By Alex Littleton- Programming Chair
During a 30-minute chair-massage that counted as VA training hours (I know, sweet deal), I got to thinking about pain relief. I’ve struggled with back pain for the better part of the last decade, and was quick to volunteer for a free treatment at a massage school down the street from the Colorado Springs VA Clinic.
As the massage therapist worked through the various knots and tension spots in my lumbar area, I felt immediate relief. As the session woefully came to an end, I remember thinking, “wow, it would feel GREAT to have this every week.” And indeed it would- massages make me feel good!
But I’ve struggled with my body long enough to know that weekly massages won’t solve my problem long term. As an astutely observant yoga teacher recently pointed out (what up Stephen!), I have a bum ankle that causes my left foot to turn too far inward when I stand or walk. This causes my knee to rotate, which in turn contributes to the misalignment of my hips. Hello back problems!
Although the pain shows up in my back, the root of the problem is structural- my back pain isn’t the problem, it’s the symptom. The root cause of the pain is further upstream (or in my case, downleg).
Being the broke grad student I am, it wouldn’t be a good investment to pay for weekly massages. Sure, it feels pretty dang good, but I’d have to continue coming back week after week to receive the healing benefits. If I really want to fix my problem, I’ll need to address this bum ankle.
As an early-career therapist, I’ve seen myself become a massage therapist for my clients. I want to help people feel less pain (which, no surprise, is often what my clients want too). After all, I joined this helping profession because I like to help.
But pain relief can’t be the only goal. If the client needs to come in week after week to receive the healing benefits of my therapeutic listening skills, then I might be treating the symptom and not the problem.
For example, if I identify “depression” as the problem, I might use my listening skills, validate the client, and attune to their emotional experience. And this may have a healing effect on the client in the room.
But looking upstream, I may find that the depression is a symptom of the problem, not the problem itself. Maladaptive behaviors, inflexible attitudes, and negative self-concepts- these all could be the bum ankles that keep the back pain coming back again and again.
I’m not suggesting that emotional validation and empathy are unimportant- they’re crucial for treatment. But for beginning therapists, it’s important to understand that by focusing solely on symptoms, you may be missing the long-term, structural, and behavioral components of distress.
It could be possible that the depression and subsequent emotional repair by the therapist is part of a reinforcement pattern that keeps the client stuck in life. This would mean that we’re passively participating in keeping a client stuck with our repeated efforts to heal them.
In the same way massages may help relieve back pain, therapeutic attunement may help relieve emotional pain. And while temporary relief may feel good (for both you and the client), it’s also important to look upstream for any bum ankles that might keep the problem coming back.