Блог Анкара

In This Chapter

^ Understanding the nature of anxiety ^ Developing attitudes that help overcome anxiety Designing a programme to face your fears

I\ Nxiety is a bully. And like most bullies, the more you let it shove you Ґ \ around, the pushier it gets. This chapter helps you get to know the nature of anxiety and to identify the ways in which it pushes you about. Fundamentally, you can beat anxiety, like any bully, by standing up to it.

Acquiring Anti-Anxiety Attitudes

Your thoughts are what count, because your feelings are influenced greatly by how you think. Feeling anxious increases the chance of you experiencing anxiety-provoking thoughts (refer to Chapter 6). Anxious thoughts can increase anxious feelings, and so a vicious circle can develop. You can help yourself to face your fears by adopting the attitudes we outline in this section.

Thinking realistically about the probability of bad events

If you have any kind of anxiety problem, you probably spend a lot of time worrying about bad things that May Happen to you or your loved ones. The more you focus your attention on negative events and worry about bad things being just around the corner, the more likely you are to believe that they’ll actually happen.

Proving For sure that bad events won’t happen isn’t that easy without a crystal ball or two, but you can acknowledge that you tend to Overestimate The probability of bad things happening. Adjust your thinking appropriately to Counterbalance For this tendency. Counterbalancing your attitude is a lot like riding a bike with the handlebars offset to the left – to steer straight, you need to turn the handlebars to the right, otherwise you keep veering off to the left. If you tend to always imagine the worst, straighten out your thinking by deliberately assuming that things are going to be okay.

Avoiding extreme thinking

Telling yourself that things are ‘awful’, ‘horrible’, ‘terrible’, or ‘the end of the world’ only turns up the anxiety heat. Remind yourself that few things are really that dreadful, and instead rate events more accurately as ‘bad’, ‘unfortunate’, or ‘unpleasant but not the end of the world’.

Extreme thinking leads to extreme emotional reactions. When you mislabel a negative event as ‘horrible’, you make yourself overly anxious about unpleasant but relatively non-extreme events, such as minor public embarrassment.

Taking the fear out of fear

When people say things like ‘Don’t worry, it’s Just Anxiety’, the word ‘just’ implies – wrongly – that anxiety’s a mild experience. Anxiety can, in fact, be a very profound experience, with strong bodily and mental sensations. Some anxious people misinterpret these intense physical symptoms as dangerous or as signs of impending peril. Common misreadings include, assuming that a nauseous feeling means that you’re about to be sick, or thinking that you’re going crazy because your surroundings feel ‘unreal’.

If you have concerns about your physical sensations you may consider seeing your family doctor prior to deliberately confronting your fears. Your doctor may then be able to advise you as to whether deliberately increasing your anxiety in the short-term, in order to be free of it in the long-term, is safe

Enough for you. It is rare for people to be advised against facing their fears.

Understanding and accepting common sensations of anxiety can help you stop adding to your anxiety by misinterpreting normal sensations as dangerous. Figure 9-1 outlines some of the more common physical aspects of anxiety.

Undoubtedly, anxiety is an unpleasant, sometimes extremely disturbing experience. However, evaluating your anxiety as ‘unbearable’ or saying ‘I can’t stand it’ only turns up the emotional heat. Remind yourself that anxiety is hard to bear but not unbearable.

Attacking Anxiety

The following are some key principles for targeting and destroying anxiety.

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Winning by not fighting

Trying to control your anxiety can lead you to feeling more intensely anxious for longer (for more on this, read through Chapter 7). Many of our clients say to us: ‘It makes sense to face my fears, but what am I supposed to do while I’m feeling anxious?’

The answer is.. . nothing. Well, sort of. Accepting and tolerating your anxiety when you’re deliberately confronting your fears is usually the most effective way of making sure that your anxiety passes quickly.

If you’re convinced that your anxiety won’t diminish by itself, even when you do nothing, test it out. Pick one anxiety-provoking situation that you normally withdraw from – examples include using a lift, travelling on a busy bus, standing in a crowded room, and drinking alone in a bar. Make yourself stay in the situation and just let your anxiety do its thing. Don’t do anything to try and stop the anxiety. Just stay where you are and Do nothing Other than feel anxious. Eventually, your anxiety will begin to ebb away.

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Defeating fear With FEAR

Perhaps the most reliable way of overcoming anxiety is the following maxim: FEAR – Face Everything And Recover. Supported by numerous clinical trials, and used daily all over the world, the principle of facing up to your fears until your anxiety reduces is one of the cornerstones of CBT.

The process of deliberately confronting your fear and staying within the feared situation until your anxiety subsides is known as Exposure Or Desensiti-sation. The process of getting used to something, like cold water in a swimming pool, is called Habituation. The principle is to wait until your anxiety reduces by at least half before ending your session of exposure – usually between twenty minutes and one hour, but sometimes more.

Repeatedly confronting your fears

As Figure 9-2 shows that if you deliberately confront your fears, your anxiety becomes less severe and reduces more quickly with each exposure. The more exposures you experience, the better. When you first confront your fears, aim to repeat your exposures at least daily.

Time

Keeping your exposure challenging but not overwhelming

When confronting your fears, aim for Manageable exposure, So that you can successfully experience facing your fears and mastering them. If your exposures are overwhelming, you may end up resorting to escape, avoidance, or safety behaviours. The flipside of choosing overwhelming exposures is taking things too gently, which can make your progress slow and demoralising. Strive to strike a balance between the two extremes.

If you set yourself only easy, gentle exposures, you risk reinforcing the erroneous idea that anxiety is unbearable and must be avoided. The point of exposure work is to prove to yourself that you Can Bear the discomfort associated with anxious feelings.

Taking it step bg step

Avoid overwhelming or underchallenging yourself by using a Graded hierarchy Of feared or avoided situations. A graded hierarchy is a way of listing your fears from the mildest to the most severe.

If

You want to kill your fear, let it die of its own accord.

You can use Table 9-1 to list people, places, situations, objects, animals, sensations, or whatever triggers your fear. Be sure to include situations that you tend to avoid. Rank these triggers in rough order of difficulty. Alongside each trigger, rate your anticipated level of anxiety on the good old 0-10 scale. Voila! You have a graded hierarchy.

After you have confronted your fear, rate the Actual Level of anxiety or discomfort you experienced. Then, tailor your next exposure session accordingly. Most situations are not as bad as you expect them to be. In the unlikely event that the reality is worse than your expectations, you may need to devise more manageable exposures for the next few steps and work your way up the hierarchy more gradually.

Table 9-1 Graded Hierarchy of Anxiety

Feared or Anticipated Anxiety or Actual Anxiety or

Avoided Trigger Discomfort 0-10 Discomfort 0-10

Jumping in at the deep end

Although we caution about striking a balance between under – and overchal-lenging yourself, jumping in with both feet does have its benefits. The sooner you can face your biggest fears, the sooner you can master them. Consider whether you can climb to the top of your hierarchy straight away.

Graded exposure is a means to an end. Going straight to your worst-feared situation without resorting to safety behaviours (which we talk about in the next section) can help you get rapid results, as long as you stick with the exposure long enough to discover that nothing terrible happens.

Shedding safety behaviours

You can overcome anxiety by turning your anxiety upside-down. The best way to make your anxiety go away is to invite it to do its own thing. As we explain in a bit more detail in Chapter 7, the things you do to reduce your fear in the short-term are very often the very things that keep you feeling anxious in the long term. (Check out Chapter 7 for some common examples of safety behaviours.)

Recording your fear-fighting

Keep a record of your work against fear so you can check out your progress and make further plans. Your record can include:

I The length of your exposure session

I Ratings of your anxiety at the beginning, middle, and end of your exposure session.

A record helps you see whether you’re sticking with your programme long enough for your fear to subside. If your fear doesn’t seem to be reducing, make sure that you’re still trying hard enough to reduce your fear by getting rid of those safety behaviours.

You can use the behavioural experiment record sheet in Chapter 4 to record your exposure and to compare your predicted outcome of confronting your fears with the actual outcome.

Mdinq Common Anxieties

The following sections outline the application of CBT for some common anxiety problems. A full discussion of all of the specific types of anxiety problems lies outside of the scope of this book. However, the CBT principles that we introduce you to here are the very best bet for overcoming most anxiety problems.

First, define what you’re doing to keep your anxiety alive in your thinking (see Chapters 2 and 6), and alive in your behaviour (see Chapters 6 and 7). Then, start to catch your unhelpful thoughts and generate alternatives (Chapter 3), and test them out in reality (Chapter 4). Understanding where you focus your attention, and re-training your attention, can also be hugely helpful (see Chapter 5). We discuss anxiety about health, fears of being ugly, and obsessions in Chapter 11.

Socking it to social anxiety

Attack Social anxiety (excessive fear of negative evaluation by other people) by drawing up a list of your feared and avoided social situations and the safety behaviours you tend to carry out (check out Chapter 7 for more on safety behaviours).

Hang on to the idea that you can accept yourself even if other people don’t like you. Be more flexible about how witty, novel, and entertaining you ‘have’ to be. Systematically test out your predictions about people thinking negatively about you – how do people act when you don’t try so hard to perform? Refocus your attention on the world around you and the people you interact with, rather than on yourself. For more help on retraining your attention, refer to Chapter 5. Once you’ve left the social situation, resist the tendency to play your social encounters back in your mind.

Waging War on Worry

To wage war on your excessive worry, resist the temptation to try to solve every problem in advance of it happening. Try to live with doubt and realise that the most important thing is not what you specifically worry about but How You manage your worrying thoughts. Overcoming worry is the art of allowing thoughts to enter your mind without trying to ‘sort them out’ or push them away.

Pounding on panic

Panic attacks are intense bursts of anxiety in the absence of real danger, and can often seem to come out the blue. Panic attacks often have very strong physical sensations such as nausea, heart palpitations, a feeling of shortness of breath, choking, dizziness, and hot sweats. Panic sets in when people mistake these physical sensations as dangerous and get into a vicious circle because these misinterpretations lead to more anxiety, leading to more physical sensations.

Put panic out of your life by deliberately triggering off panic sensations. Enter situations you’ve been avoiding and resist using safety behaviours. Realise, for example, that feeling dizzy does not cause you to collapse, so you don’t need to sit down, and that other uncomfortable sensations of anxiety will pass without harming you. Carry out a behavioural experiment (see Chapter 4) to specifically test out whether your own feared catastrophes come true as a consequence of a panic attack.

Assaulting agoraphobia

Being afraid to travel far from home, or to venture away from safe or familiar places are common characteristics of Agoraphobia.

To gain confidence and overcome agoraphobia, develop a hierarchy of your avoided situations and begin to face them, and stay in them until your anxiety reduces. This may include driving progressively longer distances alone, using public transport, and walking around in unfamiliar places. At the same time, work hard to drop your safety behaviours so you can discover that nothing terrible happens if you do become anxious or panicky, and ride it out.

Beating With posttraumatic stress disorder

Post-traumatic stress disorder (PTSD) can develop after being involved in (or witnessing) an accident, assault, or other extremely threatening or distressing event. The symptoms of PTSD include being easily startled, feeling irritable and anxious, memories of the event intruding into your waking day, nightmares about the event, or feeling emotionally numb. If you have PTSD you may be sustaining your distress by misunderstanding your normal feelings of distress in response to the event, trying to avoid triggers that activate memories of the event, or trying too hard to keep yourself safe.

To combat PTSD, remind yourself that memories of a traumatic event intruding into your mind, and feelings of distress are normal reactions to trauma. Allowing memories to enter your mind and spending time thinking about them is part of processing traumatic events, and a crucial part of recovery. Many people find that deliberately confronting triggers or writing out a detailed first person account can be helpful. At the same time it’s important to reduce any excessive safety precautions you may have begun to take.

Hitting back at fear of heights

Begin to attack a fear of heights by carrying out a survey among your friends about the kinds of feelings that they have when standing at the edge of a cliff

Or at the top of a tall building (see Chapter 4 for more on conducting surveys). You’ll probably discover that your sensation of being unwillingly drawn over the edge is very common. Most people, however, just interpret this feeling as a normal reaction.

Put this new understanding into action to gain more confidence about being in high places. Work through a hierarchy of entering increasingly tall buildings, looking over bridges, and climbing to the top of high cliffs.

Fascinating phobias

One of the interesting things about anxiety problems is the wide variety of things that human beings fear. In our practise, we still encounter people with fears we’ve never heard of before. Crucially, what matters is notwhatyou’re afraid of but how negatively your fear is affecting your life.

Sometimes people are embarrassed by their phobias because they think others may find them silly or trivial. But extreme fear is never trivial – terror and fear can be very disabling, even if your fear is of something as simple as buttons. We suggest you seek out health professionals who take you seriously so you can get help foryour phobia.

Common phobias include:

Acrophobia: Fear of heights or high levels

Agoraphobia: Fear of open spaces, crowded public places, or being away from a place of safety

Aichmophobia: Fear of pins, needles, and pointed objects

Arachnophobia: Fear of spiders

Claustrophobia: Fear of confined or small spaces

Emetophobia: Fear of vomiting

Haemophobia: Fear of blood and blood injury

Lockiophobia: Fear of childbirth

Noctiphobia: Fear of the night and the dark

Trypanophobia: Fear of injections

Less common phobias include:

Arachibutyrophobia. Fear of peanut butter sticking to the roof of one’s mouth

Automatonophobia; Fear of ventriloquists’ dummies, dolls, animatronic creatures, or wax statues

Barophobia;fear of gravity

Bibliophobia; Fear of books (if you’ve got this one, stick with us-you’re doing well!)

Blennophobia.fear of slime

Lutraphobia.fear of otters

Lyssophobia;fear of going insane

Necrophobia;fear of death or dead things

Ombrophobia;fear of rain or being rained on

Soceraphobia;fear of parents-in-law

In This Chapter

^ Finding out what naturopathy is all about

^ Understanding how it works

^ Discovering what naturopathy can be good for

^ Knowing what to expect in a typical consultation

^ Knowing how to find a safe and effective naturopath

Aturopathy is a health philosophy and healthcare system based on the idea that the body has the power to heal itself. Unhealthy lifestyles are seen as the trigger for disease and various therapies and self-care regimens are used to help the body back to a natural state of health.

In this chapter you discover the thinking behind naturopathy and how it evolved over time from the Nature Cures of the 19th century to a popular form of healthcare today that has even influenced modern medicine.

You find out how naturopaths consider that the right food, water, air, light exposure, work/rest balance, and exercise are so important, and I introduce you to the range of therapies that are part of the modern day naturopath’s healing repertoire.

On the way you also discover some tips on how to find a good naturopathic practitioner and what sort of questions you may want to ask, and I give you a naturopathic self-care technique that you may like to try out for yourself.

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Finding Out about Naturopathy

The philosophy behind naturopathy dates back to Hippocrates, in ancient Greece, who stressed that proper diet, exercise, and rest could be used to maintain health and that cures should only be used to stimulate the body’s natural healing ability. Naturopathy, Or naturopathic medicine, therefore, seeks to help you make lifestyle changes that will support your health and uses natural therapies (that is, therapies that don’t involve drugs or surgery) to support the self-healing process.

Naturopaths look for the underlying causes of disease, rather than focus on individual symptoms alone. They’re interested in the whole person, rather than just the ailment, and seek to restore, maintain, and promote health as well as prevent future disease.

Naturopathic healing approaches utilise water (hydrotherapy), air and light, diet and nutrition, herbs, homeopathy, manipulation techniques, and acupuncture. Naturopaths also give you self-care recommendations to help transform your unhealthy habits into healthy ones.

Modern day naturopathy combines ancient knowledge of natural therapies with modern scientific knowledge about nutrition and health. Because it doesn’t focus on individual disease or symptoms naturopathy can be used by anyone – even if you feel well! Naturopathy aims to help you attain your full health potential in terms of physical, mental, and emotional health.

A (Very) brief history of naturopathy

Modern day naturopathy has its roots in the work of European and American Nature Cure practitioners in the 19th and early 20th centuries, such as Vincent Priessnitz, the founder of hydrotherapy (water cure) and Johannes Schroth, who was one of the first to show the importance of diet and nutrition. (For lots more about Nature Cure and its pioneers, check out Chapter 8.)

The term naturopathy, meaning ‘natural treatment’, was first coined in 1895 by John H. Scheel, a follower of the 19th-century Bavarian priest, Father Sebastian Kneipp, who became famous for his water and herbal cures. Another of Kneipp’s students, Benedict Lust, who took Kneipp’s ideas to America, bought the rights to this name in 1902 and established the first School of Naturopathy and a national organisation of naturopaths in the US.

Nature Cure and Natural Hygiene practices (both described in more detail in Chapter had already been increasing in popularity in America and were being adopted by numerous medical doctors, chiropractors, and osteopaths, amongst others, disenchanted with the orthodox medical practices of the

Day. They were also becoming quite widely available through Nature Cure Sanitariums and private clinics.

Dr Henry Lindlahr, a medical doctor who became a celebrated naturopath, further established naturopathy by setting up several training institutions and writing best-selling books outlining naturopathic theory and practice.

Other individuals who made significant contributions to the development of this system of health and healing were: Bernarr Macfadden, who brought ‘physical culture’ to the fore and emphasised the importance of regular exercise, a whole-food diet, and fasting; Dr John H. Tilden, who promoted the idea of toxicity as the root cause of disease; Sylvester Graham, who promoted good nutrition through his wholemeal graham flour crackers and invented the dry breakfast cereal; and Dr John Harvey Kellogg, who established the famous Battle Creek Sanitarium and made several health inventions including the cornflake (you can read the story of the cornflake in Chapter 8 as well).

In the UK, the development of naturopathy as a profession was largely due to James Thompson, (a student of Henry Lindlahr) who set up the first natur-opathic training college in Edinburgh in 1919, a healthcare home, and the Incorporated Society of Registered Naturopaths; and Stanley Lieff, who trained with Bernarr Macfadden and later established a Nature Cure Resort in the UK, founded the very popular Health for All Magazine, and helped establish the British College of Naturopathy in London in 1949.

Other European practitioners also developed naturopathy as a field of practice and one of the most enduring has been the Swiss ‘Nature Doctor’, Alfred Vogel.

Alfred Vogel was born in a small town outside Basel in Switzerland in 1902. He learnt about plants and healing from his father and grandparents during his childhood and went on to establish a small health food shop, creating natural health remedies and reading, writing about, and practising natural therapeutics. The success of his publications, including the Nature Doctor, And his practice enabled him to travel widely during his lifetime to explore herbal therapy and natural cures in different parts of the world.

On one early trip to South Dakota in the US, he met Black Elk, a Native American Sioux elder experienced in plant remedies and healing.

Black Elk made Vogel a gift of a handful of seeds of the Echinacea purpurea Plant, telling him that this was highly prized in his tribe for its medicinal properties.

Vogel carefully carried the seeds home to Switzerland and, with some difficulty, nurtured them into full grown echinacea plants. He was gradually able to cultivate and harvest the echi-nacea and is credited with having introduced this marvellous healing plant to millions of people worldwide. It is now cultivated widely and is an extremely popular over-the-counter cold and flu remedy. Modern research has confirmed echinacea’s immune-boosting properties.

Mahatma Ghandi, a major spiritual and political leader in India in the early 1900s, was a strong supporter of Nature Cure and naturopathy since their methods were inexpensive and could easily be used by ordinary people. Indian natur-opathy is closely linked to vegetarianism and yoga, which Ghandi also practised himself.

Nowadays Nature Cure and naturopathic clinics and hospitals exist all over India. Many Indian doctors train in both Western and natur-opathic medicine and integrate the two in their practice.

I’ve studied and assisted in naturopathy clinics in India and have always been delighted to see the ready enthusiasm with which Indian people embrace naturopathic principles and practice.

I particularly remember the scene at one clinic where a group of us were out on the porch practising various yoga exercises, which were part of the clinic’s health regime. Our actions attracted the attention of the town’s street urchins who ran over and joined in by hilariously copying every move that we made with huge cheeky grins on their faces!

Naturopathy declined in popularity in the mid-1900s, as modern orthodox (allopathic) medicine and pharmaceuticals increased their influence, but more recently it has enjoyed something of a revival amongst people disenchanted with a pharmaceutical approach and interested in natural medicine.

Naturopathy today

Naturopathy is now widespread but its status and practice varies in different countries.

In the US and Canada, naturopaths are regulated and licensed in some, but not all, states, and they practise in a way similar to a general practitioner. In the UK, naturopaths are less numerous and not yet fully regulated and may have developed specialties in osteopathy, herbal medicine, homeopathy, or

Acupuncture as part of their training.

In Australia and New Zealand naturopathy is licensed and very popular and has been embraced by many doctors too. In Germany the naturopathic Heil-praktikers (health practitioners) are well-established and some are also trained as medical doctors. In various other countries, including the Netherlands, Sweden, Switzerland and certain African countries, to name but a few, natur-opaths are licensed and allowed to practise certain types of natural therapy but prohibited from the practice of particular aspects of medicine such as surgery.

Grasping the idea behind naturopathy

Naturopaths believe that the body is always trying to maintain a state of health balance, known as Homeostasis. This delicate balance can be disrupted by poor diet, lack of fresh air or sunlight, inadequate exercise, stress, or mental or emotional upset. Naturopaths believe that as a result, the body’s ‘vital force’, which determines health and healing, becomes weakened and leads to disease.

Other disease triggers are thought to be sluggish bowels and poor elimination of waste products, or accumulated toxins from chemicals, pollutants, and pesticides. These are thought to weaken the immune system, lowering resistance and making disease more likely.

Naturopathic practice is based on six principles that emphasise building health rather than fighting disease:

1. The healing power of nature (vis medicatrix naturae)

Naturopaths believe that the body has an inherent ability to establish, maintain, and restore health. The aim of naturopathy is to support this ability.

2. Identify and treat the cause (tolle causam)

Naturopaths aim to identify the underlying physical, mental-emotional, and spiritual causes of disease and to treat them rather than the symptoms, which are seen as signs of the body’s attempt to heal itself.

3. First do no harm (primum no nocere)

In naturopathy suppressing symptoms is considered harmful since they’re seen as part of the process of healing. The naturopath’s role is to support the body’s natural healing power instead.

4. Treat the whole person (in Perturbato animo sicut in corpore sani-tas esse non potest)

Naturopaths strive to treat the whole person, taking into account physical, mental, emotional, spiritual, genetic, environmental, and social factors, rather than just symptoms.

5. The physician as teacher (docere)

Alongside accurate diagnosis and treatment, naturopaths seek to educate and encourage their patients to take responsibility for their own health.

6. Prevention (principiis obsta: sero medicina curator)

The focus of naturopathy is on prevention, which is achieved by educating patients and promoting healthy lifestyle choices.

When the Hungarian Ignaz Von Peckzely was a child he caught an owl and accidentally broke one of its legs as it struggled to get free. He happened to notice that a black mark appeared in the iris (the coloured part) of the bird’s eye as this happened and that it remained even after he nursed the bird back to full health. Later, having trained to be a physician, he noticed similar marks in the irises of people with broken bones. This aroused his interest in studying the links between eye signs and disease.

A similar experience happened to the Swedish clergyman Nils Liljequist, who noticed his eye colour darkening when he was given hefty doses of drugs to treat his malaria. He later trained as a homeopath and claimed to observe similar signs in patients who were on extensive medication.

Both von Peckzely and Liljequist formulated theories about eye diagnosis in the late 19th-century

That were later developed into Iridology, The study of the iris to identify potential health problems. Pastor Felke, a German minister, took iridology further, by identifying different homeopathic remedies that he believed were indicated by different iris signs and the American chiropractor and Nature Cure practitioner, Bernard Jensen developed his own comprehensive method for iris analysis and taught it worldwide.

According to iridology different parts of the iris correspond with different parts of the body and specific signs and markings can indicate imbalance and malfunction.

Naturopaths may use iridology to identify health imbalance and early signs of disease. However no controlled trials have been done to validate iridology and orthodox medics remain sceptical about this practice.

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Naturopaths also believe that health is more than just the absence of disease and so they’re keen to promote and enhance general well-being.

Understanding how it works

By facilitating the body’s natural healing mechanism, naturopaths believe that the body’s ‘vital force’ can be strengthened and a homeostatic state of balance restored.

Naturopathic therapies such as hydrotherapy (water cure), massage, manipulation, and so on are also thought to help stimulate circulation and increase the oxygen and nutrient supply to the cells. In addition, detoxification and cleansing treatments are believed to promote more efficient function of the organs of elimination: The liver, kidneys, and intestines.

Exploring Naturopathic Diagnosis

Naturopathic practitioners diagnose using some or all the following:

U Observation: Looking at your tongue, face, skin, eyes (iridology), posture, and gait.

U Questioning: Asking about your general lifestyle and environment.

U Physical examination: The naturopath may palpate different parts of your body to check for muscle tone and tension, may test your body’s reflexes, or may test joint mobility and check posture.

U Clinical tests: The naturopath may take your blood pressure or listen to your chest with a stethoscope (an instrument used to listen to the heart and lungs).

U Laboratory testing: Blood, saliva, urine, or stool tests, may be used to investigate different aspects of your health such as your nutrient status or the presence of parasites.

U Live blood analysis: Some naturopaths use a technique called Darkfield Microscopy whereby a drop of live blood is analysed using a special microscope enabling it to be illuminated against a dark background. Users claim that this technique yields valuable information about various aspects of health including vitamin and mineral status, parasitic infestation, and predisposition to degenerative diseases. However, the technique remains highly controversial and many feel it lacks scientific validity.

U Subtle energy diagnostic methods: Some naturopaths use subtle energy testing devices to measure ‘vital force’ (for more about these devices, take a look at Chapter 22).

Finding Out about Naturopathic Treatment

Naturopaths may use various self-care recommendations and/or therapies to support what they call the Triad of Health: The structure of the body (bones, muscles, and so on); the biochemistry of the body (cellular and organ function); and psychological health (mental and emotional well-being), as well as interactions between these three.

The self-care recommendations and therapies are designed to stimulate the body’s self-healing capacity by increasing circulation, improving digestion, assimilation (the absorption of nutrients from food) and elimination (throwing off waste products via urine, stools, and sweating), boosting immunity, and building vigour and vitality.

The main therapies utilised by naturopaths are the following:

U Nutritional medicine: Dietary advice, and sometimes nutritional supplementation, is used to improve vitamin and mineral status and aid organ function.

U Fasting and detoxification regimes: Short or long, carefully supervised fasts, enemas, skin brushing, and colonics (irrigation of the large intestine with water under gentle pressure) may be used to cleanse and aid removal of accumulated waste matter and toxins, such as chemicals or other pollutants, in the body.

Fasting and restricted diets should only be carried out under supervision by an experienced practitioner. Fasting isn’t suitable during pregnancy or while still breastfeeding, or for the very young or frail. It should never be used as a method for weight loss. Colonics should only be carried out by someone properly trained in their administration and strict hygiene procedures are essential for both colonics and enemas to prevent infection.

U Hydrotherapy and Nature Cure: Water, sunlight, air, and earth may be used therapeutically to cleanse and fortify the body. Practical applications include compresses, wraps, baths, and packs.

U Herbal medicine: Medicinal herbs may be used to stimulate healing, restore body balance, and help prevent disease.

U Homeopathic medicine: Based on the principle of ‘like cures like’, homeopathic medicines are used to promote healing on physical, mental, and spiritual levels. (For more about homeopathy, take a look at Chapter 10.)

U Oriental medicine: Acupuncture and its associated therapies such as acupressure (pressure-point healing) and moxibustion (heat treatment) may be used to clear physical or energetic blockages and promote healing. (Go to Chapter 9 on Acupuncture or Chapters 4 and 7 on Chinese and Japanese medicine for more.)

U Manipulative therapy: Gentle manipulative, soft-tissue and massage techniques drawn from osteopathy or chiropractic may be used to restore structural health and physical balance. (Take a peek at Chapters 14 and 15 if you want to know more about these therapies.)

Naturopaths offering osteopathic, chiropractic, homeopathic, acupuncture, or herbal treatment should have received specialist training in these therapies to enable them to use it safely and effectively. Not all

Naturopaths are trained in every therapy. Ask about their qualifications to determine their exact skills.

U Therapeutic exercise: Breathing exercises, yoga stretches, and physical exercises may all be recommended to improve flexibility and muscle tone and enhance relaxation. Water-based exercise may also be used.

U Psychological therapy: Counselling, affirmations, imagery, prayer, meditation, or some specific psychological therapy may be incorporated to help balance mind and emotions and to enhance spiritual development. (You can find out more about these in Chapters 18 and 21.)

U Other treatments: Some naturopaths also use other therapies such as flower remedies (Chapter 22), biochemical tissue salts (Chapter 8), electrotherapy (Chapter 8), and magnet therapy (mentioned in Chapter 22).

U Minor surgery: Some naturopathic practitioners (generally in the US) may be trained to perform simple minor surgical procedures such as superficial wound repairs or dealing with cysts.

Some of the above approaches are controversial and are not accepted by orthodox medical practitioners. Read more about the scientific evidence for each in the relevant chapters.

Since many naturopaths see their role as health educators, working in partnership with you, your treatment may also consist of giving you lots of health information and encouraging you to make lifestyle changes. These recommendations are based on naturopathic self-care ideas for a healthy diet, healthy exercise, and healthy work, rest, and play (and I don’t mean Mars bars!).

Discovering Whom and What Naturopathy Is Good For

Naturopathy is suitable for anyone whether you feel well, and would like to optimise your health and prevent disease, or whether you have an ailment from which you’d like to obtain relief.

The conditions that are often treated by naturopaths include digestive problems, aches and pains, circulatory problems, menstrual problems, fertility problems, headaches, migraine, fatigue, and stress.

Most naturopaths see people of all ages and conditions and are used to dealing with both acute (recent and often pain-related) conditions and chronic (long-standing, degenerative) ones.

When not to use naturopathy

Naturopaths are trained to recognise serious medical conditions that require referral to a medical practitioner such as diabetes, tumours, other cancers, and so on. In such cases naturopathy may still be beneficial in a supporting role but diagnosis and treatment from an orthodox practitioner will be advised.

If you’re taking Western medical drugs together with naturopathic remedies, always ensure that both your orthodox and naturopathic practitioner are fully informed so that they can be alert to any potentially harmful interactions.

Evidence that it works

Some naturopathic concepts, such as that of vital force, and some of the therapies used by naturopaths, such as homeopathy, have been dismissed by modern scientists and medics as having no real foundation. However, other aspects of naturopathy are gaining increasing support from modern day research. For example, many studies now support naturopathic dietary principles and the benefits of regular exercise and stress relief techniques, and some of these have even been incorporated into orthodox medical practice.

Extensive research at the Bastyr University in Seattle, in the US has also demonstrated the effectiveness of a naturopathic approach in treating a wide range of conditions including glue ear, sinus problems, digestive disorders, headaches, chronic fatigue, and auto-immune conditions including HIV-positive-related conditions. In one study of a group of 16 HIV-positive people who received naturopathic treatment for a year, none of them went on to develop full-blown AIDS and 12 reported feeling significantly better.

For details of research evidence for the different therapies used by natur-opaths, see the relevant chapters on homeopathy, herbal medicine acupuncture, and osteopathy.

For more on naturopathic research, check out the Bastyr University Research database on Www. bastyr. edu/research/default. asp. Other naturopathy research may be found via the Cochrane Library (Www. cochrane. org/ reviews/clibintro. htm), the NHS Complementary and Alternative Medicine Specialist Library (Www. library. nhs. uk/cam), or the PubMed database (Www. nlm. nih. gov/nccam/camonpubmed. html). You can find further information on US and Canadian trials at Www. clinicaltrials. gov.

What to Expect in a Typical Consultation

First consultations with a naturopath normally last between 30 to 90 minutes. Your case history (details of your previous and current health and illness) will be taken and the naturopath will examine you using some or all the types of diagnosis described earlier in this chapter. You may be asked to go for further tests or to provide samples for them at home, such as urine or saliva tests.

The naturopath will discuss your health concerns and general well-being with you and will propose various lifestyle changes that you can implement to promote your health. These changes may cover diet, exercise, and other daily habits, and you may be asked to carry out a cleansing diet, or short fast, or to try some type of hydrotherapy (water therapy) at home. Certain types of therapy may also be suggested (this can be any from the list of therapies described in the ‘Finding Out about Naturopathic Treatment’ section earlier in this chapter).

Follow-up sessions are typically 30 minutes (depending on the type of therapy that is being provided). If you’re being given osteopathy, or acupuncture, you may be advised to have two sessions in the first week and less frequent sessions thereafter depending on your health condition.

If you’re feeling well and just want to optimise your health, you may only need to see your naturopath once or twice a year for check-ups and health advice. If, however, you have a specific health ailment that you’re hoping to relieve, or decide to undergo a particular form of therapy with your natur-opath, then you may need to make several repeat visits at regular intervals.

Knowing Whether Your Naturopathy Treatment Is Working

Remember that naturopathy is not really a form of treatment but more a way of life that may also involve having some therapy, depending on the orientation of your practitioner.

The key to getting benefit from naturopathic advice is really down to you – it depends on how committed you are to making the lifestyle changes recommended for restoring your health and maximising your health potential.

Making diet, exercise, and other lifestyle changes isn’t always easy, so you may find it helpful to approach things one step at a time, with advise and encouragement from your practitioner.

If you’re receiving some sort of naturopathic therapy such as hydrotherapy (water cure), herbal medicine, acupuncture, homeopathy, or osteopathy, then check out the chapters in this book about each of these for more tips on what to expect during treatment.

Be aware that many naturopathic therapies recognise the possibility of a healing crisis whereby symptoms may get slightly worse before they get better, due to the changes being initiated in the body. Such effects are usually short-lived but if you have any concerns about this, do discuss these with your practitioner.

Follow these pointers for safe treatment:

U If you’re carrying out any kind of cleansing diet or short fast, follow the instructions you have been given Exactly And contact your practitioner immediately if you have any concerns or unusual symptoms.

U If you experience a marked worsening of your symptoms, always contact your naturopath speedily for advice.

U Ask your naturopath what sort of health improvements you can realistically expect and over what sort of timescale.

U For best results carefully follow the exercise and lifestyle advice given to you by your naturopath.

U If you have no improvement after a course of treatment, then you may want to consider another form of therapy. Discuss doing so with your practitioner.

Common Questions about Naturopathy Treatment

Here are some questions that I’m often asked about naturopathy:

U Can anybody fast? Yes, just about everyone can benefit from a short fast such as a day on only organic vegetable and fruit juices or on a single food such as grapes. Such fasts can rest the digestive system and help to cleanse the body. However, fasts are not advised during pregnancy or while breastfeeding, or for infants, young children, or the very frail. Longer fasts require careful supervision and shouldn’t be attempted by the inexperienced.

W Are enemas and colonics uncomfortable or unsafe? If performed correctly, with the gentle introduction of water at body temperature, then both enemas and colonics needn’t be uncomfortable. Being relaxed and confident in your own ability to conduct the enema or your practitioner’s ability to give the colonic also helps. Hygiene is crucial for the safety of these procedures and colonics should only be performed by properly trained practitioners using disposable equipment. Having pro-biotics (beneficial bacteria) reintroduced to the intestine (usually orally and anally) at the end of the enema or colonic, helps ensure that your intestines are populated with plenty of friendly bacteria vital for gut health.

U Can I do hydrotherapy if I don’t like cold water? When your body is weak or you suffer from ill health, your resistance is often low and your ability to regulate body temperature is often impaired. As a result you can be quite sensitive to the cold and may find cold water immersion difficult. In such cases, starting with short exposure to tepid or slightly warm water and then gradually acclimatising your body to lower temperatures is best.

Never allow yourself to get chilled during cold water therapy, however. Simply get out of the water and warm yourself thoroughly. Remember cold water therapy isn’t suitable for the very young, elderly, or frail, nor for those with heart or kidney problems.

U What if I don’t like whole-foods? Changing your palate and dietary habits takes time. Your naturopath can advise you on how to make dietary changes slowly and how to experiment with a range of new foods to find healthy ones that you can enjoy.

U How does the naturopath know what techniques to use? Naturopaths are thoroughly trained in diagnosis, assessment, interpreting test results, and a range of therapies. Their training and clinical experience will enable them to determine which are the most appropriate lifestyle changes and/or therapies for you.

Finding a Naturopath

HBEff In countries where naturopaths are not yet regulated, such as the UK, anyone

C\ Can call themselves a naturopath so check that your practitioner has had a MM ) Thorough training at a recognised institution and is a member of a professional body.

In the UK, most naturopaths are registered with The General Council and Register of Naturopaths (GCRN; Www. naturopathy. org. uk) and are members of its professional body, The British Naturopathic Association (BNA; Www. naturopaths. org. uk) or Tel: 0870 745 6984. Both the GCRN and BNA Web sites have online directories of registered naturopaths.

The GCRN, set up in 1965, sets standards for naturopathy training, keeps a register of practitioners that meet its standards, and monitors members’ professional conduct. GCRN-accredited naturopathy courses are currently three years of full-time study, including 500 to 560 hours of teaching and more than 400 hours of clinical training.

The British College of Osteopathic Medicine (formerly the British College of Naturopathy and Osteopathy) (Tel: 0207 435 6464; Www. bcom. ac. uk) and Westminster University (Tel: 020 7911 5000 or 0207 911 5041; Www. wmin. ac. uk) both run courses accredited by the GCRN and offer supervised student clinics where you can have low-cost naturopathy consultations.

The College of Naturopathic Medicine (CNM) (Www. naturopathy-uk. com) also trains naturopaths in the UK. However, at the time of writing, their natur-opathy course is not accredited with the GCRN. They maintain their own register of practitioners, The Association of Naturopathic Practitioners, on

Www. naturopathy-anp. com.

In the US and Canada, naturopaths can be located via The American Association of Naturopathic Physicians (AANP) (Tel: 00 1 206 298 0125; Www. naturopathic. org) or the Canadian Association of Naturopathic Doctors (Tel: 00 1416 496 8633; Www. naturopathicassoc. ca).

If you live in Australia, you can locate naturopaths via the Australian Naturo-pathic Practitioners Association (ANPA) (Tel: +613 9811 9990; Www. anpa. Asn. au) and in New Zealand via Www. naturopath. org. nz.

India has no single body for naturopaths. Practitioners are recognised for their qualifications, which are generally either a Diploma in Naturopathy and Yogic Sciences (DNYS), awarded by the All India Naturopathy Council after a three-year course of study, or a Bachelor’s Degree in Naturopathy and Yogic Science (BNYS) obtained after four or five years of university study. The following are some other suggestions for finding a naturopath:

U Ask friends, family, and colleagues for personal recommendations.

U Some sports and leisure clubs offer naturopathic treatment.

U Many integrated health centres and health spas offer naturopathy.

Questions to ask your naturopath

U Qualifications: Most practitioners are happy to give details of their training and qualifications. If you have any doubt as to the validity of these qualifications, check them with the respective professional body.

You may want to ask your naturopath about the following:

U Insurance: If your practitioner is a member of a professional register they will be required to have appropriate indemnity insurance.

U Experience: Ask your practitioner about their experience in educating about naturopathic principles and in treating your particular health condition.

U Treatment: If you’ve been recommended naturopathic therapy, ask about the likely frequency and duration of treatment and the costs.

Counting the cost of naturopathy

Initial naturopathy consultations may cost from Ј35 to Ј65 while follow-up sessions are usually Ј25 to Ј35.

Naturopathic treatment is rarely available on the NHS in the UK. Some private health insurances cover naturopathy treatment. Check with your provider for advice. Practitioners may offer concessions for retired persons or those on benefits. Ask for details.

Ensuring satisfaction

If you’re dissatisfied with your treatment, first talk things over with your practitioner.

If you think that the practitioner has been negligent or unethical in any way, contact their professional association or registering body, which should have a formal complaints procedure.

Helping Yourself with Naturopathy

Skin brushing has been recommended by Nature Cure practitioners and naturopaths for more than 150 years as an excellent way of stimulating circulation and aiding skin cell renewal and body cleansing. Try the technique like this:

1. Buy a natural bristle brush, preferably one with a long handle so that you can reach your back.

2. Strip naked in a warm and draught-free place. On Dry Skin, move the brush in small sweeps, or small circular movements, starting at the feet and going upwards toward the heart. Brush towards the heart from the extremities inwards.

3. Use gentle pressure. The brushing should be vigorous and stimulating but not painful!

4. Use very light strokes around the breasts and avoid the breast tissue and nipples. Do not use on the face or near the eyes.

5. Brush the whole body until your skin feels warm and tingling.

6. Take a warm shower and end with a cool rinse. Also wash your brush and leave to dry out.

7. Repeat this skin brushing every morning if you can, to thoroughly invigorate your body. Don’t use this technique at night because it may leave you too awake.

Part IV

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► Considering corporate massage

► Sitting down to a massage chair

► Going through the chair routine

• •••••••••••

# # # # •

Gliess which of the following touch-gurus wrote these words: "Touch is a very powerful message. It is very honest. People know immediately when you touch them if you care about them,"

A. Brian Weiss, psychiatrist and author of Many Live, Many Masters.

B. Deepak Chopra, proponent of Ayurveda, the ancient healing science of India, and author of books such as Quantum Healing.

C. Ram Dass, modern mystic and author of such classics as Be Here Now.

D. Ken Blanchard, corporate consultant and author of the business bestseller, The One Minute Manager.

Strangely enough, the answer is D, and Blanchard is basically talking about a pat on the back, not a massage. But his statement does point out the great need for people in the work environment to use the right kind of touch with each other.

Appropriate, stress-relieving touch in the workplace is so important that an entirely new category of massage has been invented in the past several years to specifically address this issue. This category is called Corporate massage, And it has become quite popular in offices and workplaces around the world. With corporate massage, a professional massage therapist comes to your office with a specially designed chair that you sit on to receive a massage with your clothes still on. This saves time and makes the whole massage procedure easy, safe, and acceptable.

YouVe probably heard more than you want to about sexual harassment, abuse of power, and ruined careers, but the wrong kind of touch in the workplace can get you in a lot of trouble. Corporate massage, however, can help fulfill your Touch quotient (your natural need for touch) while in an environment that otherwise stifles much healthy contact.

Corporate Massage

Your first reaction to the thought of massage at work may be less than positive for several reasons. As you contemplate the idea, you may come up with some of the following:

W Can I really handle the thought of my co-workers lining up to get undressed and rubbed with almond oil in the employee lounge?

What will my (wife/husband/girlfriend/boyfriend, and so on) say?

W Won’t the boss think that this kind of massage is a waste of time? Or, if you’re the boss: Won’t my employees take advantage of this and turn the office into a massage parlor?

Will I be in an awkward position on a table or chair and look stupid while receiving a massage at work?

How much will the massage cost?

Will it mess up my hair?

These concerns are all rational, and this section is meant to set you straight on what corporate massage really is so that you’ll run straight out to contact your nearest practitioner and at least give it a try.

What does corporate massage look like, anyway? Well, imagine this scenario: It’s late on a Friday afternoon. Your whole department has been under intense pressure to wrap up that humongous project you’ve been working on for months. Nerves are frayed. Happy hour is looming. No one can think about anything but escape. Then right at four o’clock, in walks a healthy-looking individual toting a strange, padded, chair-like contraption that he proceeds to unfold over in one corner. This is the "corporate massage" that your boss promised.

One brave soul offers to go first, and the rest of you watch while he sits down — fully clothed — on the device, which seems to support all of his weight easily at the knees, elbows, chest, and head. As he leans forward and relaxes, you can feel the pressure on your own limbs start to dissipate, too. The massage therapist begins with some strong kneading of the shoulders and upper back.

"Ahh, this is great!" roars your co-worker through the circular face rest. Quietly, but quickly, people start to drift over to that side of the room, and soon a line begins to form. One after another, everyone is treated to ten minutes of much-needed relief, and a funny thing starts to happen. Happy hour is no longer calling so urgently. As you stand around chatting with newly relaxed colleagues, the ideas begin to flow again, and you end up staying till after 7 p. m., coming up with a few great new concepts that will make this project even better.

Yes, scenarios like this one can actually occur. Massage in the workplace has many such benefits, including the following:

Increases employee morale

Lowers stress

Decreases overuse injuries i> Provides some high-touch to counterbalance high-tech environments ^ Offers employees something new and different

The benefits of this type of massage quickly outweigh the concerns I mention at the beginning of this section:

J** Nobody has to undress, and if they really don’t want their hair messed up, they just have ask the massage therapist not to massage their head.

The massage is usually given in a public space and is very conservative.

The boss realizes that happy employees are productive employees.

Employees who receive this extra benefit are more likely to feel grateful and be more responsible.

So you’re left with one last issue — who pays for all this? Normally, payment is handled in one of three ways:

The company pays: This scenario, which is the most common, allows employees to forget about whether or not they can afford the massage, and it makes the boss look great.

^ Everyone contributes to a pool: This scenario is less common, but some companies still choose it. Pulling those few dollars out of your pocket may hurt at first, but what you receive is better for you than the typical office-pool birthday cakes.

Everyone pays separately: This scenario is the least common. Though it may prove quite popular, paying separately often leaves people feeling a little at loose ends. Should they pay? Should they not pay?

No matter what the scenario, the massage therapists often appreciate tips, unless everyone is aware that a service charge has been added up front.

Either way, the massage more than pays for itself almost immediately. A massage pro brought in once a week or once a month can truly upgrade the total work experience of everyone involved.

In addition to chair massage, many corporations now offer full body massage through their wellness programs, employee fitness programs, and so on. My advice? Take advantage of this benefit immediately.

Call a local corporate massage provider and ask him to come in for a free "demo-day." With the prospect of potentially gaining a new, ongoing client, he’ll probably be eager for the opportunity to prove how good he is with no investment on your part. This approach is also a way to convince your boss that the expense involved is worth the improved morale and productivity. This situation is win-win-win: The massage provider wins new business. Your boss wins happier workers. And you win as the hero who introduced this great new idea to your co-workers.

Massage Chairs

Massage in the workplace goes by various names, including corporate massage, on-site massage, and chair massage. But regardless of what you call it, this type of massage is guaranteed to involve the use of a specially constructed device known as the Massage chair (see Figure 12-1).

Massage chairs were originally developed in the U. S. by a man named David Palmer who wanted an easy way to massage his clients on the job at the Apple Computer company. Now, several models are available from a number of suppliers. The basic idea is that people can lean forward into the device, taking a load off their hips and legs and thereby position themselves perfectly to receive a back, neck, and shoulder massage. Getting into one of these things is more like lying down than sitting in a chair. Try it sometime; you’ll be amazed at how supported and relaxed you feel.

Although they may look slightly intimidating at first, massage chairs are actually quite easy to get into and out of. Here’s how they work:

1. Place your knees against the pads and lean your chest forward onto the support; then wrap your hands around front and place your arms on the arm rest.

The chair will be adjusted for you so that the face rest is the correct height; simply lean forward into it and feel your weight shift and become distributed evenly throughout your body.

If you’re wearing a dress, you can still get on. Just swivel your legs in modestly from the side.

Figure 12-1:

The massage chair, a strange-looking but comfortable piece of equipment.

(This one was custom made for the authors by Golden Ratio Woodworks.)

2. Make sure that the face rest is covered with a tissue or towel, for sanitary reasons.

Wipe the surfaces down after each treatment to prevent body oils from building up on the material.

3. Let the chair take your weight and the massage therapist do the rest.

Don’t try to support yourself in any way during the massage. Just relax and enjoy!

Make a little vow to yourself right here — the next time you spy one of these strange contraptions somewhere with a massage therapist standing by ready to work, take the plunge and jump aboard. You can find them in malls, at airports, in special storefronts like The Stress Station, and even on street corners. See what happens!

Of course, not everyone has access to chair massage. Perhaps you live in a small town where no one has ever heard of this concept before. Maybe you work at a place where people would look at you like you’re insane for suggesting that you pay somebody for the privilege of sitting in such a strange contraption.

Taking the chair on the road

Offices aren’t the only place where massage chairs are put to good use. You also see them in the front lines at athletic events and disaster sites, among others.

For example, after Hurricane Andrew struck in south Florida, I and a crew of other massage

Therapists headed to the epicenter with our trusty massage chairs to provide neck, shoulder, and back relief for weary soldiers and Red Cross volunteers.

If you don’t have a specially made massage chair around, you can use a normal chair to receive many of the same benefits. As shown in Figure 12-2, simply turn the chair around and sit in it backwards. Then lean forward onto a pillow while your partner works on you. The techniques pictured in this chapter are done in a professional massage chair, but you can recreate them easily at home by using this setup.

The Chair Routine

Following is a simplified version of the chair massage routine that people learn in classes and workshops. You can follow it exactly or feel free to concentrate on the areas where your partner needs the most work.

You don’t need any oil or cream to do this type of massage, and your partner definitely doesn’t have to take his or her shirt off. Also, creating an ideal "inner chamber" (as described in Chapter 9) for this experience isn’t so important either. Think of chair massage as a rough-and-ready kind of experience that you can enjoy anywhere, anytime, no matter how many distractions surround you.

The photographs in this chapter show some basic maneuvers. You’re free to develop your own style based on the moves I show you in Chapter 10.

Shoulders and upper back

The shoulders — where almost everyone holds a good amount of tension — are best part of the body to begin a chair massage. After your partner is comfortably seated, start with some kneading in that area (see Figure 12-3).

IiHii^pii

Figure 12-3:

The chair offers a perfect angle from which to work the shoulders using hands, forearms, and elbows.

1. Grasp the tops of both shoulders firmly, with your thumbs in back and fingers in front, and then begin kneading.

Your kneading can be relatively firm. For variety, switch both hands to one shoulder and then the other, but return to both-shoulder kneading at the end.

2. With your palms facing down, press the meaty underside of your forearms directly down on top of your partner’s shoulders.

For a more intense sensation, turn your hands palm up and press the forearm bones into the shoulder.

3. For the ultimate in pressure, bend your arm and use the point of your elbow as a finely honed instrument to zero in on tight spots atop the shoulders.

Use the fingers of your other hand to guide the elbow precisely into place, and then ease slowly into pressing because this move is very intense.

4. Stepping back a couple feet, Lean Into your partner’s back, supporting yourself with your thumbs against the ridge of muscles on either side of the spine.

Lean back, slide down, and press again, hitting several points down along the spine to mid-back.

5. With your elbow on the muscles alongside the spine, hit roughly the same points that you did with your thumbs.

Be careful not to press directly against the spine with your elbows as this could be quite painful.

Arms

When a person is seated in a massage chair, her arms are easily accessible. Support the entire weight of the arm in your hands while you’re working on it so your partner doesn’t have to help you.

1. Squatting or bending at your partner’s side (see Figure 12-4), use both hands to encircle the arm, starting at the top near the shoulder, and then squeeze.

Release the squeeze, move down a couple inches, and squeeze again, repeating this process all the way to the wrist. If you want to add something to this move, try pressing with your thumbs as you’re releasing pressure with your palms.

2. Follow the hand massage routine from Chapter 11.

Don’t languish there too long in a squatting or bending position or you’ll end up with a sore back yourself.

3. Standing up and stepping back a bit, grasp your partner’s arm at the wrist and elbow then apply a little gentle shaking.

Afterwards, gently bring the arm back around to the front and lay it down again.

4. Repeat the process on the other arm.

Figure 12-4:

You massage the arms from a squatting position either in front of the chair or to the side.

Lower back

The lower back is the hardest part to get to during a chair massage because it’s so low. You can kneel if you want to, or squat, to make these moves more comfortable on yourself.

1. When you finish the arms, brush lightly down the back to the lumbar area, get into a squatting or bending position again, and apply some firm pinpoint pressure (as described in Chapter 10) with the thumbs into the muscles on either side of the spine (see Figure 12-5).

Be careful not to press too firmly in the kidney area. (See Chapter 10 for the reasons.)

2. Press in firmly with the heel of your hands against the upper portion of your partner’s buttocks, and then make rapid circles with the right hand going clockwise and the left counterclockwise (see Figure 12-6).

First made famous in the movie, The Karate Kid, This move incorporates a little coordination on your part, along with some good old-fashioned rubbing, I know, it’s complicated, but you can do it!

Neck

As you can see in Figure 12-7, the neck is in the perfect exposed position for you to work on it to your heart’s content.

1. Standing slightly to the side, use the thumb and fingers of one hand to knead up and down the back of the neck.

You can switch back and forth from side to side and hand to hand.

2. Starting at the base of the skull, press in with your thumb on the muscles to one side of the spine.

"Walk" your thumb down that muscle to the top of the shoulder, pressing in at half-inch intervals as you go. Repeat this maneuver two more times, each time slightly further away from the spine.

MmmmmmmmBmmm

Figure 12-6:

Pressing with the heels of the palms, move the left hand counterclockwise and the right hand clockwise.

3. With your thumb on one side of the spine and your fingers on the other, make small firm circles on the base of the skull where it attaches to the neck.

Head

You can modify the three steps in this section in many different ways, depending on your intentions and the situation you find yourself in. If you’re giving seated massage to someone who’s going out on a date ten minutes later, for example, don’t mess her hair up too much because she wants to look neat when she stands up from the chair.

1. Plant your fingertips firmly on your partner’s scalp and make small circles, moving the tissue below but not sliding over the hair (see Figure 12-8).

Repeat in several spots. Before you start, ask your partner whether he minds having his hair messed up a bit.

2. Reaching your fingers forward on both sides of the head, find the temples (which are partially covered by the face rest in a professional massage chair) and press in for 5 To 10 Seconds.

This move is great for people with minor headaches.

3. Use your fingertips and thumbs to apply mini-kneading all over the outside rims of the ears, pulling gently up on the tops and down on the lobes.

Finish

Chair massage is usually an invigorating experience, and people often have to get back to work or another activity soon afterwards. Tapping over the entire back with moderately firm pressure of the fists or open hands is a great way to finish the experience and send them off into the world again.

Chapter 13