break me
I decided to get a massage this week. I rarely receive hands-on work, mostly because I don’t love structural style treatments for my own body. I usually prefer gentle indirect approaches. But something inside of me needs to be pressed down. There is a persistent energetic unruliness that I’m living with, a bolting horse in my nervous system, and it’s been completely untethered since I finished my course in June. It’s time to put it down. To get out the therapeutic, proverbial boltgun. In seeking hands-on work, in this electric moment, I am replicating the instinct of so many of my clients over the years. Pain, exhaustion, fatigue may sometimes only be met by submitting to obliteration. The obliteration makes the next steps possible.
For a long time while I was training as an osteopath, and even prior, I had this idea that the most important thing I could do was validate all that study by giving a formal musculoskeletal diagnosis to all the patients I saw. And certainly, a diagnosis provides working clarity and will help me decide whether I need to refer you on for imaging, surgical opinions etc. But it’s imperfect, and for the majority of presentations that will be classified as non-specific, a highly tissue specific diagnosis and finicky treatment is a great way to focus on everything other than what might actually be helpful.
The biopsychosocial approach to healthcare encourages us to see patients, people, as contextual. In the context of the modern world, in the context of capitalistic exploitation, the context for most people is that they’re actually fucked. Stressed, anxious, depressed, angry, sad. When they present to me with a sore arm, sore knee, stiff this or that, even persistent headaches, I take a little time to feel into their body and see where they’re at. And with few exceptions, I receive the same answers - deep, deep grief, searing anger, vibrating anxiety and always a gentle overlay of uncertainty as they begin the journey to the other side.
They know why they’ve come to see me. For better or worse, mostly for worse, the public idea of massage/manual therapy is ‘no pain no gain’. And while it’s completely inaccurate that strong sensation is required to modify musculoskeletal pain, they’re here for that sensation because of what it symbolises - obliteration. Destroy me, alter my consciousness with touch, with force, make me submit to the pressure of the touch and life, and in doing so I can start again.
Of course, you can effectively rebalance a system with five grams of contact, but most people are so exquisitely distracted, exhausted, wired, that the only thing that might interrupt the storm is a little bit of consensual, totally non-sexual sadomasochism. Me, the sadist (“is that ok?” CRACK), them, the masochist (“oh god, that hurt, do it again”). It’s this general approach that ends up offering the most therapeutic benefit in non-specific presentations, particularly where somebody is, biopsychosocially speaking, fucked. As long as they’re cleared through clinical examination and history taking, they’re ready to be destroyed. Physical assessment and careful exercise prescription reinforce the broad functional changes achieved through the destruction and facilitate rebirth.
Finding myself bolting for the horizon, both exhausted and a live wire electric current, I am seeking a form of somatic obliteration myself. See you on the other side.
