Comfort Touch

In a typical massage practice the client comes into the therapist’s office, who gets to know the person by asking questions of them in an intake interview. When working with the elderly and/or the chronically ill, there can be limitations to the client’s ability to communicate, so the practitioner of Comfort Touch is often challenged to establish rapport in other ways.

One way to get to know clients, is by observing their surroundings, whether they are in a private home or a room in a residential care facility, a hospice, or other medical setting. Notice photographs or greeting cards that are in the room that can tell you something about the person and their life. Your comment about a photo that you see can evoke a fond memory for the client about a special loved one, or a particularly happy time.

As you observe the photos, artworks or special objects in a client’s room, you develop a greater appreciation for the wholeness of the person’s life. Your words of interest or appreciation about what you notice let them know that you see them beyond the frail individual they now appear to be. For example, when I commented to one elderly woman about a photo of a sailboat on her wall, she began to tell me about her deceased husband, and all the happy times they and their children had shared in that boat.

In one skilled nursing facility, I worked with an elderly man with Parkinson’s disease. He had limited ability to speak, and seemed distant and uncommunicative. I noticed that he had a single framed photograph on the wall. It was of a young man hiking on a trail in steep mountainous terrain. When I asked if that was him in the photo, he smiled and nodded his head, indicating that is was. The photo helped me to see him as a whole person, one who carried that memory and experience of the wilderness into the present. As I shared my love of the mountains with him, he listened attentively, grateful to be seen and acknowledged.

___________________

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 begin_of_the_skype_highlighting 303-651-9375 end_of_the_skype_highlighting.

I am excited to announce the publication of my textbook “Comfort Touch” in Japanese. I received a copy last week, and though I can’t read it, I can appreciate the fine quality of its production. The translation was supervised by two medical doctors, one who is an acupuncturist, and it is published by Ido-No_Nippon-Sha.

It is so humbling and gratifying to hear how the Japanese are embracing this approach. I am especially grateful, as my study and practice of Shiatsu were so influential in the development of Comfort Touch. Japan also has a growing interest in the hospice movement.

In 1984 when I was a massage student, I had the good fortune to have three wonderful women teachers at the Boulder School of Massage Therapy, who taught me the traditional form of Barefoot Shiatsu. But I also remember another person who made an impression on me and my study of Shiatsu. Her name was Mari, and she was a Japanese exchange student, living in Denver with my sister and her family at the time.

When I practiced what I was learning in school with my family, Mari lit up and commented: “Oh, that is what my grandmother taught me!” So I practiced on her, and I also experienced her touch. Barefoot Shiatsu is typically practiced on a futon on the floor, and some of the techniques involve use of the therapist’s feet applying broad rhythmical pressure on the client’s legs, feet and back. Very relaxing and nurturing, it is also rejuvenating and energizing. Other techniques use broad compression applied with the hands to the general surfaces of the body – back, legs, arms, shoulder, head, etc. She told me that this was a form of massage that was passed down in her family from parent to child.

I have always had a strong commitment to the value of nurturing touch in the home, shared between family members. Mari and her story of her grandmother gave me a picture of this value from a culture other than my own. There are a number of significant aspects of Comfort Touch® that resonate with the idea of massage in the home. First, the techniques can be learned and shared with family members. Second, it can be practiced anywhere – there is no need for any special equipment. I appreciate the adaptability of the Japanese, and how this translates into the practice of Shiatsu. It can be practiced on a futon on the floor, a bed, or seated on a mat on the floor, or on a chair. And thirdly, the practitioner learns to be grounded and comfortable in their own body, making appropriate accommodations in order to convey their quality of touch to the receiver.

So it is with great joy, humility and gratitude that I hold my Japanese edition of “Comfort Touch.”

_______________

Below are images from my Barefoot Shiatsu class at the Boulder School of Massage Therapy in the summer of 1984. These photos were taken by Peter Byron.

Students practice Shiatsu in the seated position on mats on the floor.

_____________

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 begin_of_the_skype_highlighting 303-651-9375 end_of_the_skype_highlighting.

The winds of spring herald the changing of the seasons, from winter’s cold and introspection to summer’s warmth and expansiveness. The aroma of freshly turned soil mixes with the sweet scent of narcissus and tulips, and the delightful perfume of chocolate mint arises from the skeletons of last year’s garden plants. Enjoying this symphony of nature’s fragrances, I want to share with you one of my favorite breathing exercises.

Breathing with the Pulse

Sit comfortably in a chair or on a cushion on the floor, and close your eyes.

a.      Place the fingers of one hand along the radial pulse points of the opposite hand (at the wrist below the base of the thumb).

b.     Inhale to the count of 4 pulse beats, and then exhale to the count of 4 pulse beats.

c.      Continue to inhale and exhale with your pulse and enjoy the relaxation that comes with tuning into your body this way.

During this exercise, you can continue to hold the pulse points, or let go and continue to relax and notice your breathing. The pulse may change or slow down in this process. Be aware that the pulse can be variable, weak, or pounding. Don’t be concerned about the character of the pulse, simply do the exercise as given and notice the pulse without judging or analyzing it.

Even a few minutes of this practice can calm your body and mind. This exercise is particularly helpful in allowing you to get in touch with what your body needs in the moment.

Tulips and daffodils in my garden.

___________________

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.

Good body patterning is important to your physical and emotional self-care as a massage therapist. It is also important to the quality of touch you convey to your clients. Following is an exercise I teach in my classes that is a useful way to feel your connection to the ground and your base of support. I call it “Sinking into the inkpad.”

• Stand with your feet comfortably beneath you. Imagine you are standing on an inkpad, letting your feet sink into the inkpad. Let the ink saturate the entire surfaces of the bottoms of your feet.
• Standing on your left foot, step out of the inkpad with your right foot. Shift your weight onto your right foot, slowly taking time to let it make an inky footprint in front of you. Then return it to the inkpad.
• Shift your weight to your right foot, stepping out with the left foot, again shifting onto it and taking time to make an inky footprint. Return to the inkpad.
• Then step off the inkpad and take a few steps around the room, shifting your weight from foot to foot. Focus on the sense of sinking into the ground, connecting with, and feeling the support of the ground beneath you.

Use this awareness to increase your base of support, groundedness, and focus as you practice Comfort Touch. This awareness will enhance the quality of your touch, conveying a sense of strength and presence.

Pulmonaria, early spring flower in my garden.

__________________

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.

Many people believe that intuition is based on paranormal insights, but I have found that with a healthy dose of self awareness, intuition can be developed by careful observation and use of the physical senses. Recently, a friend asked me about a type of bodywork he had experienced. He said, “The practitioner told me that she used her intuition to determine what parts of my body to touch to balance my energy.” I asked him, “How did you feel after the session?”  He said, “I didn’t understand what she was doing, so I don’t know if it helped or not.”

Sometimes bodyworkers claim to be guided by their intuition, when in fact, they are making assumptions about what the client needs. It is always important to ask the client, “How are you? How can I help you?” With clear communication you can create the most useful and healing experience for your client.

So what is intuition? It is the process of arriving at a conclusion without having gone through a conscious decision making process. It is the sense of knowing what to do without necessarily knowing why. You might be in a situation and say, “I just knew what to do.” Or “I just had a feeling that I should simply hold her hand.” Intuition is a very useful ability to develop in the practice of Comfort Touch, as you will frequently encounter situations that require you to be versatile and flexible in your approach with the patient.

Here are three ways to develop your intuition:

1.     Experience. Practice your hands-on skills in situations that are relatively predictable and in which you can develop your confidence. For example, practice the techniques of Comfort Touch with a friend or family member, where you can elicit open and honest feedback.

2.     Knowledge. Continue your study of anatomy and pathology by reviewing or researching the diseases and conditions that are being experienced by the patients in your care. This increases your knowledge base, and gives a foundation for the insights that arise as you work.

3.     Sensation. Most often intuition is based on the full use of your senses, also called full sensory perception. For example, you may intuit that you should place your hands on the client’s shoulder, exerting a broad, encompassing pressure. The client’s comment, “Oh, how did you know that’s just what I needed?” confirmed your intuition about placing your hands there as you begin the session. But you actually may have noticed, albeit unconsciously, that the client was holding that shoulder in a rigid, contracted posture. Or you may feel a twinge of discomfort in your own body that corresponds to something that is felt by the client.

Pay attention to all your senses as you work. Notice what you see, for example, in the subtle movements created by the breath as the client is touched. Notice if she or he leans into your touch, or away from it. Feel the texture and temperature of the client’s body. Listen to the tone and quality of the individual’s voice. Even the sense of smell has information to inform our intuition. And of course, don’t hesitate to ask the client for feedback about what you notice, always respecting the verbal information the individual may share with you.

_________________

Excerpted and adapted from Comfort Touch: Massage for the Elderly and the Ill (LWW 2009).

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.

Do you remember as a child crawling under the covers just to feel their warmth? Maybe you hid under the bedspread and shared secrets with a younger sibling. Or clutched a tattered and worn quilt to comfort yourself after hearing your parents talk in low tones about the death of your grandmother. Is it the warmth or the weight or the pressure of a security blanket that creates a safe haven?

One of my personal heroines is Temple Grandin, diagnosed as a child with autism, who grew up to become a well-respected animal behavioral scientist. For many years a professor at Colorado State University in Fort Collins, she has influenced the humane treatment of stock animals all over the country. She attributes her unique understanding of animal behavior to her own experiences and challenges as an autistic person. Her hypersensitive nervous system made it excruciating for her to be touched, yet she craved the security of pressure. She recalls that when she was six she would wrap herself up in blankets and get under the sofa cushions, because the pressure was relaxing.

A few years later, while visiting her aunt’s ranch in Arizona, Temple noticed the squeeze chutes that were used with the cattle when they were vaccinated. She observed how calm the animals became when they were in the chute. So she created her own “squeeze machine,” a device made of sheets of plywood. She would crawl into it, lying on her belly and adjust the two walls of the device to exert a steady, controlled pressure on her body. The effect was relaxing to her nervous system, leaving her feeling calm and serene afterwards. Over the years she improved the design, adding foam padding to the wood, and refining the method for controlling the pressure with an air valve.

The squeeze machine was Temple’s own sophisticated version of a security blanket. At the time she developed it professionals had no understanding of the sensory problems of people with autism. They attributed their wild outbursts and antisocial behavior to psychological factors. But Grandin was ahead of her time, a child with autism who began to unravel the mystery of the disorder by creating her own tactile treatment. Her keen observation of animal behavior led to her realization that her attraction to pressure was biological.

As practitioners of Comfort Touch, how can we benefit by Grandin’s discoveries?  In some ways she validated what mothers have known for millennia – that babies are calmer when swaddled in snug blankets and held close to the their mothers’ bodies from birth, enjoying the pressure and warmth of this contact. But twentieth century birthing and childrearing practices led to generations of touch deprived children – babies separated from mothers at birth, put in bassinets, left in playpens to fend for themselves, and carried around in the ubiquitous baby carriers that have replaced mothers’ arms.

In the practice of Comfort Touch we allow our clients to experience broad, encompassing compression, the most basic of human touch, nurturing the primal instinct that craves just the right amount of warmth and pressure. Calming and sedating to the nervous system, we let our touch be the security blanket that Temple Grandin found to heal herself.

______________________________________________

To learn more about Temple Grandin and her work read these books by her:

• Animals Make Us Human: Creating the Best Life for Animals. 2009.

• Animals in Translation: Using the Mysteries of Autism to Decode Animal Behavior. 2005.

• Thinking in Pictures and Other Reports from My Life with Autism. 1995.

_____________________________________

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.

This month Susun Weed interviews me on Wise Woman Radio. Susun is the author of the acclaimed best selling Wise Woman Herbal Series. Her own wit and wisdom made this a delightful experience for me, as she questioned me about the development of Comfort Touch and its various applications from home to hospice and hospital settings. We also discuss how Comfort Touch relates to different models of medicine.

Here’s the link. Tune in and enjoy this spirited conversation with my dear friend and mentor, Susun Weed.

http://wisewomanradio.com/interviews/rose.html

Susun Weed and Mary Rose. Photo by Fred Schulerud.

___________

For more information on Comfort Touch® articles, resources, and trainings visit: www.comforttouch.com.

Mary Kathleen Rose is the author of “Comfort Touch: Massage for the Elderly and the Ill” (Lippincott, Williams and Wilkins, 2009).

I am delighted to share a story sent to my by Michele Kilgore, a participant in one of my Comfort Touch® workshops ^–

I was a newly minted massage therapist, still working a day job, when I attended a one-day course in Comfort Touch^® taught by Mary Kathleen Rose. A massage therapist with decades of experience and formidable credentials, she had developed a technique to help the terminally ill.  I needed the continuing education credits and had personal experience caring for family members with cancer. In fact, my day job was as an administrative assistant for a hospice.  I spoke with clients and their families every day.  This Comfort Touch^® class fit nicely into my CEU budget and my schedule, and it sparked my interest.  I also liked the idea of going to the source to learn, and Rose was coming to Asheville, North Carolina to deliver the information in person.  The class, sponsored by Health EDucation Network, was full, with more than 50 people crowded into a hotel conference room.

My first surprise was that there were so many medical professionals present. It seemed that less than half were massage therapists. A local physical therapy practice was well represented, and more than half the group worked in hospitals. Mary was an attractive but undramatic woman. I knew she was from Boulder, where you can’t spit without anointing a healer who has revolutionized something. I had expected a little drama coming out of Colorado. She had a low-key style of teaching and didn’t seem intimidated about teaching a massage technique to non-massage therapists.  As the hours went by, the vast extent of her knowledge about bodywork and healing unfolded, along with graceful, unselfconscious warmth. At the end of the day, I realized she had conveyed a profound message about compassionate interaction and that I didn’t know how to integrate Comfort Touch^® into my own massage practice.

Comfort Touch® is based on acupressure, a gentle pressure from the full hand, sinking slowly into the tissues of the person receiving massage.  A hand position may be held for several moments,  and movement from one position to another was soft and slow. The length of a session had to be determined by the condition of the client, and the very ill might not tolerate what I considered a normal session.  It wasn’t always possible or even necessary to work the entire body.  This was a technique that seemed more about the warmth of human touch than the manipulation of the body.  Instead of being the well-trained professional, using all my skills and techniques, and allowing the person on the table the privacy of their own experience, Mary seemed to be saying that my presence, not my knowledge of muscles, fascia, or meridians, was the most important factor.  The Comfort Touch^® practitioner was a compassionate companion.  While my goal with my massage clients had always been to be respectful, nonjudgmental, and effective, the majority wanted deep tissue work and full body massage, efficiently completed in one hour.  Even the actively ill expected to feel forceful strokes unknotting those painful knots.  Comfort Touch^® just didn’t fit into my idea of my practice.

I only began to practice Comfort Touch^® two years and a few personal changes later, as a hospice volunteer.  Then I began to understand what Mary Kathleen Rose was saying. Then I was prepared to learn her techniques.  However, she was in Colorado, and I was not.  I excavated my class notes, ordered her DVD, and set my intention to be of use.  I did find teachers.  Each time I put my hands on a person enrolled in hospice I was humbled.   I was almost always in awe. I sat quietly between hand movements, discovering the subtleties of compassion, and my patients taught me Comfort Touch^® just as Mary said they would.

My first hospice patient was not actively dying, as hospice terminology strangely and accurately labels the last few hours of a person’s life, but was withdrawing from the world in alternating periods of anxiety and serenity. There was still some pain in spite of the medication.  The caregiver was exhausted but didn’t want to leave a dying loved one alone, even if only to take a shower.  Since massage calms anxiety and decreases pain, I arrived to provide Comfort Touch^® and the caregiver took a long shower.  It seemed like very little happened while I worked with the patient. I held hand positions for a few minutes.  The patient sighed.  The face seemed a little less tense. The breathing slowed. The caregiver, still with wet hair, came back into the room to check on us and asked if I could stay a little longer. I did. The next morning the caregiver called the hospice team leader to request another massage as the patient had slept through the night, required less pain medication, and had even eaten. I returned twice. The caregiver sat on the back porch through one session as the day was especially beautiful.  Then the team leader called me to cancel a scheduled massage. The patient had passed away.

Hospice volunteers usually care for only one or two patients at a time. It was a paradox that some patients, after being admitted into hospice care, got better. I worked with one patient for almost an entire year, scheduling sessions every week. Often the primary caregiver would hesitantly request a massage too.  I offered Comfort Touch^® rather than conventional massage because it seemed the natural thing to do.  The response was the same—sighs, less tension in the body, slower breathing, small signs of a burden eased.  Occasionally hospice called to ask me to provide massage for a patient who was actively dying.  For people who enjoyed massage when they were healthy, Comfort Touch^® often appeared to smooth the turbulence of the physical passage, but I never asked for confirmation.  Framing the question was impossible, and the answer wasn’t necessary anyway. I love having massage now, just getting on the table makes me feel relaxed.  I am sure I will enjoy one just as much while I am dying.

Working as a hospice volunteer was an intense experience that transformed my life.  I am grateful to the Mary Kathleen Rose, who taught me Comfort Touch^® one Saturday several years ago. She gave me a tool that allowed me to be present with the dying, offering a service I was trained to perform, and giving me the opportunity to learn what can’t be taught.  A little drama came out of Colorado after all.

___________

For more information on Comfort Touch® articles, resources, and trainings visit: www.comforttouch.com. Mary Kathleen Rose is the author of “Comfort Touch: Massage for the Elderly and the Ill” (Lippincott, Williams and Wilkins, 2009).

A couple of weeks ago I had the pleasure of attending the show Cavalia, a wonderful showcase of artistry, skill and beauty featuring acrobats, aerialists, equestrians and 60 magnificent horses. One of my favorite pieces involved equine liberty trainer Sylvia Zerbini and her herd of eight Arabian horses.

Liberty is a form of improvisational work that capitalizes on the natural and playful tendencies of the animals. Zerbini uses verbal cues and her own body language to communicate with the horses. In an interview in Equine Chronicle, she said, “For me, a touch means a lot more than just a touch. I use a ‘comfort’ touch with my horses, maybe a little bit of a scratch where they like it.” She is very protective about who touches her horses and how they touch them. She says, “When they’re used to my touch, someone else might pet them too fast or in a place they don’t like, then they flinch and it’s uncomfortable for them.”

Watching her performance with the horses was a pleasurable, magical, and joyful experience for me. It was fun when I later read the interview with her, and saw her reference to “comfort touch” as she works with these beautiful, large and highly responsive creatures.

It is easy to appreciate the principles of Comfort Touch at work — slow, comforting, respectful –whether with four legged or two legged beings.

Happy horses in Montana — Jazzy and Rio enjoy Veronica’s touch.

_______________________

For more information on Comfort Touch® articles, resources, and trainings visit: www.comforttouch.com.

Mary Kathleen Rose is the author of “Comfort Touch: Massage for the Elderly and the Ill” (Lippincott, Williams and Wilkins, 2009).

A student of mine once described Comfort Touch this way, “It’s like having your body hugged in a thousand different ways.”

Recently, some friends hugged as they said goodbyes after getting together for a drumming class. Lightheartedly, one person said, “Someone really should teach a class on hugs.” And I thought, “Aha! The 6 principles of Comfort Touch can provide the perfect quidelines.” After all, a good hug is slow, comforting, respectful, into center, broad, and encompassing.

In a good hug the contact is slow. The intention is comfort. Remember that the root words of comfort are com meaning “with” and forte meaning “strong.” Together we are strong and comforted. A hug should always be respectful – of oneself and the other. This attitude allows for appropriate contact, respecting one’s own personal space and the space of the other person; with gentle acknowledgement of the pleasure of connection. And a good hug touches into center, with contact that is broad and encompassing.

So remember the principles of Comfort Touch next time you greet or say goodbye to those special people in your life.

____________________________________________

Mary Kathleen Rose, BA, LMT, 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.