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Healing Physiological Effects of Esalen® Massage: Part II, by Perry Holloman

In part I of Healing Physiological effects of Esalen Massage, I talked about the remarkable power this method, and others, like Deep Bodywork, possess to stimulate a process called unwinding within our clients. We defined unwinding as the restoration, either partial or complete, of autonomic flexibility, the capacity within the nervous system to move appropriately between sympathetic and parasympathetic control, depending upon circumstance.  I also hypothesized that a loss of autonomic flexibility is a meta-process behind the stress related illnesses we see in many of our clients, and in a significant percentage of the general population. The deep states of relaxation produced by Esalen Massage and Deep Bodywork are remarkably effective tools in dealing with these types of stress related conditions, and in gradually restoring autonomic flexibility within our clients.

Can we identify the components of Esalen Massage and Deep Bodywork primarily responsible for supporting the unwinding of stress within the nervous system and restoring autonomic flexibility? In my experience over the last 30 years as a practitioner and teacher the answer, I believe, is yes. We can identify them, and we can teach them to our students. Let’s name what some of those key components are:

1) Slowing down the pace of our work.

This is an essential element in creating the conditions necessary for the restoration of autonomic flexibility. There are at least two important reasons why. First, the more archaic structures within the brain, the limbic system, and the brain stem, are designed to respond to unknown stimuli with suspicion, which has obvious survival value. As bodyworkers, if we work too quickly, we can trigger defensive responses that operate at unconscious, reflexive levels, limiting the depth of relaxation our clients can access during our work. Secondly, for similar reasons, our clients will tend to bond less deeply with us if their nervous systems are preoccupied with defensive activity. For unwinding to effectively occur, a bond of trust must be formed between practitioner and client. We can make the comparison between an overly stressed, “tightly wound” client, and an animal which through whatever circumstance is similarly “tightly wound”. If we move too quickly to make physical contact with such an animal, we are likely to be met with a growl, scratch or bite. Approaching our clients with sensitivity, through slowing the pace of our work, raises the potential for them to receive the full benefit of our touch without the filter of defensiveness.

2) Working with gravitational energy, rather than our own muscular energy.

Johanna and I spend a great deal of time during our seminars teaching people to let their bodies become conduits for the flow of gravity, from the fabric of the universe into the bodies of or clients. The difference in the quality between gravitationally applied, and muscularly applied touch are clearly palpable to our clients. Gravitational touch does not trigger defensive activity when applied slowly. Muscularly applied touch often does. The difference appears to be related to the “groundedness” required in the application of gravitational energy while working. Transmitting gravitational energy requires establishing a “base”, from the pelvis, through the legs and feet and into the ground. This type of “base” is similar to that taken when doing Tai-Chi, Aikido, or in many standing yoga postures. Working from this type of stance, and “falling” into our clients automatically transfers gravitational energy through our bodies into those of our clients. Practitioners working in this way automatically slow down, and the feel of gravitationally applied work is reported always as more “substantial”, as “flowing” and “relaxing”.

3) Learning to move like a Tai-Chi master, embodying “flowing stillness” in our practice.

As we slow our work down through connecting to the gravitational field, embodying the rhythms of “flowing” and “stillness” greatly increases the potential for catalyzing unwinding within our clients. Many years ago, when I first came to Esalen, I had the privilege of dancing with Gabriel Roth while she was developing the “5-Rhythms” movement form. Gabriel was also head of the Esalen Massage crew for some time, and the rhythms of “flowing” and “stillness” at the core of her movement work are apparent in a competent Esalen Massage. If we can learn to embody these rhythms while touching, treating our massage work like a movement practice, then a synergy of elements begins to occur: slowing down, connecting to the gravitational field, and moving with the qualities of flowing and stillness, like a tai-chi master. For some reason, when one human being touches another while embodying these three elements at the same time, the effect is that a process of unwinding begins to happen in the person being touched. The person practicing enters a palpable state of deepened “presence” which, if we could find a way to monitor brain activity while touching in this state, is probably measurable.

In summary, the central nervous system is designed to self heal, like any other part of the human body. Because the central nervous system is the conduit for, and therefore particularly effected by powerful emotional experience, it can, and does get “wound-up” in the course of living life. We call that process “stress”. When a certain threshold of stress is reached, the CNS can lose it’s capacity in varying degrees to self-regulate and heal. This is one way of describing a “loss of autonomic flexibility”. This process I hypothesize to be at the root of many of the stress-related conditions we see in our clients. Esalen Massage and Deep Bodywork, when applied with the elements described above, are powerful tools which can slowly restore the self regulating capacity, or autonomic flexibility, to the autonomic portion of our nervous systems.

I hope this blog post is helpful to everyone in their work!

Perry


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Healing Physiological Effects of Esalen® Massage: Part I by Perry Holloman

I just finished teaching the final section of an Esalen Massage Certification Training in Dortmund, Germany, and had another opportunity to witness the profound effects of this work on our trainees. Because they had had a year to develop competence in this approach, many different aspects of the healing power of this work were observable. Some of those are: Increased fluid exchange in localized areas of the body and throughout the body in general (people would report local or generalized sensations of pulsation, lasting sometimes hrs. after treatment); A profound sense of relaxation that participants only achieved rarely during the deepest hrs. of sleep (more about this phenomenon below); A clear sense of the interconnectedness of the body’s different segments, and of the periphery to the thorax and spine; The return of flexibility to stiffened joints, and the local areas surrounding them; Lastly, as I discussed in previous articles, the emergence of buried trauma-related experiences which were contributing factors to different pain-related symptom-pictures exhibited by some of our students.

For the purposes of this article, I want to focus on one of the above subjects only: The remarkable power of this work to effect deep relaxation in almost everyone, and people suffering from stress related illnesses in particular.

During an Esalen Massage, people often report a profound sense of relaxation that is unlike relaxing experiences with which they are familiar. I frequently hear the following types of descriptions from my clients and students:

“It was like being asleep, yet I was completely aware of everything you were doing.”

“Time seemed to stop. I thought you had been working on me for a few minutes, and 1 ½ hrs had already gone by.”

“I was dreaming, yet completely awake at the same time.”

I have noticed that in these states the presenting symptoms of a client become more available to the potentially healing effects of this work. For example: A painful area where a client exhibits a heightened sense of “hyper-vigilance” toward touch is unusually available for contact; A client who normally would experience great sensitivity toward deeper touch is remarkably open to it; Clients who have asked me to stay away from a defined problem area “for fear of making it worse” actually ask me to put my hands on those areas. These are some of the typical differences I experience in clients who have entered deeper states of relaxation. Two of the primary physical indicators of the arising of this state are: Sudden physical “jerkings” of the body of the client;  Increased gurgling of the digestive organs, indicating increased peristaltic activity of the intestines.

So the question that interests us as bodyworkers is: Are these indicators pointing toward something that can be viewed as a valuable “meta-process” within the experience of the client, and the “client-practitioner field”? The answer to this question in my view is an emphatic yes: We are witnessing the manifestations of one of the most important meta-processes arising as a result of competent bodywork, and that process is often called “unwinding”. This term is used rather loosely not only in bodywork circles, but often in general vocabulary to denote either the process of return-to-normal-functioning of a body part or system from aberrant functioning, or the generalized releasing of stress and/or tension from the system as a whole. Here I mean all of that, plus something much more specific: The return of “autonomic flexibility” within the nervous system of a living system, no matter how primitive. As an end to part I of this article, I want to define autonomic flexibility as that essential process of being able to switch back and forth between sympathetic, and parasympathetic processes within the autonomic nervous system, appropriate to what is really happening moment to moment within the field of the individual. The loss of this capacity within stressed individuals and trauma victims is something that I see more and more in my practice, and can be described, I believe, as one of the great maladies of modern society. All of the great stress related illnesses, and problems such as sleeplessness exhibit a loss of autonomic flexibility as a meta-process behind the presenting symptoms. Esalen Massage and Deep Bodywork are two of our greatest tools in reaching living organisms at a level where these problems can be addressed.

In Part II I will discuss important clinical considerations for identifying and supporting processes of unwinding as they occur in our clients.

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Deep Bodywork® in the Treatment of Trauma Related Disorders and Post-Traumatic Stress: Part III, by Perry Holloman

From 1991-96 I lived in Germany with my wife, Johanna, and taught somatic approaches to Gestalt Therapy at the Gestalt Institute of Dortmund (sadly, no longer in existence). I was introduced to a text by a man named George Downing which is one of the most valuable books I have ever read on working with the body in psychotherapy. (Two others are Kepner’s Body Process, and Peter Levine’s brilliant book on healing trauma, Waking the Tiger.) Downing’s book is unfortunately only available in German, and it’s title, translated is: The Body and the Word in Psychotherapy. As it turns out, Downing also lived and worked at Esalen for a period of time in the 1970’s, writing a great basic book on massage called The Massage Book.

What makes Downing’s book so practical for somatic practitioners is his structured understanding of the felt sense. He describes how to recognize it, and to harness it as a diagnostic tool. He also describes it’s component parts in a manner simple enough to make it useful to us in supporting our clients’ innate capacity to self-heal. He breaks the felt sense down into five general categories, some of which are composed of easily understood sub-categories. The five categories, which relate to 5 levels of conscious experience, are: Sensing; Feeling; Movement; Verbal Cognition; Visually oriented Cognition (the capacity to think and remember in pictures or scenes). Sensing can be subdivided into our perceptions of sensation originating from outside of the body, and Proprioception, the capacity to experience sensation generated inside of our bodies. One very helpful diagnostic tool that Downing suggests is observing if clients have the ability to utilize all of the five categories. Although everyone orients more powerfully toward certain categories over others, the inability to utilize one or more of the five categories can be important information about a given person. In the traumatized individual, it is quite typical that one or more of the categories reveals itself to be inaccessible, particularly when feelings and memories associated with their trauma are triggered. Remember, the five categories are a way to describe the structure of the felt sense, and the felt sense is the key to unwinding the effects of trauma. Sensitively applied bodywork is the quickest and most effective method for helping people access their felt sense, and whatever barriers may arise in it’s different component parts as a result of trauma.

Let’s look at an actual case study using an understanding of the structure of the felt sense to assess what is happening with the following individual:

Linda, a student of mine, asks me to work with her because she has episodic depression, which affects her work and intimate life. I have observed a breakdown in Linda’s felt sense under the effects of bodywork which follows this pattern: Fairly quickly after being touched, Linda’s breath begins to accelerate in synchrony with an elevated level of anxiety and feeling of “buzzing” in her body, due to hyperventilation. She has difficulty using words to describe her experience, and soon “loses touch with any sensation in her body”. Soon, any capacity to move her body is lost, and the only capacity which remains somewhat available to her is feeling, as she describes afterwards having felt “consumed by anxiety”, and “completely frozen/incapable of moving or speaking”. Witnessing the almost complete breakdown of Linda’s felt sense, I realized that we will have to restore her capacity to sense, feel, move, and describe her experience verbally before a deeper exploration of the content of her trauma is possible. We work together once a week over a six month period, and I used focused touch to hold her awareness in parts of her body which have historically gone numb. I don’t let her hyperventilate, slowing her breath down and having her stay in eye contact with me to manage her anxiety. In addition, we focus on the feeling of support she experiences in relationship to her boyfriend, creating a “secure base” for her in the realm of feeling. By slowing the pace of her internal experience down, focusing her awareness bit by bit on her sensing and feeling body, helping her slowly articulate what she was experiencing, and creating secure bases for her along the way, by the sixth month she was able to begin the work of delving into the content of the trauma at the root of her difficulty. We worked an additional 3 months on this content, after which she and her boyfriend got married and moved to another city. She has stayed in touch with me via e-mail, and reported that her episodic depressions are much less severe, and no longer keep her from working as a physical therapist nor incapacitate her in her intimate relationship.

The value of the above case history is that it highlights a few important points about working with trauma patients that have been discussed in parts 1, 2 and 3 of this article:

1) That clients must be assessed for the appropriateness of a touch based approach to working with trauma because of its’ power to mobilize “stuck” trauma energy. (No sooner would one touch Linda than she would begin to experience anxiety and hyperventilate.)

2) Practitioners must also assess their capacity to navigate the complex waters of trauma before touching, and be prepared to become a “secure base” for their clients over a period of time. Manifestations such as trembling and shaking, unpredictable emotional and energetic releases, and memories of traumatic events can arise under the influence of competent, sensitive bodywork.

3) Restoring the “felt sense” in its’ five major manifestations is crucial to the inner exploration necessary when working with trauma. (Remember, the realm of “sensation” has two sub-categories: Sensation from the environment, and proprioception, which mediates sensations arising internally.)

4) Working slowly, and making sure that progress is anchored through finding secure bases other than ourselves along the way. This also simplifies the process of separating from the therapist when that time comes, anchoring progress within the continuity of the daily life of the client.

Namaste, and good luck!
Perry

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Deep Bodywork® in the Treatment of Trauma Related Disorders and Post-Traumatic Stress: Part II, By Perry Holloman

In Part 1 of “Deep Bodywork in the treatment of trauma related disorders and post-traumatic stress”, we discussed the importance of assessing our client’s state before we use touch as a part of dealing with the symptoms of trauma. We also discussed an honest assessment of our own capacities to deal with the manifestations of mobilized trauma energy, and the strength of the therapeutic alliance we share with a given client. After deciding that an individual is suited to receiving bodywork as a part of their healing process, there are a few basic things important to understand about the nature of trauma and how living organisms self-organize and heal.

1) Because traumatic situations either literally threaten our survival, or create the perception that our survival is threatened, an instinctual mechanism designed for self preservation is triggered. This is often referred to as the “fight/flight response”. It should actually be called the “fight/flight/freeze response”, and it is crucial to understanding what lies at the core of the traumatized person. ( For a deeper description of this phenomenon please see Peter Levine’s, Waking The Tiger.) It is this process of freezing which can create the seemingly intractable nature of trauma related symptoms and post-traumatic stress. Because both fighting and fleeing allow for a mobilization of vital energy during the potentially traumatic situation, the conditions for healing trauma are simplified if either strategy proves successful. If we find we can neither fight nor flee, a dissociative mechanism that “is like freezing” innately manifests, as a way of easing us into what could be a very painful, or lethal experience. Nature has actually acted compassionately in building this strategy into our instinctual makeup. Unwinding its effects can be very difficult.

2) Because the fight/flight/freeze response is mediated by the limbic system, brain stem, and spinal chord (all sub-cortical levels of the central nervous system which express themselves through feeling, sensing, and movement), verbally oriented therapies tend to miss the arenas where trauma, and post traumatic stress are to be found. Deep Bodywork and other somatic approaches are methods ideally suited to dealing with the core of trauma related symptoms, because they access our experience at a sensing and feeling level first, and verbally only as an important secondary process.

3) One way of thinking of trauma patients is that they are literally “frozen in space and time”, constellating around the traumatic event in an often unconsciously obsessive manner. This situation can be deeply anxiety producing, which requires any use of touch to be done extremely slowly. One of the hallmarks of Deep Bodywork is its slow, sensitive application. This allows the trauma patient to engage his or her felt-sense, our greatest tool in unwinding trauma.

Putting the above three elements together, we can understand that the use of Deep Bodywork in trauma related cases must be slow and sensitive in order to engage the felt-sense in a useful manner. The felt-sense, which is the aggregate of all of our information processing capacities melded into a felt impression of any given situation, has the power to thaw the stuck energy of trauma. As this energy begins to thaw, typical manifestations in our clients’ bodies can be trembling and shaking. I always assure my clients that “shaking is good. Let yourself shake.” Often the phase of shaking is followed by emotion, as the actual traumatic event gains access to memory. If we work slowly, engaging the felt-sense as we work, our client’s capacity to re-member, with our support, increases. Anchoring this positive change through connecting it to something positive in our clients experience is crucial at this point. This positive element can be a person, place, pet, or even a prize possession. The important thing is that it have the quality of being something like a “secure base” (Bowlby). Secure bases, according to Bowlby, are unique elements in the life of each person to which we attach, and around which we can create a stabile sense of self-hood. I once had a trauma client report to me during this process that maybe she would “trust herself to wear her red-dress again”, a prized possession that represented a certain celebration of her life energy and desire to have fun. As we imagined her putting it on after years of having left it in the closet, she was able to laugh and feel her longing for that long abandoned aspect of her experience.

Remember always to slow your work down when you observe the symptoms of trauma arising in a client. In part III, I will share some final considerations and a few case histories out of my clinical experience.

Namaste,
Perry

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Deep Bodywork® in the Treatment of Trauma Related Disorders and Post Traumatic Stress: Part I, By Perry Holloman

Over the past 30 years I have treated many people with trauma related disorders in my private practice at the Esalen Institute in Big Sur, California. To be clear, trauma related disorders and post traumatic stress can manifest very differently in different people, depending on their personality structure, and specific traumatic history. A relatively psychologically “healthy” person, taken here to mean an individual with a stabile, consistent sense of self, will internalize trauma quite differently and respond to its treatment more readily than someone who is unstable. The reason for mentioning this fairly obvious fact is this: Body-oriented therapists treating victims of trauma need to determine the relative stability of their clients before they touch, because bodywork possesses enormous power to mobilize “stuck” traumatic energy, which can potentially destabilize an already fragile individual. Once a determination has been made that an individual is suitable for bodywork, and Deep Bodywork in particular, the therapist needs to proceed with great sensitivity, providing a “field of safety” within which a bond of trust can develop between client and practitioner. With seriously traumatized individuals, this means that a “therapeutic relationship” needs to develop over a series of sessions. It also means that the professional bodyworker should encourage such clients to seek psychotherapeutic support during treatment if they lack such skills in their own training.

How can we determine if a given client is suitable for a body oriented approach to healing trauma? Here are a few key things which are important to be aware of in answering this question:

1) First, is your client able to discriminate sensations, from feelings, from thoughts/memories, or do all of these experiences arise in a chaotic, indiscriminate manner? If your client’s experience is marked mainly by chaos, an approach which does not involve touch maybe better as a beginning. Being able to distinguish between these three important inner capacities is crucial to inner healing, and can take some time to develop in clients not familiar with inner exploration.

2) Does your client exhibit a relatively rapid “oscillation” between markedly different inner states? For example, is the emergence of an expression of anger (“My boss always treats me like I’m stupid!”) followed by smiling and laughing, or some expression of compassionate understanding? The point here is not that compassion following anger is “wrong”. Rather, it is the rapid oscillation of one state into another, without holding a given state in one’s “foreground” long enough to allow for adequate scrutiny that is the issue. This can indicate an inner state of “fragmentation” which, under enough stress, can literally end up with our clients “falling apart”. Mobilizing latent trauma energy is an anxiety producing experience for traumatized individuals, and can lead to their temporary, or even chronic destabilization.

3) As a practitioner, are you comfortable holding a safe space within which sensation, feeling, and verbal as well as somatic expressions of inner experience may occur? This might include novel bodily sensations, emotions such as fear, sadness, or rage, expressions like crying, or physical trembling and shaking. If your answer to any of the above questions is “no”, it’s a better idea to refer a client exhibiting signs of post-traumatic stress to someone experienced in such work.

4) Are you going to have the opportunity as a practitioner to see this individual consistently over a period of time, establishing a therapeutic alliance? Dealing with trauma is a complex, nuanced process which requires patience, skill, and time.

If you are unclear about any of the above issues regarding your clients inner state, your own capacities as a facilitator/therapist, or the availability and willingness of your clients for longer term work, you are well advised to direct clients exhibiting post traumatic stress to an experienced therapist.

Part two will address specific interventions, as well as contra-indications in working with trauma patients.

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‘Working with Difficult Cases’ class at Esalen

Johanna and I just finished a five-day seminar at Esalen, “Mastery of Deep Bodywork: Working with Difficult Cases”. We selected three models from a number of applicants to work on during the course of the week, monitoring their progress as each received a series of three sessions of this work. Two of our cases presented with a history of traumatic injury, chronic pain, and other complications. The third presented with progressively worsening hip and knee pain due to sports related trauma. Difficult case seminars always present a challenge to Johanna and myself as practitioners and teachers, because our models either respond to our work or they don’t. If they improve under the influence of Deep Bodywork, then the benefits of this approach become obvious. If they don’t improve, standing in front of a large group of students with high expectations can be humbling.

Fortunately, our three models responded quite well to our work in very different ways: The individual with sports related injuries demonstrated a greatly improved range of motion in her hip joint as a result of Deep Bodywork. Another, who had received multiple spinal fusion surgeries and had been in a body-cast for six years of her life due to a severe scoliosis, re-learned how to breath freely after we worked extensively with her ribs and shoulders. The third model re-discovered his capacity to recognize and articulate boundaries in relationship to his own “bodily felt-sense”. He had lost this capacity due to a history of trauma in his life that had left him unable to discriminate between pain that was constructive (e.g. tissue healing; circulation returning, etc.), and pain that was destructive ( he reported having lived with a broken wrist for 6 months before having it looked at, indicating an overly developed capacity to compartmentalize pain in a manner not supportive of his own healing.) The whole class moved to a place of deep connectedness as our models spoke of the daunting personal challenges they faced in their lives as a result of their conditions.

Johanna commented at the end that this group had a lot to do with the heart, as we were all moved by the openness and vulnerability our models experienced as they progressed through this work.

We were supported by a great faculty of trained Deep Bodywork practitioners, Paul (Reynolds) Wehrman, Rob Wilkes, and Dano Rowley. We feel blessed to have the professional support that these skilled practitioners bring to our seminars, and highly recommend their work to those visiting Esalen (Rob Wilkes is regularly on the books here), Santa Barbara (Paul Wehrman has a practice there), and Long Beach (where you can look Dano up). Their contact information is available on the practitioner’s page of this website. We look forward to seeing one or two of them again at our “Healing Art of Deep Bodywork” seminar at Esalen from January 9-14, “Opening the Chest, Freeing the Breath, and Healing the Neck”. We look forward to seeing you there too!

Namaste,
Perry and Johanna

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