Being Of Service, While Still Being Kind To Yourself

August 24, 2022/in Continuing Education, Massage, Massage Clinic, Massage Therapist, Massage Therapy, Mental Health/by Jamie Johnston

Several years ago, I started this blog, and the whole reason was to be of service to my community of like-minded Massage Therapists while trying to educate and lift up the profession.

Well, the last year has been really tough to do that, and I feel like I’ve kind of let you down as a reader of this blog.

So, I thought I would share why.

Like it has been for most of us, this pandemic over the past couple of years hit hard, but I truly didn’t understand how hard it hit me and ended up going through some health issues if any of you were going through something similar, I’d love to hear back from you.

There were a few big things I dealt with and what I learned about them along the way.

Insomnia

I was dealing with major bouts of insomnia, and several things contributed to it; and fortunately for me, I live in a part of the world where I could get referred by a doctor and get help with this as part of our medical system. So I was referred to a psychologist who helped me start sleeping again.

I didn’t know this, but there are two types of insomnia, one where you have a hard time getting to sleep and one where you have no problem getting to sleep; staying asleep is the issue (this is what I had).

During our sessions, the doctor had me make a sleep log, and we determined that, on average, I was getting about five and a half hours of sleep a night. I’d go to bed around 9:30 and usually try to get up between six and seven in the morning. When I made my sleep logs, there were big gaps throughout the night where I was awake. So, the strategy we used was to “condense” my sleep.

We picked a time I would like to get up in the morning, so I chose 6:30 am. The doctor counted back 5.5 hours and said okay, then I want you to start going to bed between 12-12:30 pm. Basically, getting myself to the point that I’m so tired around midnight would make sleeping easier to stay asleep.

We continued to fill out the sleep log, and as the sleep became more condensed, we would start adding 15 minutes to my go-to bedtime. So instead of 12 pm, I’d go at 11:45 pm, and as that sleep got better, then 11.30 pm and so on, until I was going to bed around 10 pm and sleeping much better.

He also recommended that when getting up in the morning, I immediately expose myself to light as this helps reset the circadian rhythm, which made going to bed that night more inducive to sleep.

Interestingly he also told me that all the things we are told in the media etc about “sleep hygiene” doesn’t really matter. If you wanna watch TV right until bed, go ahead, and many of the other things we are taught don’t really matter either…except one.

Alcohol. I enjoy my wine, and I know over the pandemic, probably enjoyed it a bit too much. Now, I was told there’s nothing wrong with having a glass of wine at night, just don’t have any alcohol three hours before bed because while we quite often think it helps our sleep, it actually messes it up pretty good. So avoiding it three hours before bed is a good rule if you’re trying to sleep better.

Burnout

I know I’m not alone on this one.

But over the past year, burnout has played a big role in my life, and my mental health has taken a beating for it. I’m sure it contributed to insomnia as well.

However, there were a few things to learn with this as well.

Figuring out the things that are important to you and focusing on those things.

For me, I know exercise does a lot to help my mental health. Especially if it’s sports like hockey, or golf where I get to hang out with the boys and enjoy camaraderie in conjunction with an activity. Going to the gym was helpful as well, but getting that social aspect helps a lot as well.

It’s also really important to give yourself a break and be kind to yourself.

If you’ve been dealing with the same and are wanting to become more productive, one thing that’s helped me is just setting small daily goals of accomplishment. Everything seems so overwhelming most of the time but it has helped to just break things up into small chunks and try to accomplish a little each day, even if it’s just a half hour to an hour of work, at least I’m getting something done.

While the outside pressure of careers etc will never go away, sometimes we just have to accept that we can’t do it all, all of the time. It’s okay to take a break, it’s okay to have downtime, and it’s okay to step away from some things if you don’t have the capacity to do it all without beating yourself up about it.

A Break-Up and Mental Health In General

As I know probably happened to many, I also had a good relationship come to an end.

So taking into account insomnia, burnout, and, more recently, the end of a relationship, my mental health over the past year, as I said, has taken a bit of a beating.

BUT, I came to learn that it’s okay to ask for help.

I think all too often in our career we don’t ask for help. We are considered the ones people come to for help, but how often are we asking for help ourselves?

Yeah, we see posts online about “self-care” which is usually followed by suggestions for yoga or some other thing (not that there’s anything wrong with these suggestions), but how often do we really ask for help regarding our mental health?

We have people come in every day, lay on the table and vent about what’s going on in life (yet it’s suggested we don’t influence mental health at all), and quite often, we take some of that on ourselves. But how often are we talking about it?

I’d venture to guess not nearly as much as we should be.

So I’ve started having regular counselling appointments so that while the gym and sports for me is beneficial, especially for my physical health, it’s time to really start making mental health just as much of a priority.

Now, I didn’t write this article to gain sympathy or anything like that, I don’t want that.

I did it to highlight the need that we as healthcare professionals need to recognize our health is just as important as the people we are helping. To show that it’s okay to talk about it and that yes, sometimes WE need help, and it’s okay to ask for it.

As I mentioned at the beginning, I started this blog to be of service to my community, so if you’ve been dealing with anything similar, I hope you know you’re not alone, there are probably more of us dealing with this than we care to admit.

And if there’s some way I can help you, please email me and know there’s someone on the other end who’s going through the same but still pushing forward.

Amazing Low Back Exercises to Try Right Now.

May 31, 2021/in Massage, Massage Clinic, Massage Therapist, Mental Health, Pain Science, Therapeutic Exercise/by Jamie Johnston

Sometimes coming up with exercises in your clinic room can be difficult. Even more difficult is finding some that you can recommend as good home care.

Last week we went over how to do a great exercise called the “Dead Bug”.

This week we’re basically going to flip that over and progress the exercise to something called the “Bird Dog”.

What I love about these, is you can do it right on your table, and they’re easy for a patient to do at home.

Once your patient is confident with doing this exercise on top of the swiss ball, we can make things more difficult by removing the swiss ball.

This can still be easily done on your table in your clinic room, but it’s just a bit more difficult and will build a bit more confidence than when you’re using the swiss ball.

Now we can ramp things up just a bit more after your patient is confident with these movements.

By using an exercise band we can make things just a little more difficult and still build more confidence in movement with our patients.

Give these a try.

Doing movements like these will reinforce everything you did with your hands on the table and bring about greater outcomes with your patients.

If you’d like to learn more on how to incorporate more things like this into your treatments, and generate greater outcomes, register for our newest online course “Clinical Applications Of Pain Management Using Therapeutic Movement” by clicking HERE

5 Ways to Prevent Professional Burnout

February 14, 2021/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Mental Health/by Erson Religioso

A reader who works with a chronic pain, military population recently asked if I had any tips to prevent burnout. Here are some of mine and also some I gathered from Social Media.

1) Take Different Con Ed Courses

Most of us gravitate toward con-ed courses we are familiar with, have a certain reputation, etc
A good way to prevent burnout is to expose yourself to a good seminar on a topic that is novel and challenging
To most I would recommend Explain Pain or Therapeutic Neuroscience Education
Getting new ways to interact with patients, especially a chronic pain caseload that does not respond rapidly helps
- Changing your mindset as to how you view these patients prevents the “I feel powerless to help”

2) Hangout and interact with like minded professionals

join a group like PT: Practice, Education, and Networking on facebook started by my buddy Rick Daigle of Medical Minds in Motion
participate in a forum like Manual Therapists, ask questions and chime in on other people’s posts
try to start a local Clinician’s group where you can practice techniques, assessments and discuss cases semi regularly
avoid arguing on the internet or with colleagues who are stuck in a model that disagrees with your practice (to a point)

3) Consider taking part time cases in a different setting

if you’re in outpatient, try home care
even 2 different cases in a different setting once a week really helps prevent burnout
prior to all my different endeavors, I worked full time in a private clinic (as a manager), did Clinical Peer Review, and taught at 3 different PT schools, needless to say, I did not get bored!

4) Don’t take your work home with you

obsessing over a case you think you could have done better often prevents you from relaxing at home
if you need help, ask online in a facebook group, twitter, or a forum, but otherwise enjoy your time away from work
just like I tell my chronic pain patients, make sure you take time to listen to your favorite music, have a glass of wine, or watch your favorite movie

5) Strive to change and adapt regularly

part of stagnation or burnout is a lack of change, we all need variability
if you have not changed the way you assess, treat, or the framework at which you make your clinical decisions at least every 2-3 years, it is time for you to rethink things!
finding a mentor, whether it’s online or in person really helps with this as you watch them in their patient interactions

Starting Over

December 28, 2020/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy, Mental Health/by Laura Allen

*While Laura Wrote this back in April, its applicable today as we look to the new year, especially as we see a second wave hitting several places, with new shutdowns in place.

A couple of months ago, any one of us could have started a sentence with “When this is over,” and chances are, no one except your family or close friends might have known what personal problem you were referring to. Now, everyone knows what it refers to: COVID-19. For many of us, it’s personal on some level. We’ve had a friend or family member or acquaintance who was sick with it, or died from it, or maybe you’ve personally been sick with it.

At this point, no one knows when “it” will be over…” it” meaning the effects on society. There are millions of Americans out of work due to shutdowns of “non-essential” businesses. There are shortages in grocery stores…every day on my social media, I am still seeing people who can’t find a roll of toilet paper. This is Easter Sunday, and millions of Americans who would otherwise be at church are at home watching a service on television or streaming service on the Internet. Some churches are holding parking lot services where the congregants remain in their cars.

I’ve had a lot of private messages from massage therapists asking my opinion on when we’ll be back to work. The short answer is, I don’t know. Nobody knows. I live in NC, and the governor ordered things shut down until April 30. I personally believe it will be extended beyond that, and even if it isn’t, I will probably wait several weeks beyond the date that it is lifted to go back to work. I’m the suspicious type, as well as one who errs on the side of caution, and I fear a “back to work” decision from the government that is based on economics instead of actual safety.

We tend to think in terms of ourselves and our own occupation and our own lives. There may be no intention of being selfish or self-centered, but that’s the way things are. In reality, there are going to be a lot of businesses, of every type, that do not survive this shutdown. Your favorite restaurant, coffeehouse, or bar may be forced out of business. Your neighborhood florist, art gallery, or gym that is privately owned and not part of a big chain may be gone. While some landlords are giving rent relief, others are not. Some business owners simply cannot pay rent for several months when they don’t have money flowing into the business to cover that cost. In fairness, some landlords count on their rent money to make ends meet themselves.

For many massage therapists (and others), once the shutdown is over, this will be like starting all over at square one. While many may have faithful clients that can’t wait to come back, we have to consider that many of our self-employed clients or those who work in businesses deemed non-essential, may be in the same boat we’re in: unemployment checks are not coming in yet, but the bills keep piling up. A lot of people may have to choose between getting a massage or trying to catch up on their bills.

For those who are self-employed, and ICs (many of whom are misclassified, but that’s another story altogether), this situation may cause you to rethink your employment circumstances. Those who are employees have had a much easier time signing up for unemployment. While the federal government has announced the intention to extend unemployment payments to self-employed and ICs, most state unemployment websites have been waiting on instructions from the feds to get that started. NC’s website states that it is expected to be in place by April 25 for self-employed and ICs to file. If you don’t have a cash cushion, that’s a big financial strain for those who are waiting.

Anytime you choose to be self-employed, you’re taking personal risks. If you’re using independent contractors in your business, they (and you, if you have them misclassified) are also taking a personal risk. Ask yourself if you could live for 6 months without money coming in. If the answer is no, rethink your decision about your work circumstances. Go over your budget and see where you can cut expenses in order to save money. Maybe that means doing without stopping for coffee on the way to work every morning or doing without eating out. Or giving up your addiction to new shoes, or carefully tracking the mindless spending most of us do. I recently saw a meme pointing out that spending 27.35 per day adds up to $10,000 in one year. Using an app like EveryDollar can help you see where your money is actually going.

Many people are just one paycheck away from total disaster. I’ve been there myself in years gone by. This isn’t meant to be negative; it’s meant to be a reality check. We don’t know how long this is going to last, but it’s already evident that many people are in big trouble. It’s a good idea, when the world returns to some semblance of normalcy, to treat this as an opportunity to start over with a plan to be better prepared, so the next emergency doesn’t knock you flat.

It’s also a fact that at the end of our lives, none of us are going to say “I wish I had worked more.” We’ll be wishing we had taken more time to stop and smell the roses, spent more time appreciating our families, had more quality time with our spouse, or learned to play the flute or paint or whatever you think you never have time for. If you have that time now, just do it. While you’re adding up your problems, don’t forget to add up your blessings.

In closing, I express my gratitude to all the medical personnel who are on the front lines, and the essential workers who are enabling us to still go to the grocery store, the gas station, and wherever else we NEED to go. I’ve found out in the past couple of months that I don’t need to go near as many places as I thought I did. Bless all who are sick and suffering and all those who have lost loved ones. Bless you, all, and may you remain safe and well.

To Predict Chronic Pain, Look to the Brain

October 19, 2020/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Mental Health, Pain/by Todd Hargrove

Low back pain is extremely common. In fact, if you don’t have at least some back pain every year or so, you’re kind of abnormal. (Not that you’re really missing out on anything.)

Fortunately, if you do get back pain, your chances of getting rid of it in fairly short order are excellent. More than 90% of acute back pain resolves on its own in just a few weeks or months without any specific intervention. But for some people, pain becomes chronic, lasting for years. Why does the course of back pain differ so much between different people?

The answer probably cannot be found by looking solely at the back itself. Experts have tried for years to explain back pain outcomes in reference to the results of physical examinations. But collecting evidence about posture, core strength, or the condition of vertebrae and discs does very little to help you make good predictions. Posture and MRI results correlate poorly with pain, and a single structural/physical cause for back pain is rarely found.

More recently, there has been more emphasis on subjective factors – pain intensity, negative mood, catastrophizing, depression, or job satisfaction. Accounting for these factors will help you predict back pain outcomes quite a bit better than just looking at the physical condition of the back. But a good deal of mystery would remain.

Some recent research from the lab of Vania Apkarian has led some very smart people to wonder whether he has discovered the “Holy Grail” of explaining pain – the precise factors that cause some people to develop chronic pain and others to recover.

If Apkarian is right, the grail is in the brain. (An important reminder and caveat: even when the brain is a major player in pain, this does not imply that pain is “in your head”, that pain is your fault, that you can just think pain away, or that the body doesn’t matter.)

Following is a collection of quotes from several papers from Apkarian’s lab. (See the bottom of the post for cites. Full text for each is available free online.) These help summarize the results and interpretations of his very interesting research, which mostly involves scanning the brains of people with and without back pain, and at various stages of recovery or chronicity.

The Relationship Between Nociception, Acute Pain, Movement, and Emotion

Pain is a conscious subjective experience that is most commonly driven by nociceptive activity. Baliki 2015.

Conscious acute pain perception is highly malleable … pain perception can reflect moment-to-moment shifts in value judgments. Baliki 2015.

The emotional limbic brain plays a critical role in bridging nociception and pain perception. Baliki 2015.

[N]ociceptors can be active in the absence of pain perception . . .The primary reason I fidget in my chair while writing this article is because nociceptors innervating my skin, muscle, and bone command that my posture needs adjustment. Baliki 2015.

The nociceptive control of behavior routinely occurs in the absence of consciously perceived pain, rendering it “subconscious.” Baliki 2015.

Daily motor movements could easily produce injury and tissue damage if one exceeds their natural range of motion . . . which supports the conclusion that motor behaviors are collectively inhibited by nociceptors. Baliki 2015.

We argue that nociception continuously occurs in the absence of pain perception and it is a fundamental physiological process . . . we presume that behaviors modulated by nociception, in the absence of pain, are contingent on already established habitual repertoires. In contrast, when pain is evoked it gives rise to new peripheral and spinal cord nociceptive learning/ sensitization, as well as emotional learning that is potentiated by the salience and perceived value of the aversive event. Baliki 2015.

The Transition From Acute To Chronic Pain

[O]nly a fraction of subjects who experience an acute painful injury develop chronic pain. Hashmi 2013.

The majority (>90%) of individuals with acute low back pain recover full function in days or weeks with little or no lingering pain. Apkarian 2009.

The 2 critical questions that the field has yet to address regarding chronic pain are 1) Who is vulnerable to developing it? and 2) What underlies this vulnerability? Hashmi 2013.

Earlier clinical studies have identified a long list of risks for chronic pain, such as demographics, affective states, lifestyle, comorbidities, and others, yet collectively such parameters account for a relatively small amount of variance for chronic pain (10% to 20%). In contrast, the brain’s anatomic and functional properties predict development of chronic pain at 80% to 100% accuracy. Hashmi 2013.

Ample evidence now shows that the anatomy and physiology of the brain in chronic pain is distinct from that of healthy subjects experiencing acute pain. Vachon-Presseau 2016.

An accumulating body of animal and human literature has identified the cortico-limbic system, which is central to reward and motivated behavior, as a modulator for acute pain and as a mediator for chronic pain. Vachon-Presseau 2016.

In a longitudinal brain-imaging study, individuals who developed an intense back pain episode were followed over a 1-year period, during which pain and brain parameters were collected repeatedly. At the time of entry into the study, strength of synchrony between the medial prefrontal cortex and nucleus accumbens (i.e. functional connectivity) was predictive (>80% accuracy) of individuals who subsequently transition to chronicity 1 year later. Apkarian 2016.

Persistently enhanced functional connectivity between the mPFC and NAc may be interpreted as an increased emotional salience signal. Vachon-Presseau 2016.

There is now good evidence that all components of the corticolimbic system are either affected by or control or amplify persistent pain states. Vachon-Presseau 2016.

Redefining Chronic Pain

The definition of chronic pain remains tautological, as it simply asserts that it is a long-lasting pain, or a pain persisting past the normal healing period. Baliki 2015.

We propose a novel definition of chronic pain. Rather than defining pain by its sensations, we propose a definition that emphasizes the neurobiological mechanisms that control behavioral adaptations, and we hypothesize that persistence of pain is likely mediated through the reorganization of the cortex by corticolimbic learning mechanisms. (Baliki 2015)

Long-term shifts in the threshold mechanisms that gate the conversion from nociception to pain also underlie the transition to chronic pain. We further propose that the threshold shift is dependent on limbic circuitry invoking synaptic learning-based reorganization. Taken together, these ideas can be simplified as a lowered mesolimbic threshold for the conscious perception of pain, which functionally renders the brain addicted to pain. (Baliki 2015)

The Connection Between Chronic Pain and Negative Mood

Just as nociception and pain protect against bodily injury by limiting behavior, negative moods minimize exposure to danger and promote survival by inhibiting behavior as well. (Baliki 2015)

Just as chronic pain conditions are associated with decreased hippocampal volume, a rich parallel literature indicates that depression is associated with hippocampal volume decrease. (Baliki 2015)

It is therefore not surprising that these conditions are often comorbid, and indeed, there is now a small but emerging literature regarding the interaction between negative moods and acute and chronic pain. (Baliki 2015).

Implications and New Questions

How does this research add to what we already know? We have known for a while that chronic pain involves central sensitization and brain changes. But it was still possible that those changes were driven by persistent peripheral input. Apkarian’s research seems to suggest that peripheral nociception is not the central driver of chronic pain.

It should be noted that some of Apkarian’s research needs to be replicated and that others may interpret his findings differently.

Apkarian was a featured speaker at the 2018 San Diego Pain Summit, I spoke there a few years ago and wrote about my experience attending here.

I was sure to ask Apkarian some questions which are basically unanswered in his various papers: if chronic pain is mostly about the brain’s emotional systems, what can we do, as a practical matter, to help treat or prevent it? And for people who do recover from chronic pain (like me and many others), how did their brains change? Did they revert or evolve?

I suspected there are no simple answers that apply to everyone, and that success for any particular person involves somehow changing the way their brain subconsciously connects movement, threat perception, and a sense of value or meaning.

Resources/Citations

Apkarian, A Vania, Marwan N Baliki, and Melissa A Farmer. 2016. “Predicting Transition to Chronic Pain” 26 (4): 360–67. doi:10.1097/WCO.0b013e32836336ad

Hashmi, Javeria A., Marwan N. Baliki, Lejian Huang, Alex T. Baria, Souraya Torbey, Kristina M. Hermann, Thomas J. Schnitzer, and A. Vania Apkarian. 2013. “Shape Shifting Pain: Chronification of Back Pain Shifts Brain Representation from Nociceptive to Emotional Circuits.” Brain 136 (9): 2751–68. doi:10.1093/brain/awt211.

Vachon-Presseau, E, M V Centeno, W Ren, S E Berger, P Tétreault, M Ghantous, A Baria, et al. 2016. “The Emotional Brain as a Predictor and Amplifier of Chronic Pain.” Journal of Dental Research 95 (6). International Association for Dental Research: 605–12. doi:10.1177/0022034516638027.

Baliki, Marwan N, and A Vania Apkarian. 2016. “Nociception, Pain, Negative Moods and Behavior Selection” 87 (3): 474–91. doi:10.1016/j.neuron.2015.06.005.Nociception.

Apkarian, A.V., Balik, M.N., Geha, P.Y. 2009. “Towards a Theory of Chronic Pain.” Progress in Neurobiology 87 (2): 81–97. doi:10.1016/j.pneurobio.2008.09.018.Towards.

Anxiety, Crisis, And Recovery As A Massage Therapist

November 4, 2019/1 Comment/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Mental Health/by Jamie Johnston

**The author of this post asked to remain anonymous, however, it is such an important topic we thought it VERY important to share and I can’t thank them enough for being brave enough to write this for all of our benefit.

I made the mistake of going to a cadaver anatomy class, not really thinking if it was something I was fit to be doing, and signed up like you would any other continuing education.

I was at the height of a generalized anxiety disorder crisis that had been building for months, and my cognitive functioning was not letting me make the best choices. I also failed to mention it to my psychologist who I had been seeing for three months and have a great relationship with.

It wasn’t until I walked into the cadaver lab and the smell hit me, and I saw the people in bags on the tables that I realized I might have made a bad decision.

The bodies all looked like my Father, who I watched die and be put into the same bag two years before. I was surrounded by them, laid out on stainless steel tables among buckets of tools from the hardware store and fans.

For some reason, because the money was non-refundable and I needed CEUs, I justified staying when I should have left. I stuffed my nose with vaporub, put on a mask, and took breaks every 15 minutes.

We were able to touch, move, and dissect.

I kept my distance and observed, and forced my way through. There are many things I saw, which I feel today I should not have exposed myself to, although there are a few things I learned that were positive and do inform my massage therapy practice.

After throwing out my clothes and changing in the bathroom, I was tired and worn out. I drove home, showered, and went to bed.

Anxiety And Spiraling Negative Thoughts

The next day I was in shock without really understanding I was, I took a walk down to the lake. As I was walking I had some anxiety-provoking conversations on the phone with family and was in a complete daze.

As the day wore on, I got more and more anxious, and by 10 pm I was holding on just waiting for my partner to get home from work. Something snapped in me, feeling like I was full of anxiety on the inside like a container and it was everywhere all around me, there was no escape.

I left the house and started walking really fast, blindly retracing my earlier walk. I was going to throw myself into the lake to escape the anxiety, thinking that hypothermia was the only way out.

I got to the lake but I could not see how to get in because it was dark and I was on an edge with a rock wall and vegetation, I didn’t want to mess it up. If I was going to do this I had to get it right. Delayed in confusion, I sat for a while on the ground.

Just then my partner called me.

I had left them a voicemail saying I was sorry and I had done everything I could, but it was too late.

They kept alternating in a calm voice asking me where I was and telling me they loved me until I was able to respond and say where I was.

They came to get me and brought me to the hospital where I was put on a 17-hour hold. This was on a Tuesday when I was supposed to be in my university classes. On Wednesday I was let out and had an appointment with my psychologist, and was unable to really think or move or speak and was just wiped out mentally, emotionally and physically.

Massage Therapy Providing Comfort

The only thing I knew to do then was to keep moving through the things I normally do and had set up for the week, despite fully letting go of everything and giving up in my head.

I let myself physically go through the motions of doing things. On Friday I had a hair appointment, and the following Monday receiving a massage.

The feeling of being physically handled when you have given up is a thing I can’t describe. It’s like you have decided to fall into a giant hand and let it protect you. During each, I knew I could no longer comprehend caring for myself and was relying completely on the outside world, and the people touching me and making contact.

It was complete helplessness with someone holding on to you.

I sunk deep into those hands and the relief I experienced with being able to shut down for a while and let others take over is the deepest relief I have ever felt in receiving massage and compassionate touch. I also kept all of my massage client appointments during this time, no matter how I felt or how long it took to get me to work. Once I was at work, I threw myself into my work and found extreme relief caring for others.

I spent most of the year working with my psychologist unraveling my anxiety that was now paired with suicidal ideation.

I am proud to say that my anxiety is very much managed with my preventative care as well as my suicidal thoughts. This involves being vigilant about checking in with myself about my stress and anxiety levels, and determining what I need in terms of self-care for the day, and following through. I also make time regularly to reach out to the supportive people in my life and connect.

Showing up no matter what to my massage appointments and doing the work saves me, connects me to clients through touch and our therapeutic relationship. No matter how I am feeling, generally within 20 minutes of working on someone I feel better, and a day at work always makes me feel great, as well as the clients. I am so grateful there can be comfort on both sides, and I can make a massage session all about the other person while receiving human connection. I am also thankful to have worked with an amazing psychologist during that time and having school to occupy my mind, and a fantastic partner.

Massage continues to save me. Those days that I wake up and feel not quite like myself, when I get to work and focus on clients it brings me back, and generally, at the end of the day, I feel amazing and lucky. I also continue to feel a tremendous amount of relief from anxiety as the massage client. I am unsure if it is the connection to people, or the actual massage process, or both that brings relief to me. I am grateful to massage therapy for helping my clients and helping me.

If you are struggling with anxiety or suicidal ideation, it is important to reach out to someone. It can be difficult to break through the guilt and shame or even be able to talk about it. But, taking the first step is necessary because it is difficult to think clearly in that temporary irrational state, and you need the help of someone else to get through it. I have learned you don’t need to explain, just be clear and direct, and say, “I am having thoughts about ending my life.” Start with calling or talking to someone you know, or if you can’t, go to or call your nearest community mental health center, or hospital emergency room. There is also calling 911 or the National Suicide Prevention Hotline, 1-800-273-8255 (U.S).

If you know someone that struggles with suicidal thoughts, call and check in with them occasionally, or spend some time with them. What keeps people well is human connection.