Hands Off the Hands-On

By Thomas Myers

Recently, I had occasion to break bread with a few of the top continuing education teachers in our field of therapeutic bodywork. These people have risked their personal fortunes and dedicated their professional lives to developing and broadcasting new methods of hands-on healing for the working manual therapist.

We agreed that a student learns about 10 percent of what he or she needs to know during initial training. The other 90 percent comes from on-the-job training in practice and continuing education (CE). Informal surveys in my courses confirm this arbitrary and approximate figure.

Let me hasten to say that I don’t mean to denigrate the fine programs that serve to set massage therapists in motion. Though a few late arrivals to the scene show signs of a thrown-together, take-the-money-and-run educational approach—giving students contact with only a few instructors of dubious teaching background—most schools clearly go for quality education from dedicated healers enthusiastically sharing their passion. My own experience with approved programs of at least five hundred hours is that they by and large do an excellent job, given their financial and regulatory constraints.

But you simply cannot learn it all in school. You can learn to be competent; you can learn not to be dangerous; and you can be presented with a variety of options for ethical treatment. But there is simply no substitute for the growth of knowledge and depth of connection that comes from day-to-day contact with real clients in real life situations, with all their complications—physiological, personal, social, and cultural.

I am not sure that adding more hours to basic certifying education will automatically result in better-prepared practitioners. With all respect to our neighbors from the north, Canada requires twenty-two hundred hours of training to license their therapists. The result is indeed a better-trained therapist on average than we have at graduation, but in spite of the extra schooling, they are not arguably three to four times better than their American counterparts.

Figures compiled and reported in Massage & Bodywork show that many beginning practitioners do not survive more than four years in this trade. These folks who drop away are largely those who could not get a handle on the other 90 percent you cannot learn in school. Given that, let us look at the five-year practitioner—someone most likely to make a long career out of touching people to heal. By this time, he or she has established a practice, had experience with a variety of folks, and settled down into a modus operandi that probably involves a blend with one or two principal modalities predominating.

For most therapists at this five-year mark, their work has gone one of two ways. Either they have found a niche that they enjoy, their practices are full, and they are content, or—more common, I think—they feel like they are butting up against the ceiling of what they learned in school, they are frustrated at not being able to provide help to some of their clients with complex conditions, and they are ready to take on a significant amount of new education in some part of this field that intrigues them.

So, you learn a tremendous amount from your initial training and your clients and their unique situations, but there comes a time when, in order to grow, you need a leg up to the next level of your art. The best ways of providing this next step is what my colleagues and I were talking about over our meal.

Our Emerging Field
It is the responsibility of any profession to provide meaningful continuing ed for its members—doctors, dentists, nurses, physical therapists, chiropractors, and most others all find it necessary to hold their membership to a requirement for continual updating on new developments.

New professions need this updating even more, and ours is a rapidly expanding and emerging field. The interested seeker can explore a bewildering variety of approaches, including craniosacral therapy, myofascial release, trigger-point therapy, orthopedic massage, Alexander, Feldenkrais, yoga therapy, any of a number of Rolf-evolved methods, body-centered psychotherapeutics, a full spectrum of Asian-based approaches, neuromuscular training methods such as Pilates and its ilk, and an increasing realm of energetic healing. You can roll on the balls with Yamuna, get actively stretched with Aaron, explore the openness of your facets with Erik, drain your lymph with Bruno, or lift your liver with Jean Pierre. Not to mention the significant pioneering efforts made over the years by Benny, Leon, and many others.¹

Each of these is worth at least another five hundred hours to master the modality in such a way to make it work in daily practice. For most, it is not the work itself that requires the time, but the ability to see, feel, and enter into the body in a different way. While some practitioners may only have access to short courses and add some of what they learned to their existing practice, all of the disciplines named above need substantial time and layering to be fully absorbed in the richness they offer to practitioner and client alike.

This brought my friends and I to the new and disturbing trend of offering CE credits on paper or over the Web. Now, as CE providers, we clearly have a vested interest here, so I am open to hear the counterarguments from those in the profession who favor these hands-off ways of getting CE credit hours for our hands-on job.

Some will say that home study has a long history in this country. True, but home study, in these electronic days, can involve DVDs and Internet interaction, and is generally way more sophisticated in both application and assessment than what I have seen offered recently: read an article, answer a few multiple-choice questions, and collect your credits.

Someone is doing this with my book, Anatomy Trains. You pay this person $245 and you get my book (retail $55) and a few photocopied pages of pretty dumb questions. Answer them, and you get what is called 25 CE contact hours. Now, what she is doing is not illegal, but give me twenty-five of your real contact hours, for not much more money, and I will guarantee four times the educational and in-your-practice, hands-on value of this so-called course.

Some will say home study is essential for the geographically isolated, and undoubtedly it can be helpful. But those who choose the joys of being far away from the more maddening aspects of the twenty-first century (and I number among them) also need to take responsibility for salting some money away to fund their return into the maelstrom every once in a while to partake of the camaraderie and the new developments in our field.

There are those with small children, aging parents, or the like who need to be exempted from their CE requirements for a period of time, and most CE programs make allowance for these higher priorities. I was involved at the inception of both the NCBTMB and the Rolf Institute’s CE requirements, and each had a hardship provision.

In any case, the danger here is not that the few practitioners who are burdened with isolation or life’s essential duties will fail to get some educational help. The vastly greater danger is that far too many of the rest of us will use this easy avenue to escape the discipline of checking our ideas and practices against the newly arising or long-established standards of our wonderful and promising work.

Nothing will destroy our promise and dull its cutting edge faster or more effectively than choking off the growth of innovative continuing ed. If it is just that easy to get credits, and you can avoid the hassle of taking off work, traveling out of town, and all that money, there is a subtle but pervasive seduction away from the original intention of establishing CE in the first place.

Now, again, I have an ax to grind here, as offering CE is how I earn my keep these days. God knows, I appreciate that every one of the students in my short courses and longer certifications has sacrificed to be there, and I try to make the courses worthy of the costs, both overt and hidden, that people have taken on to show up. And God also knows that if the price of jet fuel or the prevalence of online CE credits puts people like me out of this business, I have a lot of other projects and clients waiting for my attention, so it’ll be okay by me.

But not for manual therapy in general. What do we lose if these people don’t show up, but merely read the book and answer some questions about it? You are reading this magazine, so that shows you are involved in moving yourself along in your profession. It’s a process of recharging your batteries (isn’t it?) and cleaning the points and plugs so that new neurons spark into life when you are presented with a novel situation or the same old situation that needs to be approached in a new way. But it is not the same as going face-to-face, tête-á-tête, and most importantly mano a mano in a real hands-on workshop.

Simply put, those who go down this road of getting all or most of their CE credits by mail or e-mail will continue, in their hands-on work, to do the same thing over and over, and sooner or later their batteries run out (we cannot all be the Energizer bunny forever without renewal) and they either quit or settle into a practice where they do the same old thing to the same old people. This may be fine for them as individuals, but it’s death to their professional development, and ultimately death to the profession.

Enabling Future MTs
We have a fine future in front of us. The world of massage and therapeutic bodywork has already shown it can add to our experience of sports and performance, pain and stress reduction, and trauma recovery. In the future, it will, if it lives up to its promise, have applications in such aspects of healthcare as surgical recovery, rehabilitation, special education, and, I believe, to many of the conditions we see popping up nowadays, such as depression, ADHD, warp-speed-itis, and all the other manifestations of somatic alienation.

My meal-mates and I agreed: we are hobbling that future if we allow continuing education to be dumbed down to where it is a joke. At best, it may shake the tree and eliminate some of the poorer CE offerings. At worst, it could put the Yamunas and Aarons and Eriks out of business, and this would be a sad and slow-moving disaster, an impoverishment from which bodywork could take decades to recover. Of this I am convinced.

Thomas Myers has practiced integrative bodywork for nearly thirty years. He teaches workshops internationally on anatomy, movement, and soft-tissue work. His book, Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists, was published by Elsevier in 2001. He lives, writes, and sails on the coast of Maine.

Note
1. For the unfamiliar, I’m referring to Yamuna Zake, Aaron Mattes, Erik Dalton, Bruno Chikly, Jean Pierre Barral, Benny Vaughn, and Leon Chaitow.

Share your thoughts! Click here to send a letter to the editor and let us know what you think. Your letter may be used in an upcoming issue of Massage & Bodywork magazine.

Please close window after reading.