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Does Therapy Have to Hurt?

This is not  new question. It raises its hoary head every generation or so. There was a big rift in the Rolf community a number of years back, when Rolfing practitioners split down the middle, complete with trademark changes, based on the answer to the question, “Does it need to hurt to be true Rolfing?” Or, “can a ‘kinder, gentler’ version of the work really get the job done?”

I don’t depend on either technique exclusively enough to take a stand one way or the other. But I have known enough of Ida Rolf’s students to have heard an interesting story repeated. The story goes that Ida Rolf’s own work was not as heavy or painful as that of a number  of her students. Ms Rolf was a brilliant theorist, writer and  therapist, but sometimes had problems verbally communicating in English with her students. She could see when somebody wasn’t  ‘connecting’ accurately or sufficiently  with a client’s body, but she couldn’t quite articulate what the problem was. In desperation she might  say, “Try pressing harder.” Though not ideal, it would often accomplish that [at least] crude degree of connection such that they could continue with a successful session

So, over time, many of the students got progressively heavier and heavier with their pressure. And the popular cliche of how much Rolfing  hurts, continued to attract some clients, and terrify others into keeping their distance

Rolfing aside (or perhaps partly because of it) we live in an era of “No Pain / No Gain.” Employment ads for massage therapists, generally prequalify applicants by asking, “Are you willing and able to do several consecutive, 90 – 110 minute deep-tissue sessions?” Meaning, massage work bordering on the most intense level of stimulation the client is able to withstand. It screens out applicants who prefer to use kindlier, more soothing pressure, pacing, etc. What some performance / results-driven therapists refer to as “Relaxation Massage,” and others sneer, “Finger Painting.”

When I was younger and more driven to impress, I prided myself on how much pain I could inflict during a session — and never against the client’s wishes.

“Can’t you go deeper?” they would ask. “I can take it.” they assured me. “I know what my body needs.” And so on. Meanwhile every sinew in their body was somewhere between trembling and clenched; quiet groans of pain; breathing between ragged and Lamaze. I became convinced that respectful cooperation between therapist and subject was not the order of the day. These people wanted to be broken and reshaped — and then left to recover their strength and dignity for the next time — which would likely be just as intense.

The lasting image I had of the encounter was that it was not about healing therapy, but about penance. As if to say, “whatever I’ve done to deserve [and I do] this deplorable state of health can only be relieved in return for receiving a fitting punishment. Sounds like a joke, but no longer a funny one. If our goal is the maximization of pain, then will any amount ever be enough?

Actually, there’s some bio-chemistry to the scenario of penance / punishment. And it’s a lot more prosaic than a metaphor. When a person allows this degree of pain to be inflicted (or self-inflicted by over-training, running, lifting, etc, the sympathetic nervous system unleashes a torrent of endorphins. These are a morphine-like substance designed to permit action (moving through physical injury; fighting; escaping, etc.) in emergency situations when it would otherwise be impossible. What is produced in the short run is a euphoric, pleasurable sensation — also similar to sexual release. Also, as with morphine, it’s quite addictive. You voluntarily put up with barely controlled intensity of pain for the high it brings. And you don’t forget to ask for it again next time. 

I’m not saying that this is a bad thing. We have every right to play with our tolerances, and some lasting good can come from it, in combination with other approaches. But I won’t  be saddled with pushing this extreme with any  client on a continuous, ongoing basis. I have learned through martial arts training how to inflict a sustained amount of pain without physically harming myself, but the psychic wounds are more persistent. It’s just not a relationship I care to cultivate.

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