Comfort Touch

My friend and colleague Mary Ann Foster, also a massage therapist, relayed this story to me:

“During a massage, a new client started to sink into a deep state of relaxation. Her breathing slowed down, her muscles softened, then all of sudden she jumped up and said, ‘I’m sorry.  I should be paying more attention. I could kind of hear the music and feel your hands, but I think I was falling sleep.’”

Maryann assured her there was no need for concern. “Falling to sleep is really okay. Just let your body sink into that state because it’s a very healing place to go.”

When a client enters the state between waking and sleeping, it indicates that she or he is generating theta brain waves. And those are the waves of relaxation. Understanding the significance of brain waves is valuable knowledge for bodyworkers. The brain emits small oscillating voltages that can be detected by an electroencephalograph (EEG) machine. Researchers have identified four different types of brain wave patterns—beta, alpha, theta, and delta. Each one is measured by wave cycles per second and each is associated with a specific state of consciousness. Beta waves are the fastest frequency, ranging from 14 to 38 cycles per seconds. They are produced during active thinking and can be recognized by several cues: a furrowed brow, eyes flitting around under the lids, questions or chattiness, jaw tension and bruxism, and most obvious—overall body tension.

Clients who are seeking relief from the stresses of life often arrive for their sessions in a beta state, and massage therapy can assist them into the slower wave states. Alpha runs about 8 to 13 cycles per second, creating a relaxed, alert feeling. As a person sinks from alpha into deeper relaxation, theta waves occur at 4 to 7 cycles per second. A classic sign of theta occurs when a client feels your touch and hears the music, but from a faraway, altered state of consciousness. Theta induces deep psychological relaxation as well as physiological regeneration. Touch is usually just enough outer stimulation to keep a client in theta from actually falling asleep, where the slowest waves of delta occur.

How can a bodywork practitioner encourage alpha and theta waves during massage to allow the client to reap the benefits of deep relaxation in the nervous system? We cultivate brain wave skills by developing our own sense of these waves through meditative or self awareness practices. We embody these skills in order to induce the deep trust required to facilitate slower brain wave states in our clients. Our challenge is to maintain a quiet, attentive state as we work. We keep the client warm and comfortably covered; work slowly with consistent pacing and pressure; and respond appropriately to any verbal and nonverbal feedback from the client.

Clients love these altered states and sometimes ask how to “keep” them. I suggest to my clients, “Imagine this feeling in your body anytime you wish to recreate this experience.”

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

Last month I talked about special considerations in offering Comfort Touch to infants and children. I want to continue on that theme a bit to talk about offering touch to children who are ill or have special needs.

Illness presents a special opportunity to offer the benefits of Comfort Touch to an infant or child. Often even parents are afraid to touch a child who is not feeling well. Remember that the intention to comfort is reassuring to the child, creating a feeling of safety, which facilitates healing. If a child is in acute distress, broad contact pressure and specific contact circling along the spine are especially helpful. The child may be in the side-lying position. Broad contact pressure on the sacrum is especially calming and grounding for the child.

The techniques of Comfort Touch are also easy to adapt for the child with special needs, e.g., a child who is in a wheelchair or has difficulty communicating. Therapists report success with autistic children and children with attention deficit hyperactivity disorder. The slow rhythm and the broad compression of Comfort Touch contribute to its effectiveness for these children.

Because I work extensively with people with diabetes, I am often asked about the value of massage for this population. Recently, a massage therapist asked for some advice about massage to child with Type 1 (insulin dependent) diabetes. Here is what I told her:

“I’m glad to hear you will be offering massage for your friend’s child. Diabetes is a very stressful disease, especially in the early stages as one gets used to a new routine, and learns to adapt. When offering touch, keep in mind the principles of Comfort Touch: Slow (slow down yourself, and feel connection to the ground), Comforting (intention is to comfort; don’t try to “fix” or change); Respectful (attitude of respect empowers the client); Into center (use direct pressure, perpendicular to the skin, rather than gliding or knead. This is more comforting and calming to the nervous system); Broad & Encompassing (use full hand, broad, encompassing contact. This is also most soothing and calming).

“Most often Comfort Touch is done with the client fully clothed, and no lotions or oils are used. With children, I recommend keeping the time fairly short to begin with (10-20 minutes) and see how they respond. Most children get the benefit of touch in a much shorter time than adults, because their nervous systems are less complex, and they are more responsive.

“Ideally, massage with infants and children should be done by a parent or family member. It can be our role as massage therapists/Comfort Touch practitioners to demonstrate how to offer touch to the child.”

This material is adapted from Chapter 6 “Special Populations” in the textbook “Comfort Touch: Massage for the Elderly and the Ill.” (LWW 2009)

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

Infants and children are a very special population who can benefit from Comfort Touch. Massage with an infant or a child is primarily the role of the parents. From the first encompassing hugs of a mother for her newborn baby, to the reassuring contact offered to a child in need, touch is a means of nurturing a developing human being. The conscious use of touch can be used in everyday tasks, such as dressing or bathing the young child. For example, the basic techniques of broad, encompassing contact pressure can be used when applying lotion or oil after the baby’s bath.

Practitioners of Comfort Touch can help young ones, using the techniques of this nurturing modality directly. But more importantly, we can assist the parents of infants and child to feel more confident and effective in the use of touch with their own children. As such we have the opportunity to help support a healthy parent/child relationships.

Parents instinctively use the Comfort Touch principles of broad and encompassing contact as they hold their children. The quality of presence and grounding of the adult, coupled with this instinctive and natural way of holding the child, allows the child in distress to relax. In this relationship the touch is mutually comforting and enjoyable for both parent and child.

The principles of Comfort Touch and the inherent adaptability of this modality make it suitable to meet the needs of infants and children. The child can be fully clothed and no special equipment or lotion is required. Often only a few minutes of touch are needed to elicit a positive response. An infant or small child can be held in the arms, while sitting in the lap of the Comfort Touch practitioner for a short session, using specific contact pressure on tonic acupressure points.

It is helpful to have a playful attitude when working with infants and children. Maintain eye contact and respond to their moving bodies, rather than try to hold them in a rigid position. Be especially sensitive to their physical responses and feedback, stopping or pausing as they adjust to your touch. If your contact is enjoyable to them, they will allow you to continue, even when they are initially in distress, for example, with respiratory congestion or colic.

The following are considerations in the use of Comfort Touch with infants and children:

• Newborn infants: The newborn infant is stimulated and comforted by touch. The Comfort Touch practitioner can help to ease the trauma of birth through the broad encompassing contact of general contact pressure. This touch is warming for the newborn, and helps to facilitate the sense of bonding connection. The new parents of the infant can be encouraged to touch and hold the baby. In some instances, where the child has hypertonic (tense) muscles, broad contact pressure and specific contact pressure can be used to facilitate relaxation of the muscles.

In hypotonic (low tone) muscles, contact circling can be used to stimulate circulation and nerve response to increase tone. This may be especially helpful to the newborn who is born with limp muscles, regardless of the cause. In this situation the baby may be in a specially heated bassinet, under warming lights. The massage therapist who is experienced in perinatal massage can use the techniques of Comfort Touch, in this circumstance, working cooperatively under the supervision of the obstetric physician and/or nurses.

• Babies: Comfort Touch can be used with babies, not only for general stimulation and relaxation, but to treat specific common ailments. For example, general and specific contact pressure can be applied to the baby’s feet to help alleviate indigestion and/or colic. The baby can be held in the practitioner’s arms or she or he may be lying down on a padded surface. Specific contact pressure on the foot, and especially the toes, can relieve sinus congestion or respiratory distress. Work slowly, watching the baby’s reaction. As you encompass the foot, move with the baby’s overall movement.
• Children: Most children do not have the same degree of tension in the musculature as adults; therefore, they respond to touch much quicker than adults. They also have a much shorter attention span, so keep hands-on sessions relatively short and focused on the area of greatest tension or pain, i.e., the shoulders or back. When working with children, it is wise to have the parents observe the session, so the child does not feel uncomfortable with being touched by a non-family member. Doing so also encourages the parents to feel more confident in offering the benefits of touch to their own children.

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This material is adapted from Chapter 6 “Special Populations” in the textbook “Comfort Touch: Massage for the Elderly and the Ill.” (LWW 2009)

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

After setting up the time for his Comfort Touch appointment, “Ron,” a new client emailed me saying:

“I apologize if this sounds too picky, pickly. I don’t know if oils are used in Comfort Touch but if so, will be OK, BUT no fragrances. All fragrances, whether in personal or oils or flowers or candles (definitely no candles), trigger coughing spasms. I hope this request is OK and I am sure you understand.”

I answered, “You are entitled to be as picky as you want to be. Usually with Comfort Touch I don’t use any oils, and totally understand your issues with fragrances.”

I share this story, because a reminder is often in order regarding the use of scents – whether in massage lotions, essential oils, or personal body products. They can be irritating, and even dangerous for some of our clients. I have worked for many years with patients in hospice and hospital settings, as well as home health care and senior facilities. People may have allergies to scented oils on their skin or in the air they breathe.

This issue is especially important when working with the elderly and the ill. Generally, people have lowered respiratory function as they age. Or they may be coping with asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD), or emphysema. Cancer of the lungs also greatly increases the vulnerability of the patient to scents. The nausea that typically accompanies chemotherapy can be exacerbated by scents.

I have heard massage therapists say, “Oh, I only use the finest quality organic oils, so these are safe for anyone.” NOT true. ANY scent can be contraindicated. Fortunately, the techniques of Comfort Touch, with its nurturing broad pressure, is offered most effectively without the use of oils.

It is also important to be mindful of the personal care products you use. Some people wear perfumes or essential oils because they enjoy them, and may be so used to them that are desensitized to the strength of their aroma. Once, I received a massage from a well qualified therapist whose technique was very good. But I was distracted by the overwhelming scent of patchouli oil that she wore. I had told her not to use scented lotion of oil on my body before the session, but it is difficult as a client, to know if you will truly have a scent-free session.

Another therapist had a scented candle. Even though it wasn’t lit, I noticed a couple of times after sessions with her that I felt nauseous. I realized it wasn’t the bodywork but the chemicals in the candle. The next time she put the candle outside of the room. Much better for me!

I am glad that “Ron” felt comfortable enough to ask me for what he needed, and didn’t need or want. All of our clients should have permission to ask for what they want, and sometimes this means we might have to let go of habits that we take for granted.

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

“Touch is elemental to human life. It’s a baby’s first experience. Hugs are the first line of defense for the scraps and scrapes of childhood. Even as adults most of us thrive on pats, hugs and squeezes. But somewhere in late adulthood, people stop expecting touch. Spouses pass on, children move away and our daily dose goes unmet…”

These are the opening words of an article written by Corey Radman for the online magazine “Whispering Tree.”  In it, she interviews me about the development of Comfort Touch, and talks with Lisa Olds, the coordinator of The Hospice Care Center in Louisville, Colorado. To read the article follow this link:

http://whisperingtree.net/articles-and-media/practitioner-spotlights/849

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

While visiting Montgomery Hospice in Rockville, Maryland earlier this year to teach Comfort Touch, I was introduced to a beautiful instrument that is used in their music therapy program. Inspired by an Australian music therapist, then designed and built by Musicmakers in Stillwater, Minnesota, the Reverie Harp is fast becoming the instrument of choice for hospice volunteers and patients alike.

I’d like to share with you the words of Lora Drezner as she speaks of her experience with this magical instrument:

“My folks tried, nagged and pushed, but despite years of piano lessons I was not the talented musician they seemed convinced ran in our family. But now, well into middle age, I have found a musical outlet in the Reverie Harp. As a patient care volunteer I became trained in playing this lovely instrument. It is simple; remove from case, place on lap in any direction, run fingertips over the strings. That is it, suddenly music fills the room, and my parents would be thrilled.

“I take the harp on many of my home visits playing for and with patients, families and caregivers. Soft music surrounds the bed, couch, chairs as we move closer together. Everyone wants to give it a try. A patient, long distant, begins to sway, hum and strum the strings. A wife, talking for hours of her husband’s illness quiets as she tries the harp, smiling as she experiments with plucking notes. A caregiver, exhausted, laughs loudly as she brings forth a broad sound sweeping her hand across the strings. And, a patient, agitated and confused, stills and listens as I somehow get the tune to Amazing Grace. She finds deep in her memories a few words to the old spiritual. We sing together and are beautiful. Time slows as I play the song over and over. She puts her head on my shoulder and sleeps for almost an hour, wakening only when I stop playing. Yes, Amazing Grace for an hour, a gift.

“It is the professional staff of Montgomery Hospice that makes these special moments happen for the patients and families by providing competent, compassionate and comprehensive care.  In working to build on their clinical excellence the staff members have become innovators, adopters of new approaches and leaders in the area of end-of-life care. The Reverie Harp is just one component of the Complementary Therapies program offered to all patients and families.”

Thank you so much, Lora, for sharing your experience. While visiting Montgomery Hospice I had the opportunity to try out the instrument for myself. Here are a couple of short videos of my first touches with it. I ordered one for myself the next week when I got home, and am enjoying it immensely.

Mary plays Reverie Harp

The soothing sounds of the Reverie Harp

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

I am often asked, “How do I market myself as a Comfort Touch practitioner?” Obviously, one needs to be competent in essential skills before beginning to sell the practice of those skills. Most people having studied and practiced Comfort Touch have already had some practice in marketing themselves as massage therapists, or in working in another health profession. Sometimes I think there is a misconception that there is something different about marketing this particular modality than there is to marketing any other service. But really there isn’t.

The largest target audience for Comfort Touch is the elderly and/or those who with chronic illnesses, or those who are in medical settings. If you are wondering how to market your skills here a few questions to consider: Do you feel competent in the skills you are offering? If so, what are you doing to actively find your desired clientele? Do you know where these people are in your community? Do you know someone who works in some other capacity with this clientele? Are you willing to do home visits? Are you willing to educate family and/or staff about your services?

These few questions should be enough to set you on your path. As in the general practice of massage, it takes commitment and motivation to build a practice. I advice my continuing education students and Comfort Touch practitioners to check online or in the phonebook to find senior facilities in your area, if that is the population they want to work with. Learn what services and resources there are in your community. Don’t hesitate to stop by a senior center and introduce yourself. Learn about the services they offer. Many communities now have Senior Resource fairs or expos. Medical organizations have employee wellness days. Ask to offer a sample of your work. It is important to educate staff, as part of your path to building a referral network to connect you with people who will benefit by your caring touch.

It is often helpful to partner with someone else who is interested in working with the same population. Too often massage therapists fear competition, but I have found that it is useful and satisfying to continue to practice with someone  else who does similar work to you. Meeting and talking with peers is an important tool for learning, networking, and gaining mutual support. Offering seated Comfort Touch at a community health fair is a lot more fun when you do it with a partner. Offering an inservice to staff at an assisted living facility, or giving a presentation to family members of potential clients can generate interest in your work.

I am also asked, “What do you charge for Comfort Touch?” There is no single answer to this. It is the same set of answers for any service. What do you want to charge? Do you work on a sliding scale – letting the client decide on the fee that works for her or him? Do you offer gift certificates? If you work a regular 2-4 hour shift in a facility, would you rather charge by the hour or by the number of clients you see? Do you want to do full body sessions, or do you want to do shorter sessions, that might be more affordable and accessible to individuals? Do you want to be paid by the individual client or the facility? What works best for you?

Think about your answers to the above questions. Be creative. I have taken many approaches over the years. I have seen elderly and chronically ill clients in their homes as part of my private massage practice, and it is no different from a business standpoint than it is with my younger clients. I have also worked in facilities where I’ve been paid by the facility for a set number of hours per shift.

As in any practice of bodywork, it takes an open mind and a willingness to put yourself out in your community to succeed.

(Read Chapter 9 of Comfort Touch: Massage for the Elderly and the Ill, by Mary Rose for more ideas on marketing Comfort Touch.)

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

A massage therapist contacted me recently, concerned about an attitude she sees in some other therapists in her particular work environment. She asked me, “How do you teach someone not to be complacent?” That does sound like a tall order! She was frustrated at the lack of professionalism regarding shared responsibilities in the facility. Her description of the problem reminded me of squabbles I had when sharing a room with my sisters as a child. For children, it is one thing, but in a working environment, there needs to be cooperation as adults to do what needs to be done.

Yes, the job of a massage therapist does involve much more than the hands-on session. It involves creating the whole environment into which people enter. Surely, they can sense the ambience of the space as they enter into a world of sights, sounds, smell, and touch. And how they feel as they come into this environment sets the tone for their experience of the massage. Whether you work in a spa, a clinic, an airport or a street fair your caring attitude attracts clients to you, and will keep them coming back.

Of course this attitude of caring about the work environment carries over into the hands-on session. Your client knows that you care by the words you speak; for example you might ask, “How are you today? How can I help you?” They know that you care by the focus of your touch and your sensitivity to their feedback. If you are distracted and thinking about being somewhere else, your client just might be thinking the same thing!

So ask yourself, “Do I care, and how do I show my clients that I care?”And remember that cooperation among co-workers also contributes to an environment that makes it a healing place for everyone – clients and therapists alike.

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-9375.

I remember a number of years ago this very touching experience. I had been going to offer Comfort Touch to an elderly patient who had suffered a stroke and was paralyzed on the right side of her body. She lay in her bed motionless and unable to speak. When I entered her room in the skilled nursing facility, I saw that her husband was gently applying lotion to her face. I stopped for a moment in silence, appreciating the love and care with which he touched his wife, ever so gently and kindly.

When he noticed I was there, he stopped. I introduced myself, saying I was the massage therapist, there to see his wife. He became apologetic, saying “Oh, I’ll get out of your way. I’m not sure if this is okay what I’m doing…”

“Oh, you are just fine,” I reassured him.” I’m sure she appreciates everything you do for her.” I asked him if he wanted to stay and watch me work. Clearly, he was interested in learning what I did, and was particularly attentive as I gently massaged her feet, with broad, encompassing contact pressure. I told him that he could do this too.

Then I quietly left the room, leaving the two of them together. When I came back a few days later, he greeted me with enthusiasm, saying, “I’ve been doing what you showed me, and I think she really likes it.”

“Yes, I’m sure she does. She is so lucky to have you!”

Many times over the years of visiting people in hospice and hospital settings, I have had similar opportunities to encourage family members to touch their loved ones in ways that are comforting. Often the caregivers of patients are afraid to touch, concerned that they might cause injury. When I show them what they can do safely – using basic techniques of Comfort Touch nurturing acupressure on the hands or the feet – they feel grateful. It is empowering to let them to know that they do make a difference.

Field of sunflowers south of Longmont, Colorado. Photo by Mary Rose.

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Mary Kathleen Rose, BA, CMT, is an ardent advocate for the needs of the elderly, and the ill, and those in hospice and other medical settings, who can benefit from safe, appropriate, and effective nurturing touch. The developer of Comfort Touch® Acupressure, she is the author of “Comfort Touch: Massage for the Elderly and the Ill,” (LWW 2009) and DVD of the same title. For information on trainings and resources visit: www.comforttouch.com or call 303-651-937