Sensory Approach to Manual Therapy
Sensory Approach to Manual Therapy
The Power of Being Genuine with Clients
What happens when a therapist loses their way? Dr. Jesse Reynolds, a respected practitioner in acupuncture and traditional Chinese medicine, faced this very dilemma. After adopting the persona of "Dr. Jess" to meet external expectations, he found himself burnt out and questioning his path. Together, we navigate his inspiring journey back to authenticity and how redefining therapeutic presence can prevent the emotional toll of burnout.
Our conversation unfolds with a focus on the softer skills that truly define successful therapeutic practice. While many practitioners relentlessly pursue technical expertise, we share compelling insights from a survey of over 3000 professionals that highlight the underestimated power of empathy, self-awareness, and effective communication. We explore practical strategies for maintaining professional boundaries and personal well-being, offering actionable advice for therapists who are eager to cultivate a more meaningful connection with their clients.
Finally, we shine a light on the importance of embracing one's unique approach to therapy. By sharing personal stories and experiences, we underscore how authenticity and individuation not only prevent exhaustion but also attract clients who resonate with your genuine presence. Join us as we unravel the complexities and rewards of being true to oneself in the therapy room, and discover how a heartfelt approach can transform both the practitioner's and the client's experience.
A bi-monthly podcast where we share the stories of our Caregivers, patients and...
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Hello everybody and welcome to another podcast of the Sensory Approach to Manual Therapy. I'm here today with Dr Jesse Reynolds, and I met Jesse about a month and a half ago, two months ago, at the Canadian Massage Conference in Calgary and got along like butter and bread, and I've really been looking forward to this podcast with him. Jesse holds a doctorate in acupuncture as well as traditional Chinese medicine, and I attended a class of his that he taught at the Canadian Massage Conference, primarily on therapeutic presence, and I found that to be such an important and vital component to a lot of the unknown characteristics of care, what it is that helps our clients get better, and we have a lot of known quantities and unknown, and for me that's one of the more unknown but also one of the more valuable, and so I wanted to talk to you just about that a little bit today, so welcome.
Speaker 2:Well, thank you very much, Troy. I'm looking forward to this conversation. Like you said, when we first met at the conference, it was like an immediate connection. I I really appreciated that and and likewise when I saw your little talk on on, I was only there for a portion of it, but you were talking about the placebo and I'm like this. This is a guy I gotta connect with, so I'm super happy that we get the chance to talk today. Thank you for having me yeah.
Speaker 1:So what is it that made you so? I mean, we can go into personal stories and I really don't mind that, but the thing that really makes that, that made me interested in speaking with you, was the idea of therapeutic presence, because you know, I've been in the industry. I've been in the profession now 20 years and whether you're a new therapist or an old therapist or a veteran doesn't really matter. That idea of being present to a client is so important and so vital. And a lot of my listeners have heard my burnout story and when I came back from my burnout I had the ability to finally understand boundaries a little bit better and barriers and putting up these limitations in my availability and my clinic hours, and I know that that helped me. But I know you spoke a little bit about your own story. That might've gotten you into that. So let's, let's hear a little bit about that.
Speaker 2:Yeah, yeah, thanks, and there are. There are so many different tendrils of this conversation. We could go on, but I do think that's a great place to start. As far as why I'm really interested in this, this idea of therapeutic presence, it's become somewhat of a passion of mine over the last few years, and for a few reasons. The first is a story that might be somewhat similar to yours and that has to do with burnout is I was exhausted, absolutely wiped.
Speaker 2:When I graduated school, I had this idea in my head that I was going to be Dr Jess, you know with the white coat and super professional. So I adopted this persona and I ended up working on really sick clients, a lot of autoimmune cases, for a long time and for a while I found it super gratifying because it's like I get to put all this education to use and there was also this ego thing that was involved in it. It's like, yeah, people are looking up to me and I seem super smart and accomplished. And I did that for quite some time about four, four and a half years, maybe a bit longer, where that was pretty much my entire practice. And as I was getting close to that four year mark, I found myself just wiped out.
Speaker 2:At the beginning, like when I was in school, it wasn't unusual for me to see, you know, 10, 15 clients a day just rolling with it. Yeah, it was a lot. But by the time I got too close to year four, it's like I would see three in a day and I would get home and I would just be like I'm done, I'm absolutely done, and I was grumpy with my partner. I just wasn't really happy with the version myself that I was. So I took some time off, I reevaluated some things and I took about a year off for practice, pretty much completely. I was teaching at the time, which is also part of the story of how I came to this conclusion. But then when I came back, I realized like, hey, you know, I need to do things totally different and I need to show up in the room as a very different version of myself. Because putting on that, yeah, yeah, please so.
Speaker 1:So, before we get into that, which I I want to hear about, because I I made a transition myself and I know it's one of the things I do in my mentorship program is help educate therapists on how to transition into a new perspective of where they want to be in the future, not where they are now, but going back to the burnout section, when you say you went home and you were wiped out. Now I know my story and I know why I was there. I want to, I want to talk about that a little bit because, especially for new therapists, it's probably one of the most common questions I get doing mentorship stuff, which is how do you walk away at the end of the day not feeling emotionally, mentally and physically burnt out and physically, physically it's actually, it's pretty easy. There's easy solutions be fit, you know. Be fit enough to accomplish the tasks required of you. It doesn't mean you have to do ultra marathons, but if you're going to plan on treating six clients a day and you have to use a lot of muscle and speed and rhythm in your practice, then you better have a cardio and a muscular system to accommodate those needs. If you do very slow, gentle work, vice versa. You have to have a system that accommodates those needs. So, physically, the mentorship program, people understand that easily.
Speaker 1:But yet when it comes to the mental, the emotional and the spiritual component of if you're going to be dealing with clients who have autoimmune disorders, you're dealing with trauma-informed care. Dealing with clients who have autoimmune disorders, you're dealing with trauma-informed care. If you're going to be dealing with prenatal, particularly for loss of child and miscarriage. If you're going to be dealing with victims of abuse, homeless, if you're going to be dealing with death, meaning maybe palliative care, let alone if you're dealing with geriatric and mainly what I do with chronic pain, people coming in feeling demoralized and depressed and hopeless about their discomfort.
Speaker 1:People don't seem to understand that instantaneous, one-for-one relationship of if I'm physically strong enough to accomplish the tasks demanded of me, I don't get hurt. If I'm mentally strong enough, I don't get depleted. If I'm emotionally strong enough, I don't get depleted. So when you walk away at the end of your day and you're feeling exhausted, when you were getting through your burnout, what was it that you found? You were picking up or not. How were you not taking care of yourself to maintain your mental, emotional, spiritual fortitude to walk away from the end of the day without your client's baggage strapped onto you.
Speaker 2:Yeah, what a great question, Thank you. And you know, I had this instructor when I was in school and we've become good friends since then and I remember at one point in time it was around year three or so, getting close to the end of my education she said listen, at the end of the day you have to have a ritual, and of course I'm in acupuncture world, so we're a bit esoteric and out there, right? She said what I like to do is I like some sage and I give myself a sage bath and my background is a tradesman, right? So I hear her talking about sage and I'm like get out of town.
Speaker 2:That's nonsense, I'm fine. So I completely ignored this idea of coming up with a ritual at the end of the day to my own detriment. And that's what I was neglecting to do is, at the end of the day, I was doing nothing at all. I wasn't acknowledging the fact that, hey, it's actually really challenging mentally, emotionally and spiritually to hear people dump on you all day. Even if it's like relatively minor stuff, it adds up and I just didn't take it seriously at all. So that was the big thing is not taking the time to create a ritual that worked super well for me. I just assumed oh, I guess sage is the thing that doesn't work for me, so must not do it, or whatever it is Right. So that was it. It's just not not participating in that super essential activity of ritualizing your day's end to leave work at work.
Speaker 1:Mine. I remember when I lived in Colorado. I've had it less here in Quebec, mainly because I'm a little less comfortable on the roads. My daughters are a little older so now I do a little more daycare pickup. My wife works from home now so I do more of the pickup duties. But when I lived in Colorado I remember, prior to having kids, my ritual was I commuted to work on bike and it took about an hour. So I had a mandatory separation from my home chores to my office of at least one hour where my brain was on a bike and listening to music or thinking whatever it was, or just being present on the bike, and it was the same. On the way home I had an hour to process everything that had happened through the day and then just to focus on nature and then to finally get home and be present to the family. And those are my rituals. And here I noticed prior to my burnout I had lost my ritual, mainly because of lifestyle changes and I hadn't created a new one. And I remember thinking I have a few clients who they've mentioned that that's what their commute is like.
Speaker 1:You know, everybody talks about hating traffic and whatnot, and yet it gives them that time in the car, away from job, away from family, where they're in between both, and they get to have that cutoff. And when they lost that commute during COVID, a lot of them found they no longer had that. I mean, bizarrely enough, call traffic me, you know, call your commute meantime, um, so that was interesting. So that's, that's a great component, the ritualistic nature of disconnecting and connecting at work. But what about in sessions? Did you find yourself ever like so? At the end of the day, you take the time to disconnect and and and find a way to, you know, feel better about and the day. But in session, let's say, somebody has a particularly rough session, they're in tears. In the sessions they have an experience that's traumatic or released In order to not bring it to your next client, in order to not transfer forward through the rest of your day with that baggage on you. Did you ever find yourself finding any tricks or tools to help manage that?
Speaker 2:yeah, eventually. So in that first four-year period, no, there were no tricks or tools, it was just, it was just a flail. But eventually, yes, I did, and I guess that really does get into therapeutic presence, which takes us into the next part of the story. It's it's. What I found is the more work I did on myself. There's pure, call it self-help, self-development, whatever one wants to call it. The more work I spent developing my own self-awareness and understanding of me in every aspect I could, the more easily I could be fully present in that moment with the client. So the trick that I eventually ended up using, if one could call it that, was simply being as present as I possibly could, because in the moment I walked out of the room, I'm present with not being in the room anymore, and that was ultimately the biggest thing I did. And it all stemmed from quite significant amounts of introspection and personal work.
Speaker 1:It's not a surprise by any means that you, you use the word presence and I don't think any. Anybody in the massage community, anybody in the you know, complimentary alternative medication, the cam therapies I don't think anybody would be surprised that you're saying presence is key. But you're also giving us the hardest thing to do, which is pay attention to self. Uh, I, I have this, uh, this little story. I tell about a lot of my mentees who are having a hard time walking away at the end of the day, not hanging onto the baggage.
Speaker 1:And I say imagine you go to a convention and you're sitting at a table and you've all got name tags on and you all have to get to know each other. So everybody closes their eyes. You come along, you put all your name tags in the center of the table and then, with your eyes closed, somebody mixes them up and you grab a random name tag and you put it on and everybody opens their eyes at the same time and if you're wearing your name tag, you keep it and if you're wearing someone else's name tag, you put it back in the center of the table and everyone's like yeah, easy enough, I know who I am, I know what my name is. I know it's not that. You know that's not my name.
Speaker 1:This is my name and I say now just imagine at the end of the day that you're replacing the word name with emotion. So look at it. If it's yours, you hang on to it. If it's not yours, you put it back in the circle. And yet, when it comes to that, people have a hard time then going oh yes, because that involves knowing thyself. It means it doesn't mean knowing your client, it means knowing you. It means when they tell you a story about a knee injury and you've had a knee injury, you don't associate it as your story. You let them have their story and you don't take it as yours. And that's a hard thing to do.
Speaker 2:Yeah, yeah, I, I completely agree and that that's it. I mean, that's that's kind of my shtick. It's all about self awareness and knowing thyself, and I find that that a tricky part is using that name tag analogy. It's like you get somebody else's name and you read it and you're like, oh yeah, my name is definitely not Frank or Susie like very clear of introspection and self-awareness. You can get a little tag that says anxious and you're like is, is that? Is that not being unaware of what does anxious even feel like in this body? Yeah, so then you take it without the awareness that it might be mine, it might not, and there's just a lack of clarity as to what actually is mine and somebody else's so then, for therapeutic presence, how do you find yourself creating so self-awareness?
Speaker 1:you know everybody goes about that a little differently some people's meditation, some people's prayers, some people's exercise, some people it's uh, mda. You know who, like everyone, has their own thing for self-awareness, and some people ignore it, some people don't care about self-awareness. Um, so, let's say you're a practitioner, you, you're starting to feel fatigue. You notice maybe you're not actually even aware that you're starting to get a little burnt out, a little tired. You're coming home, you're a little cranky, you're a little more exhausted than you should be. What are some of the things that you've done to like? Did somebody point out to you that you were burnt out? Did you, were you self-aware of your fatigue?
Speaker 2:no, no, not at all, unfortunately not. It. It was well past the point where where I should have stopped before. Eventually, it was just like I can't do this and, for better or worse, I've been to that I can't do this point a number of times in my life, and and it I'm, I'm going to say for worse. Actually I don't think there's much better about it, but but that was it.
Speaker 1:It hasn't led you to a growth. It hasn't. It hasn't created a change for a positive way for you.
Speaker 2:Yeah, I mean, I'm, I'm, I'm sure if I were to stop before that point the growth and development would be even more profound, but but that was it. I got to this point where it was like, genuinely, I actually can't do this anymore and that was the full stop. So, kind of looping back to the actionable things of what a person can look for, they're starting to feel a little bit burnt out. How does one actually develop self-awareness in this capacity? Well, like you said, there's a million ways, but one of the things that I found most helpful for me is, at the end of the day, not soap notes, a little tiny notebook and it's just client initials how I felt about them, not about the session, not about their condition, but how I felt about that person. This person really irritated me. I really got along with this person. I never want that person to book with me again. Just these feelings about the client, and for some reason that seemed to be kind of an entryway in to more awareness during the session.
Speaker 1:Did you find that doing when you started that, did that not bring it? See, for me that's almost seems counterintuitive. I can see if I were to do that, I could see that creating an environment where I would start associating my emotions to the client and begin almost being pre-anxious or going above and beyond for certain clients, you know, creating an ethical gray area where suddenly, because I'm associating an emotional context to my interaction with the client, I would almost already have a predisposition to either be in an extra good mood or extra shitty mood, which happens anyways. I mean, people do that naturally. Here, you're just being conscious of it and you're taking note. But it almost seems like taking note of it would, even you know, make it more profound and concrete. Did you not find that to be the case?
Speaker 2:No, I actually didn't, and it's. It's really fascinating that you bring that up, because that that didn't enter into my sphere, which is is such an important part of this conversation that all of these techniques are super individualized. But I found quite the opposite, that, as I really noted my feelings towards the client, then I was able to recognize, when I was with the client, what was mine like, what emotions were coming up, because it's like I reflected on it at the end of the day. I reflected whenever I saw John. Here's the feelings that came up. So next time I see John, here's the feelings that came up. So next time I see John, those feelings come up and I start to see this is me, this is mine, and other things really aren't necessarily.
Speaker 1:That's awesome. I like that. I mean, the self-reflection thing to me is so valuable and so important. So that's the component of okay, from where you came from burnout, why you found it necessary to create a change in your environment to come back into the practice. So then, when you came back into the practice, what were some of the? So you started using ritual, you started doing the note-taking to start incorporating that. How did you move from that component of clinician care to wanting to focus on helping others understand therapeutic presence? You'd said you'd already been teaching. Was it just a natural progression for you? And you've said you've been passionate about it for a while now? What created that new progression for you?
Speaker 2:Yeah, it was like the perfect ikigai, you know that Venn diagram of things that you're really interested in, combined with something that the world needs, combined with a way that you can make money right. So I've been interested in sort of the inner work self-development thing for gosh as long as I can remember, since I was a teenager, right. And then there came this point when I was teaching at a massage college where one of the instructors quit and the instructor was teaching a module and it was called sports psychology, a typical module involved in most massage therapy programs. So I got a hold of this, this program, and I look at it and I'm like this is, this is terrible. Like there, there's no way I'm going to be able to teach this. It was poorly written, it didn't make sense, it didn't have a flow and it was a nine-week program, so nine three-hour classes. So, fortunately, the place I was working, they really trusted me and they allowed me to sort of recapitulate the entire program. So I turned it into quote sports psychology, which wasn't really that.
Speaker 1:It was more just a program of self-development Most psychology being self-development to begin with and then purchasing that knowledge onto another.
Speaker 2:Yeah, exactly, it's all the same stuff, you just change the language, whether you're working with an athlete or somebody who's burnt out, right. So I make this program and I go through it I don't know five or six times, which was really really helpful. And what I found so fascinating is, over the period of about seven to eight years of teaching, I taught this psychology class, but I also taught orthopedic assessment and advanced treatments and osteology. I taught the things and invariably at the end of the two-year program, when students came up to me to talk to me, they would almost always say the best class was the psych class, the thing that helped them the most in their practice. And they'll come to me years later and they'll be like you know, I remember that class you taught on stress and anxiety and it made such a difference. So I kept getting this feedback from students being like hey, this is, this is really really important stuff.
Speaker 2:So that happened kind of in that year's sabbatical and a little bit after, and I kept doing more and more of my own stuff, my own inner work, and then by the time I actually got back into clinical practice, I realized, particularly through learning about heart math, actually heart rate variability. I realized the the way I show up seems to matter as much, if not in some cases more, than the actual treatment that I'm giving. And it was this slow realization that the more I truly just showed up with empathy and care and compassion and really nailed my communication and how I spoke and listened, I nailed all of these soft skills, the treatment which, quite frankly, at that point, I've been practicing for a while treatment was relatively simple. It didn't require a lot of thought, didn't require a lot of physical activity right.
Speaker 1:I love that you. I love that you say that, because there's so many therapists who, and so many instructors who I speak to, who find it antithema whenever I mention that know, like when you've been practicing 20 years, I don't need to concentrate too much on what my hands do. I need to be present, I need to listen to my client, I need to be there, but, like, the actual hands-on component to it is incredibly valuable and absolutely necessary, but it's almost second nature, and I've had so many instructors in the past not enjoy the fact when I say that when I'm like when you've been doing it long enough, the hand portion is secondary and the thing you find yourself spending time and working on is your ears and your mouth and not your hands anymore.
Speaker 2:And so I love that you bring that up, because I absolutely agree with you hands anymore, and so I love that you bring that up, because I absolutely agree with you. Yeah, yeah, it's such a fascinating thing, right? Because, being interested in this and owning a continuing education company, I got really obsessed about this idea of what actually makes a practitioner or massage therapist successful, like super obsessed with this. So I sent out a survey and I've gotten a little over 3000 replies, which is quite a bit of data, you can do a good research paper with that.
Speaker 2:Yeah, I know, right, it's a lot of data and I asked a bunch of questions and one of the questions was like hey, you want continuing education, what do you want to learn? And almost 80% of the replies were technique how to do this thing, how to treat this region, how to treat and when you go to a conference, that's what it is. It's technique, which is cool and essential, as you said. I mean, that's what people are coming to us for. Apparently, it's for us to apply a technique to fix an issue. Right, super important stuff.
Speaker 2:But then it got even more interesting when I started to ask other questions about, like, if you were to go to a massage therapist, what would make a massage really good? Now, based on the first answers, what you would expect it to be is they really know how to cup? Yeah, like, oh man, they're cross fiber friction out of this world. You know, like that's what you'd expect. It's not at all what I got. Quite the contrary, around 80%, once again, of the people said you know, they really listened to me really well. I felt so cared for During the session. I just I could finally relax. They didn't talk to me. They did talk to me Communication skills. So over and over again, it was these soft skills and I found this super interesting dichotomy that what people say they want is technique, for good reason, but when we talk about what's actually needed for success, a good session, it's soft skills.
Speaker 1:I think it's that classic confusion between you know, as a therapist, I think what I need is X, and as a client, what I think is Y, and the two don't match up. And so, as a therapist, we think our technique is the most important thing and as a client, it's. You know, if, if I don't have trust for you, your technique means nothing to me. If I don't believe you, your technique means nothing to me, and I think it's one of the things you know it's. I think it's one of the reasons why we get along so easily is that it's similar. When I teach, you know like, and I've noticed, when I teach my classes, I did something similar, which was I never did a survey, but I've asked a lot of students in classes how long they've been practicing, and I find that my, the classes that I teach that have to do with the soft skills, the unknown components to manual therapy. You know, not technique. Those classes that are most full are by people who have been in the practice more than 10 or 15 years, anything under 10 years. They want technique, they want to know more things to do with their hands, because that's where they're convinced the value is. And then, when they've been in the practice long enough and they have that confidence to do what their hands will. Now what they want is all the other stuff. You know all my pain class, my placebo classes, my integrating evidence-based medicine and patient-centered care classes, those things, all those classes. It's veterans or people who have been in the practice longer who are seeking the unknown qualities, and so I want to talk about that a little bit with you, because you're bringing up some really important things to me that I don't think enough therapists pay attention to and that I don't think enough clients are aware of.
Speaker 1:Because, when it comes to education, I educate my clients all the time, and what I educate my clients on is not what I'm going to do with my hands. I educate them on the importance of self-awareness. Okay, you have pain, stay within your limits, don't avoid pain, but don't make it sharp or grimace. Work into the resistance, don't be too lazy, don't be too active. You know like balance, and that education becomes valuable to them.
Speaker 1:So what they end up coming to me for is partially what I do with my hands, but really what they're seeking for is safety. Am I safe to be active? Am I safe to move? Am I safe to still perform. We just had a marathon here where I am, and I had quite a few athletes in the marathon who seek my treatment for injuries but also for my personal training stuff, and they're looking for the unknown quantity. They're not looking for the hands. So, when it comes to that component, what are some of the tools you have found, what are some of the classes you've taken or the books you've read beyond self-awareness that have helped your clients feel that connection with you? Because I think that's what therapists need to remember is that trust before the hands is more important than the hands or the needles or cups or whatever.
Speaker 2:Yeah, great question. Sometimes people ask me what was the best part of acupuncture school and I say it was that six month period where I stopped acupuncture school to get certified in hypnotherapy. Now I was doing the both simultaneously. But I say it kind of jokingly, but I also say it very seriously that out of the techniques, the things that the stuff I've learned that really helped with that, it was learning hypnotherapy and neuro-linguistic programming, essentially how to talk and how to listen.
Speaker 2:How to talk in a way that matches your client's nervous system, not what they're saying, not how they're expressing, but really tuning into those deep autonomic nervous system cues and speaking to that part of them the precise words that I use which takes a lot of cognition in the beginning but eventually becomes natural, ref. Listening, like how to listen in a way that that it's easy enough to to take up watch a youtube course on active listening, right. Like yeah, it's theoretically easy enough, but to really learn how to communicate with deeper parts of an individual's consciousness. I mean, in hypnotherapy the whole thing is learning how to have a conversation with the deep conscious or the unconscious, right? So I'd say that's it is really getting precise and refined with my language.
Speaker 1:I think it's interesting because I talk about this in a lot of my classes too. We have an entire section on my how Massage Therapy Works class, on cognitive behavioral neuroscience, and essentially it's to say, hey look, if your client comes in and they're low tone and they're depressed and they're just tired and you can see they're not doing well, you have to have some pretty good observational skills to figure out. Okay, do they have it in them to be picked up? And if they do, I can do that with my hands. But I can also do that with my words, by talking quicker, by being a little more adamant, by being louder, turning the music up, turning the fan on, creating more environment, doing tests where they're standing and active. But if they come in they're super hyper and they're really okay. I'm sorry I was late. Okay, I know I have to leave a couple of hours early. We're going to do this. Do I have it in my place to slow the breath down, slow the language down, lower my tone, speak with an actual cadence and it's funny because I use that practice all the time and every client who comes into my office, my tone changes pitch, rhythm, cadence and speed to accommodate where my client is because I'm a big fan. I mean, I think I think mark from massage therapy media recently put up a video on massage therapy media's website or facebook page on a talk I had done in new hampshire with the new hampshire american massage therapy association on homeostasis.
Speaker 1:And essentially homeostasis is balanced it's not up, it's not down, it's neutral. You know, you're not happy, you're, you're neutral, you're prepared to go in either direction. You're neutral. And I think when people, when people spend too much time down, they don't realize they can go up, but when people spend too much time up, they don't realize they're actually not satisfying. Part of their system it's about being neutral. Part of their system it's about being neutral. So when my clients come in super hyper, I talk slower and I try to get them to go lower and a lot of people find that awkward because they think, no, it's about being happy, it's about being up, but that's not normal, that's not life. Life is about neutral and homeostasis, prepared to go in that direction. So I love that you say that. But it does bring up a good question about hypnotherapy. Do you find yourself having conflict with the legalities of the associations between hypnotherapy and acupuncture? Because in most places. You can only wear one hat in a session.
Speaker 2:Yeah, good question. And fortunately no, because it turns out hypnotherapy cannot be regulated due to the fact that it's impossible to define trance in a way that's appropriate. The example I give is the driving trance. We've all been in the car driving home from work. Next thing you know, you pull in the driveway and you've got like zero memory. It's because you're in a trance-like state, right? So it's really hard to regulate and create rules around hypnotherapy. Now, there are important caveats to that and it's the therapy part of it. If somebody's like I'm anxious and you're like we're going to use hypnotherapy for anxiety, different story. But the techniques of hypnotherapy, which are largely just communication techniques, there's no boundaries crossed whatsoever because it's literally exactly what you're talking about.
Speaker 1:You're not hypnotizing them. You're using communication to help them unlock or to change their state of mind.
Speaker 2:That's it. And in hypnotherapy, one of the sayings we have is all hypnosis is self-hypnosis, all of it. The only thing that I'm doing is choosing words that can facilitate that process a little bit more readily. In fact, when people get a massage, they are in a trance-like state. When they're zonked and they're just fully in the body, ask them what's going on in their mind and they have no idea. It's gone, it's somewhere else. That's a trance state, right? So I find that there's really no gray areas there, because it's it's not crossing any boundaries. So long as I don't claim things like all right, now I'm going to drop you into trance on the count of blah, blah, right, yeah, yeah yeah, exactly awesome.
Speaker 1:So so we start with, okay, self-awareness being vital for therapeutic presence. Then we move into communication skills, which you know people can take classes, either from you, from other individuals, on communication skills. I mean, I remember in college I did special care counseling and they had a communication. They had nbc community non-violent communication class and then they also had an observation class, which was we spent literally six months observing non nonverbal communication, because you're dealing that program was specifically for people with special needs, some nonverbal. So you have to use good nonverbal observation skills and I've noticed that's been one of the things that helps me in the clinic the most is nonverbal observation. So we have self-awareness communication. What's the next component for you that brings in a therapeutic presence? Is it the actual focus on communication, like the actual language? Is it the injury? Is it the environment? Yes, we know there's these unsaid components, but what, for you, is one of those important details?
Speaker 2:of those important details. It's kind of a tricky answer because it almost ties together the two previous parts, which is kind of self-awareness and communication, because you know, and we might even be able to pull into the third leg of integrative medicine. You know, body, that's the actual treatment you're going to do, mind, that's how we're going to be communicating. But then there's that less talked about part that nobody wants to discuss and that's the soul aspect of it. Right, maybe it has a bit to do with that as well, but, but a large part of it has to do with with really understanding and this this may sound esoteric in my description, but I assure you it's founded in pretty good science. Uh, ineffable aspect, and the science has to do with the principle of coherence and it's understanding that any object that has a vibration, which is to say all objects, will affect other objects that can vibrate in the same frequency. Blah, blah, blah, that's a lot of words to say.
Speaker 2:If you take two tuning forks that are both tuned to C and you knock one and you hold it near the other one, the second one is going to vibrate. That's two tuning forks Now, while the human body and the nervous system is significantly more complex than a tuning fork. It actually follows the exact same principle. So we get these two human tuning forks that move into a proximity of each other and both of which are vibrating and the vibration, the frequency that is emitted, both of which are vibrating and the the vibration, the frequency that is emitted. It turns out, and again we we can measure. This is we can measure large amounts of frequency coming from three distinct areas of the human body, which is so fascinating. One is the brain, one is the heart, one is the gut. All three are producing quite strong electromagnetic fields. The strongest of the three is going to be coming from the heart.
Speaker 1:Now, the chakra. People are going to love this conversation right, they're going to love it.
Speaker 2:That's wonderful. What's? It's so fascinating because I learned all of this stuff before. I learned about the chakra stuff and I'm like, oh hey, that's kind of cool, um so I'm the other way around.
Speaker 1:I learned all that energy stuff pre-massage, and then I moved away from it. I'm coming back to this place of I just don't know that's it.
Speaker 2:That's such a that's that's it. I just don't know. I just don't know. But but when I, when I begin to understand and again this largely came through the the uh study of heart rate variability is understanding the state of our nervous system, whether we are in a sympathetic arousal or a parasympathetic arousal essentially fight or flight, arrest and digest. Oversimplification, yes, but we can actually measure which state an individual's nervous system is by measuring their heart rate variability. Super easy to do you get a little finger clip, an ear clip, I mean even my ring does it. Apple watches do it. Very easy, by far the most accessible and reliable measurement of the state of the sympathetic nervous system.
Speaker 2:Now it turns out the state of the sympathetic nervous system is also going to dictate the vibration that the individual is emitting. So if I am in a profoundly sympathetic state, I genuinely emit those vibes, right Like. I'm truly emitting this kind of calm, and the word I like is regulated vibration. I move into the sphere of somebody else who's dysregulated. Maybe they're in a sympathetic state of arousal.
Speaker 2:Then, as our two clouds meet, as our two tuning forks become in proximity, the question is whose vibration is going to affect the other person's If we both stay firmly in our own frequency. I'm in parasympathetic, they're in sympathetic. There's going to be some weirdness, it's not going to feel good, right. But if I join that person in a state of sympathetic arousal, I join them in anxiety. They actually feel validated, they feel good, they feel. On the other hand, it turns out if I can just genuinely produce a stronger field, stay more firmly in my own state of regulation, they're going to join me and that's's part of the thing. That's. That's like the the. The biggest thing that I've realized is the more profound state of presence and emotional regulation I can manifest within my own nervous system, the stronger I affect my clients. All nonverbal, nothing to do with the words I say, absolutely nothing to do with the techniques. It's literally just how I show up in that room prior to anything else being said, and that's again all the self-awareness. That's the inner work and emotional regulation.
Speaker 1:It's wonderful and horrible all at the exact same time, because the beauty of it is that means, you know, we can use our own presence as part of the intervention. And you know a term I came up with when I was speaking um, with, with my on my last podcast, with with a person in israel. We were talking, and I came up with this term in my mind, which was the totality of intervention influence. If it is greater than the totality of intervention influence. If it is greater than the totality of discomfort disorder influence, they walk away feeling better. If the totality of the discomfort is greater than the totality of the intervention, they walk away feeling not as good. And so now it means okay, well, the totality of intervention influence. There's a component of it that's going to be your hands, as I talked about in my placebo class. There's a component that's unknown with placebos. There's a component which has to do with bedside manner. There's a component that has to do with whether they believe the treatment will work. And here we're talking about there's a component of presence that will take place, where your presence can actually be part of the reason the intervention works, because if they come in anxious and just being in your presence and your strong enough presence brings them down into your regulated state, then they walk away, maybe less anxious.
Speaker 1:But I've also found that frequently what I'll find myself doing, especially with clients who have new pain, like I just spoke with a client this morning who called. She said she was going to to cancel appointment because she twisted her ankle yesterday. And I spoke to her on the phone and she's going to come and see me because I'm like, hey, for a twisted ankle, like some of the stuff we do is going to be really good for you. And over the phone when she first started speaking, she was very much in that high arousal this sucks, this is going to be horrible. I wanted to run this event, I can't do it anymore. And I joined her there. Yes, it sucks, yes, it's unfortunate, yes, it's painful, that blows. And I joined her there with the intent of, after a little bit of period of time being there, when the moment was right, to start bringing her down into okay. Well, now that we've both lived in your despair for you, now let's move away from the despair and start living in where I see hope, and she joined me on that journey. And then we walk away feeling hopeful that the treatment will be beneficial and that exercise will be helpful and that she'll have less pain and things like that.
Speaker 1:But I find that exactly what you just said, you know, using that presence. But I find that affirming their presence, giving them a sense that they are right, that they're allowed being worried about what they're worried about, that they're allowed feeling the pain, that they're justified in their stress, they're justified in their anxiety and they're justified in their discomfort. To me it's one of those key components that so many therapists ignore in the beginning. If a client comes in worried about their pain, they're allowed being worried and join them in it, join them in their worry, tell, affirm how unfortunate it is with the intent of moving away from it.
Speaker 1:The reason it's horrible is because now it means that as a therapist, I have to have a presence that's strong enough to be the I. I guess dominant is the correct term, even though it sounds so aggressive, but it is the correct term and that's exhausting. Being present, and in the beginning, can be exhausting. I think when you've been doing it long enough, it becomes second nature and it's it's no longer, no longer difficult to be present and have a presence that's strong, but it can be exhausting. So that's why I think it's wonderful and horrible at the same time.
Speaker 2:You know, I I agree with that, and this kind of goes back to the beginning as well. For myself, it stopped becoming exhausting when I realized that the key to presence is authenticity. It's exhausting when you're trying to be the present practitioner. It's exhausting when you're attempting to follow all of these rules and go through this process attempting to follow all of these rules and go through this process and I do want to circle back to the description you just said about sitting in the discomfort with them in a moment.
Speaker 2:So it's super exhausting until there comes this point when it's like I know myself I know that naturally I'm not that empathetic actually, and that sounds strange as a practitioner, but it's something I've come to realize is really being that bleeding heart empath. That's just not me. But if I show up in whatever empathy looks like for me and I'm in it, it's easy peasy Because all I've got to do is be me fully, and the more I do that, the more I find I'm regulated and the more my client feels comfortable to be themselves fully and completely. So yeah, you're totally right, it is super hard and exhausting because there's a lot of navigating to do in there. There's a lot of figuring out well, who actually am I that know that myself again.
Speaker 1:Yeah, and I think that authenticity brings so much value to it.
Speaker 1:It's what they know, it's what they say. You know, like one of the popular memes nowadays is this is my husband's or my wife's or my partner's or my children's or my brother's or my siblings' love language. You know it may not be what I want, but it's what they can offer, and I think that's so important to remember that as a practitioner, we can't be everything for everyone. You have to be true to who you are and you will get a clientele who appreciates that value, and for people who don't appreciate that value, you got to let them go. But that's so hard for new practitioners because they're like I haven't paid my rent, I don't have enough clientele, my resume is not built up, my clientele, and so they want to be everything for everyone, and I think that's it goes back to what we talked about with the technique, like I'm not everyone for everyone and I don't have tons of techniques.
Speaker 1:I have my techniques. I don't do swedish, I don't do relaxing. The only relaxing massage I do is an asmr massage that I created, but I don't do swedish, I don't do, I don't do reiki anymore. So I'm not everything for anyone and I don't want those techniques because it's really not authentic to me. And so it's one of those things where I find the techniques. I want to have a jack of all trade experience as a therapist, but as clients they're like no, if you're really really, really good at this one, it's like thinking about a car mechanic if someone specializes in your engine and you go see them for your lights, they might be able to help you, but it might take them twice as long and they might not do a good job. This is the same thing be authentic to who you are and you'll find that presence more there. So you wanted to talk. You wanted to go back to what we were talking about earlier yeah, yeah, your.
Speaker 2:Your description of of somebody comes in and they're in pain and be with them in that pain is is that's. That is a uh technique that's taught in many forms of counseling psychology, somatic, experiencing so a lot of these, these modalities that have to do with psychological or counseling. The process is, uh, first off, you validate and the description I say is you walk up to a hole and you see somebody sitting in a hole. How helpful is it to say get out of the hole? It's not right. In fact, it's not even that helpful. If you throw them a rope and say here's a rope to get out of the hole, it turns out what's the most helpful thing to do is, as um, contradictory as it may seem get in the hole, climb down there, sit with them in the hole and be like oh, wow, yeah, this sucks down here, like I'm with it, it's deep, it's dark, yeah, like the thing you're experiencing makes complete sense.
Speaker 2:it sucks and then slowly being that there, having that therapeutic presence so the term I use is being the biggest clock I give give this clock analogy right Little by little, eventually, they start to kind of vibe with you, you know, and you're like, okay, we're here Now when you're ready. No hurry, I know the way out. I just climbed out so I know how to get out of here. So we're going to do this together. I'll be right behind you or in front of you, whatever you want, right you? Got to work with them.
Speaker 1:The oldest adage would be lead by example. Go down by the hole and then say, hey, look, here's a step, I'm going to take it. First You're welcome to join me and then you're leading by example and it's. But you can't lead by example if you don't go down there and if you're not authentic. Because, for an example, I had a client yesterday who's going through menopause right now and she wants to start working out and she's going through menopause and she has arthritic pain from hormonal changes and all these things and I I offer workout programs now in my practice, separate from my massage stuff.
Speaker 1:And I said you know, like I have a friend in Spain right now who she's a personal trainer coach and she specializes in perimenopause and premenopause. So I use her as a resource for all your guys' questions. Because guess what, as much as I read a book, I'm not experiencing what you're experiencing. So it's like you can tell me about your pain and I can say I want to be down there on the whole with you, but the truth is is I can't and my friend is not present to you or your needs I am. So I'm going to use her as a lifeline and my authenticity is I have limits. I'm not able to go as deep into your experience as you are, but I can project myself and I can be as close as I can. I can support and I think that's an interesting component of jumping down in the hole with them. I love that analogy. I think that's really fantastic.
Speaker 2:Yeah, and it gets tricky too, because there are those times when you simply can't relate. Like you're seeing somebody who's menopausal. As a male, there's no way to relate with what's happened. As a man working with prenatal clients, it's literally impossible to genuinely understand. But, like you said, you get as close as you can and my experience has been that effort of again being present and getting as close as possible. That counts more than just about anything. Again, subverbal people need the words for you to say like listen, I'm going to do my very best here. They see it, they feel it, they're aware of it, and then that builds that therapeutic relationship.
Speaker 1:They see it, they feel it, they're aware of it, and then that builds that therapeutic relationship. So now, on the flip side of that, the nightmare component in my mind, where I'm going with this therapeutic presence which I think is a wonderful component to care, especially the unknown quantities, qualities of manual therapy is so I create empathy, I jump down in the hole with them. I have good communication, I'm vibing well, I'm there with them. The end of the day hits. How do I walk away out of the hole if my client stayed down there? How do I walk away going? Okay, I was able to be empathetic and I was able to be present with my clients.
Speaker 1:But now I'm going home and I have a partner who wants to tell me about their day, or I have a child who wants to tell me about their day, or I have friends who want to tell me about their day. And what's the first thing we're going to do? Is we're going to default into therapeutic presence, but now you're not getting paid for it, you're not being compensated and emotionally you're now taxing yourself because you're not putting your limits. So what are some of the things you've learned? To create the boundaries, to say I'm on duty, I'm off duty. But then there's those gray areas, those people in your life who you're never off duty. You're never off duty. You're always the support for your partner. You know she's my support, my wife is my support and I'm hers. That's going to be a lifelong experience, as long as we're together. And so where do you find yourself being able to create that recovery? Is it purely the ritual from the end of the day, or do you find yourself being able to have boundaries with people?
Speaker 2:Yeah, wow, you really, you really nail it on the head there, troy. That is the most challenging part about this. Whether or not anybody adopts any of the practices or ideas we've talked about, they're doing it already. They're doing it already, yeah, and it does get challenging. So, first off, I'm going to address the sort of how. How does how do I delineate between I'm showing up for my client in this therapeutic presence and then I've got a friend who just wants to tell me about a hard period in their life.
Speaker 2:Well, I I believe that that humans are remarkably adept at becoming the version of themselves that the situation requires. There's unhealthy versions of this, and that's going to be putting on a persona, and you know, persona means mask, right? It's Latin for mask. So it's like putting on a persona and it's not you, it is fully a mask. I don't think that's healthy at all. But what Carl Jung often says is there's this process of individuation. First off, you get through the process of acculturation, where you learn how to behave like a normal human being, and then you get through the individuation process, which is learning how to integrate all parts of yourself and manifest specific parts of yourself when situations require. I'm a 99th percentile introvert. Like you, don't get much more introverted than me.
Speaker 1:And yet. I'm probably on the opposite end. I'm a 99% extrovert, very much so.
Speaker 2:Right. And even so, I'm sure that you can. You can do the introvert thing when the situation requires right. Same thing I could do the extrovert thing when the situation requires.
Speaker 2:So to to kind of get to the point here is I believe that there is a oftentimes unconscious or subconscious distinction between these two versions of self that are present during different interactions, is I can sit there with a friend and I can also be empathetic and I can also get in the hole with them, and I can also do all the same things. And yet there's a slight difference in the flavor. There is a difference because it's contextually different. Some part of your being knows this is my best friend, this isn't a client. There's a different level of emotional involvement that is actually appropriate in this situation and circumstance and it also comes from saying to friends and people like I'm here, I really want to listen to you, but I still need another 20 minutes, I need an hour, I need X amount of time. That's where the boundary comes in, where it's like I got to do my thing to decompress so I can be fully present for you. And that's really understanding what boundaries are, how to establish them in a healthy way.
Speaker 1:That's a key distinction there, I think boundaries. I think everybody likes talking about boundaries until they've gone through burnout. And then when they go through burnout and they come out of it, they go no, now I have boundaries and now I understand my boundaries. And until that moment I talked about boundaries for 20 years. And then, at year 18, I was like, oh, I didn't listen to any of my boundaries. And then I got burnt out and almost quit the profession. And when I came back I was like, oh, now I have boundaries. You know, I limit myself to 16 sessions a week and I will not do more. And if I have somebody who wants to come and see me as an emergency session, it's double the fee, which is a massive amount of money, to see me. So it's not worth it. Therefore, it doesn't happen. That's the boundary. It's don't make it. Don't make it happen For me.
Speaker 1:I found one of the things that I've integrated into my experience to separate the clinical practice from personal life is that I always have a drink when I'm dealing with friends or family.
Speaker 1:It's not always alcoholic, sometimes it is a beer, a gin and tonic, whatever it is, depending on the friend or the community. Sometimes it's coffee, sometimes it's tea, but it's never just because when I'm with my client, I'm not drinking while they're on the session, right, I'm treating them. So here it's, my hand is busy doing something else. I'm not massaging a foot, I'm not massaging a hand, I'm not giving them a scalp massage. You know like my wife and I will watch TV and I'll give her a foot rub or we'll be driving and I'll accidentally realize that it's been an hour that I've been massaging her hand, not paying attention because my hand is just unconsciously doing it. And so here, when it's friends or community who aren't clients, it's I physically hold a drink in my hand. That makes it where I understand there's a separation between the two. I'm a different persona during that experience where I've individualized that, compartmentalized that portion of my life to be present.
Speaker 2:Yeah, yeah, yeah. I like that. I really like that. Having an external cue that's a reminder to your consciousness like this is different. This, this is, this is we're showing up different. Now, that's brilliant.
Speaker 1:And I think, I think the idea, I mean, I love everything you're saying about therapeutic presence. You know, know thyself, that's key, but I mean, is that special to us? No, that's special to humans and good luck with it. Right, like that's? That's the debate of why humans exist, to start with. So know thyself and good luck figuring it out. Two is communication learning how to appropriately communicate with the clients, being, you know, bedside manner, and that's such a key component. And you know, one of the ones that I thought about when it came to communication was, I remember, when I taught my integrating evidence-based medicine and patient-centered care class, one of the things that research shows us when it comes to client stories. You know, like, do you mind me asking how old you are?
Speaker 2:Yeah, I'm 38.
Speaker 1:38. Okay, so I'm 44, you're 38. That puts us at 82 years old. Now if we divide 82 by two, that's going to be 41 years old. Neither of us are 41 years old and yet the average people of this Zoom call is 41. So the average of most research might not actually to apply to any individual within the experience. So when you tell me your age of 38 or mine of 44, that's there for the individual story within the paper. That makes the average important.
Speaker 1:So when clients come in and they tell you about their stories, the evidence portion says here's what we should recommend doing based on your arthritis, your age, your condition, x, y, z.
Speaker 1:But their individual story isn't represented inside that paper. But then if we only do their story, we're ignoring all the probable outcomes of statistically, if you have arthritis and you don't move, this is how bad it gets and X, y, z. And so I think one of the downsides that a lot of people have when it communicates stories is when someone tells a story, the first thing they find themselves doing is trying to relate it to self oh, you've had a knee injury, I've had a knee injury. But when we say I've had a knee injury, in that moment we're taking away our client experience and we're making it our story. But it's the communication is. The client's story was valuable, the client's experience, and I think when it comes to communication, a lot of people forget that it's not about you as a therapist. You might think correlating your story or relating your story is empathy, like I'm creating a connection and there's a component to it of that, but it's a tricky line between stealing their story and making it you as a therapist, versus acknowledging and, you know, confirming their story yeah, yeah, it's a hard balance, isn't it?
Speaker 2:because because you're right that there is a capacity of it, that shared experiences help create a stronger connection, more rapport, right? If they hurt their knee skiing and you hurt your knee skiing, then you kind of like you can commiserate in that experience. But the line between taking that experience away from them and making it yours, it's a fine line and it requires quite a bit of practice and quite a bit of stepping over that line and making mistakes before you figure out exactly how far can I move into that. And the thing that makes it even trickier is it's different person to person.
Speaker 1:And it changes from day to day and you'll find it. You'll find it harder and easier day to day Some days you, as a therapist boy, I feel I slept great last night, I ate great, I worked out. Man, I'm present, I'm ready, let's do this. Other days you come in and you're like well, it's a shitty day, good luck getting the best care out of me, kind of thing.
Speaker 2:Yeah.
Speaker 1:Yeah, well, awesome. Anything else you want to say, jesse, before we go?
Speaker 2:Oh man, we could talk about this stuff for another four hours. I'm sure of it. Great place to wrap it up, yeah.
Speaker 1:Awesome. Well, before we go, I want to say thank you. I'm so grateful for the work today, or for the conversation today. I really enjoyed it and I also wanted to give you a chance to talk about some of your education, some of your material. If anybody's interested, how can they reach out to you? How can they get in touch with you? One especially if they're in the Calgary area as clinics, as clients. I have a lot of listeners in Alberta, but even just as students, people who are interested in attending some of your online or in-person education.
Speaker 2:Yeah, thanks for the opportunity. The easiest place is to go to the webpage it's just aimonlinecom, and from there you can find all the things. I've got a podcast as well, where I talk about a lot of these different topics, and that's probably it. From there is all the links of booking and social media stuff, so one place to go from there.
Speaker 1:Awesome. Thanks so much, jesse. I hope I get to see you at another convention soon. I'll be at the CMC in Ontario, I hope. If not that one, I hope I get to see you at one in the future soon.
Speaker 2:Yeah, likewise, likewise, and thank you very much. It no-transcript.