studies. And those are like the big studies, like the big reviews, the ones that
really matter, the ones that have been checked and published in major journals. Over 30,000 clients
and over 30 years of data collection, it's been really consistent at that .20 .30 thing. It's super
meaningful. It means it really works. And if you think about your best sessions, those ones that
just flow, you just feel effortless. The clients often see this level of kind of trust and connection
that's just inspiring. It actually gives you energy rather than takes energy. The thing where
everything just clicks. Do you think it was because you found the knot that had been hiding out for
the last 40 years? Was it because you just worked extra hard that session? Or maybe it was because
you finally got certified in your 15th technique. Or was it just because something was happening
between the two of you? Something that maybe you couldn't fully put your finger on? Things around
trust, safety, presence, felt understanding. That's therapeutic alliance. So that's some
of the science behind it. But let's dig in a little more. What is it? We're working LNTs here.
Nobody's on this call if you're not doing that. So we need stuff that we can use. This goes from
Carl Rogers. He's developed what's called a humanistic theory. Really cool stuff. Googling
if you're not familiar. Really wonderful things. They use this a lot in psychotherapy. But I think
they translate really beautifully into our world of bodywork. And the first is one of my favorite
combination words is unconditional positive regard. If you think about that, it's accepting
somebody without any judgment. Like with our clients. They don't have to apologize for the way
they're presenting. They don't have to feel like they haven't stretched enough or slept enough or
drinking enough water or been getting enough bodywork or done the homework you gave them last
session. They just feel received and accepted as they are. That's the first one. And just think
how that feels for yourself. You can feel when you're with somebody that has unconditional positive
regard. It's like it's palpable, but you can't really explain it. That's the effect you can have
on your clients too. The second very closely related is empathetic understanding.
This is the way I think about this in like actionable ways. And so that it's not just another version
of unconditional positive regard is it's how we're tracking their experience in real time.
This is challenging as providers, as people who have learned techniques and valuable techniques
to not just rely on our own internal checklist, to be listening moment to moment. It's almost like
tactile listening and being able to adjust on the fly. I think of that as empathetic understanding.
It's like they might be the kind of client that tells you, oh, I never have to tell people to go
lighter. You can go as deep as you want. So you're kind of thinking, okay, I'm going to need to use
some elbows, maybe some stretching. I'm going to need to really get in there because this person
is really wants deep work, right? But maybe as you're working on that person, you're feeling
the muscles tensioning as you're trying to go deeper because they asked for that.
So it's just kind of like leaning into this empathy of like, well, why are they asking for that? I mean,
I don't know, but I'm just being a really transparent with you guys because we can keep it real. We're
in a room of a massage therapist here, right? When people tell me that it used to kind of annoy me.
I was just like, come on, man, like, really, you're not going to like have any connection to your body.
It's just like make it hurt as bad as possible. And you think that's going to like help.
Because I felt like I knew better, right? And I'm not saying that I was wrong, but having that attitude
of I know better was actually the opposite of empathic understanding. So I really, I try and
just check myself. I'm not saying I have this perfect right now. But if I notice myself kind of
thinking that, I'm like, I wonder, I wonder what happened to them to like, why are they feel that way?
And B, is it true? You know, like only the tissue will tell you and adjusting in real time.
I think is the way to do that. So okay, then the third one is congruence. And that's just like
authentic presence. This is a big one for all of us, especially. I mean, man, I've had days where
I had to go to the office and I was having problems at home, you know, I was running late and stressed.
I was tired and didn't sleep good. My hands hurt. My thumbs did not feel good.
And I had a full roster of clients, you know. So how do you be congruent when you don't feel great,
you know? I mean, that's a bit of a paradox, right? And we know that like our state matters so much.
We know our nervous system matters so much. And we know we can't fake congruence. People sense
that a mile away. So that's one of the questions that we're going to kind of keep coming back to
today. And these are these are tools. These are things that we can do. You can reverse engineer
some of these things. It doesn't mean you have to disappear to the Himalayas and become
some enlightened nervous system master. There are ways we can do this. And I think all of you
already have a leg up on this as massage therapist, right? So to help us dig into this a little more,
let's just talk a little bit more about some of the background. The science behind it. What is
co-regulation all about? Like it's a word we hear a lot, right? One of my favorite researchers on
this is Dr. Dan Siegel. And you all will get these slides. So if you want to dig into some of
these people a little more, read some more of their work, you can reference that there. So he's not
only research, but also coined this awesome term, interpersonal neurobiology. Interpersonal neurobiology.
How relevant to our work is on teas, right? I think it helps give us the why behind why co-regulation
works. And one of the things Siegel really focuses on is that the brain itself is a social
organism. Okay, what does that mean? Social, I'm sorry, social organ. The brain is a social organ.
What the heck does that mean? Well, it means that our brain and our nervous systems, they don't
operate in isolation. You know, Dr. Siegel started his work as a developmental neuroscientist.
He really studied how brains develop from infancy through adolescence. And this doesn't
change. Some of these aspects don't change when we become adults. Nothing happens in isolation.
Our brains are literally, literally shaped by relationships. They respond
moment to moment and over time to relationships. They can really only co-regulate in relationship.
So when two nervous systems are in proximity, especially in a setting that involves trust,
your attention and touch, you know, hallmarks of what we do as massage therapists,
they're going to influence each other. Okay. It's also a two way street. Hello. And that's
that's kind of heavy for those of us that work with so many people, right? So part of this is
not only keeping yourself protected so you can stay inspired and have a long career and keep
helping and impacting people. It's also to protect yourself from in training to somebody else's
nervous system that might be more dysregulated than yours and and a lot of your clients probably
are, right? That's why they're coming to get massaged or leaning on youth to be a regulatory
anchor. And this isn't just like a metaphor. It's measurable physiological entrainment.
And so when you're dysregulated, which looks like in a treatment room, kind of rushing,
maybe bracing, not paying attention to our body, not breathing, mentally fragmented,
thinking about all things outside the treatment room, outside the moment, pushing through fatigue,
you're also still co-regulating just in the wrong direction. And
neuroception is a really fun term. That's from Stephen Porges and a lot of the work that
a lot of the nervous system science does come from Dan Segal and Stephen Porges. They've done
a really good job of publishing that work and the practices. There's been some debate,
especially recently about like how the actual anatomy of the nervous system and all this stuff
works. If any of you are in kind of psychology realms, you might have seen some of that. It's kind of a
big topic right now in that world. But the thing is, is what has not been debated,
is that the actual methods, the practices themselves are working for people and they have been working
for people for decades. So for always co-regulating, the question remains in which direction are we
regulating? So let's just think about this. Two therapists, same training. And again, I'm not
not sharing anything. I myself have not experienced here. So life is not perfect. I really believe we
fail forward. And if it wasn't for some of the challenges I've had with my own body and my mental state
and my feelings about this career, I would not be here today, certainly talking about any of this.
And it's not a story about like good and bad, right? It's just two different states. And we can choose
where we want to be. And I promise you, I wasn't going to gaslight your experience. So I want to make
sure that we're not going there when I say that. Or when we look at this slide. It's just reinforcing
that aspect of being super mindful about these little things. Because these are little decisions. We
might not be able to affect the big things going on in life, but we can make choices moment to moment.
I can make sure that I get to the office 30 minutes early. So I'm not rushing and trying to get the
table warmer up on time or my salt stones to heat, you know, all those things. I can get
there early. You know, little things like that. So I hope that this is more of a kind of set you
free kind of idea rather than a, oh, why aren't you doing this kind of idea? And okay. So we talked
about some of the science. We've talked about framing self cares like self advocacy. Let's talk
about something we can actually do. And I love this term. And I can't remember where I heard it. So
I can attribute it. I definitely didn't make it up was commit to last so you can show up more.
And I don't know about you, but I used to think that if I was going to start a mindfulness practice
or an exercise routine or whatever that I had to let go super dedicated on it, you know, if I wasn't
going to dedicate at least 20 minutes or maybe even more to like a breathwork or mindfulness routine
or some journaling activities that I wasn't doing it. And something that, you know, the kind of crush
of time and the intensity of life is showing me is that if you can just take one or two minutes,
that alone is extremely powerful. Okay, so try to think of things you can actually do
between sessions, something you can actually do before the session. And like I said in the
beginning, a lot of you are already experts at this and probably already doing a lot of this.
So, hopefully as a reminder, a little bit inspiring to like revisit this stuff, if you're like me.
And you kind of let that let this slip sometimes. So this first practice, again, you get the slides so
you can come back to it. And this is all based on research too. So stuff that like actually works to
change your state and help you kind of be the best you can be for yourself so that you can help others.
It's a three-part thing. And I think you can get this down to about two minutes. And you just
breathe for one minute, okay? And if you think of an in-breath and an out-breath as each being five
seconds, that's just six breath cycles. And it's 60 seconds. Not one of us here can't spare 60 seconds,
okay? And I know you all know what that can do when you just take that little break to just
breathe for one minute. So that's where we start. The next one is anchoring. So the first one is you
get yourself regulated, get somatically tuned with your own body. Then we anchor into a value.
And this is something you'll need to explore on your own. This is a fun self-discovery process.
If you Google for an A Brown values exercise, she's got this awesome worksheet for free online
that lists a bunch of different values or many on there that I had never really put towards before.
And you circle, you know, everyone that you just love. And then you go back over the list and you
maybe pick out six that you feel like, this is really, if I can only pick six, these are the ones
that really matter. And then of those six, maybe post, put those somewhere where you can see them.
And then each day, just think of one that really matters to you. You know, you think of a story
is behind each value. Think of people that inspire you. Like you really go deep with this. That's
what's called an anchor. Your values are your North Star. They are the kind of bedrock of what gets
you through life and good times and bad. So you just think of that. And you just put a simple
I am statement. I am patient. I am kind. I am love. I am grace. You know, whatever your value is.
Okay, so that's like within yourself, you've become grounded in breath. You've identified
your value. Now you orientate. Let's get back to the treatment room. Okay, what does this client
that maybe they're maybe you're doing this all while they're getting on the table, right? It only
takes two minutes or maybe even a minute and a half. So what does this next client need from my
presence today? And just think about it. Think about what they need. Think about it from a place
of unconditional positive regard and empathic understanding of that person. Okay, so that's one
thing. So simple. I don't about you, but the simple stuff, sometimes the most effective.
All right, so the next thing, that's kind of a thing to do before treatments. Let's think about
what we can do during a session. We have all these little opportunities during a session,
during transitions, maybe removing from one body part to the next, maybe you're going over to change
out your oil or to grab any central oil or grab your hot stones or your salt stones,
maybe you're getting a hot towel, whatever, those little transitions. Just feel yourself
breathe during that time doesn't take any extra time just integrated in. Another big one and this
one really was a paradigm shifter for me. So I hope it serves you is a strength based queuing.
I was totally the guy who'd be like, oh man, look at this knot. Your shoulders, wow,
this is so tight. And, you know, and that's kind of how clients talk to us too. They're like, oh,
I'm just a wreck. My neck is all messed up. You know, all right, all the things you've all heard
them. So how do we get creative and kind of reframe those things? You know, instead of me focusing
on how tight the thing is, I could say I can feel us starting to let go. Because what does that do
that encourages their attention to like kind of a positive place, you know, instead of like,
oh, this side is way worse. So your right side is so much worse in your left.
Be like, your body's working harder over here. Or I wonder what it's protecting, you know,
or like in the slide, your breath shifted. You know, maybe they start holding their breath, you
know, they went from breathing really deep to all of a sudden kind of holding and be like,
I notice your breath shifted. What's going on? So part of this is just kind of keeping an air
of positivity. Remember, your therapeutic use of self, your therapeutic alliance is more about the
environment you create than the techniques you do. And I think these are just some of the nuts and
bolts of what you can do to create an atmosphere of just positivity and growth. I want your clients
to leave your office and feel like, huh, my body is awesome. Like it's, it's working for me,
not against me, you know, not only is that going to serve them, it's also going to keep them coming
back, you know, and I think it interrupts negativity bias as, as kind of biological creatures where
you have a negativity bias, we're looking for threats in the environment, because that's how we
stayed alive. So creating that environment of safety and then helping frame people or reframe
challenges as strengths, powerful stuff, that's the stuff that will really stick with your clients.
Okay, so that's kind of the during session. How about between sessions or after session? If you're,
right, again, I'm trying to think of real quick things. So I think it's like 60 seconds. And this is
you kind of applying that strength base frame to yourself. Like what went well, you know, I mean,
I used to beat myself up sometimes after sessions if I didn't feel like it went really great. Like,
I should have done this. I should have done that. Or I wish I had asked that. Or I shouldn't have
said this, you know, all these things that like I wish I had done or should have could have what,
you know, it's like kind of should all over myself. So instead, take the strength base lens and turn
it to yourself. What went well? You know, what, what shift did I notice? That's your awareness,
you know, you're training that every session. What did I appreciate? And then what can I bring
next, especially if it's in between sessions. So part of that too is just kind of completing
the sessions, like let that one go, you know, trust in yourself, believe in yourself,
and then start the next one fresh, take the best, leave the rest. All right, so we've been talking
about a lot of nervous system stuff. I think it's literally the most important thing we could talk
about. But I did want to leave you with some biomechanics stuff here too. I used to have
incredible hand pain. I worked very hard. I was really proud of myself as a deep tissue therapist,
sports massage. I did a lot of training and different techniques. And, and I mean, come on,
is there anything better than your thumb at the end of the day? Like, it is so awesome. You can feel
so much, you can get all the different angles. It's just like the perfect tool. And I would
sacrifice my body to get to a technique, to get to a spot, to get a stretch done, to engage the
tissue in a certain way. And it was so bad at a point that I got my own like, what do you call
paraffin bath? And I would just like give myself paraffin baths at night and then alternate,
and I got bought this like compression ice thing that would like, you know, I would like
compress with the ice water around your hand and wrist and then release. And then we just kind of
help circulation and flow out. It was actually a cool treatment. But that was how I spent my nights.
And then I would go back the next day. And I felt like I was hurting myself, but I just kept going.
And I kind of hated that, you know, and I don't think I'm alone. I have many friends
in the profession. And I don't know one of them that's been doing it for many years that doesn't
talk about body pain. Body pain is a big deal in what we do. And if we don't figure it out,
we're not going to be able to keep doing what we do. And we're not going to be able to keep having
that impact that matters to people. And I think that our therapeutic use of self becomes elevated
when we're using our body in ways that aren't hurting ourselves, right? So here's some ideas.
I know a lot of you already know about the basics of how to use your body, table height,
all the things. So these are just some ideas that hopefully you haven't heard before.
Think about session design in terms of how you load your body, all right?
Before, especially before COVID, my main client load were professional runners in Bend, Oregon.
They would often just arrive in their running shorts, lay down on the table and just want me to,
you know, that like I don't feel any pain kind of thing.
So what I realized is I spent a lot of time warming up the tissue just so I could get deeper.
So I was like, what if I just put a heating pad on this, work on a different part of the body,
maybe do some breath work with my client or get them inhaling, some essential oils,
something to help their nervous system calm down. While the heat pad is basically doing the work
that I used to take four or five minutes of kind of Swedish style strokes to get the tissue warmed
up. And then I got, I never used the massage guns. I just kind of came into vogue more lately.
I've got the old school thumpers. Anybody use the thumper as Canadian company? I really like the
thumpers. So I had this handheld thumper and then I'd take the heating off. I'd use the thumper on
the leg. And then when I put my hands on the leg, the tissue was already like melted. It was
amazing. So I can go right to work with some like active stretching, things like that, which
gets me to my next point, share the load. If any of you have not experimented with muscle energy
techniques, go learn it right away. Go to YouTube, check it out. It's easy. Okay, you do not need
to go to a big fancy workshop or get another four year degree to do that. Here's a really
simple way to think about it. Let's, let's talk about the legs. Let's talk about the SOAS. So if
you're laying face down, one of the ways I access the SOAS and to our hosts, I am watching the time
and we're about to wrap up. If I don't like to dig through the abdomen to work the SOAS, it's just
not my style. So I like to do stretch it when they're face down, you know, internally rotate
and stretch up. So once I reach that endpoint, I can ask them with about 20 to 40% of their effort
to drive their knee back down to the table. And I just hold that and then ask them to relax. And
then I stretch again, you know, that's kind of a version of proprioceptive neuromuscular facilitation,
which is called PNF. You can also call that muscle energy. It's just finding a stock point
and then having them initiate the opposite motion and then going back to the stock point and releasing
it. It's, you get better outcomes. It's a little less work for you. It really works. The other thing
is like, view your thumbs as precious commodities. They're expensive. Like, don't use them. Like,
my thumbs hurt so bad that I had to get good. You know, I'm a big fan of the half knuckle.
So I got really good at using other tools. But I wish I hadn't waited that long. Okay. And now
my thumbs, they actually healed and feel pretty good now. Thank goodness. And then the other thing
is to think about like workload periodization. That's an exercise science term. It's like,
don't load your schedule. Try to figure out how to spread it out. Like, maybe your best thing is to
client some Monday and three on Tuesday, take Wednesday off and repeat or vice versa. Just
versus doing like five of your hardest deep tissue clients on one day. And I know that that is easier
said than done in the real world. But work fills the space. You give it. So if you create a calendar
and try to design it in that way, your calendar will fill up in that way. If you just leave it all
open because, you know, you need the work, I get it, we need to make a living, it will just fill up
all randomly. So create the container that you actually want to work in. Okay. And this is just
talking a little bit more about the thumb here. I'm going to share these slides with you. I'm basically
just reiterating a lot of things here. And we're going to skip ahead. Just remember your state is
clinical. Regulation isn't luxury. Borrow, steal my three rituals or make up your own. Think of stuff
that's less than a minute and you can actually do before session, during a session, after a session,
it will change everything. I don't have anything to sell you all. I still love to hear from you.
This is my email. Shoot me an email. I've been meaning to get going on a sub stack about nervous system
science for body workers. If you got any articles or ideas, shoot it to me. Our work with horses is
over here on a different sub stack. You can get these slides and check it out if anybody's interested
in that. Your email is going to have the slide deck and also the CEU materials and we're all here
for CEUs. I hope this has helped you. I just want to you to know how much you matter, how much
your work matters. Your hands have held so many people. And today isn't just about making
today's about making sure someone holds you too, even if that's someone is you. All right. Thank
you so much, everybody. I hope this was helpful for you. I'm going to stop sharing.
I am not a massage therapist and it was helpful for me. Some of those principles that you're talking
about really relate to just general thought and connection to your body. And so thank you, Josh.
Really amazing content. And thank you, everyone. I've been watching the chat.
Really helpful comments and really positive stuff, sharing your own experience. So thank you
all for being in that community and being in that connection. That is what massage therapist
appreciation week is. And that's what we do here at MIP. So thank you, Josh, again, for your time
today. We really appreciate it and we'll send you some of this fun, good feedback as well on the
chat so you can see. With that, everyone, thank you again for joining. We will be sending this recording
out to you via email tomorrow. So stay tuned for that. And in that email, we'll have all of the
information about the CEUs, how to check in with Josh, see what he's doing, et cetera.
So thank you all. And I hope you have a great rest of your Thursday. I will see you all
soon. Thank you, Josh.
Thank you. Bye bye, everybody.