Блог Анкара

• •••••••.••••••••••••••••••••••••••••••••••••••••ft

In This Chapter

► Walking through your first appointment

► Where to go to get a massage

^/robably the biggest barrier that stops people from ever signing up for ▼ their first professional massage is a fear of the unknown. Let’s face it: If you have never ventured into a room with a stranger to get rubbed before, you just don’t know what to expect, and the thought of becoming vulnerable in any way doesn’t inspire you to take the first step.

But hold on. Think back for just a minute. Do you remember any experience in your entire life that was Not Scary the first time you tried it? Go as far back as your first day at kindergarten. That’s Scary. Getting your first massage is just another step along the road of discovery in your life.

\four First Appointment ufith a Pro

You can use the following seven steps as a guide to help you breeze through your first appointment with confidence and poise, starting before you even arrive and lasting right up until you walk out the door.

Preparation

In order to get the most out of your massage, you have to do a little more planning and preparation than you would, say, in order to go get a haircut. When you schedule your massage, keep these points in mind:

Don’t eat a large meal within a couple hours before starting the massage. You don’t want to be lying face down on a belly full of lasagna while somebody is pressing on your back. Light meals and snacks are okay, and a larger meal several hours earlier won’t affect you.

If possible, don’t wear a lot of jewelry, which takes a lot to time to take off and put back on again.

Refrain from consuming alcohol before your massage (unless it’s a sensual massage and you’re sharing a bottle of bubbly with that special < someone to get in the mood). Although alcohol can help relax you, it

Also slows your responses and deadens some sensations. You want to be alert and responsive because massage is a two-way dance and you need to do your part.

W Make sure to schedule enough time before and after your massage so r you’re not rushing to get there and flying out the door when you leave. : Hurrying tends to counteract the relaxing effects of the massage itself.

\^ Turn off pagers and cellular phones during the massage. This probably seems obvious, but it may surprise you to know that beeps, buzzes, and rings have interrupted many tranquil, soothing massages.

Make sure any childcare details are completely taken care of before you begin so your mind can be at ease during your session.

No particular time of day is best to receive a massage, but most people have their own personal preference. Some like the morning so they can experience the benefits throughout the day, and others like a massage right before going to bed at night. Whichever your choice is, try to schedule far enough in advance so you get the time you prefer. Many massage therapists are busy, and their "prime times" are taken up early.

Communication

When you arrive at your massage destination, especially for the first time, you need to engage in a little communication with the person who is going to massage you. So it helps, of course, if you speak the same language as that person. And I don’t mean just the same native tongue, but the same Intention, Too. If what you want out of the experience is fundamentally different than what the massage therapist intends to give, you’re headed for trouble.

For example, if you came in for an hour of blissful relaxation and escape from stress, but what the massage therapist intends on giving you is a session of active, muscle-stretching sports therapy, neither one of you is going to have a good time. The best time to confirm your intentions is on the phone, before you meet face-to-face, but you need to reconfirm this understanding with some clear verbal communication after you arrive, as well.

When you finally meet your massage therapist for the first time, there may be some nonverbal communication required also, in the form of paperwork to fill out, like the actual massage therapist’s intake form. "Why do I have to fill out these medical forms if all I want is a simple massage?" you may ask. Well, it’s for your own good. Massage affects the entire body, and it’s best if your massage therapist knows as much as possible about your health history. If a massage therapist doesn’t ask you to fill out a form, however, it doesn’t mean she doesn’t care about your health; that’s just her style, or the policy of the spa or health club where she works.

Another type of communication you share with your massage therapist is both nonverbal and non-written — body language. Your massage therapist, by profession an expert in the language of the body, may try her best not to laugh out loud while your body silently struggles with embarrassment and anxiety at the prospect of getting your first massage. Just kidding! Actually, as you may imagine, massage therapists become very adept at making their clients feel at ease in a potentially uneasy situation. It’s the little things they do (and don’t do) that make the difference. It could be where they point their eyes or how they manipulate sheets and towels to make you feel protected and respected. It’s the way they just relax and accept you when you make yourself vulnerable by being there.

Besides, they’re just as eager to make a good first impression as you are, partly because it’s human nature and partly because they want you as a repeat customer!

Getting comfortable

In most massage situations, after you arrive and go through your communication rituals, the next step is undressing and lying down. This can be tricky. It’s the moment many people dread, and the one that keeps them from ever getting a "real" massage. The way it works is like this:

1. The massage therapist explains how you’re supposed to get up on the massage table, pointing out where your head should be, and whether you should be face up or facedown. If you ask whether you should get completely undressed or not, the stock answer is something to the effect of, "Most people take all their clothes off, but you can get undressed to the level of your comfort." Then she leaves the room. Do not feel intimidated by "most people" who all so bravely get naked for their massages. It’s up to you if you want to keep your underwear or some clothes on, and it’s OK either way. Refer to Rule # 8 in Chapter 7, "It’s cool to be nude (or not)."

2. After the massage therapist is out of the room, remember to take your time. Don’t worry about getting barged in on, cause it ain’t gonna happen. She knocks before coming back in, and usually she waits much longer than necessary to make sure you have plenty of time. Take this opportunity to remove jewelry, watches, and anything else that may

Entangle a finger (wedding bands are okay). Usually, there is a little table or shelf to hold your belongings, and you can find a hook for your clothes. If you have long hair, you may want to tie it back so it doesn’t get in the way. Also, it’s a good idea to visit the bathroom Before You lay down on the table, even if you don’t think you have to go. Getting a massage with a full bladder takes a lot of the enjoyment out of it.

3. Lie down on the table in the position you were told and pull the sheet or towel up over your body, completely covering yourself.

4. The massage therapist knocks and asks if it’s okay to enter again. When you give the go-ahead, she comes in, and then usually washes her hands. She does this for three reasons:

• To reassure you that her hands are clean

• To wash away any dirt or germs she may have contacted since scrubbing them the last time a few minutes earlier

• In many areas the law requires it

^ME/lf 5. She makes sure you’re comfortable, checking the room temperature, * ^ ^ tucking the towel around your body, and adjusting the lights and music.

She may also slip a little pillow or piece of foam rubber beneath your knees, ankles, or head to help support you. These cushions are called Bolsters, And they really help you feel more comfortable. If you feel a strain or lack of support in any area of your body, just let the massage therapist know.

6. After everything’s set, your massage therapist uncovers just the area that she is going to work on. If she plans to massage your neck, she pulls the sheet down to the top of your chest. Massage therapists always leave women’s breasts covered, and no one’s "private parts" ever get exposed.

Sometimes no matter how hard you try, all these massage rules go out the window. Like the time I was working at a spa and had the opportunity to massage Dr. Ruth Westheimer. I’ll never forget the experience because, for one thing, she threw her robe off before I ever had the chance to leave the room and let her get undressed. Then, full of confidence, she strode to the massage table and tried to climb aboard. I say "tried" because, as it turns out, she was a little too short to reach. I wanted to reach down and give her a boost, but I couldn’t figure out how to do it without getting a little too personal with Dr. Ruth, so I averted my eyes as best I could and offered ineffectual words of general encouragement.

Luckily, she knew what to do. "Don’t worry!" she chimed. "I’ve had this problem before!" Then she proceeded to push a chair up next to the massage table, climb onto it, and from there crawl up onto the table, where I immediately covered her with a sheet in the proper professional fashion.

Avoiding the bathrobe dance

As a massage therapist in spas, on many occasions I’ve entered the massage room to begin a massage only to find my client lying there, face down, rigid with nervousness, with her bathrobe tied super-tight around her waist. Before leaving the room to let her disrobe, I’d instructed her to take her robe off and lie down under the sheet I’d provided, but some clients are too tense to hear those instructions.

And so that’s when we begin the bathrobe

The bathrobe dance is an awkward ordeal that usually lasts about two minutes. While the massage therapist tries to assist as best he can, the client rolls, wriggles, and writhes her way out of

The bathrobe while remaining face down and completely covered at ail times. The client’s rump usually scoots up in the air, arms and legs splay every which way, and her face turns bright red.

Then, after the robe is finally loosened from around her body and her arms are out of the armholes, the massage therapist has to drape a sheet or towel over it before skillfully slipping the robe from underneath. This entire procedure leaves the client even more tense than when she started, and more embarrassed than she would have been if she’d simply listened to the instructions.

If you find yourself on the table still wrapped in your robe, make things easy on yourself. Don’t wear yourself out before the massage by wrestling with your robe. Instead, say something like, "That was so silly of me," and ask the massage therapist to leave the room again to give you another chance. Then get off the table, slip out of your robe, and lie down beneath the sheet like

You were supposed to in the first place.

If, rather than a bathrobe, you have a towel wrapped around you before the massage, make sure not to lie down directly upon the knotted part so you have to do the "rock-n-roll" to loosen it. Instead, open the towel up and lie straight on the table with the towel still covering your backside.

The first touch

The very first moment of contact between you and the massage therapist can tell you an awful lot about how the rest of the massage is going to feel. Each massage therapist has a "personality" in her hands that you quickly get to know.

When the massage therapist is closely attuned to you and your body, this moment can be almost sacred. It’s an intimate joining-together of your consciousness with the consciousness of another person, which just plain doesn’t happen that often in the modern world.

Take advantage of this initial contact by tuning in especially closely to what’s happening in your own body. In the same way that you pick up a lot of information about the person who’s touching you, she’s picking up a lot of information about you. It’s a good opportunity for you to concentrate on your breathing and relaxation.

During the massage

During the massage, your massage therapist continues to keep you covered at all times, only exposing those areas that she’s working on at the moment. Massage therapists are experts at this technique, called Draping, And they make you feel completely comfortable, almost as if you were fully dressed during the experience.

Yes, you are comfortable and modestly covered the whole time, but what are you supposed to actually DO while you’re getting a massage? That’s the biggest problem many people have, especially "type A" people. They figure that getting a massage is just plain boring and that’s why they decide not to do it.

Okay, so getting a massage is not exactly the same as bungee jumping from a hot-air balloon, attending a rock concert, or brokering a multi-million dollar deal in a corporate boardroom. But if you let it, massage can become compelling, thrilling even, in a very internal kind of way. It’s like taking a roller coaster ride inside your own skin.

The trick is not to try and make anything happen, but to just let whatever happens happen. You’re not supposed to do anything. Your massage therapist tells you if you have to move a certain way or breathe a certain way or visualize a certain image. Besides that, the less you do the better. Think of massage as a trip to the beach. You’re Supposed to Just lie there and do nothing.

"But what if I fall asleep?" you gasp. "Wouldn’t that insult the massage therapist?" Not at all. In fact, some massage therapists take it as a compliment that they can get their clients to relax this deeply. However, your creative input to the massage process is just as valuable as the massage therapist’s input, so it’s better if you stay awake. And, if you snooze through a massage, you may be missing some of the most pleasurable moments of your life. Who wants to pay good money for a nap?

If you’re the type that cannot conceive of an entire hour spent doing nothing, try this: Talk to the massage therapist about things that matter, like your health. Most massage people are pretty well versed in the art of taking-care-of-yourself, and you stand a good chance of having a conversation that goes beyond mere chitchat, offering you some real benefits.

Under pressure

So, what’s the right amount of Pressureto Ask for during a massage anyway? Pressure refers to how hard or soft the massage feels, how painful or soothing. Usually, your massage therapist has a lot of experience in this area and can find just the right pressure to su:t your particular body type and your level of sensitivity. But there may be times when you want her to change the pressure, and it helps if you know what to ask for.

It’s silly to suffer through a massage that’s too soft or too hard just because you’re too bashful to say anything about it. You can use this scale from 1-10 to communicate your desired pressure level to your massage therapist:

1 Light as a feather. The fingertips merely skim over the surface of the skin to provide stimulation to the nerve endings, but no pressure is exerted onto the body.

2-3 Very light to light. Many people prefer this kind of silky, gliding touch, but it drives others crazy because they think the massage therapist isn’t "getting in there and working the muscles."

4-6 Moderate to moderately firm. This is where most massage takes place. You can definitely feel some pressure, and you know the massage is having some definite physical effects, but never so much that it’s annoying.

7-9 Firm to very firm to deep. At these levels, you may begin to squirm a little. And you may even say something like, "What are you trying to do, kill me?" Rest assured, the massage therapist is not trying to kill you. She’s just being merciless in her attempt to root out and destroy any tightness she’s found. Mercilessness can be a good quality in a massage therapist.

10 Profoundly deep massage. This level reaches to the core of your body’s deeper structures, actually altering your posture and inner alignment. This should be reserved for masochists, people with a high pain tolerance, and those who know what they’re doing.

If there is a distraction ofsome sort, such as a loud noise or a telephone ringing, try not to take it personally. Nobody is out to ruin your massage experience. Instead of letting an interruption spoil things for you, focus instead on the exchange of positive energy between you and the person giving you the massage.

Keep communicating. When appropriate during the massage, give feedback to your massage therapist. Words spoken about the massage help keep you focused on the massage. If at any point you want the massage therapist to change what she’s doing, you have a right to let her know. After all, you’re paying, and the customer is always right. Let her know what you want, which may include:

: More pressure or less pressure. This is often referred to on a scale from 1 to 10 (see the sidebar, "Under pressure" in this chapter).

^ More or less time spent in a particular area. But be aware that the massage therapist may be using her knowledge to achieve a certain goal, working in the area that’s most effective, even if you think it’s not directly connected to your problem.

A glass of water.

A trip to the bathroom.

A chance to express your feelings and ask for reassurance, especially if a strong emotion begins to surface during your massage.

Beware of the massage therapist who claims she can only perform "deep" work and then proceeds to pummel your body even after you request lighter pressure. It’s never necessary to undergo a painful ordeal in order to experience the relaxation you seek.

Coming back stoutly

Take it easy getting off the table and back into your life. There’s no need to hurry. In fact, most massage therapists suggest that you just lay there and absorb the effects of the massage and the relaxation for a few minutes before getting up again. Unless you’re late for something urgent, such as an international plane trip to go receive the Nobel Prize at an awards banquet being held in your honor, follow this suggestion. These few minutes can be an exquisite interlude during which your cares and concerns seem a million miles away. Relish it.

Then, when you finally decide to get up, don’t be shy about asking for help if you need it, as you may feel a little wobbly at first.

There is a special way to get yourself off a massage table that helps you keep the effects intact. Instead of essentially doing a sit-up and re-tensing all your muscles in order to get upright again, simply roll onto your side and push gently against the table with both hands while you slowly roll back into a sitting position. Your feet and legs will end up hanging over the edge of the table, as you see illustrated in Figure 8-1. Then you can slide your rear-end off the table like a buttered pancake.

Afterglow

When you first step on the floor again, exercise caution because massage oil left on the soles of your feet can cause you to slip. Take your time getting dressed, making sure you’re not forgetting anything. It’s not necessary to take a shower, as your skin absorbs normal amounts of oil or cream, though you

May want to take one if you’re going out later. If the massage therapist used excess oil, you can wipe it off with a towel or some rubbing alcohol before putting clothes back on, especially silk garments.

Figure 8-1:

There’s a right way and a wrong way to get off a massage table. This is the right way.

Take some time to reorient yourself. Be cautious about driving your car right away as you may feel a bit "disconnected," as if your body were inside of a big box filled with cotton.

Before you leave, take the massage therapist’s business card, and consider making another appointment so you don’t have to worry about it later.

To tip or not to tip

You’re all ready to head out the door when suddenly it occurs to you that perhaps you should tip the person who just gave you the massage. Is it appropriate? Would she be insulted if you gave her a tip? Upset if you didn’t? The answer is… "it depends."

It depends upon where you received the massage. Was it a spa? Then a tip is almost always expected, unless the spa has a policy against it. Was it at a sports medicine clinic? Then tips are not usually part of the procedure. Did you receive the massage at home? Then a tip is definitely appreciated, as the massage therapist went out of her way to provide the service.

Overcoming the heebie jeebies

If, even after trying some of the suggestions in this chapter, you’re still harboring a tiny bit of fear and loathing about massage somewhere in your subconscious mind, that’s all right. I felt the same way, too, the first time I disrobed for a session as a student at the Massage School of Santa Monica many years ago.

It’s perfectly natural to feel somewhat anxious at the thought of somebody you don’t even know touching you for an extended period of time. And the thought of somebody you Do Know touching you for a whole hour may even be worse! In the highly sophisticated, jet-setter

World of massage therapy, these feelings of anxiety are known by the technical term "heebie-jeebies." Unless you grew up in a household where massage was as common as Saturday morning cartoons, the heebie-jeebies may present a problem when you’re first getting ready to climb up on a massage table and simply

My advice? Feel the fear and do it anyway. Plunge in and get that massage. Afterwards, if you’re like 99.9 percent of all people, you say to yourself, "That wasn’t so bad! Why didn’t I do this a long time ago?"

Some massage therapists feel tipping for a massage is inappropriate. They want their work to be considered in the same category as any other health care provider’s. You wouldn’t tip your chiropractor, your homeopath, or your M. D., right?

So how do you know what to do? Tipping ultimately boils down to an understanding with the massage therapist. If you’re at all uncertain, simply ask, "Is tipping allowed here?" The customary tip amount in most locations is usually in the $5-$10 range, more if the massage therapist is working late, went far out of her way, or did an especially good job. And, remember, you never Have To tip for massage. It’s not like tipping a waiter, who’s making the bulk of his income through gratuities. Massage therapists are usually pretty well paid for what they do. Tips are the icing on the cake for them.

Where to Go to Get Massaged

You have an array of choices when it comes to where you receive a professional massage, ranging from right in your own bedroom all the way up to super luxurious spa resorts on the island of Maui. I personally recommend Maui. Wherever you are, it helps if you know a little bit about each environment and what you can expect when you receive a massage there. That’s what this section’s all about.

L/our outn home

Getting a professional massage in your own home is great. In fact, some people think it’s the creme de la creme of massage experiences. You don’t have to drive anywhere. You’re in safe, familiar surroundings. And, best of all, afterwards all you have to do is roll over into your own bed or onto your own couch. The massage therapist leaves, and you float off on a wave of bliss in the comfort of your own home.

What could be better?

However, there are some downsides to the in-home massage visit. For one thing, you’re basically inviting a stranger to set up her business right in your own bedroom or your den, which is kind of an invasion of privacy. And another thing — when you’re at home, you’re surrounded by your own life. Every detail is there to remind you of your pre and post-massage existence, which may perhaps detract from the "escape" factor of your experience.

Then there are the distractions. If you have children, you can pretty much count on them wanting to crawl up on the massage table with you and "help" the nice massage person do her job. This is very endearing of the little tykes, but it’s not the straight and narrow road to total relaxation.

Only sign up for an in-home massage if you’re comfortable with other people in your private space and you can keep distractions to a minimum.

The massage therapist’s home

Many massage therapists have a space set up in their own homes for giving massage. This can range from a dinky little corner in one end of the living room to an entire suite of offices with a separate entrance. You may like the "personalized" feeling of visiting a massage therapist in her home, where you can take advantage of the relaxing environment she has (hopefully) set up. On the other hand, if you’re the type of person who prefers a more clearly defined edge between the personal and professional aspects of your transactions, the massage therapist’s home may not be the best choice of location for you.

Also, you have to take into account certain practical details as well, such as whether or not the massage therapist has pets. If you’re allergic to cats, and the massage therapist’s house is a veritable kitty kennel, you may break out in a rash and not enjoy the massage at all.

A good massage therapist should put the rest of her life on hold while you’re in her home, but some have a tendency to attend to their own business while you’re there, answering the phone and the doorbell, for instance, which can

Greatly detract from your experience. You may need to make an extra effort to enforce rule # 9 from Chapter 7. You’re the boss, even if you’re in her home, and for this hour you’re in charge.

Spas

Some of the most beautiful massage environments in the world can be found in spas, and you find out more about them in Chapter 15. Grand Destination spas Dot the map in every state now, and if you look in your Yellow Pages, you’re likely to find a Day spa That you can check out right in your own town.

While spas are often pleasant and luxurious, there are a couple things you should keep in mind when signing up for a massage in one:

Massage therapists in spas only keep a (usually small) percentage of the profits, which sometimes leads them to give less than their absolute best work.

J> Massage Therapists in spas are "on the clock," and you’re likely to get a massage that is exactly 50 minutes long, so she has time to prepare the room for the next client. It’s a rare massage therapist who can still give you a feeling of timeless bliss within that shortened hour.

Often, the style of massage given in spas is dictated by a lowest-common-denominator mentality, and massage therapists are not allowed to use their advanced techniques for fear of alienating a clientele who wants "just a rubdown."

These warnings notwithstanding, there’s no reason to believe you won’t receive an incredible massage in a spa. Some of the best massage therapists work in them. Also, if you end up finding a massage therapist you really like, you can ask her whether she also takes private clients outside the spa, which may mean a better deal for her and a better massage for you. Be diplomatic when doing this though, as many spas have a policy against their massage therapists "stealing" customers in this way.

Cruise ships

Cruise ships are fun places to get massages, if you don’t mind rocking back and forth a little bit while you’re on the table. Almost every ship has its own spa, and you can visit for a half-hour or an hour of massage as easily as visiting the midnight buffet. A massage during your cruise may add to the exotic flavor of your trip, but there are a couple less-than-exotic points to keep in mind as well:

^ Because floor space and portholes are at a premium on ships, massage rooms onboard are usually teeny tiny little quarters with no natural light. If you’re used to ample luxurious massage spaces, you may feel a little claustrophobic in this environment.

Even more so than in spas on land, shipboard massage therapists are part of a massage assembly line, and sometimes the massages are limited to half an hour. It’s rough to coax the best from your massage therapist because she sees so many people come and go — none of whom are repeat customers.

Make sure to sign up early — as soon as you come on board — if you’re thinking about getting a massage during your cruise because the best time slots fill up fast. You may want an appointment during a "sea day," rather than in port, so you don’t have to decide between getting a massage and going ashore to sightsee or shop.

Hotels

Many hotels have their own spas, so all you have to do to book a massage is call the spa desk. For those hotels without a spa, you’ll want to contact the concierge to arrange your appointment.

One note about concierges: Watch out! They often take a good chunk of the massage therapist’s fee for themselves, and they have a stable of ever-ready massage therapists at hand who allow them to do that. So, the quality is not always the best. You may be better off placing a call directly to a professional that you find listed under licensed practitioners in the local Yellow Pages or newspaper. That way you can avoid the fee and perhaps find higher-quality work as well.

All in all, hotel rooms are on the low end of the totem pole as far as receiving massages go. They’re impersonal, they’re cramped, and they often have that funny hotel-room-smell that no amount of incense or positive thinking can overcome. If you find yourself in a hotel room somewhere with nowhere else to go for your massage, and only a concierge to put your trust in, do what seasoned massage recipients the world over have done for years: enjoy it anyway. (See Chapter 17 for more info about hotel massages.)

Health clubs

Health clubs are becoming better places to receive massages. In the past, you were likely to wind up in a tiny cinder-block cubicle vibrating with the sounds of music from the aerobics room next door. These days health-club owners are more aware that their customers want a little nook of tranquility, and a well-trained massage therapist, available for massage. Depending upon the place, some of these clubs offer massage therapists a good percentage of the

Profits, and even a chance to run their own concession, so you may very well find some motivated individuals. The massage is often high-quality, especially if you’re interested in sports-related therapy. And in a health club you can receive your massage immediately after a strenuous workout and a limb-loosening sauna.

Clinics

Many massage therapists open up their own clinics. The setup is similar to any other professional office, like a chiropractor’s, a doctor’s, or a dentist’s. You walk in the front door into a waiting area with a potted plant, some magazines, chairs, and a reception desk. Behind the desk is a hallway with a few doors opening into rooms. The rooms behind those doors, however, can differ decidedly from other clinics. Depending upon the personality and style of the massage therapist, a massage treatment room can range from white-tiled sterility with anatomical charts on the walls to a softly glowing, plush chamber of warmth filled with the strains of celestial music.

One specialty in this area is known as the Sports massage clinic. The massage therapists in these facilities concentrate on rehabilitating you after an injury. They often work with orthopedic physicians and physical therapists. A trip to this type of no-nonsense massage clinic may feel more like a hospital visit than a spa visit.

Student massage clinics

Because of the wide disparity between massage therapists and the environments they create in which to work, it’s a good idea to go check out each environment personally, or at least get a detailed description of it from a friend, Before You sign up for your first massage there. That way you can avoid the nasty surprises that can surface, such as when you make an

Appointment at your local day spa for a relaxing hour of escape only to find the massage room is directly adjacent to a bank of two dozen noisy hair-drying machines.

In This Chapter

^ Discovering the origins of Tibetan medicine

^ Understanding the Tibetan medical concepts of health and disease ^ Determining your body ‘type’ according to Tibetan medicine ^ Exploring Tibetan therapies and how they work ^ Examining the evidence for Tibetan medicine ^ Finding a Tibetan physician

/n this chapter I introduce you to Tibetan medicine, which has been practised for more than 2,000 years. Its aim is to treat body, mind, and spirit in order to bring about balance. Since the occupation of Tibet by China in 1959, many exiled Tibetan physicians have settled in India and in the West, establishing Tibetan medical training and offering consultations.

I tell you about the Tibetan medical ideas about health and disease – and how all diseases are thought to stem from one key source – and show you how you can identify your ‘type’ according to the Tibetan system of ‘humours’, which are thought to determine your physical, mental, and emotional health.

You’ll find out about Tibetan medical therapies and also discover some Tibetan medical healthcare tips that you may like to try out for yourself.

A (Very) Brief History of Tibetan Medicine

The origins of Tibetan medicine go back to native Bon practitioners In Tibet; shamans who used herbs and rituals to help heal people. Later, healing practices were more formalised, incorporating medical teachings from the Buddha from around 500 BC.

In the beginning all medical knowledge was passed on by word of mouth and along the way medical ideas from India, Persia, and China were added in. In the 18th century the Buddha’s instructions were compiled into four great medical texts called the RGyud bzhi (pronounced ‘gyu-zhee’), otherwise known as the Four Tantras. These texts are still used to teach Tibetan medicine and Tibetan physicians are able to quote long passages from it by heart.

In modern times public interest in Tibetan medicine has grown due to media attention for His Holiness the Dalai Lama, the leader of the Tibetan people and a Nobel Peace Prize Laureate, who is a great supporter of this system of medicine and also the attention attracted by celebrity Tibetan Buddhists such as Hollywood actors Richard Gere and Steven Seagal, which has led to increased media coverage for all things Tibetan.

Tibetan Medicine is integrally connected with the life philosophy and religion of Tibetan Buddhism. The origins of Buddhism date back to around the fifth century BC when the royal Prince Siddhartha from Lumbini, India, left his palace and family to seek spiritual enlightenment. He endured all kinds of extreme ascetic practices, such as lengthy fasting, but finally discovered a middle path of calm reflection and balance that led him to attain enlightenment under a Bodhi tree at the age of 35. From then on he was known as the Shakyamuni or Gautama Buddha and spent the next 45 years of his life teaching his philosophy of compassion, insight, and awareness, which are the foundations of Buddhism.

According to Buddhism anyone can become enlightened and so it is said that there were

Many Buddhas before the Guatama Buddha and there are also more to come.

Buddhism spread from India to other Asian countries and became the national religion in Tibet. According to legend, the Buddha also gave medical teachings and to do so he is said to have taken on the form of another Buddha, the Medicine Buddha known as Sangye Menchela. This Buddha is always coloured blue depicted holding a bowl of life-giving nectar in his hands and a myrobalam fruit symbolic of his ability to heal. The myrobalam tree grows in India and Tibet and its fruit is used in many Tibetan medicines even today. Traditionally this fruit is said to be able to cure all diseases and it is now known to be rich in certain valuable ant/ox/dants(plant compounds that help to fight and prevent disease).

Tibetan physicians now practise in many major European cities and elsewhere around the world, including the US, Canada, Japan, Russia, and Australia. Many Tibetan physicians are also monks, and their colourful maroon-and-gold robes and cheerful, smiling faces are always eye-catching and memorable.

Modern pharmacological research, which has also looked at Tibetan herbs, has lent credence to this system of medicine, which is now increasingly popular in the West.

Grasping the idea behind Tibetan medicine

‘Health through balance’ is the central theme in Tibetan medicine. To be healthy, you need a balanced lifestyle, moderate behaviour, good diet, calm emotions, and spiritual health. An imbalance in any of these areas, such as constantly staying up late, eating badly or regularly getting angry, is thought to lead to disease. So the aim of diagnosis and treatment is to examine each of these areas, identify key imbalances, and then use remedies to restore balance and alleviate symptoms.

In this system all diseases are believed to have just one root cause – human ignorance. This concept comes from Tibetan Buddhism and it doesn’t mean stupidity! Rather this concept means if we aren’t enlightened we remain ignorant about the true nature of reality and are instead blinded by the illusions of the material world. This ignorance causes mental suffering and discontent, which in turn leads to physical imbalance and eventually, disease.

Understanding Tibetan medical concepts of health and disease

In Tibetan medical theory our human ignorance means that we suffer from three Poisons; Three types of negative thoughts that disturb our peace of mind. The three poisons are:

Attachment (or desire): That is, strong desires for certain possessions, people, or states of being; for example, we long for a new house or car, we fall in love and become really attached to a person, or we constantly desire happiness.

Aversion (or hatred): A dislike for certain things, individuals, or states of mind and a desire to avoid them; for example, we may dislike rain and grumble when the weather is bad, or we may dislike a particular

Person and seek to avoid them, or we may try to shy away from pain and unhappiness.

U Confusion (or ignorance): That is, indecision, mental lethargy, and list-lessness; we are mentally confused, can’t make up our minds about things and don’t want to make the effort to wake up out of our ignorant state to enter an enlightened one.

According to Tibetan medicine these mental poisons also affect three humours that play a role in the physical body.

I IU Loong (pronounced Lu-ng) - vital energy or ‘wind’ I Tripa (pronounced Tree-pas) - body heat or ‘bile’ I Peken (pronounced Beh-gen) - moisture and fluids or ‘phlegm’

The three poisons and humours are closely connected. The poison of attachment or desire stirs up the wind humour; the poison of aversion or hatred gives rise to the bile humour; and the poison of confusion or ignorance aggravates the phlegm humour.

The humours are believed to circulate through the body via a network of subtle channels (similar to the Nadi Of Indian yoga or the meridians in traditional Chinese medicine). They’re similar to the three Doshas In Ayurveda (these are described in Chapter 5) and each has certain qualities and functions.

The wind humour

The wind humour is based in the abdomen and lower body and has the following qualities and functions in the body:

I The qualities of movement, lightness, and dryness

IU Influences physical movement, respiration, thinking, digestion, and reproduction

I Helps regulate vitality, breathing, and mental clarity

The bile humour

The bile humour isn’t the same as the Western idea of bile from the gall bladder. The ‘bile’ predominates in the centre of the body and its range of qualities and functions in the body include the following:

Iu The qualities of heat, lubrication, oiliness, and odour Controls hunger, thirst, complexion, and skin Affects digestion, vision, and temperament

The three Humours Are seen as three types of energy that determine the function and make up of the body’s organs and tissues. They are:

The phlegm humour

The phlegm humour doesn’t just refer to the gooey white stuff you sometimes find in your throat. This humour resides mainly in the upper body and its range of qualities and functions include the following:

U The qualities of coldness, heaviness, and stickiness

Influences sleep, joint mobility, and mental awareness U Affects digestion and excretion

According to Tibetan medical theory, when all three humours are balanced, good health results, but when any one humour predominates, disease occurs. Here are some examples of the kind of diseases linked to each humour:

U Typical wind diseases are joint pain and mental agitation.

U Typical bile diseases are digestive disorders, such as indigestion and gallstones.

U Typical phlegm diseases are joint stiffness and pain such as arthritis, chronic bloating, and diarrhoea.

The balance of the humours is said to determine your personal physical, mental, and emotional make-up as well as your predisposition to certain diseases. Your constitutional type is therefore described according to whichever humour or humours predominate in your body.

Determining Your Body Type According to Tibetan Medicine

You can determine your body type by completing the quiz below and after you know your type you can adjust your diet, lifestyle, and daily habits to help balance the humours and improve your health.

Taking the Tibetan medical humour quiz

To identify your body type according to Tibetan medicine, answer A, B, or C to each of the following questions:

1. What is your build?

A. Slim, lean, hard to gain weight; very tall or short

B. Medium build and height; may be quite muscular

C. Heavy build, tendency to put on weight, may be short

2. What type of skin do you have?

A. Dry, rough, and cool to touch

B. Oily, smooth, and warm

C. Pale, moist, or oily and cool

3. What are your nails like?

A. Dry, brittle, and rough

B. Strong, oily, and flexible

C. Smooth, thick, and wide

4. What type of hair do you have?

A. Fine, thin, flyaway, brittle

B. Dry at the ends but greasy at the roots, or coloured, processed, or frizzy

C. Normal to oily; sometimes lifeless and greasy

5. What does your tongue look like?

A. Long and thin; pale with a clear coating

B. Red-tipped with a greasy, yellow coating

C. Full bodied with teeth marks and a thick, white coating

6. What type of appetite and digestion do you have?

A. Irregular appetite and occasional digestive problems

B. Good appetite, often hungry, regular digestion

C. Steady appetite, slow eater, slow digestion

7. What is your temperament?

A. Talkative, active, creative, imaginative, prone to anxiety

B. Organised, industrious, impatient, irritable, determined

C. Stable, calm, slow, thoughtful, possessive

8. What is your sleep like?

A. Insomniac and wake often; little sleep needed and an early riser

B. Hard to get to sleep and lots of dreams but wake energetic

C. Deep and heavy; hard to wake up and still feel tired

9. Which do you dislike most?

A. Draughts or hot and cold temperature fluctuations

B. Hot conditions

C. Cold and damp conditions

10. How do you feel when you have to make an important decision?

A. Nervous but excited

B. Decisive and confident

C. Confused and undecided

Determining your type

To determine your personal humour make-up, add up the numbers of A, B, and C responses that you made for each of the quiz questions and see which you have the most of:

U Mostly A responses: Loong/Wind type: You’re very active and able but tend to take on too much and are always in a rush. You may also suffer from headaches, joint aches and pains, and anxiety. You need to relax more and slow down the pace of your daily life.

U Mostly B responses: Tripa/Bile Type: You’re quick and intelligent but can also be impatient and irritable. You’re dynamic and can make things happen but you don’t suffer fools gladly. You may suffer from digestive problems and food-related headaches. You need to calm down and to strengthen your digestion.

U Mostly C responses: PeATEn/Phlegm type: You’re stable and dependable and people love to confide in you! Your body is quite strong but you often feel tired and can be lethargic. Your digestion is slow and you have a tendency towards sugar cravings, bloating, weight gain, and water retention. You need to get things moving in your body, increase your vitality, and speed up your digestion.

Some people fall very clearly into one of the categories above. For others more than one type may play a role in your health. These are known as Combination types. In the following section, I tell you some of Tibetan medicine’s self-care recommendations for each type.

Helping Yourself with Tibetan Medicine Self-Care Approaches

After you’ve identified your Tibetan medicine body type according to the quiz, try following the Tibetan medicine self-care tips outlined below, designed to help rebalance the humours, and see how they make you feel.

U If you’re predominantly a Loong/Wind type, try the following:

• Stop exhausting yourself. Learn to say ‘No’ and delegate more. Take steps to reduce stress and any sources of conflict in your life.

• Build some quiet times into your schedule when you can avoid noise and crowds. Talk less and make regular time just for you, to relax and indulge yourself.

• Cut down on stimulants like coffee, tea, colas, and sugar because these wind you up too much.

• Eat slowly and chew your food well and don’t do anything else while eating.

• Limit your intake of cold or raw foods and increase your intake of warming foods such as soups, casseroles, and steamed vegetables. Root vegetables are particularly good for you because they help to nourish and ground you.

• Calm your mind and body with yoga, meditation, and deep breathing. Consider taking up an artistic hobby such as painting as an outlet for your creativity and imagination.

• Spend time in the loving company of close friends that nurture and support you.

U If you’re predominantly a Tripa/Bile type, try the following:

• To improve your digestion, avoid saturated fats, rich foods, hot peppers, and spices.

• Cool yourself by eating lots of salad and raw or lightly steamed vegetables.

• Drink lots of good quality water (filtered if possible) every day.

• Avoid hot, stuffy environments and direct heat and keep out of the sun.

• Layer clothing so that you can keep cool and regulate body temperature.

• Take regular exercise, especially at the end of the day to release stress and tension and pave the way for a relaxed night’s sleep.

• Practise patience and find how to overcome feelings of irritability or anger. Breathing exercises, relaxation training, and yoga can all help with this.

U If you’re predominantly a Peken/Phlegm type, try the following:

• Eat little and often. Avoid dairy produce, refrigerated foods, oily foods, and saturated fats, which will slow you down further and make you feel heavy.

• Stabilise your blood sugar levels and reduce cravings by incorporating sunflower and pumpkin seeds in your diet and eating porridge for breakfast.

• Drink boiled water sprinkled with finely chopped fresh parsley to reduce water retention.

• Don’t let yourself get stuck in a rut. Change your routine regularly, for example take a different route to work or do daily activities in a different order to stimulate your senses and overcome lethargy.

• Take regular, brisk exercise to increase vitality, speed up your metabolism, and improve digestion. Daily speed-walking is particularly good for you.

• Exercise your mind with mental challenges such as crosswords or mathematical puzzles.

• Sing your heart out, to the radio or in a choir, to energise your body.

Exploring Disease Types in Tibetan Medicine

In Tibetan medicine imbalances of the three Poisons And the three Humours Are believed to lead to 84,000 different types of disease! To make these more manageable they have been classified into four categories:

U Diseases due to early life: These diseases start in infancy or childhood and are due to factors during conception, pregnancy, early feeding, and so on.

U Diseases due to present lifestyle: These diseases owe much to your bad habits such as late nights, drinking, smoking, junk food, sedentary lifestyle, stress, and so on.

U Diseases due to past life: These are diseases relating to the Buddhist idea of Karma, The law of cause and effect and the belief in the concept of rebirth. According to this law it is said that actions in one life may produce a result in a subsequent life. Therefore, a disease in this life may be related to an action or experience in a past life.

U Diseases due to spirit influence: These diseases are thought to be due to the influence of some elemental forces or restless spirits (‘ghosts’ in the West).

Tibetan medicine believes four conditions influence disease. These are:

U Diet: You can’t get away with eating loads of junk food forever without it starting to affect your body. Different types of foods are believed to have a direct effect on the balance of the different Humours.

U Behaviour: Different lifestyle behaviours are also believed to influence the Humours As mentioned earlier in this chapter. For example insufficient sleep is believed to aggravate the wind humour, too much sun exposure may aggravate bile, and too much lying around and doing nothing will make a phlegm condition worse.

U Weather/season: Climates and weather conditions affect the balance of the humours. For example, wind can stir up the wind humour, heat stirs up bile, and cold and damp aggravate phlegm.

U Spirit: This refers to your mental state. For example, agitation and worry are believed to aggravate the wind humour, irritation and frustration to disturb bile and indecision and confusion to contribute to a predominance of phlegm. The Tibetans are great believers in positive thinking and in dispelling negative thoughts, which may be why they’re generally such smiley and happy people!

If these categories and conditions all sound too complicated to you, then you may like the way Tibetan medicine always boils things down to simple principles. This system of medicine also has two basic categories into which all diseases can be divided. They are:

U Hot diseases: Typified by redness, swelling, hot extremities, and acute pain.

U Cold diseases: Typified by coldness, stiffness, pallor, cold extremities, and chronic pain.

Restoring Balance with Tibetan Medicine Therapies

Tibetan medicine is currently used to treat a wide range of diseases including digestive problems, arthritis, late onset diabetes, headaches, fatigue, skin disorders, and respiratory problems. Tibetan physicians treat many thousands of patients with these health problems each year and there are large numbers of anecdotal reports of improvements but as yet little research evidence to prove effectiveness.

In order to restore the balance of the humours, Tibetan medicine uses five main types of therapy:

U Dietary adjustment: Dietary changes are fundamental to Tibetan medicine and are the first line of therapy. Eating correct amounts of food (not too much or too little) and adjusting the type of food you eat according to your constitutional type is essential. (Refer to the earlier section ‘Helping Yourself with Tibetan Medicine Self-Care Approaches’.)

U Behavioural change: Making changes to your daily lifestyle and habits are the second line of treatment. Tibetan physicians advise regulating behaviour according to the humours so, for example, talkative wind types are advised to spend time quietly alone resting, while lethargic phlegm types are encouraged to get out of bed early and to get moving.

U Medicines: The main medicinal approach in Tibetan medicine is the use of herbal remedies. Plant roots, leaves, flowers, bark, fruits, minerals, and occasionally animal ingredients are all used and the formulae usually contain multiple ingredients. The remedies may be given in the form of pills, powders, decoctions or ointments.

U Other therapies: Tibetan physicians also use massage, bone-setting, and some acupuncture and moxibustion. The acupuncture and moxibustion techniques have mostly been adopted from Traditional Chinese Medicine (TCM) and quite recently incorporated into Tibetan medical practice (for more on TCM, see Chapter 4). However one technique unique to Tibetan medicine is Golden Needle therapy, which I describe in Chapter 9.

U Religious rituals, prayers, dream analysis, and astrology: Spiritual healing in Tibetan medicine is based on Tibetan Buddhist and Bon practices and can involve prayers and rituals by the physician and/or the patient. The Medicine Buddha also plays a role and his picture and mantra (a prayer saying his name) are often used to invoke healing. Sometimes dreams are investigated for healing signs and many doctors also study Tibetan medical astrology in order to be able to interpret disease and recommend appropriate cures. Many Tibetans also wear precious gems or talismans believed to help protect against disease.

Examining the Evidence for Tibetan Medicine

Research evidence for Tibetan medicine has concentrated mainly on specific herbal formulae. One of the most well-researched is the formula known as Padma 28 which has been trialled in Switzerland, Israel, and Denmark and been found to be effective for treating intermittent claudication (restricted circulation in the legs making walking painful and difficult), cardiac problems, and inflammation. (See Www. swiss-inter. com/padma2 8e. htm for more information.)

A Californian study on Tibetan herbal medicine for breast cancer produced mixed results but had design flaws. Other studies have looked at Tibetan herbal medicine for various ailments, including diabetes, depression, and AIDS, and have yielded some promising results but more research is needed.

Research is currently being carried out at the Tibetan Medical and Astrological Institute (TMAI) in northern India (see Www. men-tsee-khang. org for more information). It has also been stimulated in other countries following recent International congresses on Tibetan Medicine held in the US, Tibet, and Taiwan, and as a result more research studies are underway. (More information on these congresses and other aspects of Tibetan medicine is available at Www. dharma-haven. org and Www. tibetmed. org.)

The more esoteric aspects of Tibetan medicine such as prayer and chanting have not been scientifically evaluated.

Finding a Tibetan Medicine Physician

Full Tibetan medical training takes at least seven years and is currently only available in India, Nepal, and Tibet. Courses on or about Tibetan medicine are available in Europe but none fully qualify a person to practise as a Tibetan medical physician.

No regulation or professional association for Tibetan physicians currently exists in Europe although an International Association for Tibetan Physicians (IATP) is in the process of being established in the US. Several individual Tibetan physicians are members of European professional associations for herbal medicine or acupuncture and carry liability insurance for practising

In Europe. Various Tibetan physicians are now resident and practising in different countries in Europe and also the US.

In the UK, the Tibet Foundation (Tel: 0207 930 6001; Www. tibet-foundation. org) in London organises visits from highly experienced, qualified, and insured Tibetan physicians several times a year. They also sometimes have details of visits by Tibetan physicians to other countries.