Wednesday, November 10, 2010

Is Massage Medicine?

Hello, my name is Earon Davis. I'm an adjunct professor in the Health and Wellness Program of Kaplan University's School of Health Sciences. My careers have included being an environmental policy analyst and lawyer, an advocate for consumer health, a nonprofit consultant and manager and an officer for a nonprofit involved with international documentary films. Currently, I am also a massage therapist, Reiki Master and Integrative Bodywork Practitioner for a major hospital system in the Chicago suburbs.

Let's get started with something controversial :)

I'd like to explore the question of whether massage is just a "fou-fou" relaxation indulgence or a full Complementary and Alternative Medicine (CAM) modality just as important and powerful as the others. In fact, massage is already part of numerous other CAM modalities, such as Chiropractic, Osteopathic, Chinese Medicine (Tui-Na), and Ayurvedic! But the image of massage lags behind, whether for cultural or political reasons, as does the ability of massage therapists to earn a living wage.

Which of the following factors do you think are most important in explaining the lower status of massage and massage therapist than other CAM practitioners?:

- Massage therapists are not yet licensed in all States, and many States have developed licensing only in the past few years.

- Massage therapist training is less extensive than other CAM practices, with massage school not even requiring a college degree.

- Massage has been attacked for centuries, like other CAM professions and their predecessors, by organized religion and organized medicine.

- Touch is at the core of massage, and has raised discomfort and outright opposition from Protestant and Catholic institutions. Massage seems to have been relegated to sexworkers and seen as not "wholesome" or "respectable."

- In many ways, massage (like touch) is sexualized in our culture. The mass media have long played into the stereotypic "masseuse" as a "bimbo" and basically willing to engage in sexual behavior with their clients. This may be sexist, since around 85% of massage therapists are female. Airline Stewardesses of the 1970's actually had to change the name of their profession and become "flight attendants" to overcome the stereotype of promiscuity.

- Massage, given the lack of clothing, is just too intimate for many people. The act of removing one's clothes to receive relaxation and pain relief from a practitioner is just too suggestive. Today, even doctors rarely touch their patients, and it is typical for a physician examining a patient of the opposite sex to require a staff member of the opposite sex to be present.

- Culturally, Americans are often far too self-conscious and ashamed of their bodies to be comfortable with massage.

- Massage reminds us that we are animals, and we don't like to be reminded to take better care of our bodies. Many of us are touch-deprived and lonely, so massage actually can make us think about things that are dissonant for us. Although massage is probably the oldest healing modality known to humans, we like to think of ourselves as advanced beings somehow no longer needing to be touched and physically nurtured in a non-sexual way.

Of course, there are many factors in the late emergence of massage as a medicine. Recent studies have confirmed significant biochemical benefits for massage, including reduction of stress hormones and improved immune functioning. When these effects are provided by taking a pill, we call it a medicine. When provided by a massage, which is less risky and improves self-esteem and outlook in addition, we tend to dismiss it as somehow less useful.

Well, let's get some discussion going here - whether or not you agree with me. I'm a professor, not a politician :)

As one of my teachers has said, "May all good medicine be yours!"

Earon S. Davis, JD, MPH, NCTMB
Adjunct Professor
School of Health Sciences
Kaplan University


Anonymous said...

Hi Earon - your post is very thought provoking, and I believe that you've touched on many relevant points.

I really appreciate what you've said, about "touch" in our culture. I think about how in India, infant massage is such an integral part of well baby care - something that the mainstream wouldn't necessarily associate with India per se - and how in the Indian culture, there is so much more touching and physical contact than in the west. Any connection here? I think so.

I know from my own experience, as both an Oriental Medicine practitioner and as a patient, that massage is one of the most powerful healing modalities that I've experienced. It's been really exciting to see the recent research about the biochemical changes that take place during massage; partly that's our peculiar western minds, wanting to "prove" what we already know from our own experience, and partly it's so helpful for allopathic physicians - and maybe insurance companies?- to have a justification for writing prescriptions for massage therapy.


Behty Harrison
Chair, Department and Health, Wellness and Nutrition
Kaplan University

Anonymous said...

I am a Licensed Massage Therapist in my state you have to be tested by the state medical board in order to give massages. I am constantly trying to educate people on the benefits of receiving a massage and am proving myself with everyone I've touch. It is a shame that such a negative stigma has to be associated with something that is far more beneficial to your heath and on so many levels. If this were prescribed and covered by insurance I wonder if the same connotation would be applied.
Susan Daino, LMT

Kaplan Center for Health and Wellness said...

Thanks, Behty! I have known about the prevalence of infant massage in India and feel that it may play a role in the relative balance between work and personal life in that culture. If we acknowledge our body and stay in touch with our human needs, we may have a better chance to avoid extreme workaholism as seen in the US.

Many of us in the massage profession remain ambivalent about insurance reimbursement - if that will mean deeply discounted rates and moving into the medical model and out of the health and wellness model. Look at what has happened to physical therapists, let alone doctors! They are stuck in a culture of medicine that views patients as biological machines - and doctors as cash cows.

Earon Davis, Adjunct Professor

Kaplan Center for Health and Wellness said...

Susan, thanks for your comments! The sexual stigma of massage is quite a complex and pervasive cultural phenomenon. The massage profession has been trying to remove the stigma by advancing professionalism and reclaiming the term, "Massage" from sex workers and escort services. I'm not sure it is worth the effort. I remember when flight attendants on the airlines were called "stewardesses" and the culture had essentially equated them with promiscuity. In the case of massage, it may be time to change the profession's name to "bodyworker." It might be easier to start anew than to try and rehabilitate a term which our culture has long ago adopted as synonymous with sexwork.

But, on another level, perhaps our culture's obsession with sex plays a major role in the stigma. This obsession is unhealthy to the extent that it has been exacerbated by the long history of sexual domination and abuse of women.

As women gain some control over their bodies and violence against women (including disparate groups like domestic partners and sex workers) is no longer tolerated, it may well become safe for more people to receive massage/bodywork with confidence that it is safe and non-sexual.

Until then, massage will continue to be an extremely challenging career path. Negotiating the vagaries of intimacy in our culture, among mere mortals, requires a great deal of continuing work on one's intuition, boundaries and communication skills in addition to our clinical judgment and manual skills.

Susan, your points are well taken. I might also reverse your final question and ask whether massage can be prescribed and covered by insurance as long as the stigma lasts. Which condition will change first?

Earon Davis, JD, MPH, NCTMB
Adjunct Professor, Kaplan University

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