Yesterday I saw a friend who had had a nasty car accident at the beginning of January. She had a compound fracture of her humerus and a lot of associated soft tissue damage. Her arm was immobilised in a sling and she could only sleep sitting up, I felt that she was still carrying a lot of stress from her ordeal. She asked me to massage her arm during class while I was sitting next to her. She was super-sensitive to any shock on the side that was hurt and I tried to move carefully while I was beside her. Her arm was immobilised in a sling and the tissue around and inferior to her shoulder joint were flabby and hypotonic. In contrast, her entire trapeze muscle was rigid with tension, that formed a large knot above the medial superior corner of her scapula. To begin with I coud do nothing more than stroke her shoulder and arm, and take her hand gently in mine. I tried simply placing my hand lightly onto the tense area, but even the lightest touch caused her to flinch with the discomfort of the recognition of her own tension. I moved to work gently on her neck instead and this worked better. She tolerated a lot more pressure and seemed to find relief in being able to get some traction on her tension here. As we slowly worked together she started pushing back against my fingers, it felt to me that she was reclaiming conscious control of the tension process in her neck, bringing relief. After working on that for a while, I tried moving back to passive contact with the knot of tension in her shoulder, and she could tolerate it. I felt the energy start to move in the knot as she allowed her attention to remain in the muscle, and could feel and see the muscles twitching in lines proximal to the knot, up towards her neck and head. This also seemed to bring her relief and she reported being able to rotate her head further laterally than before. I then went to moved to work on her rhomboids where she said she was feeling tension. We located a spot where the pain was centered and I applied gradual pressure with my thumb, allowing her to lean back into the pressure and thereby regulate it. She gradual pushed harder and harder until I had to place my other thumb over the first to maintain the pressure. Over the space of 5 minutes I gradually worked along a deep tension line that ran laterally and superiorly away from her T3-4 up and across towards the superior medial angle of her scapula. By the end I was inside the main knot itself, and she was still regulating the pressure at a level that required me to use both my thumbs. Afterwards she expressed her thanks and seemed more relaxed.
For me the experience underlined the importance of establishing and working within a frame that the client can recognise and feel safe within. Initially, the lightest touch direct on the main tension was intolerable because there was no experiential frame that the client felt she could control. This reminded me of how unhelpful it is for someone to tell you that you are suffering while you are not ready to open to it. Later, after the cooperative work on her neck had established a frame for her, we could work successfully into the tension, starting in surrounding proximal areas and working distally. I was struck by how much better things worked once she was actively guiding the process herself rather than being processed by me. It seems to me that as massage therapists, we do not heal clients as much as help the clients heal themselves. Its not something done to the client, but something done by and with the client. It also gave me a sense that my ideas on psychosomatic tension were quite reasonable.