Setting appropriate fees

Posted on April 25, 2012 by angela

How do you value your time? What do others charge, and is that relevant to you? Do you believe that because you are caring for people it isn’t right to take their money? Do you worry about whether your clients can afford your treatments?

To make an impact on a client’s health and wellbeing they need be able to afford to see you regularly. It is your job to treat them, not to worry about their financial status. If you want to treat those who can’t afford therapy, do some voluntary work when you have enough paid work to live on.

Charge the most and be the best
Ringing round other therapists to ask what they charge will give you an average, but that doesn’t take into account experience, professionalism, specialisation, or any additional skills. The more highly trained and experienced you are, the more you can charge.

We all like value for money. If you provide a fantastic service to your clients, they will be prepared to pay what you ask; you will gain their loyalty and they will recommend you to others. If you charge too little, you undervalue yourself, and undercut your colleagues who charge a more realistic rate.

Calculate your costs
Unless you charge a fee that more than covers your costs, it simply isn’t worth working! If you add the costs of insurance, equipment, CPD, travel, room rental etc., and divide it by the number of clients you see, you’ll have an idea of your costs per treatment. Obviously the more clients you see, the more your costs reduce and the greater your profit will be. Equally, you could charge more but see fewer clients and earn the same amount of money.

Remember that clients are not only paying you for the time you spend with them. They are also paying for your training, expertise, experience, advertising, practice administration, travel, equipment and CPD. You need to take that into account when setting your fees.

Fluctuations in income
If you are self employed, you are unlikely to achieve a steady income all year. Whether this is due to seasonal fluctuation, holidays, illness or other market forces, you will have to factor that into calculating your fees. The money you earn for the weeks you work will also have to keep you for the weeks you don’t work or are less busy.

Reducing Fees
Try not to be sucked into peoples’ sob stories about their finances; often the worst offenders are those with the most money. I remember one woman being so outraged when I raised my fees by £2 that she never came to see me again. Yet she had been telling me about her second home, her children at private schools, holidays abroad and had arrived in a luxury sports car with a personalised number plate!

You may choose to reduce your fees on occasion, but you won’t be able to afford to do so unless you charge the majority of your clients a full fee.

Review your fees and costs regularly. You can either put your fees up a bit (at least annually) or put them up by a larger amount less frequently. Ultimately, if you give great service, your clients will pay whatever you ask, and you will be the only person to agonise over your fees. CHW

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The Bowen Technique – Lymphatic drainage

Posted on April 24, 2012 by angela

We can all get swollen feet or ankles from being on them too long, or when we’re on holiday in a warm, humid climate, and even those relatively mild and transitory occurrences of swelling can be uncomfortable and perhaps will even restrict certain activities. Certainly the lovely dress shoes taken on holiday may not fit for the moment and you know what Cinderella’s sisters felt like.

But many people live with lymphoedema, the constant swelling, usually in limbs, which is uncomfortable, restricting, unsightly and can be an invitation to infections.
Lymphoedema is the result of an impaired lymphatic drainage system which can no longer remove the volume of lymphatic fluid within a given area of the body. This lack of normal drainage produces tissues that are filled with protein-rich stagnant lymph. If there is even the slightest break in the skin, bacteria can enter and thrive in this fluid, reproducing quickly and causing serious infections that can spread rapidly. People with lymphoedema are particularly at risk for cellulitis, an infection of the skin, usually in the lower limbs.

Even a small reduction of the swelling of lymphoedema is welcome and there are nurses who specialise in treating this condition, using the manual lymphatic drainage treatment. But it has been found that Bowen Technique can also be very helpful for lymphatic drainage. More than a decade ago now, lymphoedema nurse Eilish Lund wrote up her experiences using Bowen on her patients. She was amazed and delighted with not only the volume reduction but in the pain relief that Bowen produced.

Over the past year or so, I have been treating Margaret, age 67, who was recommended to try Bowen by her lymphoedema nurse.

Seven years previously, she had had uterine cancer and the uterus and ovaries were removed. Three years after that, her right knee was replaced. She came for treatment with lymphoedema in both legs, especially the right knee area, although the ankles and feet were very large and puffy also. She had not been able to wear regular shoes in several years. She was wearing thick support stockings to try to manage the swelling. Her feet and legs were often tingling and hot feeling and sometimes it felt like ‘toothache’ in one leg, especially when in bed. Her husband is disabled as a result of arthritis and two strokes and she was worried that she was not going to be able to ‘keep going’. In spite of all this, she is a very optimistic and cheery person.

So she came to Bowen with eagerness to see what it was all about. During the week after the first treatment, the pains in her feet diminished and she had more energy. She felt good at the Keep Moving exercise class. The problem had definitely improved and her ankles weren’t nearly as swollen. She was still getting a lot of tingling in her toes and feet and up the legs, especially just above the right knee replacement, but she said it now felt ‘different’ – hard to say exactly how.

After her second treatment, she reported some pains across the tops of both feet for a few days which then cleared and the decrease in swelling in her legs, ankles and feet was less than the week before. She was delighted to be wearing regular socks instead of support stockings and – best of all – she was fitting into shoes she hadn’t worn for a long time.

The week following the third treatment saw these improvements holding well, plus she noted that her balance was better. Her energy levels were also consistently better and when they flagged a bit, she recovered more quickly.

After some months of Bowen treatment once very five weeks, the lymphoedema nurse took leg volume measurements and “couldn’t believe the amazing reduction in leg volumes!”

Margaret had one incident of cellulitis which flared up on her feet and ankles and this set her back a bit and it took a few months to really be clear of the effects of it in pain and redness and swelling.

The Bowen procedures that have been most helpful with Margaret’s condition are the hamstring, knee and ankle procedures. Whilst these sets of moves are used for all manner of musculoskeletal problems and dysfunctions of the legs and feet, they include gentle ‘teasing’ moves that address the lymph nodes behind the knees and follow along the centres of the hamstrings and between the gastrocnemius muscles, promoting the circulation and assisting in lymphatic drainage.

On a global scale, accurate statistics on the prevalence of lymphoedema are difficult to determine. One reason is that many cases are never diagnosed accurately. Another reason is that it is often not reported. But a sampling of several government research studies estimates that there are between a low of 100 million and a high of 200 million men, women, and children around the world with some degree of lymphoedema.

“If only we could Bowen
the world,” we Bowen
Technique practitioners always say!

With much admiration and appreciation for the work of those who practice manual lymphatic drainage and all the dedicated lymphoedema nurses who work to make a difference to those who suffer with this condition. CHW

© ECBS & Janie Godfrey
For further information, a full course prospectus or a list of accredited practitioners contact:
European College of Bowen Studies, The Corsley Centre
Old School, Deep Lane, Corsley
Wiltshire BA12 7QF
Tel/Fax: 01373 832 340
Email: info@thebowentechnique
Web: www.thebowentechnique.com

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Deafness in children

Posted on April 23, 2012 by angela

I see a lot of children in practice and one of the commonest problems they manifest is poor hearing.

One of the most memorable cases involved a four-month-old baby who had been diagnosed as profoundly and permanently deaf. After just a few treatments over three months his hearing had become normal.

Palpation of the cranium had revealed compression from birth in the region of the temporal (ear) bone. Releasing this compression had allowed the function of the ears to return to normal. The compression had probably been caused by the moulding of the cranium during the second stage of labour.

More commonly I see children who have had a series of ear infections leading to glue ear and the threat or even the reality of grommets which are inserted into the middle ear to allow the glue-like fluid to drain.

Recently I have seen a couple of infants who have benefited from treatment, one who did not need surgery after three treatments and another who had had grommets but was still deaf, five treatments being sufficient to improve his hearing.

Children who develop glue ear often have pressure on the ear structures as a result of retained memory in the tissues of the birth process. The compression thus created does not allow the fluids to drain readily from the area causing congestion and making the child vulnerable to ear infections. These in turn create scar tissue which reduces the space even further.
The child may be lucky and grow out of the problem as the area enlarges with age.

The craniosacral therapist evaluates the area by palpating the bones of the skull and the underlying structures. The skilled therapist can tell if the bones, sinuses and soft tissues are mobile, detecting the motion through the flow of cerebrospinal fluid (CSF) which causes an expansion and contraction of the tissues.

Disturbed motion or immobility in the tissues often correlate with the symptoms. The therapist gently eases the tissues using feather-light but precise pressures easing the restriction. Babies and children usually enjoy the treatment and are very cooperative, often sighing at the point of release. Relief of symptoms usually occurs within a treatment or two.

Even in adults deafness can sometimes be eased using this technique. The associated effects of this kind of dysfunction in the temporal bones can be linked to jaw and teeth problems, also headaches and sinus problems as these structures are interlinked. Treatment at an early age can help to mitigate or prevent these problems. CHW

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The antidote to food cravings

Posted on April 20, 2012 by angela

Most people experience food cravings from time to time. For the majority of people they are temporary and don’t lead to any lasting problems. However, for others, they can lead to bingeing, obesity and an unhealthy eating pattern. By Dr Mark Atkinson MBBS, BSc (Hons), FRSPH, FBSIM

If you fall into the latter group and want to understand cravings better, or your client has cravings, then this health report is for you. Here is my integrated medical approach, or antidote, to food cravings.

What is causing the cravings?
A craving is an intense, often uncontrollable, desire to have a certain food. When working with patients with cravings, my priority is to help them identify and resolve the underlying cause of their cravings. While there are many causes; including pregnancy, sleep deprivation, calorie restriction, eating disorders and pre-menstrual syndrome; I am going to explore the three most common causes that I see among my patients. For each of these, I encourage you to identify which is relevant and then to follow my recommendations.

Cause 1
Blood-sugar imbalance/insulin resistance
Cravings for sugar or fatty foods are often triggered in response to fluctuations in your blood-sugar levels. This most commonly occurs in the afternoon. There are many reasons why this fluctuation can happen, including poor diet (high in refined carbohydrates and sugar), excessive intake of caffeine or alcohol, stress, obesity and insulin resistance.

Other symptoms of blood-sugar imbalance include shakiness, weakness or dizziness, fatigue, tiredness, headaches, palpitations, cold sweats, lack of concentration, fuzzy head, depression, anxiety and extreme hunger or lack of hunger.

In the case of insulin resistance, the body’s cells become resistant to insulin, the hormone responsible for lowering blood sugar, by moving it into the cells. As a result of this resistance, blood sugar is converted into fat instead and stored around the middle, as so-called ‘tummy fat’.

If it sounds as though this could be a cause, my recommendations are:
[ Eating three main meals a day, and a snack mid-morning and mid-afternoon, and making sure some protein is included with each of these, as this helps to stabilise blood sugar. Examples of protein sources include eggs, nut butters (such as almond, peanut and hazelnut), hummus, tahini (sesame seed spread), seeds (pumpkin, sesame, flax, hemp, etc), nuts, fish, lentils, beans, poultry (chicken and turkey) or dairy (goat/sheep milk, cheese, cottage cheese and yoghurt).
[ Avoiding or limiting consumption of sugar, sweeteners, refined carbohydrates (white bread, cakes, biscuits, muffins, white pasta), monosodium glutamate, starchy vegetables (e.g. potatoes), alcohol and caffeine.
[ Choosing foods like vegetables, wholegrain breads, brown rice, basmati rice, whole wheat pasta, whole wheat noodles and sweet potatoes, rather than refined or processed starches such as white bread, white rice, white pasta and potatoes.
[ Including foods high in fibre such as apples, oats and beans.
[ Taking a chromium supplement, preferably with GTF. GTF stands for the glucose tolerance factor. It refers to a special type of chromium, first isolated from brewer’s yeast, which is a complex of chromium, vitamin B3 and three amino acids. This form of chromium works closely with insulin in helping the uptake of glucose into cells.
[ Alpha-lipoic acid and L-carnitine (100mg of each three times a day). Alpha-lipoic acid is an antioxidant that can improve insulin resistance and increase glucose uptake into muscle cells. It works particularly well when taken alongside an equal dose of L-carnitine.
[ Glutamine (5g heaped tsp in water sipped throughout the day). Glutamine is an amino acid which can greatly aid blood-sugar control. It helps prevent hypoglycaemia because it is easily converted to glucose when blood-sugar dips. This helps to prevent cravings and keep blood-sugar levels balanced.

Cause 2 – Stress and emotional eating
Boredom, anxiety, stress and depression can cause cravings for carbohydrate-rich foods and might be an unconscious attempt to increase levels of the feel-good brain neurotransmitter, serotonin. Serotonin is manufactured in the brain from an amino acid called tryptophan, or from serotonin’s immediate precursor, called 5-HTP. Tryptophan is found in foods such as meat (particularly chicken and turkey), tuna, salmon, tofu, oats, kidney beans, lentils, chickpeas, almonds, peanuts, pumpkin seeds, sesame seed and tahini (sesame seed paste). Tryptophan is absorbed into the brain more efficiently if there is plenty of carbohydrate present, which could possibly explain why certain individuals gravitate towards sweet or starchy foods when upset or stressed.

If it sounds as though this could be a cause, my recommendations are:
[ Writing a list of the main causes of stress in your client’s life. For each of these, identify what steps can be taken to address them and then take action. If you are unable to do anything about them, then you can shift your relationship to them by accepting the reality of the situation. See my book The Mind-Body Bible for more ideas.
[ Ask your client to notice the craving arising in their body and breathe into it. Without judging or trying to get rid of it, they should allow the craving to be there and, as they do so, notice how its intensity starts to decrease and then disappears altogether.
[ When they notice the craving, they should say to themselves, “I am feeling _______; to take care of myself I need to _______.” So, for example, “I am feeling stressed, to take care of myself I need to call a friend, take three deep breaths, or rest.”
[ Taking Theanine or a 5-HTP supplement. I often recommend these to patients who would like to take a natural supplement that can help them switch from a stressed to a calm state of mind.

Cause 3 Food sensitivity/intolerance
While this sounds counter-intuitive, some people actually crave the food to which they are sensitive or intolerant! Any of the following symptoms might indicate a food intolerance or sensitivity: bloating, flatulence, constipation or diarrhoea, difficulty losing weight despite exercising and eating healthy foods, skin problems or headaches. The most common food sensitivity-related cravings are for wheat, gluten and dairy.

If it sounds as though this could be a cause, my recommendations are:
[ Getting a food intolerance test in order to discover which foods might be triggering cravings.
[ Avoiding foods to which your client is intolerant for about three months and then re-introducing them on an occasional basis.
[ An important contributor to food intolerance is the presence of leaky gut syndrome, in which, as the name suggests, the gut allows partially-digested food to enter the bloodstream. Limiting or avoiding alcohol and anti-inflammatory medications (such as aspirin and ibuprofen), treating Candida and parasites will help to repair leaky gut, as will taking a probiotic supplement and glutamine powder. CHW

Dr Mark Atkinson is a holistic medical doctor who is widely recognised as being one of the UK’s leading authorities on natural health, wellbeing and happiness. He is the founder of The Faculty of Integrated Medicine, creator of Human Potential Coaching, the Chairman of The British Society of Integrated Medicine, a Fellow of the Royal Society for Public Health, a Fellow of The British Society of Integrated Medicine, a member of The International Society of Addiction Medicine and consultant to one of the UK’s leading suppliers of nutritional supplements – Higher Nature. His website is www.drmarkatkinson.com

Written for Choice Health Mag
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Hydrolats for Facial Care

Posted on April 19, 2012 by angela

Hydrolats, which are medicated by nature of their chemical make-up, have been
used in skin care for centuries.

They are employed more and more in therapeutic and everyday cosmetics, in particular because they are non-irritating and non-aggressive to the skin and to mucous membranes, due to their very low content of soluble essential oil molecules. Because of their affinity for the skin, they are well suited for skin care preparations – cleansing, baby care, face and body care. They are sometimes added in the aqueous phase of creams and lotions, to make products such as aromatic baths, masks, creams, lotions and gels.

All hydrolats will help to hydrate the skin and can even counteract the drying effects of a long aeroplane flight, as well as those caused by air-conditioned rooms and cars. They can be used alone as toners, or added to other substances such as aloe vera gel, and are also effective blended into masks. Blends can be made for all skin types, for daily maintenance of the following skin types and problems: dry, sensitive, greasy, red or blotchy skin, acne, dermatitis, psoriasis, rosacea and eczema.

For greasy skin, blend a teaspoonful of Fuller’s Earth with cypress hydrolat to a smooth creamy paste. Apply to the skin and leave for up to 20 minutes to deep cleanse and hydrate.

Creams and lotions
Moisturising creams made with a higher percentage of water to oil are the most effective, the oil aiding the penetration of the water, which is vital to replace moisture lost daily by the skin. Simply add 20ml of your chosen hydrolat to 100ml of moisture cream to enhance the effects of the cream and to rehydrate your skin to the maximum. The large molecules of the hydrolat will penetrate the skin more easily in a moisture cream than just as water. Once in the skin, the hydrolat will renew, refresh and regenerate the skin, giving a plumper appearance and softer feel. Ideal hydrolats for mature skin would include rose and neroli. Sandalwood hydrolat is also hydrating and calming for skin problems.

Sprays
Hydrolats can be used undiluted in sprays as a skin or body tonic, or as a toner for the face after cleansing. Another great use for sprays for the face is during the menopause for hot flushes, when diluted peppermint hydrolat can deliver a soothing and cooling effect instantly. German chamomile hydrolat makes a very effective spray for the face to help control eczema and to improve the appearance of flaky, red skin.

Using hydrolats for facial health is part of keeping balance and equilibrium, without any side effects or unwanted sudden effects – everything is achieved by gentle and subtle energy to help improve emotional health over a period of time. CHW

Bibliography
Understanding Hydrolats: L Price
Hydrosols: S Catty

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Stress – is it all in the mind?

Posted on April 18, 2012 by angela

Imagine you are on a beautiful beach. The sand is white, the sky is blue and cloudless and the sea is a deep turquoise. It is a sunny, warm day and you are lying on the beach without a care in the world.

You have nothing to do today, so you can just relax and enjoy the feeling of the sun warming your skin. In the distance you can hear the waves gently lapping the shore as you relax in this beautiful beach paradise.

As you imagine this, take a moment to notice how your body feels. How do your muscles feel? What do your heart rate and your breathing feel like?

Now, imagine a different scenario. It is morning and you are at home. Outside the morning is grey, wet and cold. Today you have a very important appointment to keep which means you must catch the bus on time. But already the morning is not going well. Your alarm did not go off on time and you have overslept. The shower was only lukewarm and you are now rushing to get ready to leave on time, because you must not be late for this very important appointment. As you leave the house, you look down the road and you can see the bus already at the bus stop. You start to run down the road…

Now, take a moment to notice how your body feels now. How do your muscles feel? What do your heart rate and your breathing feel like?

Whenever I use this visualisation with clients, the responses I usually get for the beach scenario are that people feel warm, relaxed, soft, calm, with slow heart rate and breathing. For the bus, people say they feel tight, anxious, restricted, with rapid heart rate and fast, shallow breathing.

The purpose of this exercise is to demonstrate how the autonomic nervous system works on the body to maintain homeostasis – the bus scenario demonstrates the sympathetic nervous system or the ‘fight or flight’ response, whereas the beach scenario represents the parasympathetic nervous system or ‘rest and digest’ response.

The most powerful aspect of the exercise to me is the fact that the brain cannot actually differentiate between real and perceived situations and so will create the same physiological response even if we think about a scenario.

On the one hand, this demonstrates the power of meditation and mind-body relaxation techniques. However, on the other, it helps us to understand how stress can affect the body.

If we are constantly in a state of anxiety due to work or other external factors, our brain – and therefore our body – will perceive this as a threat and switch into ‘fight or flight’ mode. If this happens on a regular basis, the body will spend a disproportionate amount of time with elevated heart rate, shallow breathing, constricted blood vessels, slowed digestive system – all responses of the sympathetic nervous system.

And this, in turn, will lead to many of the physiological symptoms our clients present with – high blood pressure, restricted musculature in the chest and neck, irritable bowel syndrome (IBS) and so on.

In my practice I see many clients who come for treatment of repetitive strain injury (RSI) type symptoms. Although their primary pain symptoms are centred around their hands and forearms, the restrictions causing these are always in the neck and shoulders. And, in many cases, they are in high -stress jobs, often with a busy and stressful home life. Unsurprisingly, they also suffer from a number of other stress-related conditions.

I generally treat RSI clients using a combination of myofascial release, trigger point therapy, soft tissue release and stretching focused on releasing the restrictions I find in their neck, shoulders, chest and back. By relieving the tension in the fascia and other soft tissues, this allows the local structures to return to normal function – particularly the nerves and blood vessels which have been constricted causing referred pain and other sensations.

As I work with clients, I generally find they report a number of other beneficial side effects of the treatments. They are often able to sleep better, they feel they have more energy, which they describe as feeling ‘lighter’ and they are better able to cope with their busy lives. In other words, they are accessing their parasympathetic nervous system.

The most interesting learning for me from this feedback is that bodywork does not have to be relaxing to produce these results. Working with people in chronic pain caused by tissues that have become ‘stuck’ often means that they can experience ‘good’ pain during my treatments as the tissues release. However, the mind recognises the resulting changes and releases the body from ‘fight or flight’ as a result.

Which means my clients can spend more time on the beach, and less time running for the bus. And I know where I would rather be! CHW

© Amanda Oswald runs the Pain Care Clinic in Brighton and Harley Street, London specialising in the effective treatment of chronic and acute pain conditions. She is also a co-director of RSI Clinics and teaches at the Wilbury School of Natural Therapies in Brighton.
For more information contact: www.paincareclinic.co.uk
07742 567528.

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Take a look behind the mask!

Posted on April 17, 2012 by angela

We all have an in-built ‘first impression sense’ of others’ characters gained through their appearance and a set of unwritten guidelines we pick up along life’s journey which provide these insights. While avoiding becoming judgemental is strongly encouraged, I am sure you have experienced the opportunity to know fairly quickly whether someone is kind, trustworthy, critical or fiery and so on.

I believe that we all have a natural talent for face reading and if this is developed and employed in the proper way, the benefits are abundant and amazing.

Ancient origins
Face Reading was known as a ‘silent treasure’ in the mists of Chinese and other Oriental cultures. Originally a skill known only to the advisors of the ruling emperor, its secrets were kept within the walls of his kingdom. The reason for its great standing is that the Chinese had developed, over a number of decades, a reliable way of reading the face and this proved a very powerful tool when dealing with other rulers and members of the empire.

It is believed that this secret ‘weapon’ was only initially written down in the later dynasties. Prior to this it had been a verbal tradition, handed down through generations and added to by further continued observation of individuals’ characters and actions.

As changes started to take place in the historic system ruling in China, the knowledge started to ‘leak’ to the public. During my time in China, it was not uncommon to see Face Readers practising their talents openly on the streets.

While this may seem odd, they pitched their little stalls alongside the street barbers, insect sellers, dumpling vendors, palm readers and those who made a living by offering a service to check weight and blood pressure to passersby.

Within families it was used to determine if a prospective son or daughter-in-law would be a good match for their offspring, which of course can have its place in our social world today!

Transition of a tradition
Face Reading gathered hundreds of insights within its toolbox. The uses and benefits are accurate and helpful in many ways and still an echo of its traditional usage.

What Face Reading can do for you:
[ Understand yourself better – your strengths and reasons why you let yourself struggle in life
[ A reflection of the health or energy integrity of your body [ What emotions are causing you challenge [ Where to focus your attentions and energy in order to have a more fulfilling life
[ Understand others better and therefore create better relationships [ you work with others, it can help you understand them better and build more beneficial encounters either with your customers or clients or staff.

So what is being read?
Over the years that I have been developing my skills as a professional Face Reader, I started with an intense fascination. Initially I was sceptical that one could reliably understand others’ health or emotional status simply through observing facial features.

However, after a few years of listening to clients’ case histories and silently correlating what they said with what I observed in the facial features which then allowed me to deliver my complementary therapy skills accordingly, I could not deny the accuracy of this system.

Over the proceeding decades I have discovered a further way of reading the face which is equally as accurate and adds greater insight into the ‘soul’ experience of the individual.

Tell-tale signs
In Face Reading there are numerous indicators all of which have their contributory influence on the overall understanding of the individual. Here are just a few:
[ Face Shape – are you a mountain, water, moon or metal face amongst others? This tells of the overall character and predisposition of the individual [ Hair line – indicates the mental character of the individual [ Eyes – the window to the soul and also the sign of emotional character [ Chin – tells of determination and self confidence.

Then the lines of the face add to the story by speaking of the organs of the body and what they are carrying in terms of emotional baggage which may be a pre-indicator of health concerns.

In fact every feature of the face can have a number of significances… it is only when they are considered collectively that the full scope of Face Reading yields its rewards.

Face Reading and you!
Learning the skills of Face Reading can help you both personally and professionally. The number one golden rule in the classes I teach is that Face Reading is NOT an invasive skill for creating judgements about others. It is highly accurate, insightful, fun and helpful to be able to employ the skills of a Face Reader in your work and life in general. Ultimately, the greatest benefit is that you can learn more about yourself so that you can make the necessary adjustments to help you life a more happy, fulfilling and rewardingly stress-free life. A good therapist employing the art of Face Reading will be able to direct their treatments to best serve you and recommend positive avenues for you to explore to help improve your health and life quality. CHW

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Working with highly effective massage techniques

Posted on April 13, 2012 by angela

The Splenius Capitis Muscle is a small flat muscle found in the posterior neck region. It originates in the lower posterior cervical region of the spine. It runs in a superolateral direction from the lower C-spine, and slightly narrows in width as it approaches its attachment at the lateral aspect of the skull’s occipital bone. When contracting unilaterally, this muscle ipsilaterally side flexes and rotates the head. When acting bilaterally, the splenius capitis muscles extend the head.

Anatomy
[Inferior attachment sites
The ligamentum nuchae
The spinous processes of C7-C3 (or C4) vertebrae

[Superior attachment site
The mastoid process of the occipital bone
The lateral 1/3 of the superior nuchal line

Actions
Acting unilaterally: ipsilateral side flexion and ipsilateral rotation of the head
Acting bilaterally: extension of the head and neck

The Techniques
Caution: Make sure you carefully assess the structures prior to performing the following techniques. Also, ensure that the tissue has been adequately warmed up before performing any deep techniques or stretches.

1. Myotonic Release
Objective: To reduce and potentially eliminate contractures and adhesions commonly found in the splenius capitis muscle. Contractures and adhesions in the splenius capitis can result with chronic repetitive strain injuries and overuse injuries (such as would result from an anterior head carriage), the chronic stage of healing after traumatic muscle strains (e.g., athletic neck injuries), and other traumatic injuries that cause damage to the muscle or other structures in the posterior neck region (such as front impact motor vehicle accidents).

Positioning: Have your client lying supine with the head fully on the massage table. As this is a passive technique, your client should be fully relaxed. To perform this technique, stand at the head of the table.

Technique: First, place the hand that is on the opposite side of the muscle being treated underneath your client’s occiput. This hand will be the hand that guides the head and neck through the full range of motion required for the technique. Place the client’s splenius capitis muscle into a maximally shortened position with ipsilateral side flexion, ipsilateral rotation, and a slight extension of the head.

With your other (contact) hand, place a deep fingertip pressure at the origin of the muscle, just lateral to the spinous processes of C7-C3.

Gradually lengthen the muscle by slowly moving your client’s head into flexion, contrilateral side flexion, and rotation. At the same time, perform a deep muscle strip in a superolateral direction along the length of the muscle from the origin all the way up to the insertion at the mastoid process. Once you reach the end range, hold the muscle in that lengthened position for an additional two or three seconds.

At the end of the range of motion, bring your clients head back to the starting position and then repeat the movement. Repeat this stroke for a total of 3-5 passes.

This myotonic technique is a very effective technique in that the deep strip addresses contractures, adhesions and trigger points in your client’s splenius capitis muscle. In addition, this technique simultaneously adds a range of motion element to the facet joints in the C-spine, as well as a stretch element to the splenius capitis muscle itself.

2. Passive Stretch
Objective: To lengthen the splenius capitis muscle. This stretch will work to reduce pain in the muscle caused by trigger points as well as muscle tension. A properly applied muscle stretch will also improve the flexibility, strength and overall functionality of the splenius capitis muscle by reducing contractures and adhesions. (NB: If scar tissue in the muscle has been treated with friction techniques, a passive stretch following the friction techniques can help to functionally realign the scar tissue so that the muscle can function in a more efficient manner.)

NB: Stretches are most effectively performed after the muscle has been adequately warmed up with massage and/or properly administered hydrotherapy.

Positioning: Have your client lying supine with the head fully on the massage table. Again, this is a passive technique so your client’s muscles should be fully relaxed. Begin your technique standing at the head of the table, with both your hands placed underneath your client’s head.

Technique: Caution: As with any technique, please remember to perform this passive stretch with great care, particularly since you are dealing with complex neurovascular structures in the neck region.

To stretch the splenius capitis muscle, slowly and carefully bring your client’s head and neck into pain-free forward flexion (see figure 3).

Make sure you perform this stretch in a gentle, sustained manner, always staying within your client’s pain tolerance. If your client feels pain, you have gone too far with the stretch. Also check in with your client during the stretch to ensure that he is breathing properly. Hold this stretch for approximately 30 seconds, and then gradually release the stretch by returning your client’s head and neck back into the starting position. Repeat this stretch a total of 3 times.

(If you wish to affect the suboccipital muscles as well, simply provide an additional capital flexion at the atlanto-occipital joint, thereby opening the space in the suboccipital area and thus lengthening the suboccipital muscles.) CHW

The techniques highlighted in this article are courtesy of The Massage
Therapy DVD (which contains an interactive library of 112 of the most highly effective techniques for treating the Torso) is available in the UK at Choice – Health & Wellbeing Magazine. To order this DVD, or to find out more information, please contact us on 0161 284 6602 or log on to www.choicehealthmag.com

Motivation: Are you a ‘towards’ or ‘away from’ person?

Posted on April 12, 2012 by angela

Motivation. The word has its roots in the meaning ‘To Move’, and, depending on our psychological preferences, we are ‘moved’ to take action (or not) by considering the carrot or the stick. In other words, are you moving towards pleasure or away from pain?

Of course, the effect or result may be the same – but crucially, if we understand which stimulates our action or inaction, and recognise the same in others, then we can understand and influence ourselves and others to a greater good.

Let me illustrate how motivation works by telling you a short story. A while ago I was out with a friend. We passed a collector for a national charity who duly waved her collection tin under our noses.

My friend pursed his lips in a tight smile and mumbled, “Just a minute”, as he fished a £2 coin from his pocket. He dropped the coin in the tin and we both moved away.

He glanced at me, “Why didn’t you put any money in the box?” he asked.
“Because I didn’t want to,” I answered.
“Neither did I,” he said with a frown.
“So why did you, then?” I asked.
Silence.

“Well.” I observed, “You obviously wanted to more than you didn’t – otherwise you wouldn’t have done so!”

A short argument followed as my friend tried to convince me that he would have preferred not to have donated £2. He even tried to project his guilt on to me; calling me stingy! But this was nothing to do with me and my choices, so I was unrelenting. My point was this: if he had genuinely preferred one course of action, he would not have taken the other. My preferred action was to hang on to my money. His was to donate. We both acted accordingly.

That said, I perfectly understand feeling awkward about either (or more) possible courses of action – but the one you take is, by definition, your preferred course. It took him a while but my friend eventually saw the uncomfortable truth. For a variety of reasons his donation of £2 made him feel better than if he had not contributed. We established that he didn’t want me to consider him tight-fisted. He didn’t want to let the collector down. He didn’t want to feel guilty. The feelings associated with not donating, would have hurt more than the ‘pain’ of dropping £2 in the box. So the charity copped the money!

This is a perfect example of how hidden our motivations are at times. Hidden even to us! When it comes to motivation, we will do something only if it suits us; is better (in our judgement) than the alternative(s). And what motivates one person may not motivate another.

In my story above, it is clear to see that my friend was motivated by moving away from pain. Had he contributed his £2 because he wanted the charity to continue its good work or because he wanted to reinforce his self-image as a generous person, or even that he wanted the chance to flirt with the charity collector, then clearly, he would have been moving towards pleasure.

Are you ever faced with alternatives that will bring you pain no matter what you decide? In this case you will invariably take the path which offers least pain. On the other hand, are you ever faced with courses of action, any of which will bring pleasure? It is 100% inevitable that we choose the option that will bring us most pleasure.

Is this being selfish? When we were small, adults told us not to be selfish – and this often stays with us. But then, the accusation of being selfish is often a highly manipulating strategy in itself: (i.e., “Why don’t you want to come to the cinema with me – you’re so selfish!!” Hmmm!).

Without getting too semantic, I think ‘selfishness’ is an irresistible, natural and extremely useful human trait. It is selfishness – the consideration of myself – that allows me to recognise that I would feel bad if I let someone down (I wouldn’t want to feel that way). The same stops me from stealing (I would feel guilty – and probably get caught!). Selfishness helps me choose the best course of action for me and my family and reinforces my love for them (who wouldn’t want the best for themselves and those closest to them?).

So our motivations need not (indeed, should not) be without regard to others. In fact, our very consideration of the effect of our actions on those around us will add to whether we choose to do something or not. Our options may include an attractive but thoughtless one, so we balance our decision with the pain or pleasure we could bring to others – and make a choice accordingly.

Even when we do something apparently with no regard for ourselves; make a sacrifice; go out of our way; put someone else ‘first’, I would still suggest that the glow of satisfaction we get from our ‘selfless’ behaviour is our motivation. And this highly personal reward compensates us for our efforts. It makes us feel good (or less bad!). To deny this, I believe, shows a lack of self-awareness – and can manifest in the most thoughtless (some would call it ‘selfish’) behaviour of all, including emotional manipulation and/or a victim mentality.

Be honest with yourself! Ultimately you do something because, taking everything into account, you want to do it! As another friend of mine says, “Even Mother Theresa wanted to go to heaven!” Cynical? Not at all (after all, think how many people benefited from Mother Theresa’s actions). My friend is merely recognising basic human motivation!

Here’s an idea. Ask yourself: Why do you do what you do? Choose what you choose? Act the way you act? Bring to consciousness your reasons for making a decision. Towards or Away? Neither is right or wrong – it’s just your preference. Once you recognise your preference, can you see the preference in others? Gain pleasure or avoid pain? Help them make the right decision by talking from their perspective – not yours! CHW

The programme is available at www.marketingtherapy.co.uk Email andy@marketingtherapy.co.uk

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Life as a skin cell

Posted on April 10, 2012 by angela

Today is my birthday. I have the distinguished pleasure of being a newly ‘born’ keratinocyte which makes me the most common type of cell in the skin’s epidermis; as a matter of fact, we make up from 90-95% of all epidermal cells.

Having just been through the cell birth process I am residing near the lowest layer of the epidermis, the basal cell layer or stratum germinativum. While this location has its benefits, such as an abundance of oxygen and nourishment provided by the underlying local capillary system, my plans will not allow me to linger here long as I am about to embark on a journey that will coincide with a cellular metamorphosis ending when I reach my final destination, the stratum corneum.

During my journey my structure and chemical make-up will continually change as I undergo a process called keratinization. Several major changes will occur as I go through this genetically programmed process of differentiation. I will lose the ability to reproduce, I will increase in size while my shape will flatten, new organelles will form together while some of my existing organelles will undergo a reorganisation; eventually all of my organelles will be lost. In addition, I will start to synthesise new proteins and lipids while my membrane properties will change. And finally, by the time I reach my destination I will be severely dehydrated having lost 70% of my water content. At the end of my journey I will be a dead corneocyte. But please do not confuse this with being non-functional. As a completely differentiated corneocyte I may be dead, but I am fully functional, particularly in terms of my ability to form a barrier and protect my sibling cells that lie beneath me.

The itinerary for my journey is extremely well defined and is just part of my job as an epidermal cell. It will take me at least 14 days to reach my end point, the stratum corneum, and another 14 days until I transit through the stratum corneum and eventually slough off your body. So while the journey is scheduled to be about 28 days, it can vary depending on your age and the condition of the skin.

As a new basal cell inhabitant my neighbours are actively dividing parent cells that coexist with a few immigrant cells known as melanocytes. My parent cell is a stem cell, it divided and gave rise to a daughter cell – that’s me.

Most of us basal cell residents are taller than we are wide and we all contain bundles of keratin filaments which form a type of flexible skeleton that helps us maintain our form. As long as we reside in the basal layer we will be able to maintain open lines of communication with the underlying basal cell membrane at the dermal-epidermal junction.

Once I migrate north, out of the basal cell layer I begin to change into a stratum spinosum cell. It’s here where the nature of my keratin proteins change somewhat. Sometimes they refer to me as a prickle cell. Once I reach this point in the epidermis my shape begins to change again and I am more polyhedral when residing in the lower spinosum levels and I take on a more flattened appearance a few layers out.

Now that I am a fully fledged spinosum cell you can also see characteristically large bundles of keratin filaments called tonofilaments around my cell nucleus; these extend out to the desmosomes on the outer membrane of my cell. In areas that are subjected to continuous friction and pressure such as the soles of the feet, there are more of us that form a thicker stratum spinosum layer.

When I reach the outermost layer of the stratum spinosum you will see a new type of organelle appear in my cell. It is called a lamellar granule. Lamellar granules contain glycoproteins, glycolipids, phospholipids, sterols and several enzymes. At first they assemble in the outer edges of my cell cytoplasm then cluster in vesicle-like pockets of the extracellular space before I release them. Eventually, lamellar granule enzymes convert the precursor barrier lipids into lipids that coat the stratum corneum cells and provide a barrier to skin permeation. In the very outer layers of the stratum corneum the enzyme cholesterol sulfatase modifies the lipids, which assists not only in proper hydration of the epidermis, but in the desquamation process itself. The absence of this enzyme in lamellar granules corresponds with a loss of intercellular lamellae and a failure of the stratum corneum cells to slough – a condition known as retention hyperkeratosis.

As with all maturing processes, life is becoming extremely structured for me now. There is an abrupt transition from the moment I stop being a stratum granulosum cell to my emergence as a stratum corneum cell or corneocyte. Amazingly, when I was a granular cell not only could I synthesise and modify my proteins which were required for keratinisation, but I was also instrumental in my own self-destruction. The granules in my cell contain many enzymes, some of which destroy my cell organelles including my nucleus.

As my journey comes to an end I find myself an inhabitant of the stratum corneum layer. This is the outermost layer of the epidermis that provides mechanical protection and is the major barrier to water loss and permeation of environmental substances into the skin. My role here is very simple – to protect you!

All in all it has been anywhere from 28 to 42 days on average since my birth as a basal daughter cell. I have endured numerous structural and chemical changes during my metamorphosis but my time has come to leave you though you probably won’t even notice, as most of us will be shed as individual cells or small clusters that are invisible to the naked eye. From the time I was born my internal clock has been programmed to run its course. And now that time is here. I hope I have served you well. CHW

© Diana L Howard PhD
The International Dermal Institute specialises in postgraduate training to ensure your technical skills excellence and business success. For a calendar of forthcoming classes, please call 08000 564544 or take a look at our wide range of classes at www.dermalinstitute.co.uk

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