Monday, December 19, 2011

Alliance for Massage Therapy



Let's Cozy Up!
What is an Alliance?
I am thinking about the future.   I am also thinking about some conversations I had last week with others committed to the advancement of massage therapy and education.  I am thinking about shared blog conversations.   I am also thinking about the Alliance for Massage Therapy Education.  (AFMTE) http://www.afmte.org/.    I looked up the meaning of the word Alliance and found:

Definition
Coming together of two or more firms to create a unique organizational entity (such as a joint venture), in which each firm retains its individual identity and internal control. The purpose of an alliance is to (1) achieve joint strategic goals, (2) reduce risk while increasing rewards and/or, (3) leverage resources. Since an alliance is neither an acquisition nor a merger, it requires new control methods and new management skills.

A connection based on kinship, marriage, or common interest; a bond or tiehttp://www.thefreedictionary.com/alliance

Close association of nations or other groups, formed to advance common interests or causes.

Then I read the following from the Alliance for Massage Therapy Education web site.

The Alliance for Massage Therapy Education is an independent non-profit organization established to serve as the voice, advocate and resource for the entire education sector – from entry-level massage training programs through post-graduate studies. The Alliance is the only organization that brings Schools, Teachers, and Continuing Education Providers together under one roof. http://www.afmte.org/

There have been changes in the Alliance and it might be time to rethink the concept of member dues as a form of financial sustainability.  I am very committed to the Alliance but I am also in MEMBERSHIP  DUES OVERLOAD!   I just thought I would present the possibility of an alternative “kinship” structure for the Alliance that reflects the definition of Alliance in the name of the Alliance for Massage Therapy Education.

Using the definition above –

----Coming together of two or more firms to create a unique organizational entity (such as a joint venture),

Right now the AMTA and the ABMP  both have segments that target massage education in addition to the Alliance for Massage Therapy Education.  There are also three different meetings and as a result a splitting of resources. Wouldn’t be great if there was an Alliance where all three come together, pool resources   and stand together in a joint venture for quality massage education?

--- Each firm retains its individual identity and internal control.

Cooperation instead of competition and conflict   -  WOW

The purpose of an alliance is to (1) achieve joint strategic goals, (2) reduce risk while increasing rewards and/or, (3) leverage resources.

AGAIN WOW- Think of the potential!

How about we become partners (defined as persons who share with others in some action or endeavor activity or a sphere of common interest) is a strategic  alliance

Strategic alliances are agreements to operate collaboratively between otherwise arm’s length organizations to accomplish a strategic purpose. Alliances can be either equity or non-equity alliances but all are formed to achieve benefits for the organizations that would not be achieved by operating individually.


Strategic alliances usually have a unique value proposition that uses the specific competencies of each of the organizations to achieve competitive advantage. By sharing complementary resources and capabilities alliance partners achieve quicker and more efficient growth than they would if they developed the resources or capabilities within their own organization.


http://www.mbanetwork.co/strategy/differences-between-a-joint-venture-and-a-strategic-alliance/itemid-192


We could at least brain storm it.
ANOTHER WOW –

Sunday, December 11, 2011

Expanded response to Ravensara



I read your response to my blog to my advanced students this weekend and they were impressed.  I used it as an example for how to develop an opposing statement and/or engage discussion.  I told them that what I did not realize is that this discussion may end up being an example of how a conversation of this type can evolve. Later  Laura Allen posted on Face book

Laura wrote: "Two ladies I admire--Sandy Fritz and Ravensara Travillian--can disagree and be gracious about it. That is the hallmark of civil argument and it would serve certain people to take a lesson in it.”.

 So I posted the blog to see if this important topic would be discussed and thanks to you it is and additionally an example ( at least to Laura  ) of a civil argument.   Later, one of my students emailed me a quote from Einstein about energy and physic and mysticism. I checked it out and identified that maybe Einstein may not have made the statement but I did find this one.

Even though the realms of religion and science in themselves are clearly marked off from each other, nevertheless there exist between the two strong reciprocal relationships and dependencies.
Albert Einstein - "Science, Philosophy and Religion, A Symposium" (1941)

I made the statement  ---I think it is the mystical factor when in reality there is no mystery at all.

Ravensara replied:  Here, I respectfully disagree.


The arguments linking thermodynamic energy to the energy healing concept all, universally, without exception, require a mystical leap of faith to make that connection. …..That metaphysical leap of faith contains the mystery associated with the energy healing concept, which some of us are happy to accept without questioning, and which others of us have a large problem with. The energy healing concept cannot be directly connected to thermodynamic energy without that leap of faith, which is what makes this issue so irreconcilable.

MY REPLY: Yes Ravensara- your right. I did exactly this without realizing it. My intention was to point out the line between evidence and opinion yet I still confused the two.  You write --Here is where Fritz takes the metaphysical leap of faith I mentioned earlier:

I think the big question is if humans can purposefully direct their energy fields. Here is what I suggest- approach each client with the energy of compassion, respect and intent to help using solid massage application.

RAVENSARA points out: In the first sentence, she is speaking of objectively-detectable electrical activity at the subcellular level. In the second sentence, she is speaking of complex and sophisticated emotions and cognition that are not objectively detectable.

By juxtaposing the sentences, she is claiming that they are the same thing, but she is not doing the work to connect the dots to demonstrate that they are, indeed, the same thing.  She is, implicitly, asking us to take the same leap of faith to consider the two phenomena (subcellular ionic activity and complex emotions/cognition) to be equivalent to each other.

MY REPLY: Yes Ravensara you caught me. I did not intend to do this but on review, I did. This is a clear example of why "Experts" should be challenged and I am glad you did.

My point better clarified is this- as a massage therapist be mindful of your intentions, presence and influence and represent massage methods clearly without confusion. There is good evidence for benefits of massage and there is indication that one of the mechanisms of benefit may be the interaction of the therapeutic relationship which would fall into the psychosocial model. Christopher Moyer has pointed this out.

 Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull. 2004;130:3–18. doi: 10.1037/0033-2909.130.1.3.[PubMed] [

‘Later Ravensara writes - The important question is, what is the significance of those electrical impulses? Is it nothing more than white noise, generated by millions of independent interactions at the subcellular level, or is it a top-down, coherent entity that has an independent existence and properties of its own? 

MY RESPONSE:  This is clear concise and brilliantly stated Ravensara. I wish I would have said it that way.   The aspect yet to be understood within the realm of scientific evidence is---- can the energy of the body function as top-down, coherent entity that has an independent existence and properties of its own that can be use purposefully to influence a physiological process in another.

What constitutes quality evidence?  I copy and pasted this from http://www.aota.org/DocumentVault/AJOT/Evidence-Guide.aspx

Levels of Evidence

Level I:
Systematic reviews, meta-analyses, randomized controlled trials
Level II:
Two groups, non-randomized studies (e.g., cohort, case-control)
Level III:
One group, non-randomized (e.g., before and after, pretest and posttest)
Level IV:
Descriptive studies that include analysis of outcomes (single subject design, case series)
Level V:
Case reports and expert opinion that include narrative literature reviews and consensus statements

Adapted from “Evidence-Based Medicine: What It Is and What It Isn’t,” by D. L. Sackett, W. M. Rosenberg, J. A. Muir Gray, R. B. Haynes, & W. S. Richardson, 1996, British Medical Journal, 312, pp. 71–72. Copyright © 1996 by the British Medical Association. Adapted with permission http://www.aota.org/DocumentVault/AJOT/Evidence-Guide.aspx

I point out level V evidence.  Case reports and expert opinion that include narrative literature reviews and consensus statements.


I ask the question,”  Is there a level of evidence for energy work application based on case reports, expert opinion, narrative literature reviews and consensus statements?”


Another question I ask is “ Even if there is evidence for energy work  do these methods fit within the definition and scope for massage?”


 My opinion is that massage functions though the physiological and mechanical changes that occur when mechanical forces are applied to the body.  My opinion is that massage should be taught and explained in this way as well and researched from this perspective.  It is also my opinion that there is benefit derived from the psychosocial interactions of the therapeutic relationship. I also think that there are other methods the interface well with massage, but are not massage. Examples include hydrotherapy, thermotherapy, possibly aromatherapy, music therapy, Shiatsu and within this realm energy therapy maybe. Others methods included in this realm for me would be use of magnets, kinesio-taping, and various ointments and products that cool or warm the skin.   I think that these types of applications are adjunct or in addition to massage and should be explain as such.  Some of these methods have high levels of scientific evidence and some have none and this information should be disclosed to the client in an informed consent process..


Ravensara states concern with the following issues.
·         How do we, as practitioners, provide a safe therapeutic space for all clients, without litmus tests for belief?

MY RESPONSE:  I agree with the question and think we can within the framework of ethics and professionalism develop guidelines to help massage therapist in this area.

·         How do we, as educators, provide a safe learning space for all students, without litmus tests for belief?


MY RESPONSE: I agree with the question and think we can within the framework of ethics and professionalism and critical thinking develop curriculum guidelines to help massage educators in this area.  I have attempted to write text books with this in mind.

·         What are the commitments to principles that we, as an evolving profession, wish to make, and what are the impacts of those commitments on collaboration and communication with other potential partners on the healthcare team?  

MY RESPONSE: This is a huge issue Raven and I think the massage community continues to be immature in this area.  The massage community needs to grow up (my opinion) before this issue can be considered. It makes me sad that the profession I love remains so divided.
Raven states: There are three outcomes that I can imagine coming out of this; there may be others that I have not thought of.


1.     We come to a working arrangement with a code of ethics that practitioners of all specialties can commit to working under, one which does not require forcing any particular belief or set of beliefs on students or clients; 

 MY RESPONSE: THIS IS POSSIBLE, BEING TRIED, CAN BE REALLY CONFUSING BUT WHO KNOWS---

2.     We agree that such a working arrangement cannot be reached, and the profession splits under mutual agreement into different areas of practice that commit to varying degrees of belief in vitalism/dualism;

MY RESPONSE: I THINK THIS IS WHERE I STAND PERSONALLY AND PROFESSIONALLY RIGHT NOW AND SUGGEST THAT THE CONCEPTS OF ADJUNCT METHODS  WHICH ARE NOT MASSAGE BUT CAN EFFECTIVELY BE INCORPORATED INTO MASSAGE BE CONSIDERED.

3.     We do nothing, and the profession splits in an uncontrolled way along that fault line, with unpredictable fallout from that split.

MY RESPONSE: THIS OUTCOME IS REFLECTS OUR HISTORY- I WONDER WHAT OUR LEGACY WILL BE?
                    Those reading this blog may enjoy the paper found at this link

Int J Ther Massage Bodywork. 2009; 2(2): 15–27.
Published online 2009 June 29.
PMCID: PMC3091464

Copyright © The Author(s) 2009. Published by the Massage Therapy Foundation.

Directions and Dilemmas in Massage Therapy Research: A Workshop Report from the 2009 North American Research Conference on Complementary and Integrative Medicine

Christopher A. Moyer, PhD,1 Trish Dryden, RMT, MEd,2 and Stacey Shipwright, BA, RMT2




On a final note, Ravensara commented on my sharing the picture of my granddaughter and the circumstances of my son’s death.  The compassion I felt in your response is genuine and I honor and appreciate you for it.  We all have a story with many chapters.   How we turn the pages of our life influence the quality of the journey. 

The very worst thing that could have ever happened to me did happen and because of faith, hope and love I can cry and laugh, continue to grieve yet move forward. I still struggle to forgive but I am getting there and I have been blessed. This is my life and my spirit but it is not the massage I can give nor the results the clients receive.  I am a more gentle soul because of the events and my walk through them and I think a more empathetic person which makes me a better massage therapist and educator and so we circle around the issues again.


Even though the realms of religion (spirituality) and science in themselves are clearly marked off from each other, nevertheless there exist between the two strong reciprocal relationships and dependencies.
Albert Einstein - "Science, Philosophy and Religion, A Symposium" (1941)

Saturday, December 10, 2011

An Excellent Response.

The following comments to my post on  Energy based methods are excellent and I hope all that read them carefully consider the valid points made. Ravensara actually restated some of my points better than me and I agree with her. She questions me about this statement----


Results are mixed. No one questions that humans have electrical fields.

Clarification.   What I found was that the results are mixed for the affects of "machine" delivered energy methods. I wonder how we can make the evidence leap to effects of human energy fields when the evidence is inconclusive for the "machines".

I had hope that I would get some response on this post.  It was actually based on a statement Laura Allen made about energy in one of her blog posts.  We need as a profession to figure this out.  The little angel in the blog post is my beautiful granddaughter -healer extraordinaire.  She is my son Greg's little girl. Greg was killed when a distracted drive hit him when he was crossing a street. His wife was five months pregnant at the time.  This little girl absolutely carries the energy of my son for me. She heals my heart and soul. This is faith on my part. No religion - just faith.

I believe that science will actually in the future find evidence of the energetic connection between humans.  However, that is evidence does not exist currently.  I support evidence based and informed massage practice.  Anyone who has read my textbooks cannot question that.   I thank Ravensara for time, thoughts and intelligence and hope we continue this dialog.

PS.  I have encouraged my students to join POEM-----

A response to Fritz' blog post "Energy Based Methods"


 Ravensara Travillian

This is a topic which always inspires a lot of passion, so I'll just remind everyone once again of the discussion policies here at POEM.
You are free to hold any opinion you want, and you won't be censored simply for disagreement (although you may well be challenged to show your evidence and connect the dots), but you do have to express yourself in a civil, appropriate, and professional manner.
This is a place that represents massage to all stakeholders in the community; for that reason, I don't permit it to degenerate into bar-fights that diminish our efforts to become a healthcare profession.
Professionals can have different, even opposite, opinions on issues and still respect each other. I have a great deal of respect for Sandy Fritz; I just disagree with her on the issue of energy-based methods.
If I did not respect her and my audience's ability to understand the arguments I am making, I would not spend the time and effort to spell out my thought process to consider and respond to. That engagement and reciprocity is the opposite of negativity; I consider not engaging with others in the realm of ideas a much worse snub than simply disagreeing.
I refer to her by last name when I mention her directly in the post; that is not rude, abrupt, or brusque. It is an accepted form of professional discourse which levels the playing field by not implicitly favoring people with titles such as "Dr." over others, concentrating instead on the issues, facts, and evidence that they bring to their arguments.


Sandy Fritz has written a blog post about energy-based methods in massage, available by clicking here. She has clearly given a great deal of thought to these issues.
A thoughtful post deserves a thoughtful response, so I am taking the time and effort to respond clearly and in detail to the points she is raising.

I just taught a class on incorporating energy based methods into massage. Every time I teach this class I wonder why this area continues to be controversial.

The concept of "energy" as it is described and as claims are made about it is at the heart of the culture wars currently raging in massage.
These philosophical arguments have gone on for centuries, and we are not about to resolve them anytime soon. The only thing we can do is decide, as a developing profession, either to be on the same page about them, or to split and go our separate ways, because they are not reconcilable.
This irreconcilability is the reason that this area continues to be so controversial. The arguments that cannot be reconciled include:
  • dualism versus monism:
    • Dualism is commitment to the statement that things in the universe belong in two mutually exclusive categories--matter as opposed to spirit, for example.
    • Monism is commitment to the statement that all things in the universe belong to the same category--that there are not two different categories at all.
  • vitalism versus materialism:
    • Vitalism is:
      • 1 : a doctrine that the functions of a living organism are due to a vital principle distinct from physicochemical forces
        2 : a doctrine that the processes of life are not explicable by the laws of physics and chemistry alone and that life is in some part self-determining [Merriam-Webster Free Online Dictionary: Vitalism accessed 8 December 2011]
    • Materialism, by contrast, holds that all things can be explained in terms of what we know about:
      • matter;
      • energy as it is understood in the scientific sense;
      • the interactions among those entities; and
      • emergent effects arising out of those interactions that are more than the sum of their parts.



I think it is the mystical factor when in reality there is no mystery at all.

Here, I respectfully disagree.
The arguments linking thermodynamic energy to the energy healing concept all, universally, without exception, require a mystical leap of faith to make that connection. When we get there in her post, I will show where Fritz does exactly the same thing.
That metaphysical leap of faith contains the mystery associated with the energy healing concept, which some of us are happy to accept without questioning, and which others of us have a large problem with.
The energy healing concept cannot be directly connected to thermodynamic energy without that leap of faith, which is what makes this issue so irreconcilable.


" Energy work" is different than spirituality but the two are often interconnected.

Fritz is quite right here that the two are linked, although I would take it further and state that the two are always interconnected.
The fundamental question that lies at the center of the debate is whether the physical material world that we can directly observe is all that there is, or whether there is a spiritual world that lies beyond physics (metaphysics = μετά/meta, "beyond" + physics).


To understand the plausibility of energy methods it is necessary to understand more about physics.

I agree on the surface with what Fritz says here, but I think we mean very different--even opposite--things by it.
Fritz has presented foundational information about physics in a way that she thinks obviously makes her case for the connection stronger.
I disagree with her interpretation about what the facts mean, and I think the disagreement arises out of the metaphysical leap of faith that she takes in conflating three things:
  • the well-understood facts about thermodynamic energy from physics;
  • the way that people in New Age circles talk about "energy"; and
  • emotions.

To ensure that we're all on the same page, the definition of "plausibility" is "seeming to be valid". A plausible explanation is an explanation that, on its face, makes sense or appears to be in accordance with what we know.
From the point of view of physics, whose specialty is the study of energy and matter, the energy healing concept is not plausible, because it contradicts so much of what we already know about physics.
Certainly, it is possible to find physicists who agree with New Age claims about energy, just as it is possible to find earth scientists who are skeptics about anthropogenic global climate change, despite the overwhelming consensus of scientists that it is occurring.
The point of evaluating a claim is not whether you can find a few individuals who agree with you; it's whether the claim holds up under scrutiny holistically--in light of the entire discipline and of the evidence. The way that the energy healing concept is expressed in New Age philosophy, it contradicts so much of the foundational knowledge in physics that the overwhelming majority of physicists do not find it at all plausible.
So the burden of proof that energy-healing advocates have set for themselves is not just to come up with plausible-sounding words, but to show that their hypothesis actually explains facts in the material physical world better than the consensus of mainstream physics, accumulated over centuries of observation and testing, explains them.
I also pose the question to our developing profession--how do we want to present ourselves to our potential colleagues on the healthcare team, such as medical physicists?
Do we accept and respect the work they have done to establish knowledge in their own specialties, or do we insist that we ourselves have the knowledge to evaluate the evidence in other specialist fields, and to insist on contradictory claims instead?
Which path does our profession choose, and why?
One of the e-Books under development at POEM is an introduction to foundational knowledge in physics. My intent is to provide you with the tools that--if you choose to make use of them--will equip you to evaluate claims in light of what we already know about physics, and of emerging evidence, and to determine whether those claims hold up when examined.


Here is my point. Machines that use energy waves are being studied.

Fritz is absolutely right on this point. Thermodynamic and electromagnetic energy is used in applications ranging from diagnostic medical imaging (X-rays, CAT scans, MRIs, and so forth) to ultrasound for pain relief to magnetism to treat severe depression, and much more.


Results are mixed. No one questions that humans have electrical fields.

I'm not sure what she means by "results are mixed", but it's true on many levels. For example, you can see soft tissues clearly on MRI images, not so much on X-rays.
But I think that I may be missing the point she wants to make here, and I welcome clarification.
And that human tissues have bioelectromagnetic properties is also indisputable. It's a fact that has been established decades ago.
The important question is, what is the significance of those electrical impulses? Is it nothing more than white noise, generated by millions of independent interactions at the subcellular level, or is it a top-down, coherent entity that has an independent existence and properties of its own?


Here is where Fritz takes the metaphysical leap of faith I mentioned earlier:
I think the big question is if humans can purposefully direct their energy fields. Here is what I suggest- approach each client with the energy of compassion, respect and intent to help using solid massage application.

In the first sentence, she is speaking of objectively-detectable electrical activity at the subcellular level. In the second sentence, she is speaking of complex and sophisticated emotions and cognition that are not objectively detectable.
By juxtaposing the sentences, she is claiming that they are the same thing, but she is not doing the work to connect the dots to demonstrate that they are, indeed, the same thing. She is, implicitly, asking us to take the same leap of faith to consider the two phenomena (subcellular ionic activity and complex emotions/cognition) to be equivalent to each other.


Don't mix up your spirituality with your massage and respect each clients spirituality as sacred spaced.

I can totally agree with this statement, as long as it is extended to afford exactly the same respect to clients who do not have, and do not feel the need to have, any spirituality at all.
If we aspire to become healthcare providers, religious discrimination has no place in our developing profession. If we afford exactly the same respect to non-believers as to believers in the public therapeutic space, then I have no quarrel at all with people practicing their own private spirituality in their own way.
Requiring faith in untestable and unprovable metaphysical ideas as part of a healthcare profession is inconsistent with a mission to provide equal quality service to everyone who seeks it.
For that reason, the biopsychosocial model of massage, under development here at POEM, respects everyone's freedom of conscience as a human right in their unique personal space, but explicitly excludes metaphysical leaps of faith from the universally-accessible knowledge repository that is being built.


Keep an open mind -who knows what technological advances will be able to figure out.

Fritz' principle is a good one to keep in mind, but consider this as well: many eager, earnest, committed people have been trying for decades, without success, to make the connection between the well-established principles of thermodynamic energy in physics, complex mental processes like emotions, and the concept of energy in New Age thought.
If they have spent this much time and effort in that effort without success until now, how likely is it that they are going to definitively succeed in future?
Where are our time and effort and resources, in an age of limits, best and most effectively allocated with the most likelihood of success?
At what point do we say that specific hypotheses have had a fair chance, and failed at it, to demonstrate that they work better as an explanation or a predictor of processes in the material world?


This is taken directly of the NIH web site.

At this point, Fritz is quoting someone else who wrote for the NIH website, so I am not engaging directly with her anymore, but with the anonymous author of the text at the site.

Some CAM practices involve manipulation of various energy fields to affect health. Such fields may be characterized as veritable (measurable)

Now this equivalence is not true--juxtaposing a term in parentheses with another term implies that the two terms are synonyms, but here, they are not. "Veritable" (L. veritatem [nom. veritas] "truth, truthfulness," from verus "true" Online Etymology Dictionary accessed 8 December 2011) does not mean "measurable"; it means "real", "true", "actual", or "genuine".

or putative (yet to be measured).

Whoever wrote this for NIH did the same thing with this definition as they did with the one for "veritable".
Putative means "claimed".
"Yet to be measured" is an equivocation that implies it can be measured; they just haven't gotten around to it yet. However, there are at least two other possibilities:
  • it is yet to be measured, and never will be, because it is inherently unmeasurable;
  • it is yet to be measured, because all attempts to do so have failed.

Reading that sentence as they wrote it, implying that the only difference between veritable and putative energy is whether it has been measured yet, is quite misleading.


A more accurate statement would be:
Such fields may be characterized as veritable (true/real) or putative (claimed).

But that comes across very differently than the other version, doesn't it?
This rewrite also serves to highlight clearly where the leap of faith occurs--between physics, which can objectively measure electromagnetic energy, on beyond physics into metaphysics, where claims are asserted, but cannot be objectively measured.


Practices based on veritable forms of energy include those involving electromagnetic fields (e.g., magnet therapy and light therapy).

Absolutely true. These kinds of therapy are solidly in the realm of physics, and while the principles understanding the forms of energy used in them are fairly well-understood from a physical point of view, new and exciting applications are being developed by researchers all over the world and applied in the clinic.


Practices based on putative energy fields (also called biofields) generally reflect the concept that human beings are infused with subtle forms of energy; qi gong, Reiki., andhealing touch are examples of such practices.

The practices reflect the "concept", or idea, of biofields. There is no mention of any empirical reality to justify the concept that they reflect, because research in these areas has stalled at still trying to demonstrate they exist--a state it's been in for decades now. The empirical reality does not yield results that advance the concept.
In real life, a dogwhistle makes a sound that it so high-pitched (high in the frequency of its energy) that human ears cannot hear it, although dog ears can.
Similarly, in rhetoric, the metaphor "dogwhistle" refers to a term or phrase that carries a hidden message, that some readers are able to pick up on, but which is undetectable to other readers.
The use of the term "subtle" in energy-healing contexts is a vitalist dogwhistle for "spiritual component". Readers who are familiar with vitalist writings recognize the appeal to the spiritual contained in the word; other readers interpret it as an adjective meaning "delicate" and do not recognize that this statement is a commitment to a vitalist metaphysics.


The 2007 NHIS found relatively low use of putative energy therapies. Only 0.5 percent of adults and 0.2 percent of children had used energy healing/Reiki (the survey defined energy healing as the channeling of healing energy through the hands of a practitioner into the client's body).
http://nccam.nih.gov/health/whatiscam/

When we are working with survey definitions, we are still working with concepts, not with empirical physical reality. To say that energy healing is "the channeling of healing energy through the hands of a practitioner into the client's body" is not the same thing as to actually do it.
Energy healing research is stuck in the position of trying to prove it exists in the New Age conceptualization that its advocates promote, and as a result, it has not advanced in decades.
In my opinion, if its advocates would stop trying to force a dualist/vitalist explanation onto it, and investigated it in terms of psychological processes, they would get a great deal more traction, both in the laboratory and in the clinic.


When I was looking for some sort of current "energy healing" used in the health care world I found Pulsed RadioFrequency. Pulsed RadioFrequency (PRF) is a relatively new technique derived from a well established and proven intervention, thermal radiofrequency (RF).

PRF is well within the domain of physics, and the new derivation of PRF from thermal RF is an example of the advances and new implementations from research that are being delivered to the clinic from the material physical energy side of the discussion.


Both procedures are used in the treatment of chronic pain. Unlike RF treatment, PRF does no direct damage to the nerve. During PRF treatment, electrical energy is applied with a small needle to the affected nerve using a pulsed time cycle that delivers short bursts of RF current, any frequency within the electromagnetic spectrum associated with radio wave propagation. When an RF current is supplied to an antenna, an electromagnetic field is created that then is able to propagate through space. Many wireless technologies are based on RF field propagation.
These frequencies make up part of the electromagnetic radiation spectrum:
  • Ultra-low frequency (ULF) -- 0-3 Hz
  • Extremely low frequency (ELF) -- 3 Hz - 3 kHz
  • Very low frequency (VLF) -- 3kHz - 30 kHz
  • Low frequency (LF) -- 30 kHz - 300 kHz
  • Medium frequency (MF) -- 300 kHz - 3 MHz
  • High frequency (HF) -- 3MHz - 30 MHz
  • Very high frequency (VHF) -- 30 MHz - 300 MHz
  • Ultra-high frequency (UHF)-- 300MHz - 3 GHz
  • Super high frequency (SHF) -- 3GHz - 30 GHz
  • Extremely high frequency (EHF) -- 30GHz - 300 GHz

This is excellent information, and I applaud Fritz for presenting it. I agree that we should know basic physics as foundational knowledge, both as MTs and as citizens who vote on policy issues, and that's why it will be included in POEM e-Books.
Source: http://www.astrosurf.com/luxorion/Radio/spectrum-radiation.png accessed 9 December 2011

The details of specific imaging and treatment technologies are not so important for our information needs, but understanding at a very high level what other professionals on the healthcare team do will promote collaboration and communication with them for the benefit of the client.


Fritz includes some links to PubMed articles. These articles posted here can be categorized into two groups.
The explanatory mechanisms in this group of articles fall solidly into the domain of testable, observable, medical physics.
  • http://www.ncbi.nlm.nih.gov/pubmed/20440207
    Snidvongs S, Mehta V. Pulsed radio frequency: a non-neurodestructive therapy in pain management. Current Opinion in Supportive and Palliative Care. 2010 Jun;4(2):107-10.
  • http://www.ncbi.nlm.nih.gov/pubmed/18721175
    van Boxem K, van Eerd M, Brinkhuizen T, Patijn J, van Kleef M, van Zundert J. Radiofrequency and pulsed radiofrequency treatment of chronic pain syndromes: the available evidence. Pain Practice. 2008 Sep-Oct;8(5):385-93.
  • http://www.ncbi.nlm.nih.gov/pubmed/12535508
    Niemisto L, Kalso E, Malmivaara A, Seitsalo S, Hurri H. Radiofrequency denervation for neck and back pain. A systematic review of randomized controlled trials. Cochrane Database of Systematic Reviews. 2003;(1):CD004058.
  • http://www.ncbi.nlm.nih.gov/pubmed/22008239
    Rohof O. Intradiscal Pulsed Radiofrequency Application Following Provocative Discography for the Management of Degenerative Disc Disease and Concordant Pain: A Pilot Study. Pain Practice. 2011 Oct 19.
  • http://www.ncbi.nlm.nih.gov/pubmed/21116663
    Chua NH, Vissers KC, Sluijter ME. Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review. Acta Neurochirugica (Wien). 2011 Apr;153(4):763-71.

The explanatory mechanisms in this group of articles, by contrast, fall into the domain of metaphysics:

Note the following sentence in the "Methods" section of the Abstract:

"METHODS...Subjects were also assessed on their awareness of their own biofields, and they filled out various questionnaires, including estimates of how well they thought they would do and their openness to spiritual beliefs and experiences."

If, as advocates claim, energy healing is independent of spirituality, why did they survey subjects on their openness to spiritual beliefs and experiences?
  • http://www.ncbi.nlm.nih.gov/pubmed/15025891
    Schwartz GE, Swanick S, Sibert W, Lewis DA, Lewis SE, Nelson L, Jain S, Mallory L, Foust L, Moore K, Tussing D, Bell IR. Biofield detection: role of bioenergy awareness training and individual differences in absorption. Journal of Alternative and Complementary Medicine. 2004 Feb;10(1):167-9.
Similarly, in the "Methods" section of this Abstract:

"METHODS...Twenty-seven (27) physicians, psychologists, and nurses participated in a 5-day intensive bioenergy healing training course with Rev. Rosalyn Bruyere."

If energy healing is indeed independent of spirituality, is it merely a coincidence that this course was taught by a minister?

When I saw the picture that Fritz closed her post with, I could almost feel the oxytocin (popularly called the "love hormone") mainlining into my blood as my pituitary cranked it up to 11.
That child in the angel costume, with the caption "Believe", is the most winsome and appealing child I have seen in some time. It is a lovely picture for a blog post.
But despite that, I cannot go along in good conscience with the caption.
I fully support Fritz' and everyone else's freedom of conscience to believe as they wish, and to practice any form of spirituality--or none at all--in their private life and space. That is not the issue here.
The issues that I am concerned with include:
  • How do we, as practitioners, provide a safe therapeutic space for all clients, without litmus tests for belief?
  • How do we, as educators, provide a safe learning space for all students, without litmus tests for belief?
  • What are the commitments to principles that we, as an evolving profession, wish to make, and what are the impacts of those commitments on collaboration and communication with other potential partners on the healthcare team?

I applaud Fritz for putting herself out there to engage on the issues, and for advocating for her point of view honestly and frankly. As I said previously, she has given these issues a great deal of thought, and she deserves a thoughtful and engaged response.
I see these issues of vitalism, dualism, and belief (for the profession as a whole, not for individuals' consciences) as a fault line along which massage is likely to split.
There are three outcomes that I can imagine coming out of this; there may be others that I have not thought of.
  1. We come to a working arrangement with a code of ethics that practitioners of all specialties can commit to working under, one which does not require forcing any particular belief or set of beliefs on students or clients;
  2. We agree that such a working arrangement cannot be reached, and the profession splits under mutual agreement into different areas of practice that commit to varying degrees of belief in vitalism/dualism;
  3. We do nothing, and the profession splits in an uncontrolled way along that fault line, with unpredictable fallout from that split.
We need to have this discussion out in the open, as professionals, in order to decide what we want to do about these fault lines, or else history is going to decide it for us
.http://poem-massage.org/content/response-fritz-blog-post-energy-based-methods#comment-524

Thursday, December 8, 2011

Continuing Education



There are many facets to continuing education. Theoretical and factual content can be presented in electronic format. As Whitney points out there is a real difference between a fully integrated online course include informational content, integrating activities, discussion boards and chat and assessment. I have written and present online courses at the school.  A webinar is a helpful introduction to content but very limited in ability to support skill development.  A webinar can be used as a marketing tool as well which is a common practice. Marketing in not continuing education.  I myself am confused about the continuing education currently being offered.  I consider myself a massage therapist and I want to learn about information and perfect skills that make massage more effective.  The continuing education being offered is like a hodge podge of methods and sometimes gimmicks that are often not even related to massage.  I hate gimmicks so I am not even going to address the topic.  Some information being offered provides beneficial adjunct methods that can enhance massage.  Hydrotherapy is an example.  Possibility essential oils would be another adjunct method. 
More important I think continuing education should involve more assessment skills especially palpation, more critical thinking to develop a massage application that meet the needs of a client on that day and keep massage therapists current with research that explains how and why massage is beneficial.  Ergonomics and body mechanics is essential. We can never get enough anatomy and physiology.  Courses about how to be efficient would be helpful. As each of us mature as massage therapists I think we come to realize that it is not about learning more stuff but about being really effective with our skills.   I am a consolidator which makes me a simplifier. I get frustrated when there are 20 names for the same basic style. 
I teach continuing education. The topic is Massage Excellence.  I work with small groups around a broad topic that I know a lot about because I have been taught by an expert, did my own research, practiced the skills, learned more through application with my own clients and students and that I have found to be effective.  The classes do not have a fancy name.    There are no gimmicks and the participants help build the syllabus by answering the question, "So what do you want to know and what are you going to do with it?  Frustratingly enrollment is low even though the cost is affordable and I am really good at what I do. This is why I posted the question.  I wonder what massage therapists want from continuing education.  So what do you all want when you pay for continuing education?

Monday, December 5, 2011

Energy Based Methods

I just taught a class on  incorporating energy based methods into massage.  Every time I teach this class I wonder why this area continues to be controversial.  I think it is the mystical factor when in reality there is no mystery at all.  " Energy work" is different than spirituality but the two are often interconnected. To understand the plausibility of energy methods it is necessary to understand more about physics.

Here is my point. Machines that use energy waves are being studied. Results are mixed. No one questions that humans have electrical fields. I think the big question is if humans can purposefully direct their energy fields.  Here is what I suggest- approach each client with  the energy of compassion, respect and  intent to help using solid massage application. Don't mix up your spirituality with your massage and respect each clients spirituality as sacred spaced. Keep an open mind -who knows what technological advances will be able to figure out.

This is taken directly of the NIH web site.
Some CAM practices involve manipulation of various energy fields to affect health. Such fields may be characterized as veritable (measurable) or putative (yet to be measured). Practices based on veritable forms of energy include those involving electromagnetic fields (e.g., magnet therapy and light therapy). Practices based on putative energy fields (also called biofields) generally reflect the concept that human beings are infused with subtle forms of energy; qi gong, Reiki., and healing touch are examples of such practices. The 2007 NHIS found relatively low use of putative energy therapies. Only 0.5 percent of adults and 0.2 percent of children had used energy healing/Reiki (the survey defined energy healing as the channeling of healing energy through the hands of a practitioner into the client's body).
http://nccam.nih.gov/health/whatiscam/
When I was looking for some sort of current "energy healing" used in the health care world I found Pulsed RadioFrequency. Pulsed RadioFrequency (PRF) is a relatively new technique derived from a well established and proven intervention, thermal radiofrequency (RF). Both procedures are used in the treatment of chronic pain. Unlike RF treatment, PRF does no direct damage to the nerve. During PRF treatment, electrical energy is applied with a small needle to the affected nerve using a pulsed time cycle that delivers short bursts of RF current, any frequency within the electromagnetic spectrum associated with radio wave propagation. When an RF current is supplied to an antenna, an electromagnetic field is created that then is able to propagate through space. Many wireless technologies are based on RF field propagation.
These frequencies make up part of the electromagnetic radiation spectrum:
  • Ultra-low frequency (ULF) -- 0-3 Hz
  • Extremely low frequency (ELF) -- 3 Hz - 3 kHz
  • Very low frequency (VLF) -- 3kHz - 30 kHz
  • Low frequency (LF) -- 30 kHz - 300 kHz
  • Medium frequency (MF) -- 300 kHz - 3 MHz
  • High frequency (HF) -- 3MHz - 30 MHz
  • Very high frequency (VHF) -- 30 MHz - 300 MHz
  • Ultra-high frequency (UHF)-- 300MHz - 3 GHz
  • Super high frequency (SHF) -- 3GHz - 30 GHz
  • Extremely high frequency (EHF) -- 30GHz - 300 GHz

here are some links off pubmed

http://www.ncbi.nlm.nih.gov/pubmed/15750367
http://www.ncbi.nlm.nih.gov/pubmed/15025891
http://www.ncbi.nlm.nih.gov/pubmed/15025885

Believe

http://www.ncbi.nlm.nih.gov/pubmed/20440207
http://www.ncbi.nlm.nih.gov/pubmed/18721175
http://www.ncbi.nlm.nih.gov/pubmed/12535508
http://www.ncbi.nlm.nih.gov/pubmed/22008239
http://www.ncbi.nlm.nih.gov/pubmed/21116663
other links
http://www.chalicebridge.com/Oschman&Daily/OschmansOnTheirBook.html