Touch, Techniques, and the Therapeutic Journey with Monica and Forrest

Forrest and Monica, two therapists from the town of Nelson, BC, join me to discuss the  manual therapies like osteopathy, massage, and acupuncture. They share their journey from education to practice. With their stories, we have a  look into the art of listening and communicating, and how these skills contribute to effective patient care.

Our discussion explores the evidence and anecdotes behind manual therapies, as we consider the challenges of marrying traditional techniques with modern evidence-based practice. With Forrest and Monica's experiences, we illuminate the significant role of human touch in evoking therapeutic responses, and how it serves as a common thread across different therapeutic disciplines. Additionally, we'll navigate the intricacies of creating a calming clinic atmosphere that promotes wellness and the importance of your approach in eliciting a desired response in patients.

Lastly, we debate the delicate balance between ethics and compassion, sharing personal stories that highlight the power of personalized treatment. Monica introduces us to the "three legs of a stool" concept in patient communication, vital for ensuring a comprehensive approach to patient care. We also touch on the emotional aspect of physical illnesses and the necessity for a safe space where clients can express and process their emotions. This episode promises not just to enlighten but also to inspire both practitioners and patients in the continuous journey of healing and self-discovery.

To listen to their podcast please search for The Healthful Perspectives.
Monica can be found at www.acunelson.com and Forrest through rebalancing.ca

Chapters

• 0:08 Manual Osteopathy Exploration With Forrest & Monica
• 11:12 Understanding Manual Therapy Techniques Effects
• 14:53 The Importance of Osteopathy Technique
• 18:40 Importance of Communication Skills and Safety
• 27:59 Balancing Ethics and Compassion in Healthcare
• 40:50 Effective Communication in Patient Care
• 44:24 Health Podcast Launch and Continuing Education

Transcript

Eric: 0:08

Hello and welcome to another episode of Purves Versus. My name is Eric Purves. I'm a massage therapist, course creator, continuing education provider, curriculum advisor and advocate for evidence-based massage therapy. In this episode, we welcome Forrest and Monica. Forrest is an RMT and Monica is an acupuncturist, and both are manual osteopathic practitioners who live in Nelson BC. In this episode, we discuss their experiences, training in osteopathy, the importance of active listening, better communication strategies and the powerful effects of the clinical encounter.

Eric: 0:42

If you enjoy this episode, please rate it and share it on your favorite social media platforms. You can also support my podcast by making a donation. Please visit buymeacoffeecom. Slash helloob. Purpose Versus can be found on YouTube, so please check us out there and subscribe. Thanks for being here and I hope you enjoy this episode. Hello everyone and welcome to another episode of Purpose Versus. Today I am excited to welcome to you Forrest and Monica, who are two massage therapists from the wonderful mountain town of Nelson BC. This is my first time ever meeting Monica Thanks for being here and Forrest. Some of you may know I've known Forrest for a couple years now and they're going to be telling us today kind of about some of the new projects that they're involved with, but also, we're going to have a conversation, too, about some of the things that we feel are most important for massage therapists to know. So thanks for being here, guys.

Monica: 1:35

Thanks for having us. This is super exciting.

Eric: 1:38

Yeah, my pleasure, Thank you. So let's start off with first Monica. Just tell us a little bit about you. Who is Monica?

Monica: 1:46

Who is Monica? Well, I live in a small little mountain town of Nelson, bc, and I have a practice of Chinese medicine acupuncture. I practice manual osteopathy and Thai massage here. So I have a private practice and there is a little bit of a focus on pain management. And I have some professional athletes that I treat and I was for a long time going to trail to work on the hockey team there. So I really have a passion for chronic pain and I was a teacher at the Chinese Medicine School here in Nelson as well and I love to ski and mountain bike and snow bike and do all the fun things that the Kootenai provides.

Eric: 2:40

Sounds like you're well suited to be living in the Kootenai and in Nelson, in particularenays and Nelson particularly are you from Nelson Monica?

Monica: 2:47

I am not. I'm from the coast actually whereabouts. Burnaby is where I grew up, and then I lived in Whistler and Pemberton for quite a while too nice, nice.

Eric: 2:57

I love Pemberton and Whistler. It's beautiful there and Burnaby's nice too. When I was a kid, actually, my dad lived in Burnaby and so I spent a lot of years over there visiting him, so I'm quite familiar with Burnaby what Burnaby was like in the 80s anyway was Metrotown still there. Metrotown was there. I think it was pretty new and the Skytrain had just been. Was they built?

Eric: 3:18

they finished the Skytrain when, uh, when I was a kid, when my dad was living there. I remember taking the Skytrain the first day it was ever launched really yeah I'm, maybe I'm dating myself here, but anyway, completely useless piece of information. Most people that aren't from BC probably have no idea what the Skytrain is well, I've had some good times on that Skytrain.

Monica: 3:41

Let me tell you yeah, thanks, monica.

Forrest: 3:44

So Forrest, tell us a little bit about you um, I've been living in bc now for just over 20 years and found myself in nelson about 10 years ago. I've been practicing registered massage therapies for 17 years. Went back to school with monica actually a few years ago to do manual osteopathy, and I run a general practice here, and then I also teach at the Registered Massage Therapy School. I've been doing that since it opened, and then I'm also teaching my own personal courses and later this year I'm going to launch an online education as well.

Forrest: 4:26

And yeah, otherwise I'm a dad and I seem to wear a lot of hats and have some pretty busy days.

Forrest: 4:30

But I'd say, like monica, I moved to the coonies for the mountains and the lakes and being outdoors and being in nature and, uh, just trying to figure out how to strike a balance with that nowadays. Um yeah, and then monica and I first met a number of years ago at a backcountry ski hub. We never knew each other and then we kind of linked up and we realized on our first kind of day out ski touring with each other that all our other buds there were high on mushrooms and I kind of looked at Monica, I was like I guess we're babysitters today and I was like you get the mic. So we took off for the day and led our buddies through the mountains and watched them fumble around and be dorks. And then we connected doing that and realized we taught at the same college, which we didn't know that before. And then, ever since then we've just been chasing each other around at the same clinics and going to school together and, yeah, we can't seem to break apart our friendship anymore. We just keep hanging out.

Monica: 5:35

That's so true. I like to say that Forrest follows me around a little bit. I actually did not think he was going to come to osteopathy school with me. I actually did not think he was going to come to osteopathy school with me, and so when he said I'm in, I was just so thrilled to have to have a good bud to go through school with.

Eric: 5:53

I love that story for the osteopathy school. Like probably pretty ignorant on this one. It's all. Do you guys have to can use it, mostly distance, or do you actually have to go into classroom?

Monica: 6:13

Like how's that work work? Most of it is distant, so you do these online lectures and then you have to go for two weeks to toronto and do the more practical side of things.

Eric: 6:20

Okay, such a I mean, yeah, I guess, when you're, if you're a working professional, I guess it's easier that way to you know, you don't have to shut everything down. You guys can just, you can learn, and they just only have to take a little bit, a little bit of time here and there. Did you guys? What did you find about the osteopathy school? Like, do you, did you find it was worthwhile?

Forrest: 6:38

I found it a hundred percent worthwhile. I've been planning to do osteopathy for a really long time. I just couldn't figure out how to.

Forrest: 6:47

If you knew anything about nelson. It's really hard to get in and out of here, especially in the winter, um, so it's really stopped me from like doing the one in vancouver, because it's like one week a month for five years. I'm like there's no guarantee you can fly out for six months of the year here, and so I've been wanting to do osteopathy for a long time. So when Monica, you know, brought this to my attention, she's like you can do it all online and then we do two week practice in Toronto and I was about a month away from having a child and I was like you're crazy, I can't, I can't do this. And she kept bugging me about it. She's like you can do it, you can do it. And I was all right, I'm going and we're doing this. Um, and it worked great.

Forrest: 7:27

The, you know, go at your own pace, watch all the videos. I mean there's hundreds and hundreds of hours of videos um, and the fact that, like I run a practice, I could be learning and utilizing things that I was, you know, watching in my practice every single day. So I found for me it was super useful because I could implement it constantly and the practicum was what kind of finalized it. For me it was like the little tidbits that I couldn't quite suss out of the videos and out of the education. When we did the practicum is when it all came together and I was like, oh, that's that pressure I was missing or that's that concept that I didn't quite understand. By the end of the two-week practic I felt very ready to start, you know, fully implementing the skills that I'd been learning for the last year.

Eric: 8:12

I'm curious how do you like, how did it differ from, like say, traditional massage therapy, education? What was, what was the advantage of doing that, like professionally?

Forrest: 8:23

So like, rather than being in class.

Eric: 8:26

No, just like, just in terms of like pursuing it like, why, like what was the purpose of pursuing that, rather than just sticking with being an RMT?

Forrest: 8:34

for me.

Forrest: 8:35

Like I mean years and years ago, when I first graduated, I was primarily just doing like Swedish techniques and after a couple years I was getting pretty exhausted and a colleague of mine was doing all myofascial techniques and he was doing 40 hours a week and wasn't exhausted and I.

Forrest: 8:51

So I started switching gears a long time ago and then I started taking courses, courses from Natalia, who he kind of would describe like the way he worked was massage therapy with an osteopathic approach, and the more courses I took from him over the years, I started implementing this much more subtle way of you know, going through the body treating and just a different understanding of the depth of how tissues relate, and it just kind of started perking my interest into the osteopathy world.

Forrest: 9:26

I took some other courses with some other people. It just seemed like everything was pointing me towards osteopathy. So like I would say there's just I think osteopathy really focuses on like how everything relates, whereas I found through my massage therapy education at least like initially it was very kind of like somebody walks in with a knee pain and you just really get focused on their knee pain, whereas osteopathy is like okay, they have knee pain, but like what was before that and what was before that and what was before that and you start really trying to define the layers of compensations over the decades, and that's kind of what's I find more impactful in the practice nowadays is really trying to understand how everything connects right, yeah, I mean.

Eric: 10:15

So I'm not sure. But you guys know, but like other listeners will know like, one of the things I'm really involved with is evidence-based practice, and this and the use of research, evidence and practice and curriculum development is kind of. I'm always very, very curious about osteopathy because there tends to be kind of two distinct schools of it. There's kind of the old school, where everything is basically tissue-based, structure-based and it's just a lot of technique stuff.

Eric: 10:41

And then there's there's a movement now in osteopathy, and particularly in the UK, where they're they're trying they're moving away from that because there's not a lot of technique stuff, and then there's there's a movement now in osteopathy, and particularly in the UK, where they're they're trying to, they're moving away from that because there's not a lot of evidence to support those kinds of traditional osteopathic approaches, and at least in terms of the explanatory models or the narratives around them. How do you, how do you reconcile that those two things? Because if you're like I, like this approach but maybe there's not a lot of evidence to support it. How do you feel about those contradictions?

Monica: 11:12

I think for me, if something works, I continue doing it. And the second I became an osteopath and started to implement those techniques on a daily basis. Quite simply, it just works. And to me the proof is in the pudding. And I'm the same as you, eric. I do really appreciate having those studies to kind of back like the evidence-based, but there really is no substitute for is it providing results for my patients?

Eric: 11:48

Yeah, no, that's no. Yes, that's great and I think that's the thing is. Is that there's, when we look at, say, osteopathy or massage therapy or acupuncture, right, we look at the evidence base and it's like, well, there's not a lot of evidence that supports that anyone is approaches particularly better than other. However, if we look at you know our clinical experiences we may find that, oh well, I approach people in this specific way or this specific framework and it helps, and people I get my client send it to feel better, so that I think this is an important thing to realize. It's just the problem or the concern that we have with any approach, whether it's traditional massage, physical therapy, chiropractic, osteopathy is we have to be. I think you just have to be mindful of the, the stories that we're thinking of, the stories that we're telling ourselves or the stories that we're telling our clients, because that's where the evidence base, I think particularly can, can influence us in a positive, a positive way.

Forrest: 12:50

I think that the the challenge with evidence, evidence-based manual therapy techniques in general, is the evidence shows that it works, but it doesn't really define why it's working. Like, on what mechanism is my hand resting on your shoulder any better than me needing your shoulder? And that's what I can't seem to figure out. Like as I've been digging through evidence and research to create my courses to like okay, so I'm doing joint moves. Why do joint moves? Oh, they work. Oh, they work. But why are working and that seems to be across the board when I look at the evidence is the why is really missing? Like, what's the mechanism? But we're like oh, okay, it's successful. Yeah, doing joint mobs is successful. Doing switch massage is successful. Putting acupuncture, doing needles, successful.

Forrest: 13:39

Having a conversation with somebody and just validating their life and hearing what they have to say is extremely powerful. Um, but what's the mechanism underneath that, the why? It seems to be missing in the research and the evidence. Like they can't seem to connect that dot fully. Like is it neurological? Is it endocrine? Is it hormone? Is it like, is it all the above?

Eric: 14:03

yeah, and the evidence from from the work I've done, it is, I would say it would be an all of the above, right. We know that any response from any touch that is neurophysiological and there's, you know, there's hormonal and neurotransmitters and uh, all you know, um, you know changes in inactivity in the noiceptive system, like there's all these things that are impacted through touch. And I think, yeah, so that's. I think, if we really look at all of these approaches whether it's osteopathy, massage therapy, acupuncture there's a million different stories about how they all work that are different. But really, if we look down to it, how they all work, that are different. But really, if we look down to it, it's it's just touch and it's some type of neurophysiological, neuroimmune response, just a different way of interacting with, with the human.

Eric: 14:53

A lot of people think that technique doesn't matter and I'd say, well, it matters when it matters, and that's I'm sure that's what you guys have probably discovered in your osteopathy training is that like, maybe you slow down, you take a different approach, or you try to do things or think about things differently than you would traditionally and maybe that allows you to hold space and provide touch that's different than what they've had before and that's kind of what I was gonna say that's kind of what I try to teach my students in fifth semester right now, because at this point they're starting to put everything together and now they're asking but like, how do I know which one to use for which person?

Forrest: 15:31

and a lot of times I'm like that's through experience you start to recognize the signs before the person gets on the table, about what is the approach today that will work best for that person's nervous system, or where we're meeting with them, where they're at. But that's a hard one to teach somebody if they don't have the experience to, to, to use.

Monica: 15:55

So, forrest, you really just took the words right out of my mouth. So, eric, I would say that the biggest thing that manual osteopathy has brought to my practice is really bringing this element of parasympathetic response, and I'll fully admit that before I studied osteopathy, you know I was all about the deep pressure and I was all about the deep needling, and after studying osteopathy I became really aware of how necessary it was to have someone drop on my table into that parasympathetic response, and so you know, things like cranial osteopathy, visceral manipulation, those are all ways that, as a manual osteopath, we can achieve that, and I found that when I have a patient drop on the table, that's when I get the results.

Eric: 16:55

Yeah, cause you're giving them that, that safe space to just kind of feel comfortable and cared for, and just turning that and turning that volume down on their, on their overall system, so that way they can, way they can just be in a better place.

Monica: 17:10

For sure, and trust is a huge part of that, and you know, part of what we wanted to discuss today around having someone feel heard. I think that that parasympathetic response does start the second that that person comes into your clinic 100%.

Forrest: 17:29

Eric, you were talking about redoing your whole entire clinic at one point to make the aesthetics of when people walk through the door that it lowers their nervous system, and so it does. It starts right when the person walks into the space itself like it does. It starts right when the person walks into the, the space itself, you know. Does it feel sterile and white and abrupt, or does it feel like it's calming, relaxing and allowing them to like? You know maybe?

Eric: 17:54

drop down a notch or two and that's and that's. That's such a huge thing and I think that's something that probably isn't a common thought for a lot of people in the msk world. Is you the value of like? What's your clinical, what's your clinic look like, you know? Is it you know? Is it? Is it a welcoming, safe place, or is it something that's like full of like, really bright lights and very medicalized? And I don't think there's a right or wrong one. I guess it really depends on what you're looking for.

Forrest: 18:22

But it has to meet the individual. Like, everybody wants something different for the most part it's hard to match a hundred percent of the time. But if you can get 70, 80% of people in that head space when you walk through the door, I think that's the win.

Eric: 18:35

Yeah 100, 100. I love that. Uh, yeah. So, monica, you mentioned, yeah, some of the things you guys want to talk about today was kind of about the, the importance of kind of communication skills and safety. So let's go there, tell me a little bit more about what you about about that. What are you guys thinking?

Forrest: 18:53

I I had a specific case that I was going to bring up.

Forrest: 18:57

Um, it was one that really kind of watching the person's reaction in front of me was like, oh my gosh, I just hit the exact wording that person needed to have said to feel safe and welcomed into my space. And I think, if I'd gone about it in my old forest way from 10 plus years ago, I wouldn't have got them into that headspace and we'd had a very different treatment and I'd have lost them as a as a patient, very quickly. And so I think that's where, like, the first thing that happens is is communication skills, and it's really, unfortunately, communication skills are a learned process. They're they're super hard to teach, they take a lot of time, um, but I I think what we were talking about is like validating people's experiences, you know, letting them feel like they've been heard and they they're, you know, being understood, and that the person who is asking all these objective questions is also being very compassionate, and I think that's super important. But it's really hard to get new learners to figure out how to do that.

Eric: 20:15

Yeah, it's not really taught well in school at all, at least from my experiences as a student as well as an educator. You know the it's very much a yes, no kind of discussion, rather than, like you know, tell me what you're feeling, tell me what's going on, tell me what brings you in here today. Rather, rather, it's just very much like this focus on like, where's it hurt? Why is it hurt, what, what did you do? Tell me all about it. Let's figure out the cause and then let's fix it. Is that the truth.

Forrest: 20:45

I don't want to slander the CMTBC so much, but they've really boxed massage therapists into this little tiny corner where we can't ask a lot of things, otherwise it starts to get viewed as like we're doing some sort of counseling and then we tell our students like you're not counselors, so we're really reinforcing the narrative that you don't want to get into touchy-feely with your patient instead of teaching.

Forrest: 21:11

Like something that I've learned through. Like I've sat in about 10 years worth of men's groups, thousands of hours of facilitating and being facilitated, and one of the things I learned through that was, like this active listening skill. So somebody could tell me 15 emotions that they're currently going through and in the back of my mind I am memorizing those emotions. Oh, need to say, if I can repeat back 75% of what they just said, they know they've been hurt and they know that I want to connect with them and so it's not even counseling it, but it's learning that skill that like, as you're talking to somebody, you're doing two things you know where you want to take the conversation, but you also need to learn how to paraphrase and really memorize everything they've said to you so you can say it back. And it's something that, like you can't just learn overnight, you've got to like be practicing it very actively.

Monica: 22:17

I love that yeah ahead, Monica.

Eric: 22:19

Do you have any doubt onto that?

Monica: 22:21

I do actually. So in Chinese medicine we actually did do three years of counseling studies, because we do counsel our patients right. So one thing that I can offer for the listeners today is this concept of three legs of a stool. So that's what we always want to think of. And so, forrest, you touched on one of the legs of the stool, which is mirroring, and the other two legs are listening, and the third one is advice.

Monica: 22:52

Now, I understand that in the RMT profession it might be a little bit different how you deliver that advice, but what I like to call the two R's, which is resources and referrals. So these are things that we can always give to our patients and I'm pretty sure that would fit into your guidelines as an RMT. So referrals would be things like counselors, addiction clinics, mds, grief support, and I have a list of these at my clinic ready to go, so that it's not like I'm fumbling around. It's boom, here you go, this is what you need. And then resources is like hypnosis podcasts, emdr podcasts, books or articles that I can kind of direct the patient toward, and so in this way, if you're mirroring their feelings, like Forrest just mentioned and I can't wait to hear your story Forrest about your patient, by the way, but if you mirror what that patient said and then give them referrals and resources, I believe that that's such a great place to start place to start the.

Eric: 24:02

And that's such a, it's a, it's such an important skill and such one that may not be realized, people may not realize it's as important as it is. I've. Really that cause actually creates that connection, that creates a strength in that therapeutic relationship and that that person will start to gain, gain trust in you, because you're actually like oh, I listen. Like the person might think, oh, I, I, I listen, this person listens to me, they understand what I'm going through, they understand my, my situation, whereas a lot of times it's much easier for us just to kind of yeah, yeah, yeah, yeah, tell me what's wrong, let's get you on the table, let's do something to you, rather than taking that really important time, like you guys mentioned, to just be there for them and even in a regular question that a lot of my students ask is well, you know, the person comes into our student clinic and they, you can tell they just want to get on the table.

Forrest: 24:54

They don't want to go through all the assessments and all that kind of stuff, and I'm like, but it's your job to make sure that you are, you know, creating a space that you do what you need to do to make sure that you're effective.

Forrest: 25:09

And so if they're trying to rush you through so they can get on the table, but you're the leader, you're the one that's supposed to lead the conversation and draw them into the why you're having these conversations. And so I don't know, I find in the last kind of 10 years I spent a lot more time 15, 20 minutes talking to people before they even get on the table, because I'm digging at stuff, I'm curious, and maybe that's part of it is I'm really showing my curiosity about what they're going through and I educate as I go along, like I don't try to do a sterile environment where I'm like, okay, we're doing X, y, z, like I'm very creative in the moment about how this process is going to proceed, and I do that by really watching. You know their facial expressions, their body language, how they talk to me, how they talk about themselves, their body language, how they talk to me, how they talk about themselves and I think, yeah, monica's right, it's mirroring.

Monica: 26:10

It's mirroring what's going on and also taking the lead. I have to say I am like one of those guilty massage patients that just wants to get on the table when I go for a massage.

Eric: 26:21

So you don't want to come see me, monica, I'll just keep talking well, I think part of the, the skill of being a good clinician is trying to, you know, determine what's what's the person want. Because if the person, their values are important and why they come is important, maybe the person just wants a massage and there's there's nothing. Maybe they just want to feel good for 45 minutes or an hour or whatever. And if that person comes in they're like I'm just stressed out, I want a massage, nothing's really, but nothing's. My neck's a bit sore, nothing's really to kill, kill me too much. Then you know, if we start to subject them to like a 15 minute inquiry, they're probably gonna be like are you freaking, kidding me?

Eric: 26:57

so I think, that's, that's part of the. Your practice is like okay, does this person like do they need more in-depth or do they just maybe they just need a good massage? Whereas if someone comes in, like you know, I'm sure, like, of course, a lot of the clients you see right With like specific injuries or complaints or long histories of stuff, you're probably going to want to take a deeper dive into their story and what's going on with them and that way you can come up with a more meaningful treatment plan what's going on with them and that way you can come up with a more meaningful treatment plan.

Forrest: 27:24

It's taken me a long time to also accept that I don't match with everybody and that it my job is to connect with who I can and to keep them um, keep them what's the word? Faithful to me? But I'm going to lose people a long way because we don't connect and I don't. You know, throw them on the table in the first two minutes and start doing treatment, and you know I'm totally fine with that nowadays, whereas a long time ago I wasn't fine with that. I would just do what the person said they needed, and I just do it to try to keep them.

Forrest: 27:59

But I've learned over time that I really I just want to work with people who want to work with me and it's not worth my time to just kind of forfeit my passion for practice because it bores me. Honestly, if somebody is telling me exactly what I have to do to figure everything out and they're telling me the sequence and I have to do to figure everything out and they're telling me the sequence and I have to do a very recipe thing.

Forrest: 28:26

I get bored and then my passion starts to fade and I am not nearly as effective when I'm not passionate.

Eric: 28:33

You can't please everybody all the time and you can't be the therapist for every single person, and you'll tend to attract a practice that represents you and who you are. And and I I don't know if anyone you know spends any time on social media you see the amount of burnout and the amount of concerns that people have in our profession and I think a lot of it has to do is because they've kind of lost that passion, because their their practice is very kind of recipe based.

Eric: 29:01

They're just doing the same thing over and, over and over again, and for some people I think they can do that, and some people I think it it burns them out. And you know, I'm just making a totally anecdotal statement here, but that's, that's my impression anyway to say the story that I had.

Forrest: 29:16

Um, so mom started this. She, she called me up and said you know, I need to get my child in to see you Child being like 21. So they came in, they sat down and they were all over the map. Like their shoulders were hunched, I feel like their body language was dropped, depressed. They were anxious, nervous, anger in them. They just really really quite mentally disturbed.

Forrest: 29:46

And I'm trying to ask questions and get an idea of, like, what we're doing today. And as we talked and I finally, at some point, I was just like hey, if you just need to sit here and talk to me, you need somebody to listen to you right now. We can do that. I don't even need to put you on the table. If you don't want to lay on the table today and you just want me to sit here and be with you, I can do that right now and I'm happy to do it. And then, their shoulders dropped, they like teared up a bit and they got so relieved to hear those words, like to watch their whole body just fully relax and settle in was amazing and I was like whoa, I just nailed what that person needed.

Forrest: 30:34

Um, I don't think they've been really hurt. They go to counseling. They're on all sorts of different types of medications. It seems like they're just kind of almost falling through the cracks of the system and no one's really like picking on or picking up on like what they really need. And it was just for me to watch that physical change in the person's body was so powerful. The record for me to recognize like my words have more implications and more therapeutic effects than actually getting them on the table.

Forrest: 31:05

And then actually, when I did get them on the table, it was a terribly frustrating treatment. Uh, couldn't use enough pressure, couldn't use light enough pressure. They couldn't stay in one position for more than five minutes. They're twitchy and agitated like. It became really quite the challenge to navigate a treatment with them. But what seemed to really be effective, as I kept seeing them week after week for quite a while, was that first 20 plus minutes of just letting them download what was going on in their brain. That seemed to be more effective than the actual you actual hands-on approach. And it's so backwards to what we're taught in massage school To even just advertise to somebody like hey, I don't even need to touch you today.

Forrest: 31:53

That actually goes against everything that we're supposed to do as massage therapists. But I'm a compassionate therapist. I'm supposed to be here to help you. If that's what helps you the most, then why am I stopping it from happening? Just to force you on the table to put my hands on you and I was, you know, I think doing one of the other pillars Monica just mentioned, like talking about resources and recommendations, but the gist of the story was just like the power of words and realizing how much their nervous system dropped just from hearing that somebody was willing to sit with them and just listen.

Eric: 32:33

That's very powerful for us and thanks for thanks for sharing that story. It's so true because if you think about a lot of those people, particularly people that have been in pain for a long time, people that live with chronic pain or chronic health concerns, oftentimes they're dismissed or they're just not really listened to and if you can be that one person that takes the time to validate them, to listen to them, and you're not counseling right? You mentioned that earlier about the. You know there's the worry that we're counseling but you're just holding that safe space for them, that is extremely therapeutically beneficial. Why would we be discouraged about it? Almost doesn't make sense, does it?

Forrest: 33:10

no, and it's hard to kind of, I think, understand what the where, that you know it. It's not a black and white line that you're like you, it's there's a gray area in there and it's really hard to get people understand, I think, as massage therapists, what that gray area is, that you can still work within. That is very effective.

Eric: 33:31

Monica, do you want to share kind of like what's your perspective on that? How is that similar or different for Chinese medicine and acupuncture?

Monica: 33:40

The thing about Chinese medicine and acupuncture is that we actually acknowledge that the emotions create illness. So part of what we're doing in our assessment is talking to them about their emotions pretty pretty outright, like all straight up, say to someone do you experience anxiety, do you experience anger, do you experience worry, do you experience grief? And then, if they say yes, I'm asking more questions about those things and then, like Boris said, I'm going to be mirroring what I've heard and then from there giving advice. And so one thing I need to mention about the three legs of the stool that we were taught is actually to make sure that there's a balance there, right, a balance between listening, a balance between mirroring and, finally, a balance between advice. So I find in my practice it's a tricky. It is tricky to strike that balance, and that's where I find that the resources and referrals are really, really important. And that's where I find that the resources and referrals are really, really important.

Monica: 34:47

But I also and I've taught my students this for many, many years is I think that when we get a patient into our office, there's this sense that we have to rush to form a relationship with them, and one thing I've taught repeatedly is that a patient practitioner relationship can take years to form, and when you're not rushed to form it and you're allowing it to to grow at its own pace, based on what the patient needs, that's when you're going to be the most effective, and I feel like we might.

Monica: 35:15

You know, in our culture everything's fast, right, fast food, fast, this fast. That Everything's fast, right, fast food, fast, this fast. That it's really important just to slow down that patient practitioner relationship. And then Forrest, in the case of your story, I think that by listening, maybe right now you can't give the right pressure to this patient, but I think that the more that you are just patient with that relationship, maybe in two years you're going to give that optimal pressure. And if it takes two years to get there, so what? That's what it takes right, we have to be patient with the process and I think that's just so cool that you were able to follow your intuition and really give that patient what, what he needed.

Forrest: 36:07

What's weird is like my ethic, my ethical side of me, felt so wrong by just saying I'll just stay here for an hour with you and not put you on the table, cause like technically I shouldn't be doing that, but that's what felt the most compassionate human thing to do, so, forrest.

Monica: 36:27

I don't know about you, but, and, and Eric, I'd love to hear your perspective on this too. But there's always like a balance between ethics and humanity Right, and I have a really powerful story to share at some point if we get there. But for me it's almost like in my practice, I have to balance the two, like professional ethics and laws, with what I feel is a humane thing to do. In the end, I am always going to follow my moral compass. You know I'm going to balance it with what the industry says, but I think that following that moral compass is super important as a practitioner.

Eric: 37:13

I agree 100% and this is actually something. This is a whole. We could have a whole other episode just on ethics. I love talking about this stuff, so thanks for opening up that topic there, monica. The healthcare ethics is not something that we really talk about enough. I don't think in musculoskeletal care. So the first principle right, beneficence right. So you should always be working in the best interest of the person, so you should always be working in the best interest of the person.

Eric: 37:37

If maybe the best interest of the person is just to sit there and be heard, and maybe you only provide a few minutes of hands-on treatment, I think our I should know this, but I'm pretty sure that in our bylaws we have to provide some form of hands-on therapy, for it to be called massage therapy. But if the best interest of the patient is to be set, to be validated, to be heard, for them to, would you I think the word used um for us was download their brain yeah, they needed.

Eric: 38:07

It seemed like they wanted to download just what was going on inside of them yeah, and they were okay with that and that's what they wanted and that's what they found valuable and I found my. In my own experiences I've had very similar things, where some of the people just want to just know I'm going to tell you all these things and it's okay, like I don't care if we only get a few minutes of hands-on stuff today. This is really important. You're sitting there, you're listening, and sometimes you might be thinking, oh my gosh, like this person is telling me everything and I'm not doing my job. But if we look at the ethics and working in the best interest of the person, then why would we tell them no, it doesn't make sense, does it?

Monica: 38:43

Absolutely, eric, and I think one thing that we can do as health professionals is point blank ask them and I will say to a patient like hey, I won't be offended if you say no, but is this helpful for you? And if they say yes, that's something I can then put in the chart. Patient said that they found it extremely helpful to just chat right and then it's charted. So if the college ever comes and assesses or audits you, then you know it's charted that the patient needed that 100%.

Eric: 39:19

And if it's a patient-centered treatment, then and that's what they want and that and that's what helped. And you know, we're we're doing. We're doing good work. I don't think we could ever get in trouble for that exactly yeah, I love that sorry for us interrupted you no that was I.

Forrest: 39:33

I had never thought about charting that before. So I'm kind of going oh, I could chart that, and then it's, it's, it's in there, it's part of the record.

Eric: 39:44

And ethically then I'm actually kind of, you know, cross the t's and dot the i's for sure, because that will help you too, right, so maybe the person doesn't see you again for two years.

Eric: 39:54

You kind of forget, forget the forget, what happened. And then you have that in your in your notes and you're like, oh yeah, this is what, this is what happened last time they wanted to chat, and this is a brief thing, what they, what they said, and this was the value, and I think it's. I think it's a good practice, in my opinion anyway. So question for you guys here question for you guys is so how do you, how do we foster more kind of comfort and competence in navigating these communication skills? Because obviously I think the three of us are all been around the block a while, a few times, and this stuff that we're talking about may seem easy, or it's never easy, but may seem. We're familiar with this, this type of conversation, these type of important things. But how do we get, how do we inspire and educate other therapists, whether it's new ones or ones that have been practicing for a while, to adopt this more communicative approach?

Monica: 40:50

I think the biggest tip that I can give, just from my couple decades of practice, is to be more straightforward with the patient, and that's something that has taken a lot of time. But you know questions that I normally wouldn't ask early on in my career. You know, for example, like if if a patient starts talking and you know we're talking about a subject, I will like point blank ask them do you want to continue talking about this or is it too much for today? And so I'll give them an out. Um, so I'm not afraid to kind of ask for what the patient needs and and I'm constantly doing that like is the music okay in here? Is the lighting okay for you? Is it comfortable? And and the more that we can be direct and concise with our patients, they're going to give us the information, but we have to give them the opportunity you force what your thoughts um honestly.

Forrest: 41:54

I've been trying to figure out how to just with, like the students that I've had over the years, how to facilitate these types of learnings in a way that they could put take it, put it into practice. And I haven't really honestly figured out how to how to educate or teach in a way that gets learners you know whether they're already practicing or you know current students how to learn these techniques and skills. I just kind of advertise that, how important it is so that they recognize that there's something that they need to keep working towards.

Forrest: 42:34

I just know for myself the only way I got to where I I am is because I started doing a lot of work on myself, and that's where I learned a lot of my communication skills was once I started spending many, many hours a week practicing communication skills on myself and on on others, in a place where that was the point of it like.

Forrest: 42:56

Like I said, I sit in men's circles, and so the whole point of men's circles is learning how to communicate, learning about emotions and feelings. So that's how I learned it all. I was actually really inundating myself in how to do it. I didn't learn it through school.

Eric: 43:16

Yeah, I would say that most of us probably don't learn it in school, but, like a lot of things, right there's, you know, our education shouldn't finish once we, you know, get our license. It should be an ongoing, lifelong process, and I love that. You know you talked about, you know, working on yourself, and that kind of self-reflection is so, so valuable and it's something that we should all do, because when we're working with the public and we're working with people and we're looking, working with people that are in pain and and and and they're, you know, they have their own lives and their own stories it's very, very important for us to reflect on on our own life and how and how we can be better for ourselves, and then, by being better for ourselves, we can be better for those people that come and see our care I couldn't agree more, eric, yeah, you, you hit it on the head there for sure yeah, so you guys are let's talk, because you guys reached out to me, because you wanted to.

Eric: 44:15

You guys guys are doing your own, are going to be launching your own podcast, so why don't you tell, tell me and the listeners a little bit more about what you guys are up to?

Monica: 44:24

So when Forrest and I traveled to Toronto, we did a lot of driving to and from our classes and it was pretty funny because every day we would get into these amazing discussions about health. And it just occurred to us like wow, if we press play on these conversations we could really provide something for other practitioners and patients. That would be just really good information for them to have. And so then the idea sprung about like we should just go for a beer and hit play and have some microphones around and see where it takes us. But the idea is to kind of take our combined 40 years of knowledge and just help people out on their path to becoming better practitioners better, you know, whether it's a patient or a practitioner. We want to. We want to try to give value, to help people on their health journey.

Eric: 45:28

I love it, and is that coming out soon?

Forrest: 45:32

I think probably in the next month. We've Monica has done a good job getting everything all kind of set up and we've had some sit-downs to talk about pieces that we want to kind of like tailor a conversation around. And yeah, I think somewhere in the next month we'll be starting to launch doing some podcasts together and if nothing else, hopefully there's something funny there.

Monica: 45:59

You can laugh along with us for a bit monica, you have quite the infectious laugh, I must admit so oh, thank you you know I first would actually like disagree, because in clinics sometimes like I, me and my patients get into these laughing fits that can be heard throughout the whole clinic and I call it laughter therapy. But my colleagues are like, oh no, monica's here again.

Forrest: 46:27

I joke with you the other day, saying I'm just glad I don't share the exact wall with you, and then I'm like two rooms down. Exactly Right you're just far enough away that it's, it's fine.

Eric: 46:38

Do you guys have a name for the podcast?

Forrest: 46:44

uh, we're gonna go with um healthful perspectives, healthful perspectives.

Eric: 46:50

Okay, I'll put that in the show notes for us. Why don't you since you have you here why don't you tell the listeners a little bit more about, uh, the courses that you're doing and what you have here? Why don't you tell the listeners a little bit more about the courses that you're doing and what you have coming up?

Forrest: 47:00

uh, so over the next kind of I think about four months, I've got a course each month here in nelson, uh, so I'm going to be doing the next one's lumbar and sij, that one after that's thoracic and ribs, following one after that's upper extremity. Um, what I'm really wanting to do is tie together more simple observation assessments, palpation skills to figure out the right approaches to which techniques to use for somebody with a certain type of condition or issue. So it's really trying to tie those assessments and techniques together a bit more. The predominant theme of like, say, techniques is going to be muscle energy, joint mobs and fascial mobilizations. Yeah, that's kind of what my aim is right now.

Forrest: 47:54

I've already taught quite a few classes in person last year, um, and so I also love just kind of bringing some case histories and and just kind of watching to see how a class can unfold, um, and try to answer other health professionals questions on like what's going on in their practice that you know they're needing support around and my long-term goal is actually this later this year, I'll be launching an online education uh that will have all of my techniques and skills recorded, so you can you can do online education without having to come to to nelson yeah, nelson's not the easiest place to get to, no, but once you're here, it's beautiful.

Eric: 48:41

It is beautiful. I've been there once, and it was a very wonderful place. I only was there in the summer, though, or spring, so it was beautiful, then. How can people get ahold of you? Do you have a website that you want to put a plug in there? You?

Forrest: 48:54

can go to my website. It's called rebalancingca. There's a registration page on there as well, if you're wanting to look at the courses, or you just send me an email from that page and I can answer any questions perfect.

Eric: 49:09

And monica, what about you? Do you have a contact information? You want to provide listeners?

Monica: 49:14

yeah, so my my website is wwwaccunelsoncom.

Eric: 49:22

And are you going to be doing any continuing education, Monica?

Monica: 49:25

I actually have a whole curriculum written. So it's just, you know, trying to trying to come up with a little bit of a plan for the next year or two. I think that it's my plan to kind of get this podcast launched and then after that I will launch my curriculum, because I am very passionate about teaching. I do love it, so I am anticipating that for my future for sure.

Eric: 49:51

I love it. Yeah, teaching is can be, you know, if you're inclined for it, it's just, it's infectious, almost it can become like addicting.

Eric: 49:55

if you're inclined for it, it's just, it's infectious, almost it can become like addicting, just to just such a good feeling to be there and to interact with people and hopefully help them think about things differently or do things differently and inspire them to pursue more knowledge is such a wonderful feeling, so I'm really excited to hear that you guys are both taking that, that approach, and you've got some hopefully, some good quality stuff coming out in the near future absolutely all right guys. Well, thanks for being here today. I appreciate you, uh, taking the time to be here and to have this, this conversation, and hopefully we can touch base again soon.

Monica: 50:34

Thank, Thank you so much, Eric. I just want to really show my gratitude for hosting us and we're just so happy to be here.

Eric: 50:43

I'm happy to have you guys.

Forrest: 50:45

Yeah, Eric, thanks for all the things over the last couple of years. It's been great getting to know you and having you as a resource and support.

Eric: 50:53

I appreciate you saying that for us. It's been wonderful working with you too, buddy, and yeah, we'll keep in touch. Okay, sounds great. I appreciate all you listeners for taking the time to be here. If you enjoyed this episode, please give it a five-star rating and share it on all your favorite social media platforms. You can follow me on Instagram or Facebook at ericpervisrmt, and please head over to my website, ericperviscom, to see a full listing of all my live courses, webinars and self-directed course options. Until next time, thanks for listening.