Psychosomatic Medicine

Acupuncture chart from Chinese medical text circa 1340s A.D.

There is nothing worse than going to a doctor with a host of symptoms and being told there is nothing wrong with you. Many people who appear on the program, Mystery Diagnosis, (my second Discovery Health obsession next to the The Food MD) have had this experience. I recall one particularly disturbing episode, where a young woman complaining of extreme gastrointestinal distress was prescribed an anti-depressant by one of the many doctors she sought answers from. Confused, she asked how these would help her to which the doctor responded that her condition was basically all in her head. When a physical illness or condition is caused by or aggravated by a mental factor it is termed psychosomatic. Essentially, that is how this young woman’s doctor viewed her illness. Many years later, she was properly diagnosed with severe endometriosis, a condition where the cells of the uterus grow in other places of the body causing cramping, severe bleeding and infertility to name a few. In her case, the cells had grown into and over parts of her GI tract. She had a full hysterectomy and a section of her large intestine removed in order to reclaim some quality of life. Take that, anti-depressants!

As you can glean from the above story, defining an illness as psychosomatic carries with it an intense social stigma here in the west, even though almost all physical illnesses have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment and resolution. When doctors dismiss symptoms like in the case of this young woman, the rest of the world follows suit. The person who is suffering internally and externally is labeled “dramatic” or even worse, a liar. For thousands of years, Chinese medicine viewed the psychosomatic as the greatest key to diagnosing deeper illness and imbalance in the body. The strength of the nervous system and physical state of the individual (including their environment) is assessed in order to understand the degree in which an organ or a system is affected. Every symptom is taken into account and treated seriously, with the objective being to restore balance. Moreover, the eastern approach considers how interconnected the body and mind are.

The biggest physical bully is emotional stress, which can infiltrate suddenly or slowly, over a long period of time. Even from a western perspective, stress can be incredibly destructive, wreaking havoc on connective tissues, digestion, vascular integrity and the body’s restorative sleep cycles if not managed properly i.e. not just a script for anti-depressants. In Chinese medicine, if the nervous system of the individual is weak, the symptoms of illness will be more psychological. On a physical level, the organ most affected by the emotional stress will be the weakest/dysfunctional one. Whatever the natural emotions associated with this organ are, they will become stronger and more destructive to the nervous system overall. As the organ breaks down, it takes the system it is associated with along for the ride, leading ultimately to disease. If the emotional stress comes on suddenly, it will affect the Heart and the Lungs. If it is gradual and long term, it will take a toll on the Liver, Spleen and Kidneys. Even more specific is the type of emotional stress broken down into these 5 categories: tense/chronic, shock/sudden, sadness, rumination and fearful emotion. This gives an even more precise view of the affected organs/systems in the body, further honing the treatment approach.

Our young woman with endometriosis would have been assessed as having a strong nervous system in the beginning, as her symptoms were predominantly physical. By the time she had gone to see the doctor who prescribed the anti-depressants, she was exhibiting a combination of physical and mental symptoms. This would signify that her nervous system was deteriorating. If she had also gone to see an eastern doctor from the get go, much of her later suffering might have been alleviated, as the weakest organ, her large intestine would have been addressed immediately with herbs and acupuncture/bodywork. Since organs are partnered in the Chinese system of yin/yang (solid/hollow), the untreated large intestinal dysfunction would have affected her lungs. This woman developed an eczema like rash all over her trunk and extremities that would get worse every time she had a violent bout of diarrhea. The skin is considered the 3rd lung of the body in Chinese medicine. This symptom developed 5 years after her initial bout of gastrointestinal distress. After ten years, she began to bleed copiously during her period, which lasted over two weeks. Initial blood tests had already indicated she was mildly anemic, but this massive blood loss rendered her immobile. Ironically, during this time, her large intestine dysfunction seemed to dissipate; however, as soon as the period would end, the violent diarrhea would return. At this point in her illness, the Spleen had become involved. Responsible for creating Blood/Qi and keeping things upright and in their proper place, it’s no wonder that when she finally got her diagnosis 15 years in the making, this was the most affected organ. (Note: One could even argue that the Spleen could have been the weakest organ overall, but I won’t complicate things for the reader) The cells of the uterus growing out of control outside of their proper place is demonstrative of Spleen weakness. The uncontrollable bleeding led to a massive loss of Qi that just couldn’t be replaced by her depleted system. The only solution, at that point, was to remove the uterus and large intestine to prevent the out of control cell growth from migrating elsewhere. While organ removal can have detrimental affects on the Spleen, it proved more harmful to keep the stagnation in there than to remove it. If I were this young woman, I would seek out an acupuncturist to help me keep my nervous system strong and balance the loss of the organs that were surgically removed. They would be able to recommend herbs and dietary changes to support her treatment. After watching this episode, it made me all the more fired up about Integrating Eastern and Western medicine. If East met West from the beginning, she and others like her would have been spared a lifetime of suffering. We would all have a better understanding of our body-mind relationship and keep the stigmatic tongue wagging at bay.

SOURCES & ADDITIONAL READING:

http://www.dragonrises.edu/learning-opportunities/articles-books/

http://www.psychosomaticmedicine.org/

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Anger Management

Even the most balanced person in the world, when triggered, can completely lose it. Anger is a strong, uncomfortable emotional response to something or someone that has provoked you. It is how we psychologically interpret an offense, wrongdoing or denial that is often met with a desire to retaliate. It is our immediate response to stop a threatening behavior or situation that many psychologists believe has a primal function to ensure survival. However, in excess, anger can have many physical and mental consequences. Think of a pressure cooker. You can only let the steam inside build up for so long before the whole thing explodes.

One Flew Over the Cuckoo’s Nest…a pressure cooker meltdown in action.

For the last few weeks I have been functioning in a fog of anger resulting from an unfortunate series of events outside of my control. All attempts to go with the flow are challenged on a daily basis as I try to weather this Category 5 Super Cell ravaging my life. With my blood already boiling in its channels, add the 90 plus degree weather and humidity here in NYC, and I feel like I am being cooked from the inside out/outside in. Therefore, it is no surprise that my digestion, skin and sleep have all gone awry. In Chinese medicine, emotions and physical illness are closely tied. Anger causes excess heat in the body, so my feeling of being cooked is spot on. The emotion itself is tied into the Wood element, whose governing organs are the Liver and Gall Bladder per Chinese 5 Element Theory. Physiological functions aside, these organs function to drive us forward in life, set goals and get things done. Despite my best efforts though, I have been feeling like all my attempts at forward movement and reasoning are met by impenetrable brick walls that hit back. The buildup of anger causes an imbalance of excess manifesting in digestive dysfunction, headaches (especially behind the eyes, as is the case with a migraine), muscle tension and tendonitis especially in the pathways of the organs (lateral leg, flanks of the torso, shoulders and neck). These are just some defining symptoms for these organs, but as we all know, when one thing is out of whack, other areas of the body will be affected.

All the elements in Chinese 5 Element Theory have a generational and controlling/controller relationship. This means that each element and its organs have the capacity to nurture and be nurtured by other elements. They also have the ability to pull energy back from other elements and vice-versa as a sort of system of checks and balances to keep everything harmonious. In the case of Wood, the Liver and Gallbladder are nurturers of Fire (there’s the HEAT again) which is comprised of the Heart, Pericardium (the bodyguard of your Heart), Triple Energizer (your Immune system and temperature regulator) and Small Intestine (the almighty discerning organ of what should stay and what should be eliminated both in your body and in your life). So you see, if there is an imbalance in Wood, some of that excess is going to visit the child. The best way to address this would be to make the nurturer of Wood stronger, in order to suck some of the energy out. That would be the Water element, comprised of Bladder and Kidney. These meridians run from the head down the spine into the back of the legs and then up the interior legs starting from the middle of the sole of your foot all the way up to your clavicle. It’s a good amount of somatic topography to cover and has a major role in all our life functions. What do you need most if faced with adversity? A good strong back bone and inner resilience. What do you need if there is a FIRE a-brewing internally? A whole lot of WATER.

The excess of anger in Wood has the potential of over controlling the Earth element, which includes the Stomach and Spleen. Appetite and digestion would be affected, as I am seeing in myself. What is typical is a feeling of fullness which translates to a lack of appetite and a total aversion to hot food. In my case, despite the excess heat in my system, all my body craves is spice. This, I learned recently, is a huge no-no because it will only serve to feed the overheated beast. When in doubt, food should be lightly cooked and no extreme of temperatures should be entering one’s mouth. There are many “cooling” foods that aren’t necessarily cold. If anything, they are more water rich, which quells the fire and also detoxifies. Some examples are lemon, orange, watermelon, celery, Daikon (Chinese radish), kelp, tomato, chrysanthemum tea and seaweed. The Metal element consisting of Lung and Large Intestine are the controllers of Wood and are greatly affected by the buildup of heat, which rises. My normally clear complexion has seen some eruptions and with the skin being the 3rd Lung of the body, it is clear how the heat is trying to escape. Hello, inflammation! Large Intestine, the great eliminator of waste in the body, can’t do such a great job under these circumstances. Bouts of constipation and poop with undigested bits demonstrate this. Hence, why it is important to adjust your diet. And apparently, some of the biggest builders of heat in the body aside from spice are caffeine, certain vitamin B supplements, sugar, alcohol and adrenaline (stress hormone produced in times of high alert, kind of like now).

So what do I do with all this HEAT? Aside from the adjustments to my diet, I sought out some bodywork to bring my nervous system down. Two hours of point work and muscle release specific to the organs involved in my excess heat and I finally felt a still point in the madness. A day later, I was boiling again over yet another uncontrollable situation. In my mind I tried to go back to the still feeling I had when my practitioner’s hands came off of my head, but it was hard. There were moments during our work together, where he had me breathe with a deep long “oooooo” sound which tied into the release of my Large Intestine. I channeled that sound, thought of a song that I could sing under my breath as I walked the streets of NY and much later, at work between clients that would settle me down. And, it kind of worked. Sort of ironic that therapeutic touch and music, my two loves in life, were exactly what smoothed my feathers out.

ADDITIONAL SOURCES

“Between Heaven and Earth – A Guide to Chinese Medicine” by Harriet Beinfield, L.Ac. & Efrem Korngold, L.Ac. O.M.D (c) 1991 Ballantine/Wellspring

“Dragon Rises, Red Bird Flies” by Leon Hammer, M.D. revised version (c) 2010 Eastland Press

http://www.pingminghealth.com/article/581/warming-and-cooling-characteristics-of-common-foods/

That’s Rolfed Up

Realigning your internal framework a la Rolf!

During the mid-point of my massage education, one of my professors described a technique known as Structural Integration. Falling under the alternative medicine umbrella, structural integration aims to put the body back into proper alignment by manipulating connective tissue (i.e. fascia) to release areas of restriction based on how the client has been moving and holding their body in space. This manipulation is done to affect the deepest level of the musculo-skeletal system (we are talking right down to the nerves) which might feel quite intense in the moment, but over time can reduce pain caused by improper movement patterns. In tandem with the work, the client is re-educated in how to move properly in order to maintain the results of the treatment.

One of the most popular modalities of structural integration is Rolfing. I was familiarized with this when a close friend, who suffered traumatic injuries from an accident, received this bodywork along with her physical therapy. She went from being unable to walk all the way to full on modern dancing within a year. I recall her saying it hurt – A LOT. Intrigued, I did some research to see what it entailed. Created by biochemist Dr. Ida P. Rolf, who recognized that the body’s systems were all interconnected through a seamless network of connective tissues, it was originally meant for the chronically disabled to help improve their mobility. However, she soon learned that her method of postural release also applied to people with chronic pain, stress and/or who put intense physical demand on their bodies. Hmm…sounds like somebody familiar, e?

Like any effective form of bodywork, Rolfing is a holistic approach, taking into consideration the individual and what their needs might be to adjust the treatment accordingly. Adjustment is key also in the depth of manipulation of their connective tissues as well as the mobilization of their joints. Some of us, although mentally psyched for it, find that our bodies will fight back. As a therapist, you have to know how to knock on the door in order to be invited into a particular area of the body. The client needs to feel safe, comfortable and trusting of your touch, especially when the work will be painful. The end goal is free and fluid movement. Usually this will be done in 10 sessions; however some people feel very dramatic changes to their posture and movement right after their first session. (See the diagram I posted in the header for an idea of what happens)

Now that the benefits and technique have been laid out for you, there is the task of finding and working with the right Rolfer. A therapist cannot claim they Rolf unless they have been Certified by The Rolf Institute of Structural Integration, the only organization worldwide that educates and certifies Rolfers. You can search for and check a therapist’s credentials via the Institute’s website Verification link. Certification aside, a therapist’s approach can and will vary. It is important to find a practitioner that communicates effectively and listens to your feedback in a constructive manner. Another friend of mine received the technique and found that her therapist would not ask her questions or address her comments regarding the work. She left the experience feeling she was treated like a body, not a whole person. That is never a good thing in any form of bodywork and usually does not produce results. If you are open to being Rolfed, take the time to research your practitioner and/or get referrals from those who have been privy to this treatment. Dramatic change is priceless.

For more information on the latest in Rolf techniques and research:

http://www.rolfresearchfoundation.org

Gouri, 2013

It’s a New Year and with that come the flood of resolutions, made with good intention, to have a fresh start of things. What often tops these lists are changes in diet and exercise. Gym memberships notoriously surge in the beginning of the year, while kitchens are cleaned out of their sundry contents to be replaced with all kinds of leafy greens and organic snacks. After a few weeks, the novelty of the fresh start wears off and for many, old habits die hard.

One of my New Year’s day clients joked that massage should be at the top of his list for 2013. In fact, all the clients I saw on that day expressed wanting to begin their year on a relaxed note. Many of them had received these massages as gifts. The Greeks call this gouri, a gesture or gift of good luck typically given to family members and friends for the New Year. Honestly, it’s a brilliant commitment to oneself to reduce stress and bring balance to the body on a regular basis. Think of all the cumulative affects of a chaotic lifestyle, rife with packed schedules, inhaled meals and little sleep and the investment of one massage per month becomes feasible. This is what I tell clients when they cannot fathom the cost of such a “luxury.” If you can spend $80 to $100 on frothy coffee drinks per month, then you can afford one massage. 

It’s pretty and smells delicious, but doesn’t last very long.

I could post heaps of statistical data supporting the benefits of regular massage on health, immunity, mobility, recovery and performance, but I won’t. What I want readers to keep in mind is a word I mentioned above – commitment. Many of us have a problem honoring commitments made to ourselves; moreover, the list of resolutions we make at the beginning of each year to change this, that or the other is a bit of a joke when we have no intention of doing anything. Why even make a list at all? If you can commit to just one thing at the start of each month, I am positive you will enact more self change then tackling an entire list in just January. Here are a few to pick and choose from:

  • Commit to one massage a month.
  • Commit to one session of strength training per week.
  • Commit to five minutes of deep breathing and/or stretching before bed every night.
  • Commit to taking the stairs at some point during your day.
  • Commit to 20 minutes in the steam room at the gym.
  • Commit to juicing one morning per week.
  • Commit to making your day off count for you!

It’s a matter of choice

Male or female?

When given the choice between a male or female therapist, which would you prefer? There are definitely many factors that play a role in this decision, including your gender, sexual orientation, religious and/or cultural mores and presumed stereotypes to name a few. Although ideally it should be an equal opportunity booking system, ultimately you want to book with someone you feel comfortable with. More often than not, the therapist that fits that bill ends up being female.

While still in school, I remember becoming very anxious about my ability to find work upon graduation. I consulted with one of my teachers, who happened to be male. I was hoping he could advise me on where it would be best to apply and what potential employers were looking for in a “rookie” therapist. Keep in mind that this teacher had a successful private practice, had been a lead therapist/supervisor at a very popular gym/spa chain and super active member of various professional groups related to massage in addition to his position as a core member of the faculty. Despite all this experience, he told me that it had been very difficult for him to obtain clients. He had to work twice as hard as the female therapists to strum up business and eventually reach the level of success he had. His skills and expertise were not the deciding factor; it was his gender that put him at a disadvantage.

Think about the power differential. The client laying on the table is in the most vulnerable state. You are unclothed and in a submissive position. You trust that the therapist towering over you has the education and skills to address your needs properly and respectfully. You hope that they don’t judge you or your body in any way. You pray their touch is firm, focused and has a flow. You want them to put you at ease from the start, so that you can mentally check out and really enjoy the benefits of the work. Regardless of gender, a true professional will be able to provide all of the above to the client, but without a doubt women win out for their perceived nurturing nature, transcending the role of “mommy” on the massage table. A recent article in Psychology Today outlines the gender gap when it comes to caretakers. Society expects women to be the natural choice due to their biology, while men are hardwired to be natural “fixers” and protectors. You might think these qualities would bode well for the male therapist, but not when it comes to massage.

Minus the watch, this is a perfectly normal image of a male therapist working the lumbar region of the back of a male client.

Then there is the tricky area of sexuality. As long as there are “happy ending” jokes circulating and brothels posing as massage parlors, the massage profession will always have to prove its legitimacy. That said, heterosexual men, whether single or married, can feel extreme trepidation at booking with a male therapist because of what other people may assume about their sexuality. Also, since the parasympathetic nervous system is stimulated during massage, an erection could occur and the thoughts of this happening with a male therapist brings on much anxiety. On the other side of the coin, heterosexual women, whether single or married, can feel hesitant to book with a male because of the possibility of an attraction related to their touch or the judgment of their body in a sexual manner. I recall one of my clients telling me she didn’t care if she had shaved her legs or had cellulite dimpling on her thighs with me because “we have the same parts” but if she had gotten a male therapist she would have felt embarrassed. Throw into this mix the complicated and often skewed ways touch could be perceived after a trauma or abuse and again, the female therapist is the “safer” choice.

You may wonder then, how male therapists are ever able to get clients and be successful in this career. There are some stereotypes that work in their favor. With respect to strength, males are definitely viewed as the stronger sex and more capable of delivering deeper work. Even more so if the work is sports specific, as most massage therapists affiliated or employed by sports teams tend to be male. It took many years for Kelly Calabrese to push through these stereotypes and become the first female massage therapist employed by a Major League Baseball Team. All that aside, education and über professional conduct will prove to be the most powerful tools in bridging the gender gap. The more informed the client is about massage and its benefits, about the background of the therapist and their skills through testimonials and reviews, the more likely they will be able to make an informed decision when given the choice of male or female.

The Energetics of Making Baby

This is an addendum to my previous post about Fertility Massage.

Keeping that bun in its oven is harder than most people think!

Chinese medicine teaches that in order for a woman to conceive and maintain a pregnancy, a combination of organs need to work in harmony. Any weakness in either one or all of these organs makes baby making all that much harder, if not impossible. However, unlike the fertility treatments of the Western medical world, the Eastern approach is much more cost effective, easily accessed and non-invasive. One of these approaches is the acupressure massage known as Shiatsu, which is performed by yours truly and a host of massage therapists in this hemisphere of the world.

Much like acupuncture, acupressure massage addresses specific points along meridians that form pathways of energy or Qi (Chi). These pathways correspond to twelve vital organs in the body, as defined by Chinese medicine. The organs, represented by their meridians, serve a particular physiological and spiritual function. Any state of disease or imbalance can be explained by either an excess or a deficiency. In order to understand how Shiatsu can help with fertility and beyond, here is a brief overview of the energetics of making baby.

One word – JING. This is your life force; the Qi that you have stored up from birth given to you by both parents. The organ responsible for storing this prenatal energy reserve is the Kidney. As we age, our JING begins to deplete naturally, but those who live hard and abuse their bodies deplete it faster. In general, any lifestyle or chronic condition that taxes your body, depletes your life force. When a person dies, the Chinese say it is because their JING has run out. Hence, when a woman has a depleted or weak JING, there is simply not enough to provide for the prenatal Qi necessary to conceive a baby. If she is able to conceive, JING is necessary to consolidate the pregnancy; therefore, the fertilized egg would have trouble planting itself in place.

Speaking of baby staying in place, the womb-home needs to be in tip top shape and position in order for the fetus to develop and grow those 9 months. The organ that is responsible for holding things in their proper form is the Spleen. The additional role of this organ, according to Chinese medicine, is to create blood. The walls of the womb are a dense network of bloody tissue (i.e. the placenta) which both cushions the fetus and feeds it by way of the umbilical chord. If the Spleen is weak, the womb and food source will be compromised making a miscarriage all that more likely.

While the baby develops physically, it is necessary for it to also do so spiritually. The baby’s consciousness comes from the Heart, the organ responsible for housing the spiritual soul. The Chinese believe that the soul comes into the body on the 81st day of life, which would be around the tail end of the 1st trimester. If we take Judeo-Christian debate out of this, essentially the first trimester is almost like a trial period; make it out of that third month and your risk of miscarriage drops significantly. I found that most women I know were reluctant to announce their pregnancies until they were out of their 1st trimester, so as not to “jinx” them. This mentality is rooted in medical fact. Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists (ACOG) with most occurring within the first 13 weeks of pregnancy. (http://www.americanpregnancy.org)

Lastly, pregnancy can be very stressful on the body. Not only does blood and nourishment need to flow freely to the developing baby, but the musculo-skeletal system of the mother needs to be able to adapt to its growth. The Liver is the organ the Chinese say governs the muscles and sinews of the body. It regulates the flow of blood/Qi to wherever it is needed, as it is needed. The ever changing state that is pregnancy demands a lot of the Liver. Therefore, this organ needs to be kept strong. A difficult pregnancy (i.e. limited mobility, muscular insufficiency, structural deformities, etc.) and even more difficult delivery are usually associated with weakness in the Liver.

Unlike other forms of massage, Shiatsu is performed with the client clothed in comfortable attire that does not restrict movement. The work can occur on either a mat or a table, depending on the client’s comfort and needs. The main goal is to tonify or strengthen the above organs involved in conception, maintenance of pregnancy and the health of the mother. Should you have a history of infertility and/or chronic miscarriage, the Spleen and Kidney would be the main focus of treatment. Their pathways of energy run along the lower limbs. So does that of the Liver. To tonify, the therapist would likely employ slow, deep and broad pressure to these points along with various stretches to unblock any stuck energy. Of course, each session would be customized to the client based on a detailed assessment and re-evaluation post treatment. The price range for a Shiatsu session varies depending on where you live, but expect that most will be priced between $65 and $120 US for a 60 min session. If this seems like a lot, know that many practitioners provide packages at a discounted rate or sometimes even sliding scale. In addition, many schools of acupuncture and massage have student clinics where treatment is offered at a heavily discounted rate. There is an application process involved and sometimes there can be a waiting list, but once you are accepted into the clinic, the quality of treatment is held to a super high standard. Students have to keep detailed records and write treatment plans, all the while consulting with supervisors on client cases. This option is a great learning experience for them and a cost effective opportunity for you.

 

 

 

The Traveling Therapist

The magical Myrtos Beach in Kefallonia, Greece

 

I can never turn down a person in need of bodywork, even when I am on vacation. During my recent ten days abroad visiting the land of my ancestors (i.e. Greece), a friend asked me to work on her tense neck and lower back. The many hours spent standing in her salon and cutting hair in various twisted positions had taken a toll on her body. Her boyfriend then piped in that he too had tension in his neck and shoulders from constant lifting of machinery. As I assessed his massive trapezius muscles, a third  friend was volunteered up by the first one for massage since she had never before received one. In the span of one evening spent on a terrace enjoying the oceanic breeze, I garnered myself 3 clients, all willing to pay for therapeutic bodywork despite the pretty widespread economic turmoil.

What came as a surprise was their openness toward massage. Although the ancient Greeks employed massage as a key part of medical practice, modern Greeks have been on a much different page with respect to bodywork. First and foremost, massage therapy is an unregulated profession. This means that the government does not mandate any kind of educational or professional standards. It is up to the individual employer to set up guidelines of professional conduct and experience. That being said, on many major beaches in tourist riddled islands like Mykonos and Santorini, there are women (and sometimes men) who troll the sands offering 10 to 15 minute massages to people reclining on towels and chairs for the equivalent of $15. I witnessed them in action back in ’06, way before the career of massage became a thought in my mind. In the bigger city of Athens, massage is often a front for prostitution. I often had to call myself a massage-slash-physiotherapist in order to avoid that “Oh, reaaaaaallly…” face from some of my relatives and family friends. With respect to spas and resorts offering massage, I remember looking into a hotel spa in Cyprus for possible work last year and seeing that the therapist they sought had to be willing to do up to ten massages per day and be paid a flat fee for the entire Summer season (4 months) of $1500 dollars. Slave labor, anyone?

The US, Canada, Germany and France all regulate massage, demanding a certain amount of hands on hours, education, license examinations and continuing education in order to practice the profession. Outside of these countries, the lines of professionalism can be easily blurred. For instance, in Japan only Shiatsu (acupressure massage) is regulated. In China, massage is completely unregulated. In New Zealand, massage therapists can register at two levels of competency, but the government doesn’t recognize or regulate the profession. Basically you can set up shop and conduct yourself as you see fit without anyone getting to say a thing about it. I pictured myself in a bungalow by the Majorcan, Spanish coast,  massaging many an expat and local while living the Mediterranean life of Riley. But let’s be realistic here. Without regulations, what differentiates me from the young girl on the beach? I have two degrees, close to 3000 hours of experience (and counting) and CPR/First Aid certification. I charge a rate that reflects my skill level and education. She is on the beach, offering up massage for a bargain, which may or may not be effective because you have no clue as to her training. You don’t have to be in an economically stricken country to be attracted to a cheap deal.

I asked my 3 Greek friends how they felt about paying for massage on a regular basis. They all insisted that I could carve out a pretty decent living if I charged something between 40-50 EURO for the hour (55-65 dollars at current conversion rate). Although people’s wallets have been and will continue to hurt, the therapeutic need for stress reduction and balance to the body is strong enough to make the expense a necessity. It’s funny how attitudes change when in the midst of a crisis. Perhaps I should head back over the Atlantic to the land of  my people and do my part in helping them cope with an uncertain future while ironically securing my own.