(Painting reproduced by kind permission of artist Nancy Neaher Maas)
How do you respond when a client has an 'adverse' reaction to an aquatic bodywork session?
Here is an example from my records of 5 years ago now. The extracts are from email correspondence with a woman I will call Moira (not her real name) in her 50s who opted for a series of 5 weekly aquatic sessions. This feedback came after the 4th session.
In her younger years, Moira was a professional dancer but at this time was doing computer work. I came to know her as a good friend and someone of extremely high integrity, courage, and self-awareness.
She also carried a burden of deep sorrow regards the state of the environment, especially of water. A couple of years after the sessions we shared, my friend ended her life apparently suddenly and without warning.
Reviewing this correspondence has further inspired me to commit my healing work to the inclusion of all aspects of our human experience. In my practice, I've found aquatic bodywork to be effective on all levels - physical, emotional, and spiritual.
Acknowledging this and developing skills to guide those who are dramatically affected by the work in safe and supportive ways, is important. Collaboration with complementary and compatible professionals as a team or by referral may also be a great help.
You'll read that Moira inadvertently benefited from adjunct work (orthobionomy) and that she found land movement (yoga) - which I offered alongside the aquatic sessions - to be valuable. What works will vary from person to person, and it is important to be guided by their experience.
Orthobionomy is a land-based method that developed out of osteopathy. It uses subtle positional release, following the body rather than pushing it through a predefined routine. Similar explorations can be done effectively in water where joints are supported yet relatively unrestricted. It is especially effective in working with symptoms from chronic stress, and pains or problems associated with postural and structural imbalances.
Moira was hyperflexible and it is possible that this led me to move her through more elaborate patterns in the water than was right for her. As a yoga teacher, I have learned to be wary of encouraging those who are naturally flexible into poses they cannot also support with strength. In the water it is tempting to overlook this, or just not notice it because of the supportive medium.
Important in any bodywork is to move slowly - giving time for both giver and receiver to feel what is happening and to sense where the body itself wants to go when a movement or position is 'suggested' to it. Allowing time to integrate these shifts in alignment is also essential.Immersion in warm water can effectively dampen sensations of pain both by relaxing the muscles and soothing a reactive nervous system. On the surface this is a good thing but it might also mask signals that would otherwise warn of overstretching. Pain and its signals are complex and often mysterious.
As I was putting this post together I met Loolwa Khazzoom online after reading her article in AARP magazine 'Drug-free remedies for chronic pain'. Loolwa has used dance to help her recover from a head-on collision that left her hurting badly. I anticipate I'll learn a lot from her.
On her website Dancing with Pain, Loolwa writes:
While there has been a growing body of research on pain medication and management — offering both pharmaceutical and natural pain relief – few health professionals are equipped to offer comprehensive guidance through the maze of Eastern and Western resources now available to those who suffer from chronic pain. In addition, few health professionals have been trained to listen adequately and respond appropriately to the needs of those in chronic pain – leading to an unintentional exacerbation of their problems.
I don't want to be one of those helping people who fail to listen and respond.
The resting position I suggested for Moira in recovery is one that I have written about in a previous series on working with psoas-related trauma - constructive rest position. Liz Koch recommends this for any practice of yoga, dance or other exercise form. I find it a very helpful and simple thing to share with everyone. It can be more effective and comfortable than yoga's svasana (corpse pose).
I hope this post will also show that there cannot ever be a one-size-fits-all program. I suggest that as practitioners we need to be willing and able to be truly present to the person we float in our arms, without judgment or assumption, especially regards their more challenging experiences.
It is an ongoing learning process and one that we share mutually with our 'clients'. I welcome your comment on this example. I would also be glad to hear of challenges you have faced in your own practice, and to offer support where I can.
Moira's feedback:
Aquatic bodywork has returned me to an intense awareness of my body that I have not had for years. That awareness is continuing and changing as I discover new layers, and I adapt every day. After the last session (after, not during), I experienced a lot of physical pain in my hips, shoulders and neck. The pain was so intense that I could not sit in a chair for more than a few minutes at a time, and since my work involves sitting in a chair (unfortunately), I couldn't get much done. I don't know the "reasons" for this, other than perhaps the sessions facilitated a breakthrough to a whole new layer of body tension that I was not aware of before. This is all positive, except that I can't take being in pain...
Anyway, I went to a spring retreat for the weekend and my friend who does orthobionomy was there. I had two sessions with her and I'm now pain free. I don't know whether I would have 'worked through' the pain on my own or what, but at this point I am truly fearful about getting another aquatic bodywork session, and I'm not generally a fearful person! What do you think? I'm sure this isn't unusual and you must have had other clients who've experienced this.
Btw, I am changing the way I work, I do not sit in front of the computer for hours at a time, I get up and move around much more, and this is great! I have already changed the chair I'm using. In fact I'm going to redo my entire workspace. Looking forward to that!
Anyway, I went to a spring retreat for the weekend and my friend who does orthobionomy was there. I had two sessions with her and I'm now pain free. I don't know whether I would have 'worked through' the pain on my own or what, but at this point I am truly fearful about getting another aquatic bodywork session, and I'm not generally a fearful person! What do you think? I'm sure this isn't unusual and you must have had other clients who've experienced this.
Btw, I am changing the way I work, I do not sit in front of the computer for hours at a time, I get up and move around much more, and this is great! I have already changed the chair I'm using. In fact I'm going to redo my entire workspace. Looking forward to that!
Sulis responds:
I am glad you let me know about this and I am so sorry that the pain affected your work. There are two factors to consider - physical and emotional. They may both apply, and in any case the physical precautions mentioned below should be taken for any further sessions.
1. In this session we achieved a further degree of freedom of movement and relaxation of musculature (in all sessions you have show remarkable flexibility). This could have moved you on a little faster than your structure could integrate, resulting in some instability in later land movement that caused you pain. I remember you talking about strong physical pain experienced in the past - was this anything like that? In other words, we may have inadvertently revealed an 'old weak link'.
This indicates that despite your great capacity for movement, it is advisable to err on the side of caution in following this to its extremes. This can be done in future sessions and should avoid any recurrence of the pain - if this is its cause.
2. You mentioned that during this session you also experienced some sadness which you ascribed more to world issues than to your own life. Deeply hidden emotions do not often come to the surface easily or willingly. In fact, sometimes the body-mind manifests strong pain in order to avoid their surfacing. This pain/ fear combination presents the body-mind with an 'excuse' to discontinue the process that might reveal something it has chosen to suppress. It's an unconscious process and not a reflection on your courageousness or otherwise.
If this is the case, it indicates that you have a choice to make regards your willingness to work with a possible emotional issue in this way. You may consider combining ongoing sessions with some form of adjunct therapy or psychotherapy.
I have found that if a person does not wish to work with a deep issue, they and the practitioner can 'decide' to keep the session on a purely physical therapeutic level. However, I cannot guarantee this since the body-mind has its very own ways of working its ends out.
Of course, your decision regards the next session will be the right one for you. My thought is that since you are no longer in pain (yes?), you could come and we would work in a way that should not risk any destabilization of your physical structure. You can, and only if you wish, use this opportunity to examine the internal process that may have been associated with the sadness you talked of.
After the session, I recommend that you lie on a flat surface, knees bent, for at least 10 minutes in order to give your body a chance to realign and stabilize itself. And, I will also honor a decision on your part not to come, or to delay.
I hope that the above helps - please do phone or email me as soon as you have had time to think about it. Once again, I am sorry you have had this rough 'wave' in the flow of the series of aquatic bodywork sessions.
1. In this session we achieved a further degree of freedom of movement and relaxation of musculature (in all sessions you have show remarkable flexibility). This could have moved you on a little faster than your structure could integrate, resulting in some instability in later land movement that caused you pain. I remember you talking about strong physical pain experienced in the past - was this anything like that? In other words, we may have inadvertently revealed an 'old weak link'.
This indicates that despite your great capacity for movement, it is advisable to err on the side of caution in following this to its extremes. This can be done in future sessions and should avoid any recurrence of the pain - if this is its cause.
2. You mentioned that during this session you also experienced some sadness which you ascribed more to world issues than to your own life. Deeply hidden emotions do not often come to the surface easily or willingly. In fact, sometimes the body-mind manifests strong pain in order to avoid their surfacing. This pain/ fear combination presents the body-mind with an 'excuse' to discontinue the process that might reveal something it has chosen to suppress. It's an unconscious process and not a reflection on your courageousness or otherwise.
If this is the case, it indicates that you have a choice to make regards your willingness to work with a possible emotional issue in this way. You may consider combining ongoing sessions with some form of adjunct therapy or psychotherapy.
I have found that if a person does not wish to work with a deep issue, they and the practitioner can 'decide' to keep the session on a purely physical therapeutic level. However, I cannot guarantee this since the body-mind has its very own ways of working its ends out.
Of course, your decision regards the next session will be the right one for you. My thought is that since you are no longer in pain (yes?), you could come and we would work in a way that should not risk any destabilization of your physical structure. You can, and only if you wish, use this opportunity to examine the internal process that may have been associated with the sadness you talked of.
After the session, I recommend that you lie on a flat surface, knees bent, for at least 10 minutes in order to give your body a chance to realign and stabilize itself. And, I will also honor a decision on your part not to come, or to delay.
I hope that the above helps - please do phone or email me as soon as you have had time to think about it. Once again, I am sorry you have had this rough 'wave' in the flow of the series of aquatic bodywork sessions.
Moira responds:
Thanks so much for your response. Very validating. I'm much less fearful now.
About that emotional stuff. I don't separate the physical, emotional and spiritual realms. That's why I don't do 'fitness workouts' and why I love yoga and dance. I wouldn't know how to keep a session on just a physical level only. I've been exploring that tremendous feeling of sadness, without trying to analyze it. I've been doing some crying, in fact I was crying when I wrote to you yesterday, as well as yelling, laughing, journaling, etc. I've come to realize that I'm very 'homesick' - that's the word that comes up. It's very personal and also connected with what's happening to the earth, it's about nurturing and the lack of, both in my own life and the body of the earth. This is important and I'm glad it's coming up. I can work with emotional stuff easier than physical pain any day. I'm just a wuss when it comes that.
I would still like to come back tomorrow. I will definitely take your advice about lying down on a flat surface afterwards for a while. I'm willing to go wherever this journey takes me, and perhaps it was just 'too much too fast'...??? Overall, I must say, the aquatic bodywork has given me back my dancer's body, my intuitive body. And for that I am so grateful!
About that emotional stuff. I don't separate the physical, emotional and spiritual realms. That's why I don't do 'fitness workouts' and why I love yoga and dance. I wouldn't know how to keep a session on just a physical level only. I've been exploring that tremendous feeling of sadness, without trying to analyze it. I've been doing some crying, in fact I was crying when I wrote to you yesterday, as well as yelling, laughing, journaling, etc. I've come to realize that I'm very 'homesick' - that's the word that comes up. It's very personal and also connected with what's happening to the earth, it's about nurturing and the lack of, both in my own life and the body of the earth. This is important and I'm glad it's coming up. I can work with emotional stuff easier than physical pain any day. I'm just a wuss when it comes that.
I would still like to come back tomorrow. I will definitely take your advice about lying down on a flat surface afterwards for a while. I'm willing to go wherever this journey takes me, and perhaps it was just 'too much too fast'...??? Overall, I must say, the aquatic bodywork has given me back my dancer's body, my intuitive body. And for that I am so grateful!
And in a follow-up to the fifth session:
Thanks for checking in with me! All is good, a bit of soreness but nothing out of the ordinary. I'm finding I can stretch through any achy places. And I really like the lying on the floor, knees bent, exercise. It really helps! Have been doing yoga also. The whole series was really extraordinary and life-changing for me. I recommend it to anybody who is self-aware and wants to explore bodywork in another dimension.
Next month, while in Chicago to present at the ATRI conference, I shall also be attending a workshop on the importance of the Body in Sacred Activism with Andrew Harvey. I will be writing more about both these events afterwards.
Meanwhile, in memory of Moira, I'd like to end this post with an extract from the foreword to Carolyn Baker's book Sacred Demise: Walking The Spiritual Path of Industrial Civilization's Collapse, written by Sarah Anne Edwards, since it takes water as a strong metaphor:
[F]ew of us are prepared mentally or spiritually for the onslaught of feelings, the tide of emotions, the rush of the unexpected that is engulfing us. After all, the world that anchors our daily lives now is collapsing right along with the dam upon which our current way of life in built. We don't know if we'll make it to the bottom of the spillway as the dam cracks and breaks away. Assuredly some of us won't. Even if we do, there is no guaranteed, made-to-order world awaiting us on the river once it has burst forth from the dam. For sure there will be no welcoming "comfort inns" along the shore. We're uncertain what the unleashed river of our life will look like or if we will have the knowledge, skills, and acumen to survive in it. But life, death, mystery, uncertainty, paradox, and danger are all part of the natural world we inhabit.
As practitioners of aquatic bodywork, perhaps we can restore and instill a sense of safety in the fluid process of life, while still acknowledging all the above.
See also Avoiding hot water - good practice for non-clinical practitioners of water therapy
