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In This Chapter

^ Discovering the origins of TCM

^ Understanding TCM concepts of health and disease

^ Diagnosing in TCM

^ Exploring TCM therapies and how they work

Traditional Chinese Medicine (TCM) is one of the oldest forms of medicine in the world. From its beginnings thousands of years ago in ancient China, TCM has spread around the globe and is now one of the most widespread forms of complementary medicine in the West.

In this chapter I tell you a bit about where TCM came from and translate for you some of the strange terminology used by TCM practitioners. You can try a quiz to help you to work out what type of TCM element imbalance you may suffer from, and read TCM self-care tips for how you may remedy any imbalance. I also give you a guided tour of TCM therapies and let you know what they can be useful for. Finally, I offer tips for finding yourself a TCM practitioner.

A (Very) Brief History of TCM

Traditional Chinese Medicine is thought to have started over 2,500 years ago. Its history is blended with myth and legend. TCM is said to have originated from two legendary emperors who were medical pioneers and keen to live long and healthy lives (see the sidebar ‘The founders of TCM’).

Legend has it that over 2,500 years ago a Chinese emperor called Shennong tasted every herb and plant he could lay his hands on and noted its effects. His insights are said to have led to the first ever text on Chinese herbal medicine, The Shennong Bencaojing (Classic of Herbal Medicine), Although in reality this actual text was written some time later. Shennong became known as the father of herbal medicine in China and is often portrayed clothed in leaves and holding or chewing medicinal plants.

Around the same time another Chinese leader known as the Yellow Emperor, or Huang di, is

Supposed to have had long conversations with his physicians about medicine. Their question-and-answer sessions are supposedly recorded in another ancient text known as the Huang Di Nei Jing (The Yellow Emperor’s Classic of Internal Medicine) And Huang di is known as the father of traditional Chinese medicine.

Nowadays some scholars believe these figures were mythical, rather than real, but in any case the knowledge said to come from them still forms the basis of TCM practice today. You often see their pictures in TCM practitioners’ waiting rooms!

Early Chinese people are believed to have used herbs as medicines and to have warmed stones as a form of heat treatment. Inscriptions on tortoise shells over a thousand years old give evidence of the use of water and simple herbal remedies for healing. Over time (in the Zhou dynasties from 1100-256 BC), medicine developed into an organised system and absorbed influences from the philosophical and religious traditions of Confucianism and Daoism. This led to the development of the concepts of Yin And Yang And the Five elements Or Phases (described in the next section). The system of diagnosing by means of the tongue and pulse and observing other body signs was also created.

Over many centuries great Chinese medical texts were compiled and Acupuncture (needle treatment), Moxibustion (heat treatment with a warming herb), and herbal medicine became widespread.

The arrival of Christian missionaries in China in the 19th and early 20th centuries led to the introduction of Western medical ideas and a downsurge of interest in TCM. However TCM was revived by Chairman Mao as part of his Revolution and it now flourishes alongside Western medicine in modern day China.

Understanding TCM Concepts of Health and Disease

TCM has its roots in the Daoist concept of living in harmony with nature and of all living things stemming from one primordial force. This force is

Represented by the Tai Ji, A symbol representing oneness made up of two interconnected, dynamically changing and also opposing forces known as Yin And Yang.

Exploring yin and yang

In the Tai Ji Symbol (see Figure 4-1), the white area represents Yang, Which is said to have the qualities of masculinity, expansiveness, activity, heat, brightness, and hardness, while the black area represents Yin, Which is said to be feminine, contracting, passive, cold, dark, and soft.

Figure 4-1:

The yin/yang symbol.

Yin And Yang Were seen as two great interdependent and creative forces that manifest in all living things, including the body and the environment. These forces are in a constant state of change. For example, night (yin) Turns into day (yang), Which later again becomes night (yin), And so on.

For this reason the white (yang) Portion of the circle also contains a black dot to represent some Yin Within the Yang, While the black (yin) Portion of the circle also contains a white dot representing some Yang. So if you look again at the symbol in Figure 4-1 you may see that it is not really a fixed design but rather can be seen as constantly moving and dancing, as black (yin) Turns into white (yang) And back into black (yin) Again.

In terms of your body Yin And Yang Represent the following:

*e The outside of the body is seen as Yang While the inside is yin.

*e The upper portion of the body is Yang While the lower portion is yin.

*e The internal organs are also divided into Yin And Yang.

E* The great ‘storing’ organs of the body – liver, heart, and lungs – are Yin Organs.

*e The active organs involved with movement and transportation of substances, such as the stomach, intestines, and urinary bladder, are seen as Yang.

Table 4-1 offers a breakdown of how all the internal organs shape up in terms of their Yin And Yang.

In TCM, good health relies on a balance of Yin And Yang So all your Yin And Yang Organs need to be functioning well and working in harmony together.

Understanding the power of qi

In TCM, Qi (pronounced ‘chee’) is the name for the vital energy believed to power everything in the universe, including our bodies. The Chinese character for Qi Represents a union of earthly and heavenly energy. (Chapter 9 has more about Qi.)

According to TCM if you have good Qi, You’ll be healthy and energetic and live long, but if your Qi Is abnormal, wayward, or blocked, disease may develop.

Qi Courses through the body via a network of channels known as Meridians. The twelve main meridians are divided into Yin And Yang Pairs:

E Lungs and large intestine

E Spleen and stomach

E Heart and small intestine

E Pericardium and triple warmer

E Kidneys and urinary bladder

E Liver and gall bladder

Traversing the meridians

The meridians course all over the body like a great rail network and are punctuated by hundreds of major and minor Acupoints, Rather like main line stations and lesser-used country ones.

The underlying theme for TCM is the restoration and preservation of free-flowing and abundant Qi.

Much research has been carried out in different countries to verify the meridians and the links between Qi Flow and disease but these have not yet been firmly proven to the satisfaction of scientists (I discuss this research in Chapter 9 in a bit more detail).

Exploring the Five Elements

In addition to Yin And Yang And Qi, TCM has a clever system of correspondences worked out called the Five Elements Or Five Phases. This system is used to understand the relationships between the internal organs of the body, mental and emotional states, the environment, and so on. These relationships may be generating and supportive (the black arrows in Figure 4-2) or they may be destructive, whereby one element predominates and can overcome another (the grey arrows in Figure 4-2). This system is illustrated in Figure 4-2.

Compare Figure 4-2 with Table 4-2. According to the Five Elements:

E The heart is associated with fire because it pumps blood around the body to warm and nourish it.

E The nutrients carried in the blood pumped by the heart support the function of the stomach and spleen (that is, fire nourishes earth).

E The kidneys are associated with water because they control fluid metabolism.

E If the kidneys malfunction, blood pressure may rise, which in turn

Affects heart function. In other words, if the body is dehydrated (lacking in the element water) the heart can’t function efficiently. In TCM terms the fire of the heart is raised, leading to elevated blood pressure and even heart attack. In this scenario, the fire element becomes too strong because the water element is insufficient to keep it in check.

You can also apply the five element principle in TCM to tastes, colours, and seasons. These correspondences, shown in Table 4-1, are used as a valuable diagnostic tool for TCM practitioners. For example, you may complain to your TCM practitioner of the following symptoms:

E Suffer from earache and aching bones E Feel worse in the winter E Crave salty food E Often feel anxious

Your practitioner would think to the correspondences in the five element table and – hey presto! – it would become obvious you may have an imbalance in your kidney/urinary bladder meridians or some weakness in the organs themselves (take a look at the bottom line of Table 4-2 to see for yourself how this links to the symptoms described above).

Western medical doctors find this system of correspondences a bit mystifying, but TCM practitioners swear by its accuracy and clinical efficacy. Therefore, even if you go to a TCM practitioner complaining of backache you may still be asked about your food preferences, emotional state, and even colour preferences. Now you know why.

Taking the Five Elements quiz

You can use the Five Elements quiz in Table 4-3 to identify your possible element imbalance and then discover simple TCM ways of restoring balance.

Work through the questions in Table 4-3 and tick a ‘yes’ for each question that applies to you.

Table 4-3 The Five Elements Quiz

The Element of Water Yes No

Do you often suffer from puffy bags under the eyes, a puffy face, or swollen ankles?

Do you often get low backache?

Do you often suffer from cystitis or other urinary infections?

Do you often have problems with your ears and/or sore throats?

Do you have problems with your bones or aching joints?

Do you crave salty foods?

Are your symptoms often worse in winter?

Are your symptoms often aggravated by cold and wet conditions?

Do you often feel anxious or fearful?

Do you feel drawn to the colours midnight blue or black?

Total Water Score (this represents the health of your kidneys /10 and urinary bladder)

The Element of Wood Yes No

Do you often suffer from nausea and lack of appetite? Do you often get headaches and/or migraines? Do you often suffer from PMS and/or cramps? Do you often have problems with your eyes?

(continued)

Table 4-3 (continued)

The Element of Wood Yes No

Do you have problems with tendon injuries and aching?

Do you crave sour foods?

Are your symptoms often worse in spring?

Are your symptoms often aggravated by wind?

Do you often feel irritable and angry?

Do you feel drawn to the colour green?

Total Wood Score (this represents the health of /10 your liver and gall bladder)

The Element of Fire Yes No

Do you often suffer from palpitations? Do you often suffer from insomnia?

Do you have any history of blood pressure or heart problems? Do you often have problems with your tongue, such as soreness? Do you have problems with your circulation? Do you crave burnt, smoked, or bitter foods? Are your symptoms often worse in summer? Are your symptoms often aggravated by heat? Do you often get overexcited or feel panicky? Do you feel drawn to the colour red?

Total Fire Score (this represents the health of /10 your heart and small intestine)

The Element of Earth Yes No

Do you often suffer from digestive problems such as indigestion?

Do you often have abdominal bloating?

Do you sometimes have undigested food in your stools?

Do you sometimes have problems with your mouth or lips?

The Element of Earth Yes No

Do you have problems with aching muscles?

Do you crave sweet foods?

Are your symptoms often worse in late summer?

Are your symptoms often aggravated by moist, damp conditions?

Do you often worry?

Do you feel drawn to the colours yellow and orange?

Total Earth Score (this represents the health of your /10 stomach and spleen)

The Element of Metal Yes No

Do you often suffer from colds, coughs, or chest complaints?

Do you sometimes have breathing difficulties or shortness of breath?

Do you suffer from constipation?

Do you have a poor sense of smell?

Do you have problems with your skin, hair, and nails?

Do you crave spicy, strong tasting foods?

Are your symptoms often worse in autumn?

Are your symptoms often aggravated by dry conditions?

Do you often feel depressed or grieving?

Do you feel drawn to the colour white?

Total Metal Score (this represents the health of /10 your lungs and large intestine)

Helping yourself: Five Elements self-care

Count up your ticks for each section of the quiz in Table 4-2. The one with the most ‘yes’ ticks indicates the element where you seem to have the most imbalance and which most needs your care, attention, and support.

Here are some TCM-based self-care approaches, which can help you rebalance the five elements:

If you scored highest for the Water element, the following may help: E Avoid cold and wet conditions.

E Keep your body warm and well wrapped, especially your feet, abdomen, and lower back.

E Avoid crop-tops (T-shirts and tops that leave the midriff and lower back exposed) and going barefoot.

E Limit salt intake.

E Drink plenty of water and eat lots of root vegetables, pulses, and warming foods.

E Wear yellow and orange.

If you scored highest for the Wood element, the following may help:

E Avoid windy conditions and draughts. E Exercise regularly to reduce stress and irritation. E Stay calm and practise patience. E Limit intake of sour foods and drinks.

E Drink plenty of water and eat lots of green, leafy vegetables, salads, and raw foods.

E Wear white.

If you scored highest for the Fire element, the following may help: E Avoid heat and stay cool.

E Wear light clothing and layers you can remove easily to adjust body temperature.

E Reduce stress and practise meditation.

E Avoid burnt or smoked foods.

E Drink plenty of water and increase intake of fresh fruit and vegetables, oily fish (up to three portions a week), and seeds and seed oils (such as flaxseed oil).

E Wear midnight blue and black.

If you scored highest for the Earth element, the following may help: E Avoid damp conditions.

E Chew food slowly and eat in a relaxed environment without doing other things.

E Avoid excess worrying.

E Limit intake of sweet and sugary foods.

E Drink plenty of water and eat warming, easily digestible foods such as soups or casseroles.

E Wear green.

If you scored highest for the Metal element, the following may help: E Avoid dry conditions.

E Practise breathing exercises and stretches.

E Think positive and seek help for your depression or grief if this is a problem.

E Limit intake of spicy, strong-tasting foods.

E Drink plenty of fluids and increase your intake of seeds (such as sunflower, sesame, or pumpkin seeds) and oily fish (up to three portions a week).

E Wear red.

Diagnosing in TCM

The four main types of diagnosis used by TCM practitioners are:

E Observation Of tongue, face, skin, nails, and hair E Palpation Of pulse and acupoints

E Listening To sounds of the body such as the voice, a cough, and digestive gurgles

E Questioning About general health and lifestyle, your and your family’s medical history, current symptoms, bowel health, and sleep habits

When training, TCM practitioners take many thousands of pulses in order to be able to feel the differences between them. Six pulses are on each wrist, with one representing each major organ and meridian. Practitioners palpate the pulses with the three middle fingers of their hand on the insides of each of the patient’s wrists, just above the wrist crease. TCM practitioners use both light and firm pressure to detect surface

And deeper pulses and different speeds and qualities are noted for each.

Each pulse has its own descriptive quality such as ‘tight like a bow string’ (a type of pulse indicating a liver problem) and my own personal favourite, ‘like pearls rolling on a plate’ (a type of pregnancy pulse).

TCM therapies are designed to balance Yin And Yang And the Five elements And to ensure the free flow of Qi.

You can think of the different aspects of TCM therapy as a tree with several branches, leaves and fruits:

E The soil in which a tree stands carries the nutrients that determine its health and growth. So in TCM the primary therapies forming the basis of health are Dietary therapy And Lifestyle advice. TCM recommends you eat seasonal, fresh, and lightly cooked food. Eat moderately, chew your food well, and select foods according to their Yin And Yang Properties. Some examples of these are given in Chapter 12.

E The trunk of the tree represents the body and both exercise therapies and breathing. These are seen as important for maintaining vitality, memory and a good flow of Qi. These movement and breathing therapies include tai chi and qi gong and are also mentioned in Chapters 16 and 18.

E The branches of the tree represent the limbs and body parts and the different therapies that can be used to correct their imbalances and stimulate healing. These include the hands-on therapies such as acupressure and tui na massage (see Chapter 17) and remedial therapies, such as acupuncture, cupping, moxibustion, and herbal medicine (see Chapters 9 and 11).

E The leaves and fruits of the tree represent emotional and spiritual health, and the therapies that support these such as meditation practises (also mentioned in Chapter 18).

You can consult a TCM practitioner for many different kinds of ailments but common ones are: pain relief; joint and arthritic problems; respiratory conditions such as asthma; skin problems such as eczema; headaches and migraines; PMS; and insomnia.

A lot of research has been carried out on Chinese acupuncture and Chinese herbal medicine. Much of this has been done in China and is not readily available in translation but a growing amount of this type of research is now being conducted in the West too. The positive research studies support the use of TCM as a valuable form of modern healthcare that has stood the test of time but more research is needed.

Research provides encouraging evidence for some, but not all, of the conditions listed and is summarised in Chapter 9 on acupuncture and Chapter 11 on herbs. I also give Web resources for accessing research evidence.

For details on how to find TCM practitioners of acupuncture see Chapter 9; for a Chinese herbal medicine practitioner see Chapter 11. For more on finding a massage practitioner who may practise Tui na See Chapter 17.

In This Chapter

► Stalking the elusive referral

► Locating a massage therapist

► Developing a relationship with your massage therapist

► Deciding whether licensing matters

Ou’re no doubt absolutely convinced that massage would make a truly

Superb addition to your life, and you’re just about ready to pick up that phone (yes, that one, right over there), dial one of the contact numbers I’m about to give you in this chapter, and order up your very first session of "touch take-out." Soon, a chipper and thoroughly professional person will show up at your door carrying a monstrous padded folding table. He or she will open the table in the privacy of your own comfortable dwelling. You’ll smile self-confidently, take all your clothes off, and then… Wait A minute!

Did I say, "Take all your clothes off?" Well, by golly, I guess I did. Suddenly, this whole, wonderfully abstract concept of massage has become disconcert ingly real. And, in spite of your appreciation for the undeniably therapeutic benefits of massage, if that professional stranger were to ring your doorbell right this minute, you may be tempted to say, "Excuse me for a moment, will you? I just have to go get my law degree at Columbia University and then I’ll be right with you."

If that sounds like you, don’t worry. This chapter’s purpose is to make you more comfortable with the people who will be massaging you, including peopl you already know, with whom sharing massage will be a new adventure.

Stalking the Elusii/e Referral

One time-honored concept used to battle your fear of a stranger in your home is to assure that the person who shows up on your doorstep to give you a massage is Not A stranger. You can accomplish this goal in two ways:

J Is* Give your cousin Billy several thousand dollars and send him through massage school so you can call him later and make an appointment.

; V Get a referral.

The second option is by far the more common choice, but that doesn’t mean you should entirely dismiss the concept of financing massage school for friends or family members. The world needs more massage therapists! If you happen to be extremely wealthy, do the world a favor and set up a massage-school trust fund. (The investment may even be tax deductible.)

A six-point mental checklist (to go over in your mind before deciding which massage therapist to try)

No matter how qualified and highly recommended a massage therapist may come to you, and no matter what other people say about her, You Still must decide whether she’s the right massage therapist for you. Remember, you’re very likely to share a great deal of yourself with this person (massage therapists are like hair dressers on steroids when it comes to the con-fiding-in factor). And, because your massage therapist will get to know your body better than anyone else except an intimate partner, you have to be willing to trust her. Sometimes, you have no precise way to gauge which massage therapist will make precisely the best "fit" with your personality, and no amount of analytical deliberation will help you decide who to choose.

That said, try using this quick checklist to judge your own gut reaction to the person you’re about to spend a considerable amount of quality time

1. Does she immediately make you feel like you’re important?

2. Does she look you right in the eye and fill you with a sense of utter confidence so that you’re already feeling better before she even touches you?

3. Is she someone you’d like to emulate as far as calmness and tranquility go? Like it or not, you will probably look upon your massage therapist as a role model in the relaxation category. A tense, uptight massage therapist isn’t setting a good example.

4. Is she "soft" where she needs to be soft (unobtrusive and non-opinionated) and "hard" where she needs to be hard (unrelenting in her serious desire to see you feel better)?

5. Is she someone you feel an immediate sense of empathy with? To use a precise scientific term here, do the two of you Click?

6. Is she the right sex? The decision on whether to receive massage from a male or female massage therapist is entirely up to you. Many people have no preference, as long as the massage therapist is competent and strong, but others feel more comfortable with one sex than the other in a massage setting. Most massage establishments will give you a choice when requesting a massage therapist. After you get started with the actual massage, you’ll probably find that the massage therapist’s gender doesn’t really matter as much as you may have thought.

Of course, you may be more comfortable going to the "neutral ground" of a professional massage establishment rather than inviting someone unknown into your home. See the section "Visiting a clinic" later in this chapter for more information.

In case you’re wondering who to ask for a referral without embarrassing yourself, the following list may come in handy. Actually, you may be surprised at how many people can potentially help you find a massage therapist.

First, you probably should NOT ask certain people to refer a massage therapist, including…

V0 Certain physicians who are not aware of the benefits of massage and who may think that all massage therapists are "quacks."

U* Your Aunt Gertrude who had a massage once on a cruise and now considers herself an expert.

J )** People who are currently under indictment for health-care fraud.

After you cross those sources off your list, you can still find plenty of helpful folks ready to steer you towards the nearest pair of helping hands. Some of those places where you’re most likely to get a good referral from include…

The contact numbers at major massage associations and accrediting organizations (see the section "Organizations That Can Help You Find a Massage Therapist" later in this chapter).

^ Enlightened physicians who are aware of the benefits of massage and who are more than happy to refer you to the ones they work with. In fact, many doctors these days have a massage therapist or two on staff.

)** Athlete friends who receive massage as part of their training.

A co-worker or family member who’s had a particularly good experience with the massage therapist she’s been using for an extended period of time.

^ The "best-of" articles that health and beauty magazines such as Shape, Self, Mademoiselle, Glamour, And so on often feature.

Your friend Tina, the one who wears the Birkenstock sandals all the time and has that look of blissed-out satisfaction on her face even when she’s standing in line at the grocery store checkout counter.

Getting a Helping Hand

You can collectively refer to the four numbers I’m about to give you as "massage central." Among them you’ll find the contact information for over 80,000 qualified massage therapists in the U. S. right at your fingertips.

Drum roll please… and the contact numbers are:

To find a massage therapist who is a member of the oldest nationwide organization, the American Massage Therapy Association (AMTA), call toll free, 888-843-2682, for their Find-A-Massage-Therapist(SM) Location Service.

To find the nearest member of Associated Bodywork and Massage Professionals (ABMP), call 800-458-2267.

\^ To find a member massage therapist of the International Massage Association (IMA), call 202-387-6555.

For a list of massage therapists who have taken the test given by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) and are therefore Nationally Certified in all 50 U. S. states, call 703-610-9015.

Of course, among those 80,000+ massage therapists, you’re going to find quite a range of skills and offerings, and there isn’t one, single tried-and-true means of prequalifying someone. However, you are living in an extremely lucky time, oh fortunate massage recipient, because in the past several years the number of highly skilled and fully trained massage pros has grown at an amazing rate all around the world.

Following is a list of contact numbers for professional massage practitioners in several countries:

W Australia: Massage Australia, Sydney, tel. (02) 4757 3050

W France: French Federation of Masseurs Kinesitherapeutes (FFMKR), Paris, tel. 01 44 83 46 00

\^ Italy: Federazione Nazionale dei Collegi dei Massofisioterapisti (F. N.C. M.), Rome, tel. 03 94 61 915 499

- U. K.: The Institute for Complementary Medicine, London, tel. 00 44 171 237-5165

Locating a Massage Therapist

If for some reason you can’t locate a massage therapist by simply calling one of the numbers listed previously, you can pursue several other avenues in quest of massage.

Checking the ads

Each locale has its own regulations regarding the advertising of massage, and sometimes the regulations vary from city to city. What may be perfectly legal in Los Angeles, for example, can be verboten in Sioux City, Iowa.

Beware those ads featuring massage therapists with huge muscles, wearing black leather vests with no shirt underneath, staring straight into the camera with a come-hither look in their eyes, especially in San Francisco. These pictures may be a clue tipping you off to the extra curricular intentions of this particular massage therapist, licensed or not. Then again, it could be a fashion statement.

Letting your fingers do the Walking

In some areas, massage therapists must include an official massage license number as part of any Yellow Pages listing for massage. According to Dan Ulrich, past president of the Florida State Massage Therapy Association, the inclusion of the license number in Yellow Pages and other ads significantly reduced the amount of unethical massage advertising. Although the license number is not mandatory everywhere, it’s a clue that you’re dealing with a therapeutic professional. If you don’t see a license number or some other professional credentials listed, call and ask for one.

Opening the bureau door

You may occasionally run into ads for massage service bureaus that guarantee you a massage within a specified period of time (usually within a couple hours). The bureaus have a central number that you call, and they send one of the many independent massage therapists on their list out to you at your choice of location. Quite often, these are very up-and-up enterprises run by entrepreneurial massage therapists who have discovered a new way to multiply their effectiveness and their income. At times, though, the quality of the services offered can be a little iffy, because all the massage therapists aren’t carefully screened all the time in all the bureaus. So, if you’re not personally familiar with the service, and you haven’t received a specific recommendation, you’re never sure exactly what you’re going to get when you call one of these places. Bureaus are most useful when you’re traveling and have no other means of contacting a massage therapist.

Getting the most massage for your money

When dealing with your massage therapist certain tactics can increase happiness for both of you, and in the process, maximize the value you receive from your experience.

W Offer to pay up front for a discounted series of massages: For example, if the massage therapist charges $50 for a massage, offer $400 dollars for 10 massages. Often, massage therapists appreciate the immediate cash flow and the guarantee of ongoing business. This arrangement is good for their business, and good for your pocketbook.

\s Ask for a massage in exchange for referring a new client to your massage therapist She will appreciate the new customer, and you deserve the recognition.

U* Inquire about rates for longer massage sessions: Often the price drops proportionally with the length of the massage, and you can receive a 90- minute massage for not too much more than a 60- minute massage. A massage therapist who charges $50 for an hour massage may offer an hour and a half massage for $65 or $70, for example.

Going back to school

Wherever you are, one excellent way to get in touch with a massage practitioner is to call a massage school in your area. There are more schools around than you think — the U. S. alone has over 800. Look in the phone book, under "vocational schools" or "schools, massage therapy." The schools often have a list of graduates in the area that they can recommend, and quite often they offer massage services in a clinic in the school.

One excellent deal that many people take advantage of is known as the Student massage clinic. In this setup, the students receive part of their training by working on real massage customers, under supervision, of course. Student massages go for only fraction of the normal cost, usually only X to % the going rate of a professional massage in the area. More often than not, the students are already quite good at what they do, and dollar for dollar this option is one of the best bargains in massage.

Keep in mind that you may be asked to fill out a detailed feedback form after the massage, for training purposes. Also, the student clinics usually take place in a big room with curtains separating the massage tables. Quite often, an instructor stops in to observe the student in action. So if you’re a super-private individual who doesn’t like to have other people around when you’re getting a massage, the student clinic is probably not for you. Also, if you have a specific health problem that you’d like to address with massage, it’s best to visit a licensed professional. For relaxation and stress relief, though, student massages are usually as effective as more expensive professional massages because the students are trying extra hard to please you (and pass their coursework at the same time!).

Pampering \lour Massage Therapist

After you choose a massage therapist and begin to develop a working relationship with him, a few endearing personality quirks may begin to surface. Some massage therapists work barefoot, even in the winter, for example. Others hold a giant quartz crystal over your body before the massage. And some tape a bunch of magnets under their massage table to "align your energy" while they work on you. Try not to take your massage therapist’s idiosyncrasies too seriously. They’re just trying to do the best job they can. It’s just that some of their methods may seem a little, um, colorful at first. Refer to rule # 9, "You’re the boss," in Chapter 7 for advice on letting your massage therapist know what you’re comfortable and what you’re not comfortable with.

As a general rule, massage therapists are a finicky and extremely sensitive lot. They’re somewhat like pure-bred cats, and although their job description calls for a great deal of touching, they also need to receive strokes themselves (often to that most delicate muscle, the ego). If you become an expert at scratching behind the ears of your massage therapist’s self-image, you can coax a better performance from him, and your relationship will be a happier one all around.

The following are some simple points to remember whenever you’re dealing directly with your massage therapist:

F Always offer encouragement first before you criticize: For example, if

Your massage therapist is applying a little too much pressure in a partic-(i Ular area, definitely let her know about it, but first say something like, |; "What you were doing a minute ago felt really great. You can lighten up | the pressure a little right now, though." ’4-

| v* Always, always, always praise the massage your therapist just gave you % immediately after you receive it, even if this is the seven hundred and eighty-ninth massage you’ve received from her: The immediate gratifi-| cation of this simple act is powerful. It’s the same reason all an actress’s f friends rush backstage after the play to heartily laud her skills. The ego F: Muscle is most delicate directly after the big performance, and for a great?’* massage therapist, every massage is a type of performance. ‘$

| W Always communicate clearly about exactly what fee you expect to pay Z} For exactly which services: Pricing of massage services may be a sensitive I Issue. Be clear on the answers to the following questions before you begin:

| • Is the charge for an hour and fifteen minute massage higher than

I That for an hour massage?

% • Does the massage therapist have a cancellation policy?

II

• Does your massage therapist reimburse insurance claims?

Licensing Touch

Being a wise consumer, when you head out looking for a massage pro to rub you the right way, you’ll want to ask yourself that all-important question: Is she licensed? The problem here is that not all good, professional massage therapists in all areas are licensed. In the U. S., only half the states even require licensing for massage. Some states require no license at all, and in others the licensing is county-by-county or city-by-city. So even someone who is very highly trained and takes her job very seriously may be license-less, through no fault of her own.

Internationally, licensing rules for massage therapists vary widely from country to country. Some countries, like Singapore, for example, have little or no regulation, while in other countries, like France, massage therapists are part of the medical community and operate out of their own medical clinics. The best course of action in foreign countries is to ask someone you trust to recommend massage. Also, you can read through Chapter 17 for some more suggestions.

The rules concerning massage licensing are too complex and changeable to list here. They differ from area to area and time to time. In fact, in Santa Monica, California, where I first started working as a massage therapist, the actual laws on the books stated that nobody could open a massage clinic within 500 feet of a church, and in order to receive your city license to practice, you had to take a test certifying that you were free of all venereal diseases. Go figure.

If you want information about how massage practitioners are licensed in your area, you can call the board or department in your state that regulates massage therapists. If there is no such regulating board, check with a local massage school to see what kind of education and certification is normal for practitioners in your area.

The best thing to do when you’re trying to determine the professional status of any individual massage therapist is to ask the therapist. I know, this strategy is stunningly simple, but it works. If she doesn’t know anything about licensing, you may have an unprofessional person on your hands. On the other hand, if she knows her stuff, she can tell you exactly who to call or where to look to verify local licensing requirements in general, and hers in particular.

Because this whole licensing issue is so confusing in many areas, you’re wise to consider certification as an equally, if not more, important factor in determining who to choose as your massage therapist.

Original sin?

Some massage therapists think that requiring licensing for massage is almost sinful, because they perceive what they do as art. They figure that licensing massage is like licensing a painter to paint, or a writer to write. Ridiculous! These people thoroughly oppose any attempts at

Control or regulation. They often live in cabins in rugged-individualist states such as Vermont, which, as an interesting side-note that has absolutely nothing to do with massage, is the only state that has managed to keep out Wal-Mart stores.

If a massage therapist has graduated from a bona-fide massage school, he has received a certificate of completion, and this certificate often notes the number of hours completed, specialties studied, and other relevant information. This certification may be the single most substantial piece of evidence of a massage therapist’s dedication to his craft, especially in those areas where licensing is not required.

Another type of certification is awarded to those massage therapists who complete a test given by a certification board, such as the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). This certification is another way of determining competency.

Remember, in massage, just as in a marriage, it’s not the actual piece of paper, but the level of commitment on the participants’ part that is most vital to the success of the relationship. A fancy, gold-embossed massage license hanging on the wall in a frame is no guarantee that you’re going to like a given massage therapist’s technique. And, on the other hand, someone with no certificate or license at all may be one of the most highly skilled massage therapists you’ll ever meet. When it comes down to choosing a pro, go with your heart and your intuition.

Chapter 7