Neuroscience and Trauma Informed Massage Therapy with Dr Mark Olson

Chapters

• 0:00 Episode Introduction
• 1:22 From Neuroscience to Massage Therapy
• 8:16 Transforming Massage Education
• 18:45 Trauma-Informed Bodywork Approach
• 28:52 How Massage Works: A Neuroscience Perspective
• 41:08 Creating Meaningful Change in the Profession
• 56:10 Current Projects and Political Context

Transcript

Eric: 0:08

Hello and welcome to the Massage Science Podcast. My name is Eric Purves. I'm an RMT course creator, continuing education provider and advocate for evidence-based massage therapy. Thank you for being here and I hope you enjoy this episode. And I hope you enjoy this episode. Hello, everyone, and welcome to another episode of Massage Science. Today I'm here with Dr Mark. Olson who is a massage therapist and neuroscientist in Sarasota, Florida. Thanks for being here, Mark. Just take a minute and tell everybody about you.

Mark: 0:46

Yeah, thanks, eric, thanks for being here. Mark, just take a minute and tell everybody about you. Yeah, thanks, eric, thanks for having me. Yeah, so, as you said, I'm a neuroscientist. I have a PhD from the University of Illinois and I studied neuroscience there because I was interested in what people, why people are, the way they are, what makes them tick, and I don't know if you want to go into that part of it, or if you wanted to, yeah, please.

Eric: 1:14

Actually, that was probably one of the things I wanted to ask you about was your kind of journey from like neuroscience to massage therapy, body work. I'm assuming you did your PhD first and then went into body work. Is that correct? Yeah, yeah.

Mark: 1:30

I was not thinking about body work at all when I was working on my doctorate, except that, you know, occasionally seemed like massage would be a neat idea and maybe a neat skill to put in my back pocket for fun. So yeah, I studied memory and attention and the visual system. I did research on whether we could track your eye movement patterns to see if we could tell from your eye movement patterns whether you recognized a place or not. And it was more accurate than a lie detector test. So anyway, I was in a very different world, but I was always interested in what makes us tick.

Mark: 2:12

So I think massage is also something that is a really good way to find out what makes us tick too. I don't know if a lot of people think of it that way, but I think of it that way Because you find out a lot of things about psychology, psychology and oneself. Uh well, at least one could through through massage. So I went to hawaii after getting my phd and I thought, well, I said I was going to take a class, so I'll take a class and found out hey, this is, this is great, I'll take some more classes. And so I became an mvp.

Mark: 2:44

I became a licensed massage therapist and started teaching classes at lots of different schools, and for a long time the neuroscience and the massage therapy kind of existed in two different realms. They weren't integrated. Until I started training in aquatic massage therapy or aquatic body work and I just started to realize, oh, there's a lot of things going on here that don't make a lot of sense If what we're telling ourselves about body work is true, that this doesn't seem to be about tendons and muscles, that people are having these psychological experiences. I'm having these psychological experiences that don't make sense if this is just about soft tissue. And so that's when my neuroscientific mind kicked in and realized oh yeah, I know a lot about all this material, and so let's put it together. And so that's what I've been doing for the last decade or so, is is blending them, which I could talk about forever.

Eric: 3:49

Yeah, oh, we can, I'm sure we can, and we can, we can get into that. That's really interesting because it's what you see. So in Canada and the U? S, you know, we can talk about political stuff here for briefly, if you'd like to, in a minute. But what we see in Canada is we see the opposite stuff here for briefly, if you'd like to, in a minute. But what we see in canada is we see the opposite. Usually you see massage therapists first and then they pursue the academic realm. They'll, they'll be like ah, you know what? I like to be a massage therapist, but I like research, I like science and I and they, they will go do masters, phds and then they will leave the massage profession almost completely yeah and we see that all the time.

Eric: 4:26

There's like five I know of PhDs that are that were RMTs in Canada, so not a lot. But I've met many like yourself in the US who have a PhD. They've got a doctorate and they're a massage therapist. But they did their academic first and then they became a massage therapist. So that's an interesting difference between the countries.

Mark: 4:47

Yeah, yeah, I mean, I don't know if I recommend one of those routes more than the other. Each of them has their pros and cons, yeah.

Eric: 4:56

Personally for me, I like the idea of like what you've done, where you go and you get this incredible education and body of knowledge and ways of thinking which you get through graduate school. I know my own experiences going to grad school. I completely changed how I think and how I think about how I think you know and I'm sure you could talk forever about that too the but then you go from that into massage. It really, I think, provides that foundational education where you can really ask critical questions and think about things differently. And, like you were saying, this isn't about muscles, tendons, joints, bones, the way we thought, yeah. So I think that sets you up in a different way than going the other route, where you have a lot of unlearning to do.

Mark: 5:47

Yeah yeah, and I think that transition, you know, is different in Canada because you guys have so many more educational hours, so maybe there's less of a gap there than there is in the States, because the education, you know, in the states is so varied and in many cases so so much less than you have in canada. So, uh, you know to I mean that's why I started teaching all these anatomy classes, because I realized, oh, I mean, I'm just a neuroscientist, I don't, I don't, I'm not a biologist, but I could teach all these things better than what I'm seeing, just because it's basic and it's, you know, in many cases it's poor, so it needs to be improved.

Eric: 6:33

So let's let's talk about, let's let's let's transition from that to let's talk about your work at the massage school, cause you were a director and at the massage school in Hawaii. Tell me a little bit about that transition on that journey and what you did differently in that program from, let's say, the status quo, what other people were doing.

Mark: 6:52

Yeah, yeah. So I started working with this one massage school that I almost immediately became the director of, on Kauai, and it was a great school and right from the start I should just say that. So the school, from the beginning, had a more like mind-body integration element than some other massage schools. So some massage schools are more focused, or?

Mark: 7:21

maybe have a more medical kind of angle or something like that. This one had more of a body-mind kind of integration mindset, which I really loved because that was much more in line and easy to integrate with my neuroscience background. I came into the school saying, hey, let's take what you're doing and let's add a whole bunch of neuroscience to it what you're doing and let's add a whole bunch of neuroscience to it. But I but the, the director died, um, that first year, and uh, I was running it, and so it was just up to me to, as as the new director, to figure out what to do, and one of the so there were two elements to this.

Mark: 7:59

One was this was a school that, even though they were doing this really great body-mind integrations, they're coming from structural integration, which has a long history of being based in this tissue-based VASHA model, and I quickly realized that this model was not accurate scientifically, and so I had a choice you know, this was kind of the brand, but I wasn't gonna.

Mark: 8:29

I wasn't gonna continue doing something that wasn't scientifically sound. So I, you know I made the choice to just say we're going to abolish all of that fascia based mindset and we're going to put the you to put the nervous system at the center of this. So that was one element that I changed, and I changed that first and then. The second element was that the body-mind integration was great, but there were some aspects to it that were not trauma-informed. I would say we're re-traumatizing, because they were using some things that were from maybe like 20th century thought, and now we've evolved from that, we know better. So I also decided to make trauma informed a central pillar of the school. So there was this neuro informed and trauma informed aspect that basically held up the entire program.

Eric: 9:30

One of the barriers that you see all the time is when I talk to massage school directors or owners is this fear of change or they don't know how to change because things have been done the same way for so long Structural, patho-anatomical, fascial-based ideas and then trying to bring in a more science-based, more neuroscience focus. I think you said you want to put neuroscience at the center of the program, which I love. That is exactly what confirms how I feel about how I think things should be done. How was that received by the other faculty and the other people in the school? I'm very curious to hear that.

Mark: 10:17

Yeah, yeah, well, that's a lot of aspects of that answer. So, um, well, um, there were definitely some who were, you know, all thumbs up and interested in like, yeah, let's, uh, you know, let's follow the science and let's um, you know, let's do it right. Uh, you know they were, they were very supportive. I had definitely had a lot of support and I would say, you know, basically all my core faculty were supportive in that process and there was there's the supportive in the like, I'm with you as a human being, and and then there's the okay, but I have to wrap my head around it because I've been thinking about this other way and so you can be supportive but still also think in older terms.

Mark: 11:14

So that's a little bit of a process of trying to think. It's a paradigm shift. It's not just adding another note on your slides. So that takes a while. I mean, it actually took me a while. Even even as a neuroscientist, it still took me a while to figure out how to rethink about, you know, body tissue stuff, because I, you know, I'm an expert in brain stuff, but I, uh, I was still thinking about, well, I mean, I'm not exactly sure how knees work completely. So you know, I'm learning this too, so let's you know, let's figure out what's actually going on. And then the individuals who were the students were totally fine, like I just started teaching classes with a neuroscience center and they were like, yeah, okay, great.

Mark: 12:03

And I would say hey, by the way, if you were here, you know know, a few years ago, we would have taught that and they just kind of looked at me like well, that doesn't make any sense, like it wasn't any problem for new people to, but the problem was trying to get the message into those who had learned it an old way, and so the most of the pushback that I got was from past graduates who had learned it a certain way and thought that what I was doing was, you know, something like blasphemy and wanted me to recant or something like that. I don't know if I really got that directly, but you know, it was kind of. There was a sense of that. You know I was, you know, just saying these terrible things about fascia you know I was uh, you know, just uh saying these terrible things about fascia, you know?

Eric: 12:49

that is so interesting because a couple things there that I that really resonates with me. One of them was being that the students that were learning for the first time were totally okay with messaging because you that was. Their anchor now was neuroscience, of course. And then when you talk about other stuff like try and put in like a fascial or tissue-based model on top of that, it doesn't make sense to them because their anchor is neuroscience exactly and then vice versa, those that had the anchor of um, you know the, that fascia tissue-based model, and then you're learning neuroscience.

Eric: 13:23

They feel an attack or they feel like it's blasphemy I think it might've been the word you used and that is so interesting because that's something that I encounter all the time in the work that I do is that when a student learns the less wrong approach, then they're able to they hold on to that and then they can progress, I think, easier into this more neuroscientific mindset, so to speak.

Eric: 13:55

And one thing I studied in I may have said this in some of my other episodes, I'm not sure One thing I studied when I did my graduate work is we looked at some of the barriers and facilitators for the use of research evidence in practice. For massage therapists was that baseline education, that introductory information that they got in their entry to practice, shaped how they viewed their, their world and your experience, which is there's evidence right there of teaching the school had that. You experienced that same thing. So for me, I feel that that is such an important thing for anyone that's listening, that's a school director out there listening, or anyone that's in education, realizing that what you're learning in school is so important and it's so hard to unlearn. That isn't it?

Mark: 14:50

yeah, yeah, and I mean I'm a little surprised actually that it was easy for folks because it's still, I mean, the tissue model isn't just taught, it's in the culture.

Eric: 15:02

Yeah.

Mark: 15:04

You know we learned I mean I had a tissue model in my mind just from going to gym class and going to yoga class. I didn't expect it to be a smooth transition, but and I'm not saying it would be smooth for everybody I mean it might help to have a neuroscientist as the teacher definitely you have that authority.

Eric: 15:23

Already dr olson's here is their neuroscience degree right.

Mark: 15:27

It makes, it, puts you in a position of authority where they they respect making stuff yeah, I mean maybe it's the authority, or maybe it's the teaching style or um, and also maybe it's just the. You know what I delivered. I mean just saying, hey, if you put people under anesthesia, all of a sudden you can touch your toes, no problem. I think convey is quite a bit.

Eric: 15:47

Yeah and and yeah, cause, if you're, if it's a fascia problem, but you remove the nervous system, there's no problem.

Mark: 15:55

Yeah.

Eric: 15:55

So it kind of just debunks that whole idea right away, doesn't it?

Eric: 15:59

right away yeah, uh, that's interesting. Yeah, my, my journey into the I'm gonna the anti-fascist way, the, the anti-fascist model, actually came from going to the fascial research congress in 2011, because it actually didn't answer any of my questions. It actually created more questions. And where just things didn't answer any of my questions, it actually created more questions where just things weren't adding up. Now, I didn't have any answer at the time, but I just knew that something didn't make sense. It took quite a few years after that to start putting pieces together. But if we actually think about how that tissue-based model, and that fashion model particularly, doesn't really make sense, we want it to, but when we look at the evidence, the research, or we think about the critically, it just doesn't.

Mark: 16:45

It doesn't, it doesn't make sense anymore yeah, well, and I think, uh, I mean all body, every aspect of anatomy, is cool, you know. So there's no question that it is cool, uh, and it makes sense that we like to think in those terms because we are familiar with three-dimensional objects and physics. I mean, even a six-month-old expects objects to fall and kind of understands the properties of matter to some degree, and so that's very intuitive to think in those terms. If you think something is more movable or more pliable, we understand what makes things pliable in our house, but we don't really understand complex networks of millions of electrical signals, those are. That's just not intuitive at all. You know, it's kind of unfortunate that the reality is this complex, because it is very difficult to understand. That's the way it is.

Eric: 17:54

Yeah, oftentimes the simplest answer is usually the correct one, but in this case maybe not.

Mark: 18:04

Yeah, Occam's razor applies in certain conditions, but not in others.

Eric: 18:08

Yeah, and I would say that this is. I would think that, based on what we're talking about, that it doesn't apply in this condition.

Mark: 18:16

Yeah, because perceiving reality and figuring out how to be a living organism cannot be simple no, it shouldn't be.

Eric: 18:24

No, no, it shouldn't be. Let's talk about trauma-informed, because I kind of go. We know that in the common ideal in the massage, body work, manual therapy world is trauma is stored in fascia. This is a kind of term that gets has been used for the 20 plus years I've been around the industry and you do a lot of trauma-informed stuff, so I'd like to hear your perspective about trauma-informed care and trauma-informed education and how what you do or talk about or educate it is different from others yeah, yeah, very happy to talk about that.

Mark: 19:03

Lots to be said. Uh, I'm going to come back to that statement about the, the fascia and the trauma there, because that's that's where these two topics come together at the same place. Uh, but a little bit of background on that. So, trauma-informed I think the first thing that people have to be really clear about is that trauma-informed it doesn't mean trauma treatment. So I was just in a event the other day where they're trying to get 1 million trauma-informed leaders within the next 10 years, and this was like in corporate world. So this is you know, you could be I don't know Goldman Sachs or something like that and have a trauma informed office environment. You know, it's not about. Obviously, goldman Sachs is not trying to do trauma work, you know, but there's people that work there and I'm not saying anything. I just pulled Goldman Sachs out of a hat. I'm not saying they actually are doing that. I have no idea.

Mark: 20:07

But the point is that any company can be trauma informed, any person can be trauma informed. It's really just a matter of knowing about trauma, how it impacts people, knowing how to respond to it, knowing how to not make things worse, but especially when we are working with people, and especially when we're caring for people, that's a special subset of trauma-informed work. It's trauma-informed care and I don't think there's any profession that is more in need of trauma-informed care than massage therapy. You could argue, even more so than psychotherapy, but I mean splitting hairs there. But the thing is, with psychotherapy you're not touching people. So massage has this very special place where a lot of things relevant to trauma come up and all people think, oh yeah, trauma touching people, sexual assault, of course, that's that. That reason alone would be a reason.

Mark: 21:07

But there are, there's so much more than that, um, and it doesn't have, doesn't be, doesn't have to be about people having traumatic experiences like that. It can be just more a deeper level around developmental trauma and how people show up and relate to you and how do you relate to them. So it's really about optimizing the client therapist relationship so they feel more safe. Because if they don't feel safe or you, you know it's not binary, it's all in continuum. But I'll just say it in a binary way If they don't feel safe, you're not going to get as much work accomplished.

Mark: 21:46

Because, again, we're not working with tissues, even though people think we are. We're working with the nervous system. We're working with interoception, and the nervous system is going to just balk at you if it doesn't have a sense of safety. So you got to start there. You know the more you can do to help people feel safe in your treatment room. I think you know the more success you'll have in other realms, especially because it also relates to pain, and that's what a lot of us are dealing with is trying to help people with pain.

Mark: 22:22

So there's just a whole bunch there where uh, you know my students at the end of the program every year they just they look at me like how in the world could you not have a trauma-informed massage? Training like that's that's insane should be foundational. Like that's insane Should be, foundational.

Mark: 22:40

Yeah, it should be foundational, but it's hard to make it foundational, which is something we could talk about later. But before we get to that, there's another thing there about the trauma in the body part that you mentioned A lot of people. This is also a tissue-based approach, a tissue-based mindset applied to the concept of trauma. To think that trauma is in the body or is in a tissue that is thinking with these tissue thought patterns, and you have to understand that tissue is not a thing that can be extracted, it's a pattern, it's a neuropsychological pattern. It is not a thing that can be extracted, it's a pattern, it's a neuropsychological pattern. It is not a thing inside tissues. And people think this way because they're like, oh, I was rubbing their shoulder and then they started to cry yeah, well, that doesn't mean something's stored in your tissue, it means that your nervous system is responding and it's all brain-based. It has nothing to do with tissue, absolutely nothing. And so to really, you know, to combine the whole fascia model thing and to and to blend that with trauma is like, you know, two wrongs make an extra wrong, uh, element, and and you know it's not too it's really not that different, in a way, from thinking that we're extracting demons. You know, if it was 200 years ago, you know we're going to extract trauma, we're going to release trauma. I'm going to release your, your, your fascia, which I can't do, and then I'm going to release your trauma, which I also can't do. Uh, that's kind of the mindset, right. But if we understand that trauma is a neuropsychological pattern and it has all this interesting relationship between interoceptive states and we understand that we're working with the nervous system, then it becomes way more interesting about what we're doing and how we're impacting people.

Mark: 24:30

And we understand that just because they started they had an emotional outburst of some kind, or emotional expression of some kind, that's not healing. For, first of all, like, like weeping, is not healing. Um, it may be useful or not, you know, but I mean, it's out of our scope to try to work with that, but. But we can be, but it is definitely within our scope to be with it. I mean, if someone starts crying, just be a human being and be there with them. So that's not healing trauma, but that is being there with people. And I think if you can't be there with people, that's also not going to be safe. So, you know, people ask well, how, what does this look like in the actual room? And we have kind of you know, dig into details there. But you know we're not. We're not going to say, oh, you know, what are you crying about? You know, tell me about your story. We're not doing that.

Eric: 25:26

Obviously, if they want to talk, you know there's no reason we can't listen I like to think of it and just to try to really briefly simplify what you're saying is it's really just a matter of just being a good human yeah just being a compassionate caring other for this person who is having an experience, and we're just there for them yeah would that be accurate.

Mark: 25:54

Yeah, yeah yeah and and but. But you know. So I would say, everybody who trains to be a massage therapist thinks of themselves as a loving human being who wants to make the world a better place. I mean, that's probably a base where most people start. That doesn't mean that we're all equally good at it, though.

Mark: 26:14

So that's the thing is one person might, you know, a lot of times things come up and you're like, well, I don't know what to do right now. I'm not really sure what to say right now. That would be helpful, but there's, you know, one thing that's not helpful is coming in with an agenda which goes back to this tissue model, like, oh, I'm going to, like, fix your posture. You know, to me the posture topic comes back in with the trauma topic of well, what if that person's posture is related to their trauma? Like, what if that's protective? Like, do you want to quote, change it? Um, that's adaptive. You know, you're pathologizing it. You can't have a trauma-informed approach and pathologize anything. You can't pathologize their behavior, you can't pathologize their posture. So just coming in with like, oh, okay, let's. Um, you know, I see that your shoulder isn't. You know, the same on both sides, so we're gonna fix that that that doesn't fit into a trauma-informed approach in my book I like.

Eric: 27:13

I like where you, we are, where you've gone with that mark. I think that's that's an important thing for any of us to really just embrace and and into our practice. Is that you said can't pathologize anything, it's not consistent or is inconsistent with a trauma-informed um model. Can you expand a little bit or discuss a bit more I'm sure you can about that? So what would you say, like say in a course, or say in a conversation with a therapist who says you know, who notices all of these postural changes in someone, and the person the patient, client, depending where you are, what you call them the person comes in and says is commenting on their posture. Anywhere you are, what you call them, the person comes in and says is commenting on their posture in a trauma-informed way. How would you have that conversation without furthering problematic behaviors or ideas?

Mark: 28:12

just to clarify the client is commenting on their posture, or the therapist?

Eric: 28:15

the client is, because that happens sometimes, right, they're like oh, my posture is so bad, and then, and then the client, and then the therapist is, of course, oh yes it is, and then just to yeah, have that conversation yeah, yeah, well, I mean, first of all, um, I'm not going to affirm any kind of good or bad quality.

Mark: 28:34

I would try to steer. Steer it towards you know well, how does it feel to you, because that's ultimately what I care about. But I get what you're saying, that you know this is very embedded in the culture, that there is a good and bad and that people associate that like well, that's why I have back pain, even though you're probably going to have back pain either way. So you know, but you know it gets put together because of the way the culture is. So you know, there's, there's, so there's no one answer to this because it depends on what you think they know and what kind of relationship you have with them. But there's lots of room for education about you know, hey, you, hey, you know there, you know you might be interested in knowing that a lot of people, you know that hasn't been there, hasn't been a found, a correlation between these things you know. So you know it's one way to explore why, why, that's the position that you like, you know do you want to be in a different position? Why do you want to be in that different position? And I mean, I think I would have to know a little bit more about the you know this imaginary person too, because one of the elements that I that I find really interesting about posture is that it's it's not just this structural thing, it's this psychological thing, and we know that, yeah, if you're sad you'll look one way and if you're proud you'll look another, but also it's the opposite direction too, that if you don't want to feel something that's true for you, you can put on a posture that blocks it, like try standing at like military attention and feeling grief. It's basically, it's next to impossible.

Mark: 30:25

You know, if I was, you know, talking with you right now and I started and I felt like I was going to cry, I could like move my body around in a certain way to make sure I don't cry. Yeah, yeah, but I could do that for the rest of my life too. You know, I could be like I feel like crying, but like crying, but I don't want to deal with that. So I'm just going to walk around real stiff and make sure I don't feel that way. Okay, so that client walking into the office, that person who I just kind of have a sense that that posture has this whole psychological story about it has. This whole psychological story about it is going to be different than somebody who seems like you know, their posture really isn't about psychology. It doesn't seem like that's. That's really what's going on for them. Not that I'm going to say, oh, I think your posture is about psychology. We're obviously not doing that. But you know, you still get a sense. Yeah.

Eric: 31:16

Yeah. Whether it's about psychology or whether it's about some type of adaptive thing, because they hurt yeah no, you mean yeah, yeah right.

Mark: 31:25

Right, because you know, maybe they're one shoulders higher, because when it's the same, that doesn't feel good. It's just a simple nociceptive not necessarily simple, but it's nociceptive in its basis Whereas somebody else comes in and they're walking around the way they are because of the psychology. So I think those are very different. Those are going to be, those are going to take different courses perhaps.

Eric: 31:51

Yeah, I mean that's a great. I love that. And what I was really kind of getting at I think you kind of you did a great job answering is that it depends, it's gray, it's uncertain, it and that's where it comes down to the being okay with not having all of the answers, but just trying to be less wrong in what we're doing. And this is something that I feel is so necessary with us in our profession. Doesn't matter whether in canada, the us, anywhere in the world, is that we? Yes, it's nice to simplify things because it gives us like clear, linear process. But if we're speaking of posture and we see that posture is it psychological, is it nociceptive in nature, is it structural our approach is going to be different for each of them. Is it nociceptive in nature? Is it structural? Our approach is going to be different for each of them. But we don't need, we can't try to fix it, we shouldn't try to fix it.

Eric: 32:48

But there's so often that belief that. So maybe the example I started off with we said, well, the client comes in, but maybe the client comes in, but maybe the client comes. I got back pain. And then the therapist looks at them and it's like, ah, it's because of you know, your right hip, your right An ominous is, is elevated and rotated, and you're you got this S curve in your spine, whatever. Blah, blah, blah. That's not helpful.

Eric: 33:12

Yeah, yeah it's leading you down the wrong path, often of your, your, uh clinical reasoning yeah, they don't know that at all.

Mark: 33:23

Yeah, I mean, they'd have to have god's eyes to be able to see what's initiating those nociceptive signals, and nobody can have that. So, um, yeah, I mean, I think the one, I mean there's the it depends is the answer. But also, be curious and humble is the answer. Yeah, and that's that's like the one thing that you can say for sure. Right is you know, if you explore with curiosity, I mean I, I think that will always lead somewhere.

Eric: 33:53

Good, yes, 100 agree. And that's the one thing I often, I always say in my courses too is people like what do you do here? I'm like, just be curious. You know there's no best approach, there's no best technique, there's no best modality or intervention for for a lot of the stuff.

Eric: 34:10

Just be curious and ask questions and just try stuff to see and be humble yeah and and I think that is what I found from talking to you and from others and just from my own journey is that approach, that curiosity, that explorative, uh, that humble approach seems to be? I'm going to say I don't know. It needs a name to make it sound sexy and you could sell it so people would take those courses. You know, if it was the, you put that into an acronym.

Mark: 34:41

You know the humble, curious, explorative.

Eric: 34:46

Make it, make it into like a four-letter acronym. People would buy that they would eat that up. But when you're teaching a course and you're and you're not providing, like this is the answer, that can be a hard sell for some people who aren't there yet.

Mark: 35:03

Yeah, well, especially since we're dealing with something that has consequences. Pain has consequences, so you do want to have an answer. I mean, who doesn't?

Eric: 35:14

want to Do I hurt.

Mark: 35:14

Yeah, yeah, I mean, but if anybody could give that answer, you know they'd be, they'd be, you know, making a lot of money, if, well, I guess she can make a lot of money without the answer. But uh, yeah, it's a pretty tough question to add to, to to answer accurately, and we all wish we could do it, but it's's just too complex to do it.

Eric: 35:43

Well, this kind of goes, I think, to your expertise as a neuroscientist and as someone who has a PhD in neuroscience and is a body worker. Let's talk a bit about your kind of like a neuroscience approach, Like what's happening from your perspective or from from what you know when we're doing work. What's happening from a neuroscience perspective and you can be as deep. You can be as detailed and as in-depth and technical as you'd like.

Mark: 36:11

Okay, great yeah, well, um, I have this whole model that's built out that demonstrates this visually. So this is one of my favorite things to talk about. Well, I mean, you have to understand how pain works first. So you have to realize that we've got the tissue inputs and then we've got spinal activity, and then that goes up to the thalamus and then that goes up to limbic structures, so you have that ascending pathway, and then you have to understand that there's also this descending pathway, coming back down to the spinal cord. That's like a basis to understand where we're going to interface with this. We also have to understand that we have immune and endocrine responses that are just kind of generating this chemical soup that the nervous system lives in, that's affecting how all that signaling is going to go at all of those points, at any or all of those points. So what do we do? You know, we're not changing tissues. We might notice changes in tissues, but those aren't actually. We're not making changes to the tissue mechanically. They might be responding because the nervous system is responding.

Mark: 37:34

So the you know, uh, we're providing, we're doing two things we're providing a touch input and we're providing a relational input. You know, because we exist as social creatures in the same room with them, and so I'm not going to provide the same touch input in one situation or another situation. If I have good therapeutic resonance with them, that's going to have a different outcome than if I have poor therapeutic resonance, and so that cannot be underestimated. You know this is person, this is. Am I conveying that this is a safe place? Do I look like somebody who knows what they're doing? Did this person have positive experiences before with me or with other people? You know, all of those things are filtering in that ultimately are going to influence that descending signal which we think of as, as you know, placebo. But placebo is not this ethereal thing, it's this actual neural signal that goes from one part of the nervous system to another part of the nervous system. So that's one way we're definitely affecting, we're influencing that descending signal, which for some people might be more useful than others, depending on how well that signal is working for them. We're also moving tissues around and by providing input we are creating signals that might shout louder than what the current signals that they have. So if they have, you know, c fibers that are complaining at a certain level, we're providing touch input that could inhibit that, or at least just shout louder than it for some period of time.

Mark: 39:14

So a lot of people think, oh yeah, you just did something magical for me, but it wasn't. We just, you know, we just did a bunch of smoke. Think, oh yeah, you just did something magical for me, but it wasn't. We just did a bunch of smoke and mirrors for you, which is a useful thing to do, but we didn't actually change the source of that. And then we're also providing relaxation, which is going to change those endocrine and maybe immune responses in a more longer term.

Mark: 39:38

Exactly how long, I don't know if anybody knows. Um, but there's a whole bootstrapping process, right. So there's the what are we doing during that one hour versus how are we helping people in a longer term? And you know, in a tissue-based model, people are like, oh, I don't want to do that feeling stuff, I just want to do this, like change the tissue stuff. But we don't do tissue. So what we are doing is changing how we feel, and from how we feel, other things could change. From there, you know, we might have different endocrine responses, different immune responses, um, so you know, I I mean there's a whole bunch more that I could say but I mean, that's kind of a real quick overview, yeah.

Eric: 40:26

Yeah, it's not as simple as just your. You know traditional narratives I'm increasing circulation, I'm, you know, decreasing muscle tone, I am like it's all mechanical right, or I'm moving lymph around or I'm releasing fascia, whatever that means. You know, breaking apart those adhesions, I guess kind of traditional stuff. It's way more complex than that because I like what you said. You said it's not just a touch input, but there's also a relational input and that and I guess we'll go back and combine that idea with goes with the trauma informed, where there's that relational aspect and that's where a lot of the people can't see this, but in air quotes, that's where the change is going to occur is a combination of these things, you being a good person who's supportive and caring and providing touch that is meaningful to the person on the table yeah, I mean, if you people came in and we didn't actually touch them and then they left, they'd, they'd probably feel a little better.

Mark: 41:30

Or if we, you know, on the first day of class, you know, for me I have my students just put their hands on the client for a half hour my students just put their hands on the client for a half hour and you know, to embed the idea that you don't have to do anything fancy to make people feel better, you just have to be, you know, attuned to them and feel, help them feel, safe. Now I will say that there, I do think that there is some room for like micro circulatory changes, not the normal circulatory story that people talk about, but I do think that there's ways that maybe peripheral nerves are not happy and maybe we are helping them be a little more happy on a micro scale.

Eric: 42:12

So there's that the DNM idea of like. The DNM idea of like changing the circulation and the nutrients to the cutaneous nerves. Is that what you're?

Mark: 42:26

referring to yeah, yeah, so, to whatever extent you know, someone's pain is based on irritation of peripheral nerves, then, yeah, that seems like a very viable explanation for some of the things that we're doing.

Eric: 42:44

One thing I'm curious about and I'll admit that I know enough to know that I don't know enough about the DNM, because I know it's used as an explanatory model. Based on your knowledge of neuroscience, does it make sense?

Mark: 43:03

I mean what I know of DNM. That makes sense to me, but I can't say that I've read it in a while to really answer that question as well as I might like to or you might like to.

Eric: 43:22

No.

Mark: 43:24

I usually give it a thumbs up all the time.

Eric: 43:27

I think it's a less wrong approach or less wrong understanding. I think it makes more sense. If we're talking about neuroscience, then we are our. Most of our impact is occurring through nerves through sensory nerves and the counter receptors in the skin and upper layers of the connective tissues. That makes sense to me, based on my understanding, but I don't know if it's I want it to make sense or there's actually evidence for it.

Mark: 43:51

So I that's where I get skeptical evidence you know, for it's kind of hard to come by, you know it's hard to come by evidence for any of these things. But just you know, just in theory. You know just on understanding neuroscience, in theory, uh, it works. And you know now if, if we're saying all pain issues that we see in our treatment rooms is is about peripheral nerves, and I would say, no, I doubt that's true. But so you know, I think we have to understand there's a lot of complexity, there's a lot of different sources for what it is. I mean, some person might have fibromyalgia and it's about, you know, descending modulation not working properly. Another person has this issue with their peripheral nerves. Another person has neural inflammation. You know it's endocrine issue or autoimmune issue. I mean there's all these different points that it could be and I think that you know they're going to show up differently and respond to different treatments.

Eric: 44:57

For sure. There's not a one-size-fits-all approach which makes sense. My understanding and I'm not bad-mouthing DNM, I just kind of came up with it as you were talking about the microcirculatory thing is that I think as long I like the model, the explanatory model, from what I've understood from it, and I did take a DNM course years ago, which was interesting.

Eric: 45:19

It was did take a dnm course, uh, years ago, uh, which was interesting, it was good. Um, what is that? It seems to make sense for mechanical things like positional movement. It hurts when I do this thing because you're loading or unloading tissues differently and I'm like, yeah, that makes sense. And then you try to make that nerve, nerves, that area, feel better, whatever you create some change in the how it, the transmission, whatever it might be. Maybe you alter the noxious stimuli somehow, whatever it might be, and yeah, it's like, oh, that feels better now but, you know, I guess it's like anything you're saying in your first day of your students.

Eric: 45:57

You're putting your hands on people. You don't have to do a lot sometimes for people to feel better. So I think that oftentimes, when we're looking at newer approaches or newer models, I think we also have to be skeptical of them, to say that this approach seems to be working, but it might not be working for the reasons you think.

Eric: 46:14

But just be humble about it yeah, maybe it's maybe it's more than maybe just blaming those cutaneous nerves isn't enough maybe if what say the one time? Like if you're just you saying, oh, it's just the cutaneous nerves, that's what you need to work on those that's kind of this very uh reductive approach, just like saying you just need to work on fascia. It doesn't work that way, because you're that's, that's too's too simple.

Mark: 46:37

Yeah, yeah, I mean, I think, understanding.

Mark: 46:40

I think that's a great positive step. You know, like I teach, you know students, that you know, hey, when we talk about Whoa, that client wanted their rhomboids worked on, or they wanted their erectors worked on, yeah, is it really about that? Is it really their rhomboids or is it their dorsal scapular nerve? Because look at where the dorsal scapular nerve is like, let's think about that. Or let's think about where those um, you know, the, the ram eye come up through the tissue along the back. That's just where everybody wants to receive their massages. So maybe it's not about those muscles at all, it's about these nerves. So I think that's a huge positive step for the massage industry to think in those terms. And then the next layer of that would be to get more into central processing and endocrine systems and stuff like that. Sure, yeah, it's a step in the right direction, I agree.

Eric: 47:38

Endocrine systems and stuff like that, sure, yeah, it's a step in the right direction. I I agree. Is that, like when I was in massage school you know it was over 20 years ago now the we didn't. We learned about nerves but we didn't really learn about them unless it was like a, like a large peripheral nerve, like the median nerve or the ulnar nerve or the sciatic. Like we learned about them and when those are problem, we never, like I don't ever remember learning about like the dorsal ram eye, other than like we had to be able to identify them on a diagram but we never talked about oh, this person might have these symptoms in this area because this nerve might be cranky, yeah, and needs to be unloaded or needs more microcircuit, like that was just something that was never addressed.

Eric: 48:17

It was always muscles fascia yep and insuligaments I agree it's a step in the right direction mostly that way still yeah, yeah, and I guess, just as a as a kind of a final kind of discussion point or just thing to just hear your comments on, is that these conversations like you and I are having and people have been having these for a long time now about these, the challenging, these old models. Now maybe it's just my observations, but it feels like in maybe the last decade or so, 10-15 years, there's more of these conversations having about, like this, neuroscience, neuroimmune, you know, trauma-informed, all these buzzwords, biopsychosocial pain science, all these these things are starting to be talking about more, but we still don't see any meaningful change in the kind of a culture or the educational competencies. And that's something that I'm really focused on probably more energy on than I need to is on trying to have conversations and with the stakeholders that are involved in making these, these kind of systemic changes there's a lot of words.

Eric: 49:24

I didn't have a question. There was a statement, I guess. But what are your thoughts on what would be ideal or what do you think it would be a good way to create more of these meaningful changes in education, like you did at your school, like how is that done?

Mark: 49:39

yeah, it is a very hard problem to solve because, you know, I did it because I just happened to have a phd in neuroscience, right, so not too many folks are in that particular position, right, I mean most people. If they have, you know, if they have that education, they're probably not teaching, at least in the united states, they're probably not teaching at a massage school, you know. So, to getting the level of education that we want into massage school, you know that they'd have to pay more, and a lot of times they don't pay very well, it's not really. You know, just in the logistics of that it's a challenging model. You know, to make it work you'd have to raise tuition and then, um, you know, but then people would have to think that they're going to make more money rather than working at Massage Envy.

Mark: 50:38

So there's already a decline, at least in the United States, of people going in to massage. Now it's been going on for over a decade. So that's part of the whole equation is just simple financial elements. Even if we could solve the, the mindset elements, so I don't really have any great solutions. It's the same problem with trauma-informed, you know. I say, hey, we should all be trauma-informed, but what it takes to do that is very difficult because you actually need people teaching that material that have enough education to not be dangerous. If you only have a little bit you know, you kind of get this sophomoric level of knowledge where you claim you know something but you actually don't, and it makes it worse. So, um, I don't know, but you know also. Maybe little by little is the way.

Eric: 51:39

Yeah, and I think that the little by little is creating communities of therapists and just people you teach, people who take your courses or students that you've taught and that kind of creating that kind of groundswell of support. And the San Diego Pain Summit was kind of like that well of support and, uh, you know, the San Diego Pain Summit was kind of like that. It felt like at the beginning, uh, we talked before we started. That that was kind of really pushed me into my direction or it kind of gave me some language and some understanding and some resources to put pieces together from that conference the first one was in 2015 that I went to and that really.

Eric: 52:13

I left that conference with a lot of excitement about, okay, this, this can be done, you know, and and. So I went and it totally changed the trajectory of my, my professional life, which is good, I'm happy. I'm happy I'd happen. But the one thing that came out of that was that trying to change things at a systemic level is almost impossible.

Mark: 52:38

Yeah.

Eric: 52:39

It has to be, uh, smaller, community based, and so you get more people talking about these things, more people in the education that will go into positions of authority or leadership or education. And so that's the hope, but I do still feel that sometimes I just wish there was more that was done.

Mark: 53:00

And you know people like yourself.

Eric: 53:01

Teaching at schools like that and being able to to just say this is how we're going to do things to me is very inspiring, because I think that is. We need more of that. But again, you said you need the education, because a little bit of knowledge could actually be a problem, you don't?

Mark: 53:19

know enough. One thing I might just add really quick. Um, just so people know that it's not a state law thing. It's not about the state saying this is what you should teach or not. I mean there are like this is how many hours of this and that you should teach, but they don't get into any more detail than that. They'll just say 200 hours of anatomy and then they don't really break it down after that. I don't know of any state that says you need to teach this many hours about. Pain.

Mark: 53:51

Like pain is not even listed, which is crazy so it's crazy, but at the same time it also means that nobody's keeping anybody from teaching the material correctly. It's not like there's these volumes saying you need to teach that, it's all about muscles. Nobody's saying you have to do that, so there's room for it. It's just a matter of the schools wanting to do it. And I think you know, maybe if there was some kind of like stamp that we could have, you know, be giving to each other that you know we're neuro-informed, or something like that, and we would build up a hey, if you're hiring teachers from around the country because that's what I did, I hired teachers from around the country. I couldn't be finding trauma-informed, neuro-centric teachers just on Kauai. I had to find people all over North America. Same thing. Maybe we could encourage that like hey, I'm a school that hires neuro-informed, trauma-informed you know faculty that maybe that'll be a thing, I don't know.

Eric: 54:57

Yeah, I like that idea and there's yeah, I know of a couple schools in Canada that have done that, but you know there's hundreds of schools here and I'm sure there's hundreds or thousands even in the us population is much bigger, uh, that that are doing that but it's, it's. Yeah, it's bite-sized, but it's. It's better than nobody doing it yeah yeah. So now that you're, you've left kuai and you're, you're, you're back in florida. Where do you, where do you doing with yourself? Now? You're not running a school there.

Mark: 55:28

I'm not running a school. I am teaching classes online, and that's you know. I love teaching at the school and I thought this is great, but I want to be working with more than a few dozen people a year. I want to like. All this material really needs to be out there on a larger plane, so I teach classes online all the time on these very topics that we were discussing.

Eric: 55:51

Nice, and how can people find you if they're looking for you, mark?

Mark: 55:54

They can go to my website at drrolsoncom. That's D-R-O-L-S-O-Ncom. Okay.

Eric: 56:01

And I'll put that in the show notes too. And just as one last bit, just in case anyone's curious, do you want to just share your feelings about the current political state and you're in of all the places that you? Could be you're in Florida.

Mark: 56:14

We already talked about fascia. So I'm an anti-fascia person and I'm also an anti-fascist and I'm not very happy about fascism that we're dealing with. And I'm not very happy about the fascism that we're dealing with, and I happen to be in a town which is kind of central to a lot of this you know right-wing agenda so I'm kind of in the heart of this. I'm looking forward to participating in the protests. Yeah, got to change protests. Yeah, we've got to change it.

Eric: 56:50

Is there protests going on there now in Florida?

Mark: 56:55

Do you have to?

Eric: 56:56

leave Florida to protest. No.

Mark: 57:00

I mean this is going to date your thing here, but the 19th of April is a big deal. We're aiming for 11 million protests around the country. It points back to an event 250 years ago, right before the United States started, where there were protests. So it's got a long history and we're going to follow that and continue that and if we get 11 million, it reaches this threshold. So have usually creates change. Anyway, there's a lot there.

Eric: 57:32

I wish I was canadian right now yeah, yeah, it's for all us canadian, so it's it's.

Eric: 57:38

This whole thing is very heartbreaking and and very, very sad and what I don't like you know, to avoid political talks, but I think right now, in the context of this conversation, it's probably good to address it a little bit. It's terrible because what I feel happening is that so many Canadians are so upset because of all the annexation threats and all the anti-Canadian rhetoric coming from the administration that Canadians are now like and I'm generalizing, you see, this is just media are anti-American.

Mark: 58:17

Yeah.

Eric: 58:18

Like well, you can't be anti, because not every American is a MAGA supporter the majority of them are not but yet everyone gets painted with the same brush and I think that that's unfair, because I have a lot of american friends. I have a lot of canadian good friends that live in the us and are kind of like what the hell is going on? Like?

Eric: 58:42

this is crazy yeah it's just, it's, it's a, it's a, it's a very. I think it's one of those things in history. We're gonna look back and we're like what the hell happened and how did this happen?

Mark: 58:53

yeah, well, I hope we are able to look back like that and even if it's not logical, it's still understandable. I mean the it's it's. It's understandable to be just, you know, at I don't even know where it is right now, but besieged with the emotion of it.

Eric: 59:12

So yeah rage yeah yeah, it makes me very sad too. So well, thanks, mark. That was fantastic. I really enjoyed that conversation. I would. We had a lot more things to talk about, so maybe we'll have to schedule another one in the future. Uh, I will, yeah, that'd be great. I had a great time and then, uh, yeah, people can get in touch with you if they have any questions or want to see what you're all about.

Mark: 59:33

Thank you thank you, yeah, thank you so much thank you for listening.

Eric: 59:41

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