tructural ntegration S ® I THE JOURNAL OF THE ROLF INSTITUTE JUNE 2013

TABLE OF CONTENTS

STRUCTURAL INTEGRATION: THE JOURNAL OF COLUMNS THE ROLF INSTITUTE® Ask the Faculty: On the Subject of Pain 2 June 2013 Rolf Movement® Faculty Perspectives: 4 Vol. 41, No. 1 Taxonomies, Vectors, and Neglected Spaces

PUBLISHER THOUGHTS RELATED TO THE CRANIUM AND OSTEOPATHY The Rolf Institute of TMJ Disc Mechanics and Correction 8 Allan Kaplan Structural Integration 5055 Chaparral Ct., Ste. 103 Bones to Fluids: A Path to Understanding Wholeness 11 Thomas Walker Boulder, CO 80301 USA (303) 449-5903 A Nonlinear Systemic Journey 15 Michael Maskornick (303) 449-5978 Fax (800) 530-8875 ON PAIN The Holistic View of Rolfing® SI EDITORIAL BOARD Integration Versus Fixing Parts: An Interview with Nicholas French 17 Craig Ellis Anne Hoff Jazmine Fox-Stern Szaja Gottlieb Resiliency as a Conceptual Model: Bridging Pain and Integration 20 Anne F. Hoff, Editor-in-Chief Szaja Gottlieb Kerry McKenna Pain Relief – A Side Benefit of the SI Disposition? 24 Linda Loggins Heidi Massa Heidi Massa A Pained Process 25 Meg Maurer Kerry McKenna Robert McWilliams, Managing Editor Deanna Melchynuk Technical Matters John Schewe The Rossiter System®: Extending Ida Rolf’s Teachings for Immediate Relief of Structural Pain 27 Richard Rossiter LAYOUT AND GRAPHIC DESIGN A Rolfer’s™ Pelvic/Lumbar Joint Restriction Algorithm: 31 An Interview with John deMahy Susan Winter Mollie Day Thawing Frozen Shoulder 34 Articles in Structural Integration: The Matt Hsu Journal of The Rolf Institute® represent the views and opinions of the authors and Third-Party Payments 37 Clay Cox do not necessarily represent the official positions or teachings of the Rolf Institute of Structural Integration. The Rolf Institute PERSPECTIVES reserves the right, in its sole and absolute Who Moves? 40 discretion, to accept or reject any article Jeffrey Maitland, Ph.D. for publication in Structural Integration: The Journal of The Rolf Institute. REVIEWS 45

Structural Integration: The Journal of The Structural Integration by Andy Crow Rolf Institute® (USPS 0005-122, ISSN 1538- Reviewed by Allan Kaplan 3784) is published by the Rolf Institute, Foundations of Structural Integration by Ritchie Mintz 5055 Chaparral Ct., Ste. 103, Boulder, CO Reviewed by Wiley Patterson, M.D. 80301. Postage paid at Boulder, Colorado. POSTMASTER: Send address changes to INSTITUTE NEWS 46 Structural Integration: The Journal of The Rolf Institute®, 5055 Chaparral Ct., Ste. CONTACTS 103, Boulder, CO 80301.

Copyright ©2013 Rolf Institute. All rights reserved. Duplication in whole or in part Cover image: Certified Advanced Rolfer™ John deMahy demonstrating correction in any form is prohibited without written of an anterior sacral torsion, based on assessment findings from his Lumbar-Pelvic permission from the publisher. Algorithm. “Rolfing®,” “Rolf Movement®,” “Rolfer™,” and the Little Boy Logo are service marks of the Rolf Institute of Structural Integration. COLUMNS

burning pain following immobilization. All Ask the Faculty pain is, ultimately, a brain phenomenon. We don’t usually say this to a client in pain. It On the Subject of Pain certainly doesn’t feel like pain is in the brain when we are consumed by it. But, it’s what Q: Could you discuss your current thinking on the subject of pain as it relates to Rolfing® science tells us. Structural Integration (SI)? What help is SI? What can our field offer a brain that is interpreting information physical bodies within the larger context A: Pain is a theme worthy of discussion in as some form of pain? What can we do of gravity and ground. This approach that it invariably surfaces in the context of to offer help, and what does this teach us entails a paradigm shift for the client who our work. And rightly so, as the insidious about pain? The signature attribute of SI often comes with the expectation that the aspect of pain is how it separates us from, is that it integrates. What does it mean to practitioner will somehow either remove rather than engages us in, the larger world, integrate? To borrow loosely from Daniel the pain or enable him/her to overcome affecting our emotions, relationships, Siegel, it is the sum of two activities that it. Instead of this adversarial approach, and sense of connection in community. improve function within a system: first my intention is to negotiate a more gentle Small wonder that vast research and a there is the action of differentiation of relationship with the pain. Engaging the considerable amount of thought has gone parts within a system; then there is a client’s interest in the qualities of sensation into how to treat, prevent, medicate, proliferation of connections between the has been an avenue into deepening and relieve, and avoid pain. Not to mention differentiated parts within that system. If enriching the integrative process. Assigning the fact that there are so many, virtually the system we are talking about is a person, the sensations qualities of texture and flavor infinite, varieties and types of pain. What we help a person know himself/herself as invites the client to go beyond the stories is a mere practitioner to do in the face of an integrated and integrate-able system. associated with the pain. Although not such an enormous undertaking? Small An integrated system (or person) has more always comfortable, our willingness to feel wonder those of us in the medical and options and typically acts more intelligently and embody our direct experience helps to somatic arenas involved in working with than a less integrated system. We posit that ensure our greater participation in life as it pain reduce it to a quantifiable 1-10 scale pain signals a lack of options. In the Rolfing naturally unfolds. of intensity. SI domain, more options equals increased While this quantification may be useful as Sally Klemm adaptability – adaptability for, among a starting place for the client/practitioner Advanced Rolfing Instructor other things: conversation, there is difficulty if we remain Pain can mean a number of things. What • Coordinative adaptation to new demand. in this “measure,” which is the domain A: aspects of pain are relevant? In the Rolfing of the brain’s left hemisphere. As we can • Economy of function in movement. SI domain we should consider: pain caused appreciate, pain does not limit or contain by our touch; pain a client comes in with / • Autonomic adaptability – improvement itself to our cognition but is felt through tells us about; pain that is brief or chronic; in heart rate variability (vagal tone). the whole of our being. Ultimately the pain that we can live with and pain that various how-to approaches and techniques • Reduced aversion/reactivity to makes life not worth living, and pain that that promise to eliminate pain in “five easy unfamiliar sensation – capacity to allow is physical, emotional, or existential. We steps” tend toward a cognitive approach body processes/sensations to occur, hope our work will help people adapt better that may or may not include the body in undefended. to all of these forms of pain. Adaptability the process! is a Rolfing principle and changing one’s • Restored proprioceptive function (so the I’m sure I’m not alone when I relate how relationship to pain – changing the way brain turns off painful interpretation). frequently clients will respond to an inquiry we respond to and shift our experience of • Lowered reactivity in stretch reflex as to what they feel by replying with what pain – is a way of describing what we do. (higher threshold in stretch reflex) and they think. This typical response illustrates Acute pain from fresh trauma, while we consequent relaxation of muscular the strong tendency in our culture to detach endeavor to meet it when it presents, is not reactivity. from our direct experience in order to speak our primary scope of practice. Typically, it’s about and conceptualize the experience. But the persistent pain dilemmas for which our • Increased security at the sensorimotor pain, like poetry, is “before the mind.” In work has the best fit. level. his poem “Love,” Rumi states: “The cure Neurologically, we can think of pain We evoke adaptability in all the activities of for pain is in the pain. Good and bad are as afferent information that the brain SI. These include touch that allows the brain mixed. If you don’t have both you don’t interprets in such a way that we experience to increase proprioceptive and interoceptive belong with us.” pain. Pain in a healthy body is a signal to discernment. The client builds a field of Currently in my practice I’m very interested take action. Pain that plagues a person and sensory awareness that transforms from in ways to engage with the client in an that actions don’t alleviate can represent a pre-session, generalized (or dissociated) exploration of his/her experience of pain in an organizational failure in the brain. quality to a post-session sensory awareness a qualitative way. Part of our role as somatic Organizational failures can result in all that is more detailed and finely discerned. educators involves guiding our clients to the versions of pain. They include chronic There is more conscious awareness of stay connected to the felt sense of their pain and the noise a person experiences as locations in the body as distinctly different

2 Structural Integration / June 2013 www.rolf.org COLUMNS and separate but also experienced as information in the body. Some of the “noise” • What does your intuition tell you? connected. It is conscious awareness can evolve into information. When noise Experience is an important teacher. If that becomes spontaneous. Fascial touch becomes information, what we call “pain” you have a sense that you should avoid is especially helpful for differentiation has the potential to change. It’s a piece of an area, go with your gut. and connection, at a conscious and non- the pain puzzle that structural integrators But if none of these things are the case, conscious level. can legitimately claim to help with. it may be time to address that gnarly, We further assist clients to anchor Kevin Frank built-up fascia between the metatarsals, or differentiation and connection when they Rolf Movement® Instructor spend time fully releasing the interosseous name aloud the sensory experience. Sense- membrane of the leg, or get under that based words strengthen sense perception A: Learning to work with painful areas scapula and improve the movement of the and differentiation. We also ask clients to can help your clients and enhance your shoulder blade on the ribs. For many clients, pause before initiation of movement, to skills. When it seems appropriate to direct work in these areas is disagreeable, select details of sensory awareness and explore an area that is painful for the client, but the increased range of motion may imagined directionality that promotes relationship and support is imperative. significantly contribute to better function ease of action. In this way we witness the As I’m sure you know, how you work and quality of life. organizational effect of new coordination. with your client is as important as what Rolfing touch spans from off-the-body We assist the client to gain an improved you do. We’re creating relationship and to downright bossy and everything in sense of competence, the sense that one has a supportive environment from day one. between. We endeavor to move seamlessly some amount of control over how the body Things like eliciting client participation; among these states, and learning how to feels and operates, even if the familiar pains checking in often; making sure we don’t go invite clients to work around the edges of are not, at that moment, entirely dispelled. too deep, too fast (usually the cause of pain, their comfort zones is just another important Pain is usually coupled with a felt sense and not therapeutic); working at the client’s skill. Working safely and productively with of powerlessness and helplessness, so any pace; finding the place of discomfort and painful areas requires you to ask good shift in the ability to control what is sensed backing off a little; adjusting or changing questions, elicit client participation, scale is significant. our approach as needed – these are just a few of the hundred little things we do that back work into doable bits, and sense into Additionally, we support a process in create rapport. When you’ve established tissue to monitor progress. Not all or even which the client learns to alternate attention all of this, then you can invite your client the majority of your work should be around between places of distress and places of to work with pain. the edges of discomfort, but knowing when comfort. Levine calls this pendulation. It’s it’s productive and how to engage your part of the Somatic Experiencing® approach Although I’ve been talking about physical client is important and requires you to be for self regulation and recovery from pain, we might also be helping a client a better Rolfer™. trauma, but it’s a fundamental process. experiencing emotional pain. The approach A person’s capacity to regulate and feel a really isn’t that different. It’s about asking Bethany Ward sense of control (in the positive sense) can clients for feedback and adjusting our Rolfing Instructor input so we’re providing just enough grow. It’s a form of skill building. We can For those of us in the helping professions, challenge that their systems need to recommend to clients that they cultivate the ability to alleviate pain is seductive. respond, while providing enough support these skills. To consciously notice sensation When the client comes with pain and and encouragement that they can respond in specific places in the body: the hands; leaves pain-free, we feel good. It feeds in a new, meaningful way. the feet; the sacrum; the skin, generally; our souls. It can also satisfy and reward and the sense of weight, generally. At first Asking questions and adjusting your work our egos, and encourage the tendency to there’s not necessarily much to notice. But so that interventions are manageable for perceive ourselves as potent “healers.” This perception is an action that, with practice, the client can allow you to address very perception, in turn, can lead to promises improves to the point we learn to notice stuck fascia. Such immobilized areas often or expectations we cannot fulfill. And yet, abundant and rich sensations at these contribute to pain. A client reporting that clients do arrive seeking pain relief, and we locations. It’s easiest to attend to places an area is painful doesn’t necessarily mean want to help them. where there are many sense receptors such you shouldn’t work there, it just means you For an authentic approach to these clients, as in the hands and feet. It’s potent when need to be asking more questions: we cultivate sensory awareness where the we must examine our understanding of body places proprioceptive importance, • Is there anything in the client’s health pain. Is it broad enough to encompass such as the sacrum. It’s refreshing to the history that is a contraindication to direct the connection of the pain to the client’s body to notice a proprioceptive resource work in this area? If so, of course, avoid whole being and environment, or the role that usually goes unnoticed: the skin. working here directly. of the pain in the client’s process? Are we acknowledging that the client’s sensory These perceptions then become places of • Is there an easier way to get the job done? experience is subjective, and that each sensory refuge at times of discomfort. Sense Great, do that instead. perception assists the brain to reinterpret person’s subjective experience has unique fixations of painful interpretation across all • Is more preparation needed? Yes? Do it! meaning? After all, the same stimulus produces in each person a different four dimensions of structure. • Are you working too fast or from an experience, with unique meaning, which awkward angle? Are you not present in Differentiation of conscious sense perception is given a different name. affects the brain’s ability to organize afferent your own body? If so, you know what to correct. www.rolf.org Structural Integration / June 2013 3 COLUMNS

To address pain as Rolfers, we must consider of Questionnaires”). Available at www. Prado, P. 2010 Dec. “Does Rolfing SI Enhance it in relation to the whole person – his/her iprlibrary.com. Quality of Life?” Structural Integration: The biomechanics, movement patterns, habits Journal of the Rolf Institute® 38(2):2-5. Prado, P. 2009. “Documentation for Clinical of perception and systems of meaning. And Practice and Research.” Available at www. we must consider the pain as a component Pedro Prado, Ph.D. iprlibrary.com. of the client’s entire process, a process that Advanced Rolfing and happens within a dynamic environment Rolf Movement Instructor and over a period of time. The interesting question is not simply whether Rolfing SI alleviates pain, but why and how it does so. ® Meanwhile, I’d like to share some incidental Rolf Movement data about pain from the research supporting my doctoral dissertation on the psychobiological effects of Rolfing SI Faculty Perspectives (Prado 2006). The data collected suggest that even though Rolfing SI does not aim Taxonomies, Vectors, and Neglected Spaces to address pain per se, its integrative, “third-paradigm” approach often does By Kevin Frank, Certified Advanced Rolfer™, Rolf Movement Instructor reduce the intensity and frequency of pain, and can also change for the better a client’s This column addresses four topics: the first is orientation, and energetic in an article subjective experience of pain and perceived another look at the taxonomies subject – how (Frank 2012) that proposed the replacement quality of life. the Rolf Institute® of Structural Integration of “structural” and “functional” with (RISI) organizes our work into categories of more meaningful terms. The proposals The research involved 874 subjects, assessment, intervention, and departments represent a movement-oriented view and investigated their experience of SI of education, and how it works in practice; and link to premises about how Rolfing through intake and exit questionnaires second, we take a look at a perceptual SI training is conceived. Jeffrey Maitland developed at the São Paulo Ambulatory approach that uses vectors; third, a brief (Maitland 2012) took up the discussion Clinic (NAPER; see Prado 2009), as well as introduction to the problem of missing with kind appreciation and amiable through the World Health Organization’s space, physiological and phenomenological; corrections to some of the logic and Quality of Life survey (WHOQOL; see and finally we touch on the delicate matter semantic underpinnings of the earlier Prado 2010). These tools elicited extensive of the energetic dimension within our work. article. Still, Maitland did not address how information about the subjects’ experience, The theme that ties these four topics together the taxonomic categories affect educational and included pain as one among is an ongoing inquiry about how we define, priorities. The current article focuses many topics. prioritize, and teach the work. this issue further, and clarifies as well Subjects who had pain at the outset also what appeared to be a misunderstanding The discussion has specific relevance described the pain’s duration, frequency of the author ’s comments about the for faculty and students who wish to and intensity on the standard 1–10 visual energetic taxonomy. better define the role of movement in analog pain scale. In our sample, the data learning and doing structural integration The Structure Question, Take Two showed statistically significant reductions (SI). At the RISI this work is called Rolf of both the intensity and frequency of pain The word “structural” in the context of Movement work – more usefully defined from before to after the process. This was “structural integration” promises the world as the perceptive, coordinative, expressive, and true for both chronic and recent-onset pain. that SI evokes lasting shifts in a client’s psychobiological dimensions of Rolfing® SI. patterns of behavior – posture, ease of Despite these positive findings, it would From a “body as movement system” (Frank movement, life view, etc. Lasting change be a mistake to characterize Rolfing SI 2008) point of view, current taxonomic is a feature of our work. Secondarily, as a good tool or modality to treat pain. definitions of Rolfing SI pre-judge any biomechanics, the study of anatomical Doing so would encourage a second- discussion about educational priorities structure and function, is also fundamental paradigm mindset and neglect the essence since discussion begins with the premise to this process and could be termed of our work. Instead, these findings should that there are faculty and trainings that are “structural.” But biomechanics is not encourage inquiry into the processes “structural” and faculty and trainings that strictly the province of education in fascial through which a third-paradigm approach are “functional.” This column continues an mobilization. Rather, it’s equally essential affects pain. inquiry into the usefulness of this premise; to matters of perception and coordination. the goal being to further nurture holistic Bibliography education in RISI trainings. The primary meaning of structure – work that concerns long-term patterns, as Prado, P. 2006. “Estudo Exploratório da Topic One: Dimensão Psicobiológica do Método Rolfing opposed to work that is palliative or for Structure and Function de Integração Estrutural” (“Exploratory repair of injury – is the crux of the issue. Study of the Psychobiological Dimension of This author proposed drawbacks to the When we use the word “structure,” in the Rolfing® Structural Integration Method: current RISI taxonomies: structural/ the sense of how patterns change slowly Creation, Development and Evaluation geometric, functional, psychobiological over time, physical-tissue properties are

4 Structural Integration / June 2013 www.rolf.org COLUMNS one component of the structures that bind session one, “Where has this been all my way of moving, from sit to stand, contrasts us, but no more or less so than the motor life?” Over the course of the series, the with her family pattern. She finds a way to patterns or perceptual or psychological practitioner uses a variety of interventions be okay with it, and to appreciate the value patterns that bind us. We are creatures including: “indirect” joint mobilizations of the former pattern. who somehow become bound. We aspire at the knee; fascial mobilization to restore Bottom line: the practitioner gets “lucky” to become unbound. Structural integrators differentiation and adaptability in the feet, – it’s a good day. The client goes home and assist people to recover their freedom to lower leg, hip; and explorations to improve begins to build a better relationship to the function gracefully in gravity. Structural adaptability in the upper center of gravity, event we call knee extension, one in which integrators approach structure in a variety etc. – a “soup to nuts” offering. Each fascial there is new clarity about the joint and the of ways. Maitland (2010, 166, 60), in manipulation includes education in sensing manner in which we learn to pre-move in describing a Zen approach to the body bony articulations, initiating movement helpful and not so helpful ways. problem, refers to “a profoundly awake, from support, and using spatial orientation unencumbered activity of feeling” that is to enhance palintonicity; to name a few. The Structure Questions, Again possible “by transcending the fixations of The client learns that she can sustain ordinary thinking” of what he elsewhere sensory receptivity in the feet in order to Which of the events in the previous example terms the “I-am-self.” This is not so far push, economically. She learns exercises are more “structural” and which are more away from SI. for knee stability. The client learns what it “functional”? If we say that the fascial means to evoke change in coordination. The mobilization is more structural, do we know Let’s drill further into how the word client learns to allow stillness and notice that that is the case? Did fascial episodes, “structure” gets used at RISI. When we moment-to-moment shifts in sensation within the package of interventions, lend make an assessment or an intervention, and awareness. more to the new equations in the brain? Did do we call it “structural” because we are the fascial work offer more to stabilize the primarily looking at how various categories Late in the series or, maybe a few months knee than the coaching of pre-movement of tissue express limitation? Or do we call it after, the client reports a flare-up of and self-care? Did one intervention require “structural” because it is an inquiry into the knee pain. The client is understandably more understanding of joint mechanics many reasons a person is shaped the way discouraged – things were going so well. than the other? Will anyone claim to say for he or she is, so patterns can change in a way We don’t like these bumps in the road, of sure? Most of us aren’t fond of uncertainty. that lasts? And, is there, in some instances, course, but they do reliably occur. How We often assert certainty in situations where built-in presumption that physical pressure does a practitioner meet them? Is it possible we wish we had it. But, is Rolfing SI a craft on fascia is the more likely avenue for to meet the client freshly, noticing what built on certainty? With time and good lasting change – the more “structural” presents now, so something unexpected fortune we may be able to make general one? To be clear: the value of fascial might reveal itself? How do we teach this? assessments built on statistical data. New mobilization is not being questioned. It is data may inform our choices in practice. During this particular visit, the client learns a fantastic method to help unlock patterns, These questions don’t have simple answers. what turns out to be the next lesson: she especially when used by practitioners In the meantime, what is important is that anticipates knee loading by tensing slightly who embody the work. The author is an we endeavor to evoke and invite structural in the hamstrings and the extensors of enthusiastic advocate for, and user of, change in all the ways our craft is able. the foot. She is now, for whatever reason, fascial mobilization. The question is, rather, ready/able to be curious about this lifelong do we have evidence that in any given There is a further question: What does it pattern. Starting from what she has already situation fascial mobilization is necessarily mean to step back a moment, from logical embodied and learned, she now feels the the more “structural” approach – the one determination, and meet a client openly, free move from sit to stand in a new way – while that has the more lasting effect? Can anyone of what we “know” from the past? What’s imagining femoral independence from the prove the general case? And, regarding important in the example is that a motivated tibia. The client practices this movement the other sense of the word “structural”: client and an open-minded practitioner slowly. As she presses her femur against the is fascial mobilization the approach that found a successful outcome – together. practitioner’s hand in the moments going requires a greater degree of anatomical Two people went through an exploration from sit to stand, she rebuilds the motor specificity? Again, it’s debatable. What we within a taxonomic spectrum, all conceived map of knee extension. Her knee remains do know is that human beings, and their to evoke postural improvement and better less compressed during the movement. postural habits, are complex. Let’s ponder stability under demand – for the long haul. The client learns to recreate this movement this complexity through an example. so she can do it at home: lying supine she A bigger question follows: how will RISI Hypothetical Clinical Example learns to imagine the calcaneus expressing continue to improve and enhance what it a down arrow of intention and the femur teaches and how it teaches it? It’s helpful An athletically active client has knee an up arrow of intention prior and during (Maitland agrees) to take care with how we pain, and a family history of knee failure flexion and extension of the knee. The use language – specifically our definition due to lifestyle and genetic factors. She practitioner coaches the movement so and use of the term “structure.” Do the terms comes to a Rolfer to receive the Ten the client finds ease in the exercise. She “structural” in contrast to “functional” Series. The client experiences fascial learns to use her eyes to help interrupt really assist students to understand the mobilization as welcome relief, not only the former pattern of co-contraction at the complexity of postural change? Or does the from the knee pain, but other aches, pains, knee. The client anchors the new postural term “structural” sometimes insidiously and restrictions of movement that have preparation – she considers how this new suggest priority toward manual pressure; bothered her for years. She exclaims after to move something physically with our

www.rolf.org Structural Integration / June 2013 5 COLUMNS hands? Maitland asserts the notion that interesting and successful. Unlike going ever again. Can you imagine that? In an structure and function are two sides of the to the gym, however, each client needs actual event, you might instantly acquire same coin. Why would we assume that we support to discover how a vector arises in an inhibition to the space formerly occupied know, a priori, that posture is limited more his or her own meaning and perceptual by the unpleasant sight – without realizing by an apparent tissue issue as opposed to system. This is where we, as practitioners, you have done so. A direction or quadrant another component of structure? meet clients in their moment-to-moment of space becomes, effectively, dimmed or curiosity and availability. erased. Or imagine you see something that Let’s restate the structural/functional is highly attractive. You might keep looking taxonomy issue more directly. There are O n e d i r e c t i o n b r i n g s i m m e d i a t e for it (subconsciously) long after it has two major aspects of structural education: improvement. Two or more directions are gone away, with the residual effect being a one primarily aimed at mobilizing tissue better. When vectors are evoked in opposing “leaning” toward the side of interest with a and one more concerned with evocation of directions, the body behaves like it’s eager corresponding diminution of availability to perception and coordination – both of these to respond, to express palintonicity. All the opposite direction. This “leaning away” approaches accomplish differing degrees of bidirectional vectors link to foundational or “leaning toward” is happening around long- and short-term change. Both involve bi-directionality – of weight and space, us more than we suppose. Although it touch. Both of these approaches lead to of up and down. Imagined vectors are might not cause the body to lean physically, both structural (long-term) and functional a way to shift pre-movement and help nonetheless the perception of space is (short-term) adaptation. Both of these restore normal coordination and posture. changed. Other common causes for approaches often move seamlessly back Vectors are a subset of tools to recover lost shifted spatial perception include injuries and forth to solve immediate and long-term or missing access to spatial relationship, a involving collisions with moving objects, challenges for the client. Revised language key component for integrated function in auto accidents, and family dynamics, to removes barriers to learning. gravity. Vectors represent a form of not- name a few. doing: we don’t do vectors; we allow the Topic Two: Vectors vector to do the work in the non-conscious Why does this matter to structural What is a vector? A vector is a force with processes of the brain. This brings us to the integrators? We care because we want to a direction. The fields of physics and topic of missing space. evoke postural change. What shapes body posture? A significant influence on the mathematics define vectors this way, Topic Three: Erased Space represented as arrows. How do vectors fit shape of our bodies is the shape of the space into SI? They’re relevant because the part of Let’s consider two forms of lost capacity we imagine around our bodies. We live in our brain that conceives movement appears to perceive our full range of peripersonal space shaped by our patterns of perception. to “think” in vectors. In order to throw or space; that is, lost capacity for the brain to Some of the ways we build a personal catch a ball, the brain has to anticipate the register areas of space around the body. version of space are described by Godard force and direction of the object and where In both cases, the body loses important in the interview “Phenomenological Space, it will end up at the crucial moment of bearings for postural integrity and function. ‘I am in the space and the space is in me’” contact. Our brain uses vectors to stand One form is lost space at the physiological (McHose 2006). Godard introduces a view up. The brain does all this without using level – physiological spatial (space) neglect of the invisible forces shaping the human math or other symbols. How does the – meaning the body has physiologically body, and its posture and movement; brain do it? We don’t yet know. But we lost the ability to process/receive some invisible templates through which we can reliably demonstrate that it does so, dimensions or areas of space around perceive space and anything in it. and the usefulness of the metaphor. One itself. It can be caused by stroke, for The relevance to SI is especially clear when can experience the brain’s receptivity to example. Another form of missing space we observe asymmetries of posture that vectors. We can learn to throw and catch; is referred to by Godard (2009-2012) as correspond to asymmetries of perception. we can improve economy of function over phenomenological space neglect. This An example is idiopathic scoliosis. We time when we support the brain with the form of lost space is not the result of a notice a relationship between the way one language it likes to hear. physiological problem. Rather, someone side of the body is willing and able to move acquires an inhibition, a block to the In the previous example, in which a client forward while the other side expresses available information about some part of learns to “unlearn” conflicted habits of hesitation in subtle or not-so-subtle ways. the surrounding space. Since structural knee movement, the client is taught to use We may then notice the difference in how integrators aren’t brain surgeons, it is arrows of imagination in the session and one eye allows the world in, while the primarily to this latter form of space neglect for self-care. We can call imagined arrows other eye blocks the world to some degree. that we can offer help: phenomenological of directionality “vectors,” or “vectors of By testing the client around issues of how space neglect is potentially plastic to our imagination.” They represent the ability objects are sensed on one side versus the interventions, to the tools within the SI to imagine a direction in space, which other, or by tracking a client’s capacity scope of practice. can be learned relatively quickly. Vectors to push or reach into space on one side have a directional component, and a force What causes phenomenological space or another, we can begin to build an component. The force component is the neglect? Many things, but let’s start with interpretation of what the client’s spatial clarity and strength of one’s imagination. very simple examples to get the sense map looks like, and we may find there are Like bodybuilding, our brain can improve of it. Imagine you see something very “holes” in that map. Our non-conscious the strength of its imagination over time, unpleasant, so unpleasant that your body mind reacts to these holes and adjusts especially if we learn in a way that is makes a reflexive choice to avoid seeing it movement and posture accordingly.

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The examples offered are simplistic. and therapeutic resonance, both of which The Space The actual stories behind people’s function as the practitioner steps out of the of RISI Education phenomenological space neglect and the way. He says, “Central to the fourth way manner by which some clients can begin to [what might be termed “non-dual” healing] This column, among other things, gain lasting shifts in their spatial perception is the practice of zero (or unification with introduces the topic of space neglect. Space – and consequently, their posture and the client) in which healing is the result neglect is another inconvenient element to function – are more complex. Still, at any of the healer’s orientation [italics added] the “structure as tissue” equivalency that stage of SI education, students can start rather than the application of technique or has lived, implicitly, in SI since its origin. to observe perceptual variations as they intention.” Orientation is fundamental to “Structure” is a tricky term, a term that examine asymmetrical posture. It’s wise SI – it’s essential to our work (Frank 2010 eludes attempts, in our field, to establish to introduce this experience early since and 2011). causal certainty. That keeps SI interesting, if it enlarges the possibilities for finding sometimes frustrating. A goal of redefining Bottom line: Energetic work by any other plasticity of form beyond viewing form as structure is to invite consideration of the name would feel as sweet. Terms other than held only in the tissue. And it’s important manner in which structure is discussed and “energetic” might fit more meaningfully to point out that when mobilizing fascial defined to students in Rolfing trainings. The and respectably within a contemporary tissue the client’s spatial map will shift, at broader our appreciation of how physical, model of SI, one that the larger world can least temporarily, even if we don’t know perceptive, coordinative, and meaning relate to. How does work, invisible to the we are doing so. Tissue work changes the structures live within us – and the more lay observer, relate to conventional models spatial map. It’s a two-way street. we have a chance to embody them, to of postural health and performance? bring these concepts alive in a personal Topic Four: The Energetic How can “not-doing” be modeled and and sensory manner – the more we listen Question – An Inquiry given consideration? What is the role of broadly to client posture and movement. imagination? (Frank 2010) What shifts As this broader quality of listening is Maitland’s (2012) article implied that this occur in client/practitioner relationship integrated into Rolfing training, it’s more author advocated retirement of energetic in moments of shared attention? Can likely RISI graduates will offer leadership work in his proposed retirement of the subtle phenomena be linked to models of within the SI field of the future. taxonomic term “energetic.” This was not biology, physics, or psychology, as are the the proposal. What was proposed, and other parts of the SI package? A working Bibliography what is needed, is that “energetic” work definition would help find the right places Frank, K. 2008 Jun. “Body As a Movement within Rolfing SI be better defined. The to put “subtle phenomena” within the System: A Premise for Structural term “energetic” can mean many things. Rolfing SI curriculum. How might we discover terms that tell us Integration.” Structural Integration: The ® more specifically that which is energetic? Whatever the many “system to system” Journal of the Rolf Institute 36(2):14-23. communications that occur between Could there be a careful inquiry into Frank, K. 2010 Dec. “The Role of Imagination practitioner and client, human beings what energetic means specifically for in Structural Integration.” Structural respond positively to sincere listening SI practitioners? Integration: The Journal of the Rolf Institute® and curiosity. Within a resonant field of 38(2):5-7. The author has been the grateful recipient of connection flows the potential for change. therapies in which, to the casual passerby, A variety of healing traditions purport to Frank, K. 2011 Jun. “Orientation and nothing happens. Nothing is visible. codify this potent connection. Each system Empathic Resonance.” Structural Integration: Those moments have sometimes been has its own idiosyncrasies and language. The Journal of the Rolf Institute® 39(1):2-5. life-changing. What are they? Could there Is there something not particular to any Frank, K. 2010 Jun. “Body Security: The be some struggle with this question? one tradition? Could there also be some struggle with Movement Brain Asks, ‘Where Am I?’’’ the question: how do these interesting To circumscribe a system or multiple Structural Integration: The Journal of the Rolf ® dimensions of work assist postural systems of subtle phenomena with the term Institute 38(1):7-8. “energetic” fosters the notion that energetic evolution in the gravity field? Frank, K. 2012 Jun. “Body As a Movement activity is somehow a separate matter from System Part 2.” Structural Integration: The Let’s reflect on implicit qualities to good what we do already. Without calling it Journal of the Rolf Institute® 40(1):6-10. SI: simple listening presence; an absence “energetic,” what is it? of reactivity, demand, and judgment; Godard, Hubert 2009-2012. Notes and There is an understandable surge of open attention and empathic resonance; correspondence with the author. stillness. These qualities often release interest about learning and teaching this inhibitions in ways that all the things we as-yet-to-be defined category of material Maitland, J. 2010. Mind Body Zen. Berkeley, do, do not. Is energy work predicated on at RISI. What needs to happen to ground CA: North Atlantic. the conversation, to notice and name the “not-doing?” If so, how might we talk Maitland, J., 2012 Dec. “Conceptual broader phenomena that underlie various about this? Fundamentally, freed from Housekeeping.” Structural Integration: The methodologies and tools? How do we patterns of inhibition, the body often Journal of the Rolf Institute® 40(2):39-43. heals itself – gravity is the therapist. Is this honor the depth and nuance of Rolfing SI an ingredient to what has been termed that’s here already? McHose, C. 2006. “Phenomenological “energetic” work? Maitland (2010, 174), in Space: ‘I’m in the space and the space is in Mind Body Zen, offers insight into not-doing me.’” Contact Quarterly 31(2):32-38.

www.rolf.org Structural Integration / June 2013 7 THE CRANIUM AND OSTEOPATHY TMJ Disc Mechanics and Correction By Allan Kaplan, Certified Advanced Rolfer™

Whenever someone comes into my office with temporomandibular joint (TMJ) dysfunction, I can’t help but cringe a little. And when I hear practitioners crow about how they always have great luck “curing” TMJ, I cringe a little more, and reckon that either (a) they get really fresh, easy cases, (b) they are extremely lucky, (c) they have a corner on the magic, or (d) they are deluded. For the truth is that the TMJ is an extremely complex anatomical system, subject to many influences both within and outside of the context of Rolfing® Structural Integration, and that using Figure 1: Temporomandibular Joint. Diagram showing the anatomical components: other paradigms sometimes needs to be ACL – anterior capsular ligament (collagenous); AS – articular surface; IC – inferior considered. From my perspective, cranial joint cavity; ILP – inferior lateral pterygoid muscle; IRL – inferior retrodiscal lamina manipulation often fills the gaps that fascial (cartilaginous); RT – retrodiscal tissues; SC – superior joint cavity; SLP – superior work can’t, because the worst cases of TMJ lateral pterygoid muscle; SRL – superior retrodiscal lamina (elastic). The discal dysfunction involve derangements of the (collateral) ligament has not been shown. All images used with permission. articular disc, situations that call for more than straightforward tissue work. Analyzing all the influences on the TMJ that could emanate from the cranial system would take volumes, well outside the scope of this piece. Simply, they could derive from forces acting upon the mandible, temporal bone, and the intracapsular disc from the other neighboring bones of the cranium, the dura and cranial membranes, and fascial chains extending down the body. Unless these forces are resolved, they can persist in holding the TMJ structures out of balance ad infinitum. If the cranial system is suspected as being a significant influence in the TMJ dysfunction, a referral to the appropriate practitioner may be advisable. For our purposes, we will limit ourselves to an overview of the immediate environment of the TMJ itself. There are several thorough articles dealing with TMJ myofascial influences written by our colleagues Clay Cox (2001), Christoph Sommer (2008), and Peter Schwind (1987), and I won’t repeat what they have already said; derangements of the articular disc are a separate entity and a primary cause for the worst cases of TMJ, issues of persistent jaw clicking and locking. A good grasp of the biomechanics of the TMJ is important in having a clear Figure 2: Normal functional movement of the condyle and disc during the full range of picture of TMJ dysfunction. The most opening and closing. The disc is rotated posteriorly on the condyle as the condyle is significant aspect is the balance of tensions translated out of the fossa. The closing movement is the exact opposite of opening. on the disc. The articular disc is bound The disc is always maintained between the condyle and the fossa.

8 Structural Integration / June 2013 www.rolf.org THE CRANIUM AND OSTEOPATHY to the mandibular condyle with its head can degrade and the disc will distort over contacting the disc’s “intermediate zone,” time and will slip forward. The net result and is sandwiched between the condyle is a migration of the disc’s contact surface and the articular surface of the temporal on the condyle from its intermediate zone bone. This creates a cushioned, sliding more posteriorly, thereby altering the contact for the two bones. While there is a biomechanics. The degree to which the degree of lateral/medial motion of the disc, disc is affected will contribute to whether it its anterior/posterior freedom is our most develops a click, displaces and repositions significant concern. Posteriorly, the disc (is reduced), or displaces without reduction. is attached to the retrodiscal ligaments, Clicking in the joint is caused when the bungee-like structures that act to keep the condyle shifts on the disc during its disc in position, with its intermediate zone motion cycle. If the disc has migrated to centered on the condyle. The ligament the posterior zone for a period of time, it tensions are balanced anteriorly by the lateral pterygoid muscle (more specifically by its superior head), part of which is directly attached to the disc, with the rest Figure 6: Spontaneous Dislocation of of the muscle inserting on the mandibular the TMJ. Spontaneous dislocation of the condyle (see Figures 1 and 2). condyle at step 5 (in Figure 2) results in an “open lock” with the disc dislocated While there is some controversy anterior or posterior to it. The condyle is surrounding the details of disc and lateral trapped beyond the articular eminence. pterygoid function, most sources agree that a hypertoned superior lateral pterygoid can Figure 5: Anteriorly Dislocated Disc on closing. The sliding onto and off of the lead to derangement of the disc. The muscle Without Reduction. The disc becomes disc will create clicks as well (see Figure 4). will exert an anterior pull, putting a strain jammed forward in the joint, preventing The worst cases are disc displacement on the disc and the superior retrodiscal the normal range of condylar translator ligament when in the resting position. With movement throughout the entire without reduction, when the disc slides prolonged tensions, retrodiscal integrity sequence shown in Figure 2. This anteriorly, completely off the condyle, and condition is referred to clinically as a does not reduce. In such a “closed lock” “closed lock.” condition, the disc blocks the condyle from sliding forward. It is not literally locked, distorts and the disc body thins, allowing but its opening is severely limited on that it to shift forward, forming a “cup” for side (see Figure 5). “Open lock” conditions the condyle to rest in. During opening, a are likewise serious, and typically occur single click will coincide with the shifting as a “spontaneous dislocation,” when the of the condyle over the lip of the cup, and condyle is forced open beyond its normal sometimes a second click will occur when range. The condyle displaces off the disc Figure 3: Functionally Displaced Disc. it slips back to the posterior zone (see and is stuck forward, beyond the articular Tension on the disc has shifted its Figure 3). A more serious condition will eminence on the temporal bone. In an open position posteriorly from the intermediate arise when the retrodiscal ligaments are lock, the disc can be located either in front zone when at rest. (This is step 1 in the further stretched, with the disc actually of or behind the condyle and the jaw won’t motion sequence of Figure 2; clicking being dislocated forward off the condyle unlock because it is mechanically blocked occurs between steps 2 and 3, with a during rest. Upon opening, the disc may by the eminence. The disc and retrodiscal reciprocal click between steps 8 and 1 as reduce (reposition), but dislocates again tissues can be crushed between the bony the condyle slides between the different contacts and stretched or torn (see Figure 6). sections of the disc. A B C

Figure 4: Anteriorly Dislocated Disc with Reduction. A: Resting closed-joint position (step 1 in Figure 2). B: During the early stages of translation, the condyle moves up onto the posterior border of the disc (reduction). This can be accompanied by a clicking sound (steps 3-4). C: During the remainder of opening, the condyle assumes a more normal position on the intermediate zone of the disc as the disc is rotating posteriorly on the condyle. During closure the exact opposite occurs. In the final closure the disc is again functionally dislocated anteromedially. Sometimes this is accompanied by a second (reciprocal) click.

www.rolf.org Structural Integration / June 2013 9 THE CRANIUM AND OSTEOPATHY

Dislocation without reduction (closed-lock) conditions are liable to create damage that is irreversible over time, because the disc is trapped in front of the condyle and its associated support structures are deranged when the jaw is at rest. The longer the disc stays out of place, the worse the damage to the tissues. The retrodiscal tissues stay under tension and are stretched, and the disc itself gets further misshapen. It is best to reposition the disc with as little delay as possible. Gently gapping the binding there by gently pushing down on the chin or at the molars may un-jam the block. Assessment is generally straightforward. Note the position of the mandible with the jaw closed. If it is off-center, one side is in open-lock, deflecting the mandible to the opposite side. If the mandible appears centered, have the client open his mouth. If there is deviation to one side and then recovery, there is dislocation with reduction on the side to which the mandible deviates; if there is no recovery, there is typically Figure 7: Handhold for Managing the TMJ. either no reduction, an adhesion of the disc to the temporal bone, or a muscular spasm around the jaw’s edge, giving a solid grip. reduced. Opening and then closing with on that side. The other hand stabilizes the head and the teeth meeting tip-to-tip (to ensure that secures the temporal bone with the middle the condyle will still be anterior on the disc) Prior to any attempt to reposition finger in the auditory meatus, the thumb can check the results, being careful not to the condyle or disc, it is important to and forefinger holding the zygomatic arch, undo the reduction. defuse the tensions on the TMJ as best the last two fingers resting on the occiput, as possible. From a Rolfing® Structural As it happens, just after writing the above and flat palm contact. In this position, the Integration perspective, this includes all paragraph, a client called for a session, joint is literally held between the two hands fascial structures related to the mandible, suffering TMJ dysfunction. Methodically (see Figure 7). including the hyoid musculature. The assessing the situation, I found dislocation lateral pterygoid is primary because it To reduce the joint, the practitioner without reduction on the left, with soft- provides the anterior force on the disc. It follows the idea of the self-reduction. The tissue spasming stemming from the area is then necessary to open the disc space movements should be done slowly and of the left mastoid process, along the in order to free the structures. Then, the with a gentle but directed force. Initially, digastric and stylohyoid to the hyoid condyle needs to be moved anteriorly in distract the condylar head by moving bone, and involvement of the entire oral order to reposition itself on the disc. the mandible in a caudad direction and floor to the ramus of the mandible. After maintain the gapping for fifteen or twenty releasing the tensions, attempts at self- Sometimes it is possible for the client to seconds. It may help to think of pushing reduction failed, so the manual reduction self-reduce the problem disc by opening with the thumb while slightly closing the was performed and successful. Notable slightly and sliding the mandible to the fourth and fifth fingers, which slightly was a “ratcheting” release of tension felt opposite side. This action translates the lifts the front of the jaw. Then traction the on the prolonged holding of the forward ipsilateral condyle anteriorly, engaging mandible forward and toward the opposite traction phase. Afterward, coaching to the superior retrodiscal ligament, and side, tracing the anteromedial motion of maintain a relaxed, anterior “hanging” of hopefully drawing the disc posteriorly the disc’s normal motion. The client can the mandible is important, as this will tend into reduction. Several tries can be made help by gently jutting the jaw forward in to keep the condyle forward, on the body before the practitioner attempts reduction. the same direction, which will help distract of the disc. Standard dental practice is to If unsuccessful, the practitioner can then try the condyle out of the fossa. At the end of combine the manual procedures with an to reduce the disc. the range, the client should relax while the anterior positioning appliance to ensure To work with the TMJ, it is important to use practitioner gently maintains the traction the appropriate positioning for several a secure position that stabilizes the head for thirty seconds, making sure that it is not days, until the disc and retrodiscal tissues and allows good motion at the joint itself. painful; no more distress should be placed can heal. With one hand, hold the mandible with on the joint! The practitioner can finish the As noted earlier, there can be restrictions the thumb intraorally along the molars, the reduction by gently reapproximating the involved that relate to other paradigms. It forefinger outside along the jawline toward condyle to the disc (un-gapping the disc is worth mentioning that in this case there the angle, and the other fingers wrapping space), and holding for thirty seconds. was a left cranial torsion present, with the Hopefully, by this point the disc has

10 Structural Integration / June 2013 www.rolf.org THE CRANIUM AND OSTEOPATHY left temporal bone flexed and out of balance with the right temporal in extension, Bones to Fluids: A Path to forcing a torsion pattern on the mandible. Obviously, without specific training, this aspect of treatment would be ignored, with Understanding Wholeness the hope that a successful reduction would By Thomas Walker, Rolfing® Instructor and Rolf Movement® Practitioner release the cranial pattern over time.

Allan Kaplan has been a Rolfing practitioner The human egg is 99% fluid and 1% genetic when tissues change. We feel the tissue since 1988. He has studied visceral manipulation material. Science tells us that 70% or more soften and become “gushier.” We describe with Didier Prat, D.O., and assisted him of the adult body is fluid. Yet, when we movements as becoming more fluid. There teaching several classes. More recently, he touch our clients, we primarily relate to the have been different explanations as to has studied with Jean-Pierre Barral, D.O. and solid pieces, the bones, muscles, fascia, etc., why this happens, i.e., pressure, heat, or completed osteopathic studies at the Canadian which make up the 30%. There are a vast piezoelectricity. Whatever the cause, as College of Osteopathy. number of textbooks written about the 30%. the tissues take on a more fluid quality, We study, memorize and often describe the differentiation and de-rotation happen Bibiolgraphy changes we see in our clients as the 30%. We spontaneously, or at least become more Cox, C. 2001 Sept. “Temporomandibular are missing much in not learning to actively easily coaxed from the tissues. Joint Dysfunction.” Structural Integration: address the 70%, which is a component of Though we value the goal of hydration, we The Journal of the Rolf Institute® 29(3): 22-29. the “fluid body.” don’t study the fluid system, the 70%! We Murray, G.M., I. Phanachet, S. Uchida, In this introduction to the fluid body I will are taught that our interventions within the and T. Whittle. 2004. “The human lateral discuss the importance of direct interaction 30% allow the 70% to emerge. We call this pterygoid muscle: A review of some with the fluid body and the potential of this integration – to combine one thing with experimental aspects and possible clinical interaction to greatly enhance our goals for another so that they become a whole. By relevance.” Australian Dental Journal structural integration (SI). This introduction this definition it must be wholeness that 49(1):2-8. is based on my experience, and the related emerges. Does this imply that a hydrated concepts, as I understand them at this time, body is whole and integrated? Could it be Okeson, J.P. 2007. “Joint Intracapsular in my practice. The evolution of the concept that fluids are the vehicle for integration and Disorders: Diagnostic and Nonsurgical of the fluid body has its origins in the wholeness? If this is true, could it be that Management Considerations.” Dental discoveries of William G. Sutherland, D.O., relating directly with wholeness will greatly Clinics of North America 51:85-103. who built on the foundations of the founder increase the effectiveness of our work? of osteopathy, Dr. A.T. Still. Okeson, J.P. 2008. Management of Sickness is in effect caused by the Temporomandibular Disorders and Occlusion, Sutherland spent fifty years patiently stoppage of some supply of fluid or 6th ed. St. Louis, MO: Mosby-Elsevier. exploring the subtle movements within the quality of life (Still 1899). body. At the end of his journey, his ability O k e s o n , J.P. a n d R. d e L e e u w. The object of any physician is to to interact directly with what has become 2011.“Differential D i a g n o s i s o f find Health. Anyone can find disease known as the fluid body has contributed Temporomandibular Disorders and Other (Still 1899). Orofacial Pain Disorders.” Dental Clinics of greatly to the understanding of healing and North America 55:105-120. wholeness in the osteopathic profession. If the body is 70% fluids, does this mean This article is a broad overview of how this that integration and wholeness are already Schwind, P. and S. Schmidinger, 1987. “The understanding can contribute to our own and always present? If the whole is always Temporomandibular Joint in the Combined Rolfing SI paradigm by understanding how present in our clients do we not recognize View of a Dentist and a Rolfer.” Notes on the “fluid system” not only is critical in the it because we don’t know how to perceive Structural Integration 1(1):10-19. development in the embryo but also in the it, we don’t know how to evoke it, or make Sommer, C. and P. Schwind, 2008 Dec. organization, function, delivery of resources, space for it, or support it as a partner in “The Temporomandibular Joint in the and maintenance of structure in the adult. our work? If we follow Sutherland’s path of discovery and development of the Context of Structural Integration.” Generally, we believe that changes in the cranial concept, we will gain insight into Structural Integration: The Journal of the Rolf structure occur from the outside inward, the answers to these questions. Institute® 36(4):17-20. through our intention and our focused, Images from Okeson (2008) used with vectorized touch. We want the fascial Sutherland began his discoveries leading permission. interfaces to become more slippery. We to the cranial concept in 1899 while want the dried-out scar tissue to become examining a temporal bone. Its beveled more pliable and soft. We want dense places edges reminded him of fish gills and he to soften and let go. We seek and perceive surmised that the temporals must be part changes. We look for continuity within of a respiratory system. He also noticed the structure. that the bones of the cranium moved independently of each other and realized We do three things in SI: hydrate, that abnormal relationships between the differentiate/de-rotate, and integrate. bones produced certain symptoms in his The first, hydration, is what we feel

www.rolf.org Structural Integration / June 2013 11 THE CRANIUM AND OSTEOPATHY patients. By manually balancing the bones, waves, moving rhythmically while a deeper profound healing can occur throughout the these symptoms would disappear. He tide moved through them. whole body. He sensed a fluid continuum, developed specific techniques that could containing no anatomy, from within the Sutherland reasoned that the different be used to free the articulations (sutures), skin to outside the physical body. polyrhythmic tempos he had been allowing the bones to express very slight describing through the years were in fact There are three major models of the yet important movements. When these created by the BOL as it passes through cranial concept derived from Sutherland’s movements normalized, physiology of the the various layers of the whole body. Thus perceptions. The terms soma, fluid body, and whole body could be improved. the “long tide” (6 cycles per 10 minutes), tidal body have evolved to describe these In the early 1930s he shifted his focus to the “mid tide” (2.5 cycles per minute), and three models (see Figure 1). the dura and its bi-laminar in-foldings that the CRI (6–12 cycles per minute) are all Because humans arise out of a single form the tentoria and the falx. Collectively, manifestations of the BOL. fertilized egg, our body is never he termed these dural in-foldings as the Innate wisdom isn’t in the body but composed of separate systems but “reciprocal tension membrane” (RTM), passes through the body (Jealous 2001). rather of Wholeness which is our and described how its coiling and uncoiling underlying origin and maintaining motion determine the motion of the bones The long tide is not affected by the central force (Blechschmidt 1978). of the skull. Sutherland began to notice that nervous systems or by external forces. It the continuity of the RTM from cranium to has been present in each of us since before At about the same time Sutherland was sacrum resulted in whole-body responses the moment of our conception. It is an progressing through his explorations, to its movements. inherent rhythm. Sutherland compared the a German embryologist, Dr. Erich BOL to the cyclic sweeping of a lighthouse Blechschmidt, was developing a different Several years later, Sutherland shifted his beam that lights up the ocean, but does model of human development than focus to the fluctuation of the cerebral not touch it. It sweeps through the patient that accepted by conventional science. spinal fluid (CSF) driven by what he termed stimulating the inherent healing forces Genetics were the rage just then, the “primary respiratory mechanism” already and always present in the fluids. asserting that pre-formation of all living (PRM). He described the CSF as circulating From these revelations the concept of the structures is carried only within the down and around the spinal cord in a fluid body emerged, in which the whole genes. Blechschmidt was studying and rhythmically pulsatile and spiral fashion. body can be perceived as a single unit of describing a process called epigenetics. Many practitioners have perceived this living substance – a whole. This model states that an embryo develops movement and refer to the pulsation as the from the successive differentiations of “cranial rhythmic impulse” (CRI) which has Healing comes about when our disease an originally undifferentiated structure. a palpable rate of 6-12 cycles per minute. is brought into proper relationship with His observations, based on the physics of our health. This is a process of bringing Focusing on the bones, the dura (RTM), moving water, showed that the movement fragmented parts of ourselves back into and the CRI is the main approach utilized of fluids (the living water or protoplasm relationship with the whole and with the by many osteopaths (of which John in the embryo) were directing embryonic deeper healing forces carried in primary Upledger is the most well-known) and lay development and that these fluid forces respiratory motion (Kern 2001). practitioners today. However, Sutherland continued through life as the ongoing moved on. He began to notice that there To summarize, Sutherland’s studies began maintenance and regenerative function was a fluid fluctuation ascending and with bones, progressed to the fascia (dura), of the human structure. Blechschmidt’s descending from the sacrum to the cranium on to the CSF, and then to the entire fluid scientific work would give credence to at a tempo of about 2.5 cycles per minute. field. This progression is important to know Sutherland’s perceptions. This movement, seemingly outside of and for our own profession since what we touch As the embryo differentiates, it is a yet inclusive of the anatomy, is palpable every day in our work includes all the subdivision of a living whole which is throughout the body. elements he described. As he deepened into integrated. Therefore cells are totally his experiences he sensed the entire fluid In the final years of his life, Sutherland integrated into the whole and within nature of the body, its tempos, fluctuations described the motion of the PRM as being themselves. and qualities, as well as its responses to the generated by external forces. He sensed all-pervading animating force of the BOL. We are never not integrated! The his patients being moved by an external, human entity is not a higher entity than ubiquitous force that he called the “breath A successful response from the the ovum (Blechschmidt 1978). of life” (BOL). Sutherland perceived the cerebrospinal fluid . . . is an intensified BOL as an incarnate process, inherent interchange between all of the fluids of Blechschmidt discovered that fluid in every living being. It passes through the body. . . . It is definitely evident that movements were occurring when there the patient’s body and the practitioner’s the reaction is systemic and includes were no structures to generate them. hands undiminished, generating a sense the whole body even into the bones His studies of the progression of these of the whole fluid body breathing at a (Anne Wales, D.O. in Sutherland movements showed that in order to have constant tempo of 50 seconds of inhale 1967). movement, some force must be present and 50 seconds of exhale. Because of this to cause them. He determined that forces Sutherland perceived the fluids as the “breathing” sensation, he called the tempo are acting upon and within the fluids organizing and healing mechanism that “primary respiration” and spoke of his themselves. Further explorations showed delivers “life” and animates the whole patients as if they were part of a sea of that there are “submicroscopic movements body. By interacting with the fluids,

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entire matrix. It is not as if it begins one Biomechanics Model → Soma → CRI (6 - 12 cycles per minute) place and ends up somewhere else. The whole matrix breathes and fluctuates as Functional Model → Fluid Body → Mid Tide (2.5 cycles per minute) it directs its therapeutic forces toward Biodynamic Model → Tidal Body → Long Tide (6 cycles per 10 minutes) specific goals. It knows the priorities of the body. There are thousands of fluid compartments in the body; however, the Figure 1: Three major models of the cranial concept derived from William G. fluid body doesn’t recognize boundaries Sutherland’s perceptions. between these compartments. Ideally, when there is balance in the fluid body, in the fluids” very much like the metaphoric of wholeness, create order, and are the there is one single response encompassing BOL perceived by the osteopaths. He used functions that create structures. These all of the fluid compartments of the body – the term “biodynamic” to refer to the ideas are reflected in our Rolfing belief that serous, visceral fluids, lymph, blood, CSF, forces in the fluids that cause order and function precedes structure. To work with etc. Fluctuations occur in every drop of organization to occur. the fluid body is to engage the function of fluid in the whole body, in every moment. wholeness and its ability to organize, shape, Blechschmidt determined it is the Sutherland talked about fluid motions by sustain, and resource the physical body. flow of protoplasm that produces the saying that “every drop knows the tide.” We can learn to experience wholeness as a differentiations we see in the embryo, When one perceives the fluid body, it feels palpable sensation instead of as a concept. and that genes are not the cause of body as if there is a single (albeit large) drop that formation, though they are a necessary Blechschmidt’s scientific descriptions offer is being “breathed.” This can be hard to condition for it. Genes are a mechanism a more tangible confirmation of the same grasp because our whole medical model is by which the information in the fluid phenomena, the often-deistic metaphors, built around compartments (think the 30% fields is manifest into physicality. Genes that the osteopaths used to describe their anatomy and physiology). are members of the orchestra, but not perceptions. Both imply that slow-tempo Sensing the dura, the RTM, and the fluid the conductor. movements perceived in the fluids are body requires the practitioner to sense and expressions of wholeness that act to shape, Shape and form are determined by fluid recognize qualities and tissues beyond the differentiate, and organize the pieces flow which shapes the limiting membrane physical contact of the fingertips. As we of the body. They also state that these out of which comes the anatomical details aspire to perceive more than the pieces, embryonic fluid movements are present (Blechschmidt 1978). more than the bones and tissues, we must throughout life. learn to “disappear” what is superficial and He described a model in which he showed Genes are like the clay that forms a sense more deeply. Sutherland taught that that the interaction between the varying fluid piece of pottery. Clay by itself cannot the fluid body couldn’t be contacted in the flows within the embryo creates barriers form into shape, it requires the hands way one works with the tissues. The dura and resistances that influence the genes of the artist. And the hands of the can’t be contacted by pressing harder or to create structures. He coined the term artist cannot act without the mind of deeper. It doesn’t respond to direct contact “metabolic fields” to describe how these the artist. Clay represents the genes, and it cannot be pushed as though it is forces of growth compress, shear, stretch the hands represent the fluid forces and separate from the whole self. and thus affect the metabolism of the cells the artist’s mind represents the Breath and, in the end, direct their differentiation Treat not with techniques but with of Life – the deific plan or the master into the component structures of our bodies. gentle contact (Sutherland 1967). mechanic often alluded to by Still Blechschmidt described how position (van der Waal, 2007). In order to relate to the movements of influences shape, which determines the wholeness in the fluid body, you cannot be expression of the cell nucleus into the The Fluid Body separate or think of yourself as apart from formation of embryonic structures. In his them. Wholeness doesn’t recognize parts, The concept of the fluid body is a teaching view, for the cell to shift from one stage to doesn’t have parts. Perceiving wholeness tool that is both descriptive and limiting, as another, there must be some external force demands that you change yourself. As a most models are. It is descriptive because it causing the differentiations. practitioner, one becomes a catalyst for is experienced as a continuum from “fluid its expression by blending with it, and The genes are not active, they are re- anatomy” (fascia) to no anatomy, with its effects are then multiplied. Dr. James active in the process of differentiation no boundaries whatsoever. It is limiting Jealous has said, “Wholeness doesn’t which is a process from the “outside” because the labels soma, fluid body, and appear, you disappear.” to the “inside.” tidal body imply that they are distinctly Differentiations arise as functions of the separate compartments. In reality, these are The fluid body is highly sensitive. If whole organism whether it be one cell or gradations along a continuum from solid to approached from a spacious perspective many (Blechschmidt 1978). fluid. I describe this continuum perceptually and a neutral state of mind, one can watch as moving from solid to “liquidy honey” to it do seemingly miraculous reorganizations. A biodynamic approach to embryology is unbounded spaciousness. Practicing “inclusive attention” (a neutral an exploration of the movements, occurring state of mind having no preference as The fluid body is a living continuum throughout the fluids, which sustain, shape to outcome, while actively engaged in and not part of a sequence of events. It and resource the “whole” person. In other unbiased listening and having a detached words, fluid movements carry the intention responds simultaneously throughout its

www.rolf.org Structural Integration / June 2013 13 THE CRANIUM AND OSTEOPATHY awareness of oneself, the client, and the continually “disappear” your hands and a seamless continuity from the physical to room around you) will allow one to get the anatomical boundaries within yourself the energetic, allowing for a more complete out of the way of the inherent healing and your client. and integrated embodiment. Those learning intelligence carried in the fluids. biodynamics (and energy work) often hold In learning to work with the fluid body, these as a higher form of intervention. This You have to hold both the condition and one has to develop more sensitive hands is as limited a view of embodiment as those the universal to have transformation and a much broader spectrum of contact. who relate primarily to the purely physical. (Jung1). It is impossible to experience the depth of We are more effective when we can contact the fluid body’s healing and organizing It is important to allow the dualities of a broader spectrum of embodiment. effects without doing so. Broadening one’s giver-receiver/client-practitioner to fade contact skills will allow one to experience D e e p e n i n g i n t o t h e a n a t o m i c a l into the background. Duality of any sort wholeness as a palpable phenomenon considerations of Rolfing SI has value, and is antithetical to wholeness since there are instead of as a concept. It has allowed me we can also expand into the wholeness no dualities in wholeness, by definition. to truly “listen to” my clients’ systems. aspects of the fluid body with effective To synchronize with wholeness in the As one is able to match the client’s pace results. Moving anatomy to the background fluids one needs to be present in one’s of change, one can instantly know when while working allows one to have an own fluid body. Direct interaction with the one has pushed his pace. One can easily expanded awareness of the whole person fluids means that one is not working with feel the continuity of the fascia and fluids under one’s hands. As Still stated, “anyone anatomy but with the 70% of physicality throughout the body and can help to bring can find disease.” Working with the that has no anatomy. To do this you need balance and coherence to a much broader fluid body has taught me how to clearly to experience yourself as a fully three- area with much less effort. Choosing understand integration and wholeness dimensional being, a fluid being. You need to listen for ease and the perception of and how to engage its effects to rebalance to begin to perceive your body as more spaciousness and hydration expands on the disorganization we often see and feel diffuse, to become more aware of the space what SI practitioners already know about in our clients. between your particles and experience your palintonicity and hydration. own fluid system. As I gained more perceptual skills and Engaging the fluid body described by sensitivity, I began to experience how the It is my experience that many Rolfers™ Sutherland and biodynamics is a simple health carried in the fluids can reorganize venture into the fluid realm by chance and concept, but it isn’t easy to do! It isn’t easy the anatomy. Now, in everything I do in engage it in the usual ways we learn to because the ability to stay in a neutral frame a session, I have the choice to relate to work with the fascia. When this happens, of mind with unbiased presence and contact dysfunction, or to the expression of health the fluids often change and express a is continually interrupted by our mind’s in the whole body. I can also choose to relate pattern that frequently seems to express impatience with pure presence. Learning to the health within the dysfunction. To shift a repeated swirling, spiral sensation. This to work in this way is really an exercise from one approach to another, I have to shift sensation may then be misinterpreted of mindfulness. What makes presence so myself. If I only relate to the dysfunction, by the practitioner as an unwinding valuable, while in contact with another, is I am much less effective in reminding my phenomenon and they may actively that presence allows immediate feedback. client’s “being” of wholeness (integration). exaggerate the motion with the intention Our client’s body reflects our level of of helping to unwind a trauma. In actuality, Rolfing SI has deep roots in osteopathy. We presence in each moment by the wholeness the client’s system may just be squirming to have borrowed much from that profession its system expresses to our perception. get away from direct contact. If you begin and incorporated aspects (craniosacral to sense the fluids and then get curious and Sutherland’s progression from bones to therapy, visceral manipulation, nerve work, shift to a more focused doing or directing membranes to fluids and the furthering of etc.) into our whole-body approach to attitude, the fluid patterns will also shift in this work by Jealous and others to include enhancing embodiment. We can learn much response to your input and intent, just as the tidal body demonstrates a continual from Sutherland’s progression from bones the smooth surface of a pond shifts when acquisition of perceptual and contact skills to fluids to further enhance our whole- a breeze ruffles the surface. In focusing, that build upon each other. In our desire person philosophy. We consider Rolfing SI you will have lost your ability to sense the to be more effective in our work (now!) we to be a whole-body, whole-person modality. client’s whole system and so will end up often lack the patience to deepen our skills, If we are to “walk our talk” we may find “tracking” your own interference reflected missing valuable steps with which we can following his progression a good path. in your client’s system. more completely understand the processes So many therapists are striking at the of wholeness and its function in health. To contact the fluid body one needs to shift pattern of disease instead of supporting one’s focus and the use of one’s hands. There is much interest in incorporating the the pattern of health. Rolfers are not Your preferences and biases will diminish energetic body into our Rolfing SI paradigm. practitioners curing disease, they are your ability to sense with expansive Those learning to incorporate energetic work specialists in health (Rolf 1977). perception. Your intentions and focus will will often do their “tissue work” in ways that In Rolfing SI, we have limited cranial touch also influence what you perceive. You don’t immediately seem to acknowledge a to the axial complex while the progression must shift from a doing mode to a sensing/ continuum from the soma to the energetic of Sutherland’s studies taught that there is a listening/being mode. You need to shift body. The fluid body is the link between seamless continuum between the anatomy from palpating to sensing, from activity the physical and the energetic. By learning and the fluids, the axial complex, and the to receptivity. In addition, you need to to relate to the fluids, we can incorporate whole body. He demonstrated that the

14 Structural Integration / June 2013 www.rolf.org THE CRANIUM AND OSTEOPATHY whole-body responses to this quality of touch offer dramatic and comprehensive A Nonlinear Systemic Journey results. To learn this quality of work requires patience, both with the time it By Michael Maskornick, Certified Advanced Rolfer™ takes to grow our personal skills and with our ability to change within ourselves, Writing an article about a non-linear the beginning of the twentieth century. I allowing the unerring partnership of the experience fits the definition of an oxymoron! was interested enough to get the training body’s inherent self-healing to assist us in Just as the description of a drunken sailor’s required to be competent in two separate but our work. walk must be linear and logical, the event probably related forms of body work, both itself is neither. Having said that as an systemic with fairly well-defined treatment Thomas Walker is a faculty member of the introduction, I now propose to write a story protocols. Thus, Rolfing SI and cranial work ® Rolf Institute of Structural Integration, a of how in some ways my Rolfing® Structural carried me through my mid-practice life, and Rolf Movement Practitioner, and a Rolfer Integration (SI) practice has taken a non- worked well. for twenty-five years. He has studied linear circle back to the beginning. Writing After taking an advanced Rolfing training, I craniosacral therapy since 1993 and began about this journey requires some significant began to think more about non-formulistic studying biodynamics in 1996. He has measures of linearity, though the events and series. I was already paying enough over 900 hours of training in biodynamics. thoughts of the journey are not linear. They attention to the above-mentioned nonverbal He offers continuing education classes on fit in where they fit, not necessarily in the communications to have a rudimentary integrating the fluid body and biodynamics order they occurred, nor in the importance ® understanding of its vocabulary and syntax. into Rolfing SI. For more information visit I now attribute to them. www.explorationsinwholeness.com. Then in one large conceptual leap, combining One of the early stories regarding the attention, nonverbal communication, and Endnotes development of the ten-session Rolfing the systemic concepts imbedded in energy format was that Dr. Rolf originally created and vitality, I concluded that all I was 1. Author ’s notes from a class with a series beginning with work below the doing was one session, over and over. The Michael Shea. waist, specifically the legs and feet. This was physical manipulations of the sessions Bibliography done to emphasize the importance of our changed in relation to the client’s structure connection to the earth and our relationship and circumstances, but my focus and Blechschmidt, E. and R.F. Gasser 1978. to the universal gravitational field. She later intention were consistent. I began to use Biomechanics and Biodynamics of Human became dissatisfied with that beginning the metaphor that each session was like Differentiation. Springfield, IL: Charles and replaced it with a session focused on looking at a gemstone through one of its Thompson Publishing. the chest, upper body, and breathing. Rolf many different facets (same gemstone, Jealous, J. 2001. Emergence of Originality - stated that it was necessary to establish different perspective). I never did get to the 2nd edition. Farmington, ME: Biodynamic/ enough energy and vitality to help the body point of the bone manipulators who only Sargent Publishing. integrate the significant changes that would adjust one bone (e.g., the atlas); my deep be introduced in the subsequent sessions. intention was not manipulation, but rather Kern, M. 2001. Wisdom in the Body. London: This early emphasis on breath and vitality the systemic organization of the person in Thornsons. established a systemic basis for my work three-dimensional space. that carried me through the early times of Rolf, Ida P. 1977. Rolfing: The Integration I had some friends and clients who liked my practice. It worked well. of Human Structures. Santa Monica, CA: what I was doing and wanted me to share Dennis-Landman. Another element that came in was that I had what I knew with them. At the time, I Still, A. T. 1899. Philosophy of Osteopathy. been playing around with neurolinguistic thought that teaching the details of cranial Kirksville, MO: The Journal Printing programming (NLP) and Ericksonian work would be more straightforward than Company. hypnosis and was beginning to notice teaching the basics of Rolfing SI, and that how my work was taking on the feel of I could create a small training in that. But Sutherland, W.G. 1967. Contributions of nonverbal communication with the body. by the time I got around to organizing a Thought: The Collected Writings of William More importantly, it appeared that the training, I was disillusioned with teaching Garner Sutherland. Anne Wales, ed. Kansas body was communicating to me in ways based on mastering treatment protocols. City, MO: Sutherland Cranial Teaching that were anything but logical, linear, or Instead, I thought I would introduce the Foundation. linguistic. At the time this nonlinearity material exclusively through awareness and Van der Waal, Jaap 2007. “Human didn’t seem to be getting in the way of the touch, allowing what you feel to guide what Conception: H o w t o O v e r c o m e physical manipulation aspect of my work. you do. Easy, right?! Just put your hands on Reproduction? (A Phenomenological The work was fun and challenging, and the head and notice what you feel. Some Approach to Human Fertilization).” since it was neither verbal nor linguistic, I of the glib statements that came from my Chapter 9 in Biodynamic Craniosacral Therapy just enjoyed the nonlinear part of the work lips included, “Do this and it will change by Michael Shea, Berkeley, CA: North as a side benefit to keep me interested. But I everything that you are already doing with Atlantic Press. was paying attention. bodies”; “Enter into this learning with a beginner’s mind, do not let your prior Around that same time, I started hearing knowledge get in the way of what there is more about working with the skull in the to learn”; “This is intended to advance your way some osteopaths had been doing since skill level beyond what a didactic training

www.rolf.org Structural Integration / June 2013 15 THE CRANIUM AND OSTEOPATHY would.” It did all that and more, but mostly the cranial sinuses. Then I read about the patterns, which are reflected in vascular to me. My students, on the other hand, were Traube, Hering, Mayer (THM) waves of the tone and heart rate, which most likely are confused and overwhelmed. cardiovascular system (Schleip 2002). I knew related to pulsations throughout the body, that John Upledger, D.O. discounted them including the cranial system. These complex You may recognize some of those thoughts in his first book, but there are more recent relationships show no distinct division coming from the realm of General Semantics studies that are not as easy to discount. between cranial movements and those (Alfred Korzybski: “The map is not the One by Patrick Botte (2010) used Fourier experienced in the rest of the body. territory”), awareness meditation, and analysis on multi-variable data to show epistemology (how we know what we This brings me full circle to where this correspondence between TMH waves, know). I was, and am, deeply interested in article started. breath, and the three primary cranial waves how our mind filters the raw information that cranial therapists monitor. (It is not clear Rolfing SI . . . Session One . . . Breath . . . Vitality. of the universe into something that we can how the CSF model can explain the existence make sense of without going bonkers. The I have returned to the beginning. The of the three tides they talk about.) At this problem is: once we become familiar with first element of Rolfing SI requires the point I am intrigued but not convinced filtered information, we no longer have as establishment of an environment within by the THM model. However, I suggest good a grasp of the unfiltered universe. A the body that is amenable to receiving new spending enough time with Botte’s paper to consequence of familiarity is that we see, information and changing in response begin to get a feel for the complexity of the feel, and experience what we already expect to that information. In order to create relationships uncovered by his mathematical to see, feel, or experience. Unexpected that environment I began to think in modeling. Regardless of the theories, I feel information is either ignored or, more likely, terms of a complex three-dimensional what I feel, and use that to initiate changes; not even on our radar; it just doesn’t exist! space determined by the shape, fluidity, it still works well. The set of blinders we create as we filter raw density, responsiveness, and relationships information gets in the way of perceiving A few more thoughts on this topic: of its component parts. That space and the and acquiring new knowledge. relationships among the many components In chiropractic Sacro-OccipitalTechnique are a reflection of vitality! Every time we put Enter Rolfing SI. Once I began to think (SOT), the generating impulse for the cranial our hands on a client, we are interacting with about filters of experience and awareness, rhythms is the breath. The mechanical that environment and his body’s ability to everything was subject to questioning. What gymnastics that convert that impulse to skull accept and sustain change. The effectiveness would the stuff under my hands feel like if movements is not germane to my thinking, of that interaction is determined by how I didn’t already know that it was fascia, it but I do think it is a valuable thought. well we listen and communicate within that was plastic, and I was in charge? The more I I recently read some osteopathic thinking nonlinear systemic space. The success of considered this, the more uncertain I became. regarding the effects of holding the base of our efforts shows in the new balance of the At first it was easy just to expand the model the skull and the sacrum. It is considered system – physical, neurological, emotional, to include bones, muscles, fluids, nerves, a calming hold for the autonomic nervous and probably some other undefined (read and everything else in the physiologists’ system. (Remember Rolf and pelvic lifts.) occult) ways. handbook. But ultimately it led me to the realms that I think of as multidimensional Just as I was editing this article, I was Bibliography chaos. What if the stuff I’m working with reminded of Rolf’s comments regarding isn’t fascia, and what if it really isn’t changing Emanuel Swedenborg’s theory that the Botte, P. 2010. See papers at http://www. in the ways I’ve always thought? How dare breath was the causal source of the circulation saintphonie.be. Click on your language of I have the hubris to think that I know what and pulsations of the CSF. choice to access the papers. a balanced, functioning system would One more diversion and maybe I can get Porges, S. 2007. “The Polyvagal Perspective.” look like for this client? In the grip of this back to talking about Rolfing SI, although Journal of Biological Psychology 74(2): 116-143. confusion, only the solid grounding of my I have been talking about Rolfing SI all Available from www.ncbi.nlm.nih.gov/ work based in feeling and sensing with my along. Somewhere in my explorations of pmc/. hands and, ultimately, what I call my whole THM waves, I was attracted to reading “sensorium” (there is something under my Schleip, R. 2002. “Neurobiological Aspects about polyvagal Theory (Porges 2007). In hands; it moves, and seems to be happier in of the Cranial Rhythmic Impulse.” Available trying to make sense of this dense theory the new position it attains) allowed me to from www.somatics.de/ articlesprof.html. regarding the autonomic nervous system, continue working un-befuddled. I was reminded of the vagal effects – heart Enter cranial work. By this time, in addition rate variability (HRV) and respiratory sinus to the above questions regarding Rolfing SI, arrhythmia (RSA) – of breath on heart rate. I was having serious questions regarding By looking at these effects as relational the cerebral spinal fluid (CSF) theory of rather than a causal, I could see how breath, movements of and within the skull and began vagal stimulation, heart rate, and, possibly, looking for other explanations or theories for vascular tone are connected. The feedback these cranial movements. In brief, I no longer loop in these relationships most likely occurs accepted that a 0.05 milliliter (0.06%) change in the brain stem, where changes in the in the CSF could overwhelm the 25% output blood flow and blood pressure influence, of the heart that was channeled into the skull among other things, the vagus nerve. Thus, and back into the vascular system through variations in our breath are reflected in vagal

16 Structural Integration / June 2013 www.rolf.org ON PAIN ON PAIN – THE HOLISTIC VIEW OF ROLFING® SI

five years. After that, if you want to add Integration Versus Fixing Parts stuff, go ahead.” I think she knew that if we really immersed ourselves in the Recipe and An Interview with Nicholas French the principles and the incredible complexity of the human structure, we would recognize By Anne Hoff, Certified Advanced Rolfer™ that we had stumbled into an infinite realm of discoveries, enough to keep us amazed Anne Hoff: I initially contacted you when of his lower legs [which] had been almost and busy for a lifetime. Sure, we can learn there was a discussion on the Rolf Forum completely severed at the knee, so was not a lot from others and expand our abilities, LISTSERV about pain issues and solving functional. I was thinking, “Is this some but if we are grounded in holistic insight, pain. A lot of the comments were about kind of curse or test?” Having no one new methods are much likelier to extend modalities and techniques, things like there like Ida or Peter [Melchior], there our effectiveness instead of confusing – and releasing nerves. Then you wrote a very was nothing to do but follow what I had perhaps reducing – it. articulate post reminding us of the holistic been taught. The leg had been severed and AH: There’s the question of how something paradigm of our work, and discussing how reattached ten years before, but without is added. I studied visceral manipulation you worked. I really wanted this issue’s pain nerve function. Imagine his surprise – and with an osteopath, and the way he worked theme to include a discussion going back mine – when he suddenly noticed after the didn’t look or feel like something that I in our lineage, to the core of what we do, second session that he could feel the carpet could readily integrate into what I do. which is integration and how that itself can under that foot. And by the end of the [Ten] Later I took a visceral manipulation class take care of pain. You studied with Ida Rolf, Series, the lower leg was more functional, from a Rolfer – Liz Gaggini – who had so I thought you would be a good person had movement and more feeling. That studied with osteopaths, but then spent to speak to. knocked my socks off. I realized this years thinking about how to bring that hadn’t been a curse, it was more like a gift Nicholas French: I have to admit that work into structural integration [SI]. So saying “Think you’re smart? Well, just pay often, when I read the Journal and listen to when she taught, it was grounded in our attention and you’ll learn.” I’ve been a fan some of my colleagues or run across their work – how we see and how we use our of the Series ever since. posts on the Forum, I feel rather dim as a hands as Rolfers. That showed me how to Rolfer. I’ve been interested in and studied AH: Talk a bit about the Ten Series. integrate that work within the paradigms of some of the things they talk about, but I don’t structural integration and holism, not add NF: It’s a difficult thing to describe. As is have a scientific background and I often it as just another thing to do. I think that’s often pointed out by colleagues I admire, find my eyeballs rolling back in my head the challenge with all the other things there it is not a “list of moves.” One guy who when I come to grips with scientific papers are to study. attempted to imitate Rolfing® [Structural or dialogues: it’s not familiar ground. I’ve Integration] was Jack Painter, who called NF: That’s an excellent point, and learned not to feel totally deprived because [his system] Postural Integration®. I was an important one to me, because the of that, and I’ve wondered why I have such told he put out a book that had step-by-step temptation to try and add on our latest love a different outlook. In part it’s that Ida’s instructions about putting your knuckles or or fascination is probably common to all work and her viewpoint were so striking a couple of fingers here or an elbow there, of us. When I was teaching I noticed how for me. She was one of the most articulate, then pushing this way, now put them here often my fellow teachers and I would be really mesmerizing speakers I’ve known. She and do this and that: a literal recipe. But of fascinated by some new book or process, certainly demanded we know our anatomy course, even if we could have videotaped which then would influence the next class and she referred frequently to scientific Ida from various camera angles and printed we taught. In the mid-eighties, a bunch of us protocols, but her main emphasis was on the out precisely what she did that was a on the faculty spent a week in Santa Fe with whole presence of the person – very different brilliant series for one model, it would be osteopath John Upledger. He was teaching from the more medical view. She once said, an interesting artifact, but it would apply us his work and we were quite fascinated. “look, if you are interested in fixing things only to that person. It’s not follow the dance His viewpoint was less about changing the and focusing on symptoms, leave here, go steps by putting your feet here and there, structure of bones in the cranium than how to medical school. We’re after larger game.” it’s a flow of perceptions and principles, one could affect the dura. So he quickly She demonstrated the power of holistic which is what made it such a challenge to translated from Still’s bony emphasis to emphasis, and it grabbed me, perhaps in all of us. Ida urged us – and she was quite connective tissue. He got very fascinated part because one of my grandfathers was a serious –to just follow her “Recipe” for the with Rolfing [SI], and at one point said homeopath (and surgeon). first five years. She knew that all kinds of that he was seriously thinking of going My very first client in private practice was other techniques would be very intriguing, for Rolfing training. Well, the result was a guy who was a roofer and had some especially when we felt confused or that we were all wildly enthusiastic about impressive injuries. He came in wanting uncertain, or simply blank. She said, “Please what we were learning, and I remember me to fix his back, and I first noticed one just follow what I’ve given you for the first Jan [Sultan] saying it was going to really

www.rolf.org Structural Integration / June 2013 17 ON PAIN transform Rolfing SI as a whole, not only were coming from what I, a newcomer, do you say to get his mind open to the idea in his practice but also our teaching. I think was doing. And before long my schedule that it’s not just about trying to fix things? we were all fascinated by the idea. Jimmy was packed – and it stayed full. All simply NF: First, I tend to recall Dr. Rolf [Asher] was the one who really followed because of Ida Rolf’s rather radical vision of emphasizing the futility of chasing it closest; the rest of us found ways to what is possible. The medical world has a symptoms around, trying to fix them: “If integrate some of what we had discovered lot of brilliance, and fine technical stuff, but you work on their symptoms, they will into our own practices. I rarely do classic they look at patients with a linear view and gradually get worse. Your job is to find the cranial work; I have great respect for that then try to impose solutions. Ida urged us roots of those symptoms, which are simply work and our colleagues who are trained to understand that the individual being is the more obvious superficial indications.” in osteopathy, but I found that mostly it just a very complex, rich source of information, It’s important to address their “help me gave me different ways to listen through and that the body is conscious, so if we out of pain,” so I might say, “I’ll be glad my hands to the person I’m working with. engage in a dialogue with it – in whatever to do everything I can, but here’s how I way we can – we can learn from that being AH: I want to go back to that quote from see this process: I don’t think anyone has what will help healing to manifest. Ida Rolf, “If you are interested in focusing the power to heal another, but I’ve found on symptoms go to medical school, we are It takes work to educate clients: “Okay, I that there is something that heals people if after larger game.” I think it’s a difficult path understand that your back really hurts, they are given the right help – and that’s a in many ways to be a Rolfer, to have been and the reason I’m starting up here is that process that we do by working together.” introduced in a pressure-cooker training to I see a connection to that problem” – even As Dr. Rolf said, “As long as there’s life and this wonderful new way of working, and something as simple as that. When I first breath left in a person, there’s always the then to go out in a world that really doesn’t started to practice and told people “I’m a possibility of positive change.” Some people know what we do. I wasn’t a Rolfer back Rolfer,” most would say, “What the hell are dubious, but you’d be surprised how in the late 60s, early 70s, but I imagine that is that?” But before very long people were many people say, “That’s really interesting, there was a big difference then, as there saying, “Oh, yeah, I’ve heard about that” – tell me more.” was much more awareness in the culture of or, “my aunt tried that,” or “my brother was I can give you an example. I had been the possibilities for human transformation. raving about how it helped him,” and it’s [practicing] Rolfing [SI] for about three Now what drives many people to Rolfing simply because what we do works. People years and one of my closest friends and sessions is not that they had a friend who who’d heard or read that our work helped colleagues referred to me one of his clients, went to Esalen and had some mind-blowing people out of pain came to us with these a large guy in his forties who had really experience, but that they are desperate to blank looks, and then we had to do this persistent low back pain. Chuck had taken get out of pain. We have a holistic mindset courtly dance of attending to their idea that him through the Series, and sent over the of aligning the body in gravity so that we were going to help them get out of pain, Polaroids. I looked at them, and the guy wonderful, transformational things can but we were going to do it in a very different had had really fine work, very nice changes. happen, and they walk in saying things way, and we wanted them to simply pay But the guy was still very concerned about like, “My left knee hurts.” So to invite that attention to what was going on in the body his pain, as it hadn’t really changed. So I person to think in a bigger way than he’s and be as patient as possible. I think what’s looked at him, and saw that he had lovely used to, it’s a challenge. It’s even more of a really been remarkable is how much Rolfing organization from the soles of his feet challenge if we are new and still exploring [SI] has spread – all over the world - since up through about L1-L3, but something the Rolfing world and can get sucked into Dr. Rolf began teaching it. But it still seems else didn’t fit. The usual rational thought thinking I have to make the person happy to be the tendency of most Rolfers to fall is if somebody has upper problems you and fix his knee, rather than have the kind back into the more linear, rational approach, work on the foundation, like fixing your of trust you had with your first client. because that is the paradigm of Western house, and that’s what Chuck had done. In culture. Sometimes it takes conscious NF: In the 60s and 70s there was a different studying with Ida, I was fascinated by the effort to remind ourselves to think back, to sense of possibility, but I’m not sure it’s different ways she saw, like, “What doesn’t remember what Ida said. Rosemary Feitis’ made our work that much more difficult fit?” When I looked, this guy’s upper body book Ida Rolf Talks About Rolfing and Physical now. It’s always been a challenge to looked compressed, too short and still. Reality is a wonderful resource. I often lend communicate what we are offering. One It just didn’t fit. He had a nice, graceful- it to clients who are really interested in the of the things that spurred me to write that looking lower body, but the upper part work, because that’s about as close as you response on the Forum was a letter from looked like it was pulled down and tacked can get to hanging out with Ida these days. a colleague saying that he had tried the onto it way too tight. So when he laid down (I also reread it periodically.) If they are Series, didn’t think it worked well, and I started working on his upper body – either open to it, I’m glad to tell them stories about he had a family to feed. I fully appreciate intuition or desperation. Naturally, he said, her, about what I’m doing and why, and it his quandary, because I had a family to “You remember that I told you it’s my lower helps refresh my awareness too, because feed, too, and as a new Rolfer used to go back, right?” I said, “Yep, I remember, it’s so many people who come to me are just over my notes with cold, tense fingers just that I’ve seen an important connection. looking for some sort of quick fix. every time before a client came, trying Be as patient as you can.” I spent the larger to convince myself that I had absorbed AH: What do you say to that client who part of the hour working on his shoulders enough information to be effective. Then comes in and says, “I’ve got this bad and arms and upper ribs, and when he got I began to realize, to my surprise really, shoulder and my neck hurts and I work at a up from the table he looked about four to that rather amazing, impressive changes computer and I heard you can fix it” – what six inches taller – and it’s the way he felt. He

18 Structural Integration / June 2013 www.rolf.org ON PAIN was happy as a kid; his back all of a sudden was nearby watching me, so of course I abilities. What I recommend is that you stop felt strong and good, and I was happy, too. I wanted to do just the right thing. I put my being lazy, get up off your behind and work had seen something that had not occurred to hands on the guy’s arm while I was thinking to find the answer you need to discover.” me before about the power of accumulated about it, and then I wasn’t sure so I sat back. No one has The Answer all the time, and tension in the arms and shoulders to affect Then I put my hands on his arm again, and there are varieties of awareness that are the shape of the entire body. I started seeing different possibilities. I not ordinarily accepted by reasonable, went through anatomy, I went through his scientific people. Class with Dr. Rolf could So part of the proof of our work is that history, I went through structural theory. feel like being in a pressure cooker, and I people get up with the kind of feeling that Every time I put my hands on him I was figure that was by design. She knew that man had. Now it doesn’t always happen considering a different approach, trying the human being is a much more complex that quickly, and I was riding on some great not to overlook anything. After doing that matrix of systems than anybody has figured work that my buddy did, but it’s an event four or five times, I was utterly paralyzed out, including the scientific world, and she I’ll always remember. So I’ll tell people with possibilities and information. I looked knew that we would go out and represent Rolfing stories and listen to what they’ve up and Peter was just sitting there calmly her work to the world, her brainchild, and got going on to engage them in the kind of observing, looking me right in the eye. I that we would immediately begin to meet attention that is open to who knows what confessed: “I’m stuck.” He said, “That’s with structural and emotional puzzles no – a different approach, a happy surprise, or funny, you’ve already put your hands on teacher ever described. Oh boy. “Here I something miraculous. I can’t count all the the exact place about five times.” Hmmm. am, a baby Rolfer, and I am supposed to startling improvements I’ve seen in clients, What if there’s something in me that knows have the chutzpah to work with this person many of which I didn’t think possible but more than I know consciously? So I went in this moment and actually accept money were verified by their physicians – and back to that arm – Peter was still watching for it, so I damn well better do something I’ve heard plenty of similar stories from – and did something that I hoped looked that helps...but what?” We had to depend Rolfing colleagues. adequately “Rolfish.” There was a lovely on our training and include all possibilities, AH: This is a beautiful example of that change, and it not only looked a lot better, including asking for inspiration. So when quote “we’re after larger game.” With that the guy said, “That feels so good!” Aha, I see those Forum emails that sound like guy, everything was going to make you something else to remember. Now, how can fourth-year medical students wanting a want to go work on the low back, try to I learn to connect with that information? quick summary of how to fix something, make the client feel better, but you were Peter just nodded and smiled. I frequently think the suggestions given able to hold this bigger picture of “there’s are really interesting, but what if they’re I guess that’s why I often feel uncomfortable something else here, this guy’s been missing something else really important? when I see Forum postings asking quasi- worked, it’s not as simple as his back’s the Sometimes I’m tempted to point out that medical questions about how to deal with problem.” You had a lot of faith in your even the cleverest answers can interfere various symptoms and conditions. Believe training to go for something that you didn’t with other kinds of learning that would me, I know that “Help!” feeling, but I’m have any guarantee was going to work. be of real help, the kind that comes only not sure that the answers given – including from finding oneself at the edge of the NF: You’re right about that faith, but I can’t the technical ones – are so helpful, because known world and having to call on those claim that I had a very clear perception of they can also short circuit an important inner resources that aren’t activated any some important principle. I think it was and necessary process in the practitioner. other way. an intuitive hit, and I figure that is an Ida knew we would suffer with such important, even essential, part of Rolfing doubts, and she urged us not to discount AH: There has to be a certain tolerance of work. I assume that all of us have that our training, all the information the client’s anxiety on the practitioner’s part, a certain capability if we pay attention to it, or make words and structure presented, or what openness to not-knowing, to allow intuition demands on it, or simply trust that it’s there we could discover if we were patient to arise. I know for myself, the more I have – especially when we are cross-eyed with enough and hung out with the challenge been able to tolerate a feeling of “I don’t uncertainty and wondering if we know long enough. When we feel “I’ve gotta be know what I’m doing,” miraculous things anything. After all, C.G. Jung identified certain,” the typical cultural response is to can happen. If I think I have to know what intuition as one of the four psychological focus on our more logical left-brain support. I’m doing, then I tend to work more out functions, which, as he said, “. . . Is It can help – or it can blind us to other useful of a formula, more rigidly, and maybe I’ll capable of seeing around corners.” Ida sources of information. She had obviously still get results, but it doesn’t feel the same was obviously incredibly intuitive (or as learned that intuition is an indispensable as when I surrender to the sense of “Okay, some would say, “psychic”). I hope stories part of Rolfing work. I don’t know what I’m doing, but I really about her are a strong presence in the want to work there for some reason so I’m One day a student asked Ida for guidance in presentations of all our teachers. just going to do it.” some important personal issue. She looked I was lucky enough to have that sort of at the student in silence for what felt like a NF: Good point: “I don’t exactly know weird, tantalizing experience one day in very long minute, and then said, “Why are what to do now, but I must do something my practitioner training, in a class taught you asking me that question? My answer . . . oh, how about this?” In the 70s going by both Ida and Peter Melchior. I was might be perfect for me, but disastrous for into the 80s, there was often a sense of a working with my first model. It was an you. Also, simply to ask me for the answer schism [in our community] between the upper session, and as I was working on implies that I can know what to do and you ones who were considered the scientific, the right arm and shoulder I noticed Peter cannot. That does not respect your own anatomical folks, and those who were

www.rolf.org Structural Integration / June 2013 19 ON PAIN the intuitive, metaphysical folks. Peter absorb, principles and ideas and all kinds “trained.” The rest was window-dressing, Melchior, a very bright, perceptive guy, said of things they must master before they stuff to keep the mind entertained so that simply, “The metaphysicians need to learn were ready to go out into the world. So the the good stuff could enter and elevate the more anatomy and the anatomists need to emphasis was on knowledge, but that was soul. The idea shows up in many ancient learn more metaphysics.” It’s just a matter simply a way to keep their minds occupied; cultures. Might not appeal to the scientific of balance. At the time, one of the theories what was important, the real issue, was mind, but it is an interesting idea, no? that was going around, at least among a few whether or not they wholeheartedly gave Nicholas French was certified as a Rolfer of the faculty, was that the Rolf Institute® themselves to the discipline, could even in 1976 and did the advanced training in qualified as a “mystery school.” So of find themselves falling in love with it. If the 1979. He was on the Rolf Institute faculty course I wanted to know what a mystery student sensed that there was something of for about ten years before leaving it to do school was, and was told it was an ancient deeper importance than simply following Jungian psychoanalytic training. He currently religious tradition. The idea was that the this formula or that strategy, then the heart practices in both disciplines in Dallas, Texas. students who came would be given all would open and the spirit could enter – Anne Hoff is a Certified Advanced Rolfer in kinds of specific work to do, information to and that’s when she or he was actually Seattle, Washington.

He continues with his doubts concerning Resiliency as a the taxonomies, particularly structure and function. Though I understand the importance of his discussion, my concern Conceptual Model is not with the dialogue amongst ourselves, the practitioners, but between ourselves Bridging Pain and Integration and the client. Unless they are already familiar with SI, we are left to educate By Szaja Gottlieb, Certified Advanced Rolfer™ clients who do not have reference points from previous experiences to comprehend Perhaps is it some consolation to know that sometimes contains a bit of verbal and SI. “Not massage, not chiropractic . . . ok, when it comes to the issue of dealing with conceptual jiu jitsu since we, according to well, what is it then?” Responses from pain from the viewpoint of integration, our founder and Maitland’s third paradigm, the practitioner truly reflecting third- the first Rolfer, Dr. Rolf herself, confronted are not therapists, but educators. Almost paradigm thinking – that Rolfers do not many of the same issues. When she fifty years later, the tension between pain fix pain, we integrate bodies; that we are presented her work to chiropractors and and integration as dialectical viewpoints not particularly interested in cause and osteopaths in the 50s in the hope they would exists for us just as it did for her, unresolved, effect but rather relationships; that we are champion her work, they appropriated her waiting for each graduate to find his own not really therapists but educators; and, techniques into their practice but set aside way as he navigates through his practice. finally, that gravity is going to repair their her integrative approach (Feitis 1978, 1990, Language matters. How we speak and write ills, not us – might seem humorous or even 13). This disappointment eventually led about Rolfing SI, particularly to our clients, bewildering to a client used to an allopathic to the establishment in the 70s of the Rolf frames our work and its outcomes. Rolf’s way of thought. Institute®, with structural integration (SI) fascination with Korzybski, a twentieth- in its masthead. Clearly, we are a different sort of animal century philosopher of semantics, indicates than what the public is used to or expects, Within the Rolfing® SI community we are in her acute awareness for how symbolic and we must consider our exchanges with profound agreement that the holistic vision systems have difficulty mirroring reality. a client and what the client will deduce of SI occupies a very special place in the Of course, language is such a symbolic from them. SI is a simple yet complex idea, field of somatics. In the 90s Jeffrey Maitland system. When the client presents his plaint, and it takes sustained effort on the part formally analyzed SI as occupying the when we introduce a potential client to of the Rolfer and sustained concentration third paradigm of holism, distinguishing the SI worldview, how do we address that on the part of the client to “get it.” We it from the first paradigm of feel-good opportunity? I do not mean with our work. may use simplified, plain English versions bodywork and the second paradigm of fix-it I mean, literally – with our words. of our fundamental concepts – such as modalities (Maitland 1992, 46-49). In this he In a recent article (Frank 2012, 6-10), integration and tensegrity – in explaining crystallized Rolf’s determined intention and in a section called “Who Answers the our work and how it will help, but to the establishes ours. Phone?,” Kevin Frank discusses this second neophyte without points of reference, it will The subtitle of Dr. Rolf’s book, Rolfing: paradigm versus third paradigm conflict all seem distant, very complicated, and a Reestablishing the Natural Alignment and that frequently manifests itself in that roundabout way of getting help. Structural Integration of the Human Body for initial phone call when clients present their It would seem logical then that the best Vitality and Well-Being bears notice. Few problem. Adding urgency to the discussion way to introduce SI is not to ask clients clients call requesting vitality and well- are recent discoveries concerning fascia, to make the leap to use our concepts and being. The great majority call because they which throw doubt on the sol-gel model on language, but instead for us to make a leap are in pain. Our response to their inquiries which we have built our work conceptually. to concepts and language familiar to them.

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The point of this article is that that gap can catalogue includes articles since 1969, and insufficient in describing the dynamism be bridged, by the concept of resiliency: shows no article with resiliency in its title.) and challenge of the gravitational field, at a word readily used and understood by least in common usage. Lastly, “balance” the general population and which speaks Balance has become an overused word in the field directly about health – importantly, the When the potential client calls with his of somatics, rendering it meaningless or reason for the client’s phone call. In the problem, the usual Rolfing reply is that an inexact in describing specific considerations. larger frame of SI, the concept of resiliency imbalance exists that needs to be corrected Spatial relations have always been the not only reflects the vision of SI, but adds by SI. However, the balance he is visualizing primary concern in the concepts involving important new elements to it. The purpose and the one the Rolfer is talking about SI. We begin with anatomy and then here is to provide a fluent platform for both may be entirely different. In the popular explore a scaffolding of relationships client and practitioner from the immediate mind, balance suggests equilibrium and between parts, first statically and then point of contact. stasis reached by equal forces opposing dynamically in gravity, flexors/extensors, Resiliency one another. The image of balance for the intrinsics/extrinsics, horizontals/verticals. general public is a stack of stones sitting on Temporal considerations, which reflect the The word “resiliency” traces back to the top of one another. This image fits very well movement of time (duration), however, 1600s and comes from the Latin resilire, with a chiropractic one: the “stones” of the are given short shrift. In SI, the concept of to rebound or to recoil. Salire is to jump body – the bones, particularly of the spine balance is, of course, not a fixed point. Nor or leap; the re adds “back,” thus to jump – are sitting balanced on top of one another. is it a fixed moment. All this balancing/ back. (Online Etymology Dictionary: When there is a dysfunction, a necessary imbalancing goes on in time, all the time. “resilience”). The dictionary meanings are adjustment to the bones will realign the Unfortunately, the word “balance” implies both familiar and pertinent: “The physical structure and thus equilibrium and health neither duration nor dynamism. property of a material that can return to its will be restored. When the Rolfer talks original shape or position after deformation about SI, the client will most certainly fall Resiliency, however, is movement in time. that does not exceed its elastic limit”; “the back on this “stone” model of alignment. The concept of resiliency is used in many tendency of a body to return to its original For the uneducated client, what else could fields to measure ongoing stress and shape after it has been . . . compressed” (The integration possibly mean? Unfortunately, potential breakdown of systems in time. Free Online Dictionary). the Little Boy Logo perceptually reinforces The application of the concept is extremely this misconception and the prospective wide encompassing hard science such as In the Rolfing lexicon, the closest word client could easily mistake the balance engineering and computer technology, and concept is “plasticity.” In fact, Rolf’s achieved by “The Line” as an alignment social sciences such as ecology, and softer definition of “plasticity” sounds like of the anatomical blocks, not unlike that humanistic sciences such as psychology. resiliency: “The definition of plastic is a achieved by a chiropractor. Resilient time in ecology, for example, is substance which under stress of pressure can the time it takes for a system to return to be deformed and on release of the stress can Korzybski’s warning about confusing the a stable state after a disturbance. It is also be restored to its original state” (Rolf 1979, map with the territory certainly applies sometimes referred to as resilience return 4). “Elasticity” is another word/concept here. Missing in the usage of the word time (Carpenter and Cottingham 1997, 6). that implies the potential of a material to “balance” is dynamism. To be more change form (deform) and then go back accurate, we should say “balancing” or Incomprehensibly, at present, resiliency to its original form (reform). Resiliency “balancing/imbalancing” to more precisely has little role in the field of somatics as resides with plasticity and elasticity within describe this ongoing process in gravity. a conceptual model, Peter Levine’s work the principle of adaptability and forms a A structurally integrated body is thus not with trauma being the exception. Yet, the close relation to balance, a mainstay of our better because it stays the same in gravity no concept of resilience captures the essence conceptual framework. Both plasticity and matter what the circumstance – the illusory of struggle that all structures take on in the elasticity, however, do not suggest health, hope of the client; it is better because it has gravitational field: the struggle to remain which is key. a superior capacity to adapt and change in neutral in gravity no matter what the gravity no matter what the circumstance. conditions. If the definition of balance, as it Though resiliency is frequently mentioned This misunderstanding potentially sets up is usually used, is the ability of a structure on many SI home pages and websites as a the tragicomic situation where both parties to maintain in gravity, the definition benefit of Rolfing SI, it usually takes on the may nod in agreement, but are actually of resiliency is the ability to maintain a role of being a byproduct rather than a goal talking about two different things. structure in gravity over time. Perhaps this or an important concept within our work. could be expressed as b/t=r. Resiliency has only had minor inclusion Balance and Resilience in the Rolfing conceptual universe. This The relationship between balance and author’s survey of articles on The Ida I want to be clear here. I am not trying resiliency becomes parallel when viewed P. Rolf Library of Structural Integration to eliminate the concept of balance or from the viewpoint of palintonicity. Derived website shows meager usage. Out of the its importance; I am trying to offer an from Heraclitus’ “unity of opposition” or approximately 1,100 articles catalogued, alternative that fits comfortably in our “oppositional balance” (Maitland 1995, only 32 mention the word in passing conceptual framework. The usage of 172), palintonicity denotes the impossibility reference. Compare this with familiar SI “balance” is problematic on several counts. of the still point, the frozen moment; all is keywords: balance, 547 articles; movement, First, “balance” or “imbalance” does not movement and struggle. As I have stated 717; structure, 701; integration, 578. (The engage the client immediately with his previously there can be no balance without problem of pain. Secondly, “balance” is

www.rolf.org Structural Integration / June 2013 21 ON PAIN imbalance. The concept of resiliency what kind of gravitational stresses does he from the Latin tenere: to hold on to; thus the occupies the same territory. The capacity deal with daily, how well does he respond definition of sustainability as the use of a to recoil from resistance is the mechanism to them, and what are his resources in resource so that the resource is not depleted of balance. If we remember its Latin origin, building resiliency? These questions are or permanently damaged (Wikipedia). to jump back, to recoil from, then resiliency probably not new for practitioners, but may As educators working in the third paradigm, describes this same balancing/imbalancing be seen from a slightly different perspective, we have always been concerned with what movement but from the point of resistance particularly time. In my own practice, the the client can do outside our practice to or potential breakdown. In a resilient body, essential question in this regard is: how support integration. The suggestions have the organism constantly adapts to the does the client move and what kinds of always been informal, coming usually stresses in the gravitational field without movement does he do? from the practitioners’ own preferences, going past its breaking point. Once there When a dysfunction does occur, particularly whether yoga, Continuum, Pilates, or is a disturbance the question then becomes a reoccurring one – such as knee pain, or CrossFit. With the publication of Müller whether the system can return to normal back problems – special emphasis must and Schleip’s (2011) article “Fascial Fitness” function or stability. Therefore we can just be given to the body’s responses. Was it and the release of their accompanying DVD, as well say, when there is a dysfunction, the same as previously? How long did the that has all changed. It is now clear that that there has been a failure in the client’s problem last, and – of special importance when it comes to fascia, specific methods resilience as there has been a failure – did it get better by itself? In other words, and movements are necessary. Especially of balance. resilient time: how quickly a system returns interesting from the point of view of this Again, I am not saying the concept of to stability after a disturbance. article is the explanation of the “catapult balance should not be used. It is just that, action of the fascia,” its elastic recoil action, Resilient time is a measure for the success in my view, the concept of resiliency more which sounds identical to resiliency as I of our own work as well. A client with directly deals with the client’s plaint of have discussed it. Fascia is thus not only an inherent problem such as a leg-length pain because it comes from the point of the organ of support but also the organ difference – a constant source of pelvic view of breakdown. This confluence allows of resiliency. The conclusion that static instability and back problems – often is practitioner and client to seamlessly discuss stretching and even certain forms of a repeat client. Though Rolfing SI will the problem of the client from a third- yoga have only a limited fascial benefit probably not be able to “fix” the problem, paradigm point of view, thus bridging is startling (Müller and Schleip 2011, 3). it might be able to add sufficient resiliency what I described earlier as the divide With the DVD and the offering of facial to allow the body to withstand stresses and between pain and integration. Additionally, fitness training, the SI practitioner, if both recover without intervention. Increased if you believe that the dynamic between parties are willing, suddenly moves into the time between visits, less incidences of practitioner and client is key in the SI category of trainer, taking on a greater role acute breakdown, attest to a higher level process, this confluence is vital. The in helping the client specifically address of integration and increased resilience. practitioner can then present integration as the resilience of his facial network and the Management, after all, is often the case a necessity in solving the client’s problem long-term sustainability of his structure. with clients who have a history of repeated on a long-term basis. To ward off present physical trauma, deep structural patterns Most of the recommended movements in and future problems, the resilience of the such as scoliosis, or simply an accrual of Fascial Fitness will probably seem a bit client must be amplified, which can only dysfunctional patterns (such as forward- foreign to the gym workout set, who are a be achieved as a result of a highly efficient, head posture) as is often found in older large part of my own practice. The exercises, economically functioning system, the clients. The promise of SI is amplification however, can certainly be adapted and hallmark of an integrated body. Simply of adaptive response. In that sense, a integrated into a regular workout program. put, the less stress in a system, the greater resilient system not only moderates the The jumping/hopping movements can be, its reserves; the greater the reserves, the intensity of stressors but also moderates for example, transformed into jumping greater the resilience. their aftermath, pain (Friborg et al. 2006). rope. Given the enormous number of people who are in gyms, trying to improve Using the Concept of Lastly, perhaps the concept of resiliency, their level of health, there exists a huge Resilience in Our Practices especially resilient time, gives us another opportunity for the SI practitioner to way to measure our work empirically. I Adding resilience into our conceptual interface with the public and introduce would conjecture that scientific studies model shifts our point of view, bringing our work. background issues into relief and involving SI and resiliency could be suggesting entirely new considerations. designed to test the potential for increase One of Schleips’s recommendations opens The implications are manifold and in of benefit from our work in terms of the door perfectly with this potential many directions. First, the reminder that adaptability to stress (performance) and clientele: use of the foam roller. Teaching ongoing challenge (stresses) are the norm recovery from dysfunction (pain). clients how to use a foam roller presents an opportunity to introduce them to their own in the gravitational field. When we get the Resilience call from a client concerning a dysfunction, fascial network, derive benefits, and expose and Sustainability we should be as interested in the client’s them to some of the fundamentals of SI such ability to rid himself of his problem as The concept of sustainability is the logical as fascial chains and fascia’s felt sense. With much as our ability to do the same. In the extension of resiliency. If resilience is the ascension of the evidence that fascia is initial interview there is a need to evaluate balance over time, perhaps sustainability water-based, hydration becomes a critical the client’s resources in terms of resiliency: is resilience over time. Sustainability stems issue for the health of the connective-tissue

22 Structural Integration / June 2013 www.rolf.org ON PAIN system (Zorn 2004, 10). Hydration of tissue, development of SI is breathtaking, except Maitland, J., 1992 Apr. “Rolfing: A Third in fact, is an essential ingredient when we in one regard: our clients. In our trainings Paradigm Approach to Body-Structure.” contact the fascia with our hands during and in our somatic explorations, though Rolf Lines 20(2):46-49. an SI session. Under the pressure of the our work is “relational,” there is very little Müller, D. and Schleip, R. 2011 Mar. “Fascial foam roller, water is squeezed out of the conversation as to how to engage the client, Fitness.” Terra Rosa E-Magazine (7). Also, fascia like a sponge, and then upon release, beginning from where the client is situated “Fascial Fitness: Fascia-Oriented Training refills, which resuscitates the tissue (Müller rather than from where we sit. for Bodywork and Movement Therapies,” and Schleip 2011, 9). I have been using the Resiliency and sustainability are the Structural Integration: The Journal of the Rolf foam roller myself and in my practice for vocabulary of potential crisis and Institute® 39(2):7-13. several years. I introduced it in my practice breakdown. In this article I have tried to use in a desperate attempt to get my clients to O n l i n e E t y m o l o g y Dictionary, these terms as a way of creating a different do something outside their visits that would www.etymonline.com. conceptualization other than balance / hold on to the gains made during sessions. imbalance for client and practitioner to Rolf, I. 1979 Jan. “Structure . . . A New Factor The results were better than expected. participate in, in the hopes of creating new in Understanding the Human Condition.” Used on a daily basis, clients reported meeting ground for both. My emphasis Bulletin of Structural Integration 6(3):1-4. less problems and needed to see me less. was on the client’s point of view and not I call the foam roller the “first tool for T h e F r e e O n l i n e Dictionary: necessarily the rightness of my ideas. My fascial fitness.” www.thefreedictionary.com/resilience. emphasis was on creating more fluid, more Foam rollers are now in widespread use adaptive responses to potential clients The Ida P. Rolf Library of Structural at gyms. Simple though it may seem to seeking out our work. Integration: www.iprlibrary.com. us, many clients do not know to use them Resiliency as a concept belongs in the house or have no idea of the objective. They Wikipedia: http://en.wikipedia.org/wiki/ of Rolf and in the SI pantheon. We can lay either quit quickly because of the pain or Resilience (ecology). claim to it better than any other somatic roll too quickly over the surface, rather modality because SI practitioners work Wikipedia: http://en.wikipedia.org/wiki/ than breaking up fascial adhesions. They with resilience on both on the local level Sustainability. are done with their whole bodies in five of fascial tissue and on the global level of or ten minutes rather than spending a Zorn, A., R. Schleip, and W. Klinger 2004 resilient integrated structure. And perhaps lengthy twenty to forty minutes getting a Dec. “European Fascia Research Project most importantly, resilience provides a fascial squeeze in terms of hydration and Report.” Structural Integration: The Journal coherent viewpoint situated firmly in the ® exploring fascia at a motile level. Though it of the Rolf Institute 32(4): 4-10. third paradigm of holism, whether we are may seem absurdly simple, teaching clients dealing with performance or dysfunction. how to use a foam roller is, in a sense, to teach self-myofascial release. As a coach Bibliography or guide, an SI practitioner can take on his appropriate role as educator and empower Carpenter, S.R., and K. L. Cottingham In Memoriam a client to become more responsible for his 1997. “Resilience and Restoration of Richard Stenstadvold 1935-2012 process. Embodying our concepts even at Lakes” Conservation Ecology [online]1(1):2. the crude level of foam-rolling fascial tissue Available at www.ecologyandsociety.org/ Former Managing Director of the Rolf ® can have a powerful effect. Who needs vol1/iss1/art2. Institute , President of the Guild for Structural Integration words when they can feel process in the Friborg, O., O. Hjemdal, J. Rosenvinge, M. flesh? And thus their journey may begin. Martinussen, P. Aslaksen, and M. Flaten Conclusion 2006. “Resilience as a moderator of pain and stress.” Journal of Psychosomatic Research As practitioners we span between two 61(2):213-9. Available at www.jpsychores. poles, our work and the client. We dwell com/article/S0022-3999(06)00006-7/abstract. in palintonus. The territory is marked by Feitis, R., ed. 1978, 1990. Rolfing and Physical challenge, dynamism, and perhaps struggle. Reality. Rochester, VT: Healing Arts Press. Our model is not the stasis of bone but the fluidity of water. It is dangerous to take Frank, K. 2012 Jun. “Body as a Movement refuge in the activity and concepts of one System Part 2.” Structural Integration: The pole and lose engagement with the other. Journal of the Rolf Institute® 40(1):6-10. Without both poles working in oppositional balance, there is a danger of a reification Johnson, S. 2007 Jun. “The Two Paradigms.” Structural Integration: The Journal of the Rolf of our concepts and a loss of resiliency in Institute® our work. Our clients are not just the end 35(2):10-18. Requisecat in pace (rest in peace) receivers of our work; they are needed as Maitland, J. 1995. Spacious Body. Berkeley, part of our own continued adaptation and CA: North Atlantic Press. response. They are as important a part of our creative challenge as our principles and taxonomies. The almost fifty years of

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• The pain-mitigating effect of grounded Pain Relief – A Side Benefit and coherent hypotheses for why the client is in pain. • The ability to entrain with the client’s of the SI Disposition? nervous system to modulate the client’s By Heidi Massa, J.D., Certified Advanced Rolfer™, Rolf Movement® Practitioner autonomic responses. • Recognition that the origin of the pain is What does pain have to do with structural What’s more, according to the exit often remote from its site, and the ability integration (SI) – and why should an questionnaires, pain reduction was far to intervene at some distance from the issue of Structural Integration: The Journal from an overwhelming measure of success: site. of the Rolf Institute® be devoted to pain? • The 29% who were motivated by pain How is the pain theme relevant to SI in • Knowledge of anatomy, and the habit expressed about the same overall particular; i.e., can anything be said about of thinking anatomically rather than satisfaction with the process as did the pain here that would not be equally well systemically. group as a whole. said in a publication devoted to physical • Comfort with ambiguity and with not or occupational therapy, chiropractic, • Of the 29% motivated by pain, about 2/3 having answers. acupuncture, orthopedics, or any other field (or 19% of the entire sample) identified whose practitioners treat musculoskeletal significant improvements other than • The mindset of not identifying with the pain? Though some SI practitioners have pain reduction as reasons why they were outcome. developed fine and even occasionally satisfied with the process. An acquaintance of mine, a gifted mechanic, brilliant pain-relief methods, discussions • Only about 10% of the entire sample was working brutal hours over Labor of the same should be welcome in any expressed satisfaction with the process Day weekend to complete the ground-up publication whose readers’ work is the specifically because of reduced pain. reassembly of a 1962 Ferrari. The car carrier treatment of pain. was picking it up Tuesday, and the engine Conversely, for over 70% of the clients, pain The work of SI, however, is something other wasn’t in yet. His boss phoned me: “Can relief was not a motivation; and because this than this; and structural integrators are you come to the shop right now and fix subset was also satisfied with the process, something other than perhaps enlightened Mike’s neck?” it seems that they sought and received but still unlicensed physiotherapists. benefits other than pain relief. Adding to “I can try,” I replied. “Set up a lunch table Though many who come to us want to stop that subset the 19% who were motivated in the back room.” Though Mike is a stoic, hurting, and despite the notion that if we in part by pain but reported benefits other he and I had worked together in the past accommodate them the world will beat a than pain reduction yields nearly 90% with some success, so at least he was not path to our doors, pain is not the point of reporting benefits other than pain relief. afraid to let me give it a shot. Besides, on SI – not in many of our practices and not Saturday of Labor Day weekend with two according to the largest research study ever At the risk of sidestepping the rush of more days of grueling overtime ahead, made of clients’ motivations for seeking SI humanity beating paths to the doors of who’s he going to call? and their experiences having received it. others, many of us don’t aim or claim to fix pain – though during an SI series, lots of Mike was in considerable pain and having In 2006, Rolf Institute faculty member Pedro pain does come out in the wash. Claiming or trouble walking around. To my alarm, he Prado analyzed the reports of 874 recipients attempting to treat acute pain is especially couldn’t turn his head without sending of the Ten Series: 160 clients of trainings in problematic on many levels: I myself shooting pain into one leg. Mike explained the U.S. and Brazil and 714 clients of the address acute pain only as first aid – usually that he had awakened that way, having been São Paulo Ambulatory Clinic (NAPER). the only available aid – to someone who will attacked by a giant squirrel and then fallen The data included the clients’ responses not be paying me. In other words, for many backwards off a ladder – all in his dream. to intake and exit questionnaires, which of us, our work is not the treatment of pain. addressed their motives for seeking the Skipping any body reading on this modest work and the results they perceived. That said, it’s a fact that even those of us and now very crabby introvert, I put him not in the pain-relief business are often on the table fully dressed, tuned in, and Contrary to what many would expect, surprisingly successful at it, managing calmed down his autonomics. During that these data show musculoskeletal pain to relieve even acute pain with rare or time, I explained that as far as his nervous to have been anything but the clients’ non-obvious etiology. How can that be? Is system was concerned, he really was attacked overwhelming motivation. On the intake there something about the SI training or by a giant squirrel and really did fall backwards questionnaires, though about 80% reported viewpoint – or something about what an off a ladder. What’s worse, because he was pain, only about 29% identified relief of SI practitioner is – that makes us effective sleeping when all this happened, his system musculoskeletal pain as a goal for the at doing something we don’t make a was poorly defended against it. I also process. And, of those that did, more than career of doing? If the answer is yes, the reassured him I believed he was going to half identified other goals, as well – e.g., possibilities include: be okay. better posture, heightened body awareness, and personal growth. In fact, for only 14% of • The importance of the therapeutic Unfortunately, nothing I tried – not even the entire sample was relief of musculoskeletal relationship. remote work at the heels or the sacrum pain the sole reported motivation. – did any good at all for his neck. Even

24 Structural Integration / June 2013 www.rolf.org ON PAIN small passive rotation caused a huge brace his “fall,” Mike had put a kink in his one of his colleagues observed, “You must convulsive jerk in response to the stabbing dural tube. But even assuming the validity have had a good talk with Mike. He’s acting pain shooting all the way to his left toes. of that hypothesis, I knew nothing about human again!” Wondering what could be happening, I how to un-kink a dural tube. So I faked it. When these little miracles happen in our asked Mike for his take on it. The mechanic Mike and I imagined that using the head as practices, we’d learn something by asking and I reasoned it out together – how turning a handle, I could access that territory and why, whether due to a particular technique his head a few degrees could possibly grab encourage it to unwind. or something else – and if the latter, his toes and everything in between with Who knows what worked – but something then what? such violence. We agreed the most likely must have because Mike’s coordination culprit was interference in the electrical and demeanor were much improved. Later, system: maybe in the course of twisting to

tensional forces, people’s pain will either A Pained Process release its hold as we proceed, or it will eventually, with patience, lose the war of By Kerry McKenna, Certified Rolfer™ attrition to better posture in the long run. “About suffering they were never wrong, the old masters: how well they understood its At the threshold of considering advanced human position; how it takes place while someone else is eating or opening a window or training in Rolfing® Structural Integration just walking dully along.” (SI), naturally I feel the squeeze to know (W.H. Auden, “Musée des Beaux Arts”) how to handle one-off appointments, where clients legitimately hope for immediate In my favorite movie, Amélie, the main not change the leg length, but we may relief. Rolfing SI as a system does not lack character’s love interest is trying to follow affect the discomfort anyway. How about the agility to address pain directly, but even a path she has laid our for him, and he is them apples? We can make dangerous if “relief” is realistically understood, and stopped in front of a statue that points up or obstructive assumptions about pain the client will forgive its brevity, is there to the next hill and clue. A child chides the like “probably a nerve impingement,” or not a larger responsibility, to address the dim hero with an old proverb, roughly “sounds like a muscle tear,” and lose the mind/body and to respect the role of pain translated as “When someone points at the trail of a more complete system—a system in its family of experience? sky, only a fool looks at the finger.”. Pain is that maintains the pain symptoms. I am Back to the Sky the finger that points at the sky. The Rolfer is wary of being distracted and losing the there to help the client examine the sky and clues that will lead me to great heights. While I endeavor to pay attention to the relate it to the finger, not to simply remove, whys and wherefores of a specific injured Pain is not the enemy. Why are we taught nor to be mesmerized by, the finger. tissue, I also need to remember that a client’s to try and rid ourselves of it? pain is an intimate experience. Each person The Finger As a Rolfer (with no other field of practice has an intimate, sometimes complicated, Talking about pain itself becomes a verbal per se), my scope of knowledge revolves relationship with his pain. That relationship model of the complications existing around around the physical sensations that anchor is as much part of the maintenance of pain. Let me illustrate. When clients ask the experience for us both. Relating the pattern as it is key to relief, equal to other me what is causing a pain symptom (and pain to the body brings us back around factors. The relationship he has with pain in they ask, because they don’t presume to to talking about sensations again, where general is a very interesting question. This know) – “Is it my old knee surgery scars?” our information is. It’s the safe spot of question trumps all healing attempts and “Is it my herniated disk?” “Is it the way I paying attention again, and in due time, I excursions off the bat. Clients may not know sit at my desk?” – I always ask around the am leading the questioning solidly out of the nature or sensation in detail, or want to it, instead of try to answer specifically. It is the pain locale and into a general realm. be too curious. The answers to “How do you a trap. “Do you have an idea?,” I ask back. “What else do you feel?” This new line of feel about pain in general?” will be the basis “Well, it hurts here . . .” they’ll begin. My questioning is meant – in short – to lead for their whole experience, facilitate and usual follow-up is to ask about the pain, to us away from the distraction that pain can block, spread caution or trust in proportion. gather as much information as I can about be, and relieve us both from the duty of They came to us, presumably to be free of how the client uses language and gestures fixing the problem, away from the cause/ pain, without ultimate awareness of how to describe his experience. I try to avoid effect model and away from coming to “pain-free” can be achieved. That’s what coming to conclusions on the causes. It is conclusion. Some clients are gifted at feeling we’re here for, whether we lead them to my experience that once people’s minds a banquet of other sensations and some ultimate freedom from pain, or lead them reach a conclusion, new information has need our gentle prompting. to their own acceptance of pain among the relationships of the mind/body family. less of a chance to penetrate. For example, Primarily, we focus on the release of a client is convinced he has one short leg, constricted tissue. In practice, I spend Recently, I have had a string of clients who and concludes that the discomfort in his Ten Series after Ten Series following the had just “had enough” of their pain. Acute back will always be there because he’ll logic that if I can help a body balance its or chronic, pain had plagued them for never change his legs’ lengths. We may months and years to some degree. I’m sure

www.rolf.org Structural Integration / June 2013 25 ON PAIN we have all had our share of clients with hand, and endeavor to remain as neutral as Keeping open to answers to these questions pain that we have wanted to instantly make I can for the sake of uncovering the client’s and more are all ways of clueing in to vanish with the wave of a magic wand. And attitudes, which are supremely pertinent. the client’s approach and attitudes. And we have all held off, in the better judgment, as always, having patience and respect Another major factor in my relationship to find a way to enable a body to support for the wisdom of the client’s mind/body to pain in general is my physical history itself more ideally. Through Ida Rolf’s models. The truth is that we can’t speed with pain and injury in my own body, principle that gravity is the organizing up or impose the results we’d rather see, which can also be a silent participant in the factor, we instead encourage ease within nor can he. healing room if I don’t acknowledge it. My gravity, which will, I presume to say, story began with the migraines I had as a transcend pain, and enable the alleviation Clouds Move Slowly – baby and that continued my whole early of it, at least as long as postural alignment A Bear Becomes a Bunny life. I was strong and athletic but these can be judged a major contributor. headaches put me down twice a month for I had a mechanic in Atlanta who was The Sky twenty-four years before my first Rolfing absolute gold. I could bring my car in and series cleared the relationships that led it’d be perfect in a day, never costing more Obviously, the pain of a broken leg should to the pattern. Before Rolfing SI, though, than necessary. But while he could fix the stop a body in its tracks. But even the dull I learned to pay attention to how I felt car as soon as he looked at it, he always pain of depression can be described as a because of the pain itself. Warning signs, asked me the questions that led me to detail way to slow down, alerting a sufferer to triggers, pressure points – the pain was my experience, which was an indispensable pay attention to his body/mind in a new motivating me to figure out how to relieve quality when I had a real mystery to solve. way. The act of paying attention ideally it! In addition, “my headaches” became “Its brake pedal becomes soft sometimes, brings enough information to find a way to part of my identity, how I got attention and then I smell chemicals and then the generally and specifically adjust the system and was forgiven weakness, even as I was brakes give out, but only every six months.” – a system that has, in effect, supported the miserable with it. Long story short, my It was an improbable problem to have. painful condition – to shift it to support a relationship with my pain became one of “When the brakes cool down a while resulting pain-free system. In other words, detailed curiosity, patience, “specialness,” the problem goes away and it’s fine.” Of the relationships around the pain shifts and resignation as well. I can’t expect every course he could take it from there. But he focus away from the locus of the sensation (nor any) client to have the same tensegrity asked me about the smell some more. And of pain on to a host of other information. model of pain attitudes as I have. I have to what did I mean by soft, and how long did But relationship is still the main issue. For listen and interact with what the client is it go soft before the smell came, and the one facet, a client’s relationship to his or reporting, applying my curiosity, patience, giving up? Did any of these things happen her own pain is a point in the tensegrity and acceptance to his whole system. independently of the others? He couldn’t find anything mechanically wrong. But he model of the mind/body. One cannot work While pain legitimately takes up a lot of without it, whether attempting to deny, or believed me. And when my brakes really attention, if a client is encouraged to feel fried out in a scary episode, I limped it into attempting to relieve the pain. Other basic what else is present in the body, change facets are the client’s relationship to his Mr. Clarke’s and we replaced them. Twice can take hold perhaps better or more in two years. body, judgments about pain, attitudes about confidently. I ask questions that leave space relief (e.g., never sees the doctor, takes for the acknowledgment of the discussion, His ability to tap into my relationship with lots of medicines, or “walk it off, sissy”), letting the client fill in the blanks. As I was my car gave me the trust in him that I needed patience, trust, the perceived skills of his taught, I use statements of validation to to eventually get the dangerous problem helpers, and more . . . all of these things hold prompt trust and confidence in whatever solved. And even if the brakes weren’t to place in the mind/body system, just as any language or gestures the client uses to be immediately fixed, I maintained patience bone holds place and relates to a structural explore and describe his experience. I keep and dedication to it because he valued model of the body. my language neutral, free of any of my and respected my relationship to my car How do we know how a client deals own associations to pain and to not trigger when other experts did not. Eventually, it with these factors? The questions we ask any associations the client may have. I try was only my close attention to the patterns about a client’s body are the most obvious to pick up nonverbal cues to the client’s after the third brake failure that led to a opportunity to demonstrate real respect acceptance or rejection of my touch or discovery that the pin got stuck open or for how he feels about pain. But first, and information. Questions that occur to me closed at random times, doing damage that frequently forgotten – how does the Rolfer frequently include: had little regularity. A car is a machine, but feel about pain? there’s also the driver’s relationship with the • Is the client not wanting to pay attention car that can save its self-destruction. I’ll be honest. Like most practitioners, I’m to sensation? Pain as a Trust Process afraid of not relieving the pain. I’m afraid • Is he paying deep attention but not of re-injuring someone when he needs talking about it? So far, I’ve written about the pain of injury, healing the most. Without examining these stuckness, and misalignment in gravity. • Is he never taking suggestions of attitudes, I run the risk of unconsciously But pain is relevant to the client and Rolfer exploring on his own? imposing my fear or agendas onto my by way of the pain of healing itself. SI client. To sincerely put away my fear, • Is he coming in with discoveries despite has deserved its historical reputation as acknowledging it and releasing it each time the presence of persistent pain? a painful process, though it is no longer it arises, I can be responsible for the task at necessarily so. Still, in any modality, we

26 Structural Integration / June 2013 www.rolf.org ON PAIN can acknowledge the discomfort of a body’s only to volume of pain, not quality free days and nights. Too often, our chief healing process, even to speak of a scab over of sensation. complaints as humans revolve around the a cut beginning to itch as it knits. aches and discomforts that denote chronic In regards to number three, paying attention misalignments, and indeed Rolfing SI can In training at the Rolf Institute®, I learned to sensation is primary in integrative work take a huge chunk out of the discomfort to ask clients to let me know when the precisely because integration means we levels of our clients. At the same time, we pain they feel under my hand feels like a accept a certain amount of all sensations, also attempt to make sense of things that are four out of five or higher, so I could gauge including pain, and find their appropriate not pointed out from the actual pain of the my pressure. After a time, I have retired messages. Most clients do not have much client. It is our job, as agents of integration, that practice, because I found that it made ambiguity around pain and do not feel to help humans to move from the rejection more of my clients nervous under my touch. shy about expressing its presence (if of pain, and the medical model that pain (Maybe putting the question out there nonverbally sometimes), but still I prefer must be relieved as quickly as possible touched on my inner fears, but I’ve noticed to ask clients to describe any “sensations” (and sometimes at great future cost), into a positive results in not asking the question as we work together, and to let me know clearer understanding of the part that pain this way. But, I would like to emphasize what they need from me as we go along. plays in the whole – which of course is a that I’m not recommending this to anyone I find that this encourages them to say, “I matter of individual meaning: like clouds who may find the one-to-five model useful need less pressure” or “I need to stop you” in the sky, the viewer sees what she sees. for clients.) My experience is that in asking if that is the case. When encouraging a client clients to gauge the working pain: to expand his personal awareness, it is often Kerry E. McKenna has been a Rolfer since 2005, more successful to trust him to feel more practicing first in Atlanta and Chattanooga, and 1. I’m telling them I may go too far, which subtlety before he even has the confidence currently in Los Angeles. She has gratefully they will look out for with a preconceived to do so – like asking a leg to bend cleanly served on the committees for practice building vigilance in the nervous system. when we know it will twist on the way, but and editing of Structural Integration: The 2. I’m telling them that I’m afraid of hurting we work to make “cleanly” the goal. Journal of the Rolf Institute®, and enjoys them, which sets up the idea that I writing for her blog, http://rolfingmatters. Pain is part of life. In another of my favorite may not be trusted or confident in my wordpress.com. Kerry has been an actress, movies, The Princess Bride, there is a great approach. dancer, and stuntwoman on stage. Her poetry line: “Life is pain, Highness. Anyone who been published in Edinburgh, Scotland through 3. I’m suggesting that pain is not acceptable. says differently is selling something.” One the writing group she met there while on Some clients are led to pay attention of the motivations in a long and happy life sabbatical in 2011. is to be as healthy as possible, to enjoy pain-

ON PAIN – TECHNICAL MATTERS ® more aligned with their gravitational field. The Rossiter System : What they wanted was pain relief – and they demanded immediate results. Extending Ida Rolf’s Teachings After I’d been in practice about a year, I was for Immediate Relief of Structural Pain fortunate enough to begin to work with a neurosurgeon, Jim J. Moore. He promised By Richard Rossiter, Certified Advanced Rolfer™, me that if I could fix his back, he’d send Founder of the Rossiter System me his patients. After I fixed his back with old-fashioned Rolfing SI, he sent his The Rossiter System® is a method for chiropractic adjustments, and analgesic “basket cases” to me for the next five years. targeted relief and prevention of structural medications no longer work. At that point, Dr. Moore was thrilled to have a referral pain – i.e., pain created by overuse, sufferers seek more drastic measures. alternative to the chiropractors, physical injury, trauma, abuse, or stress – in which Thirty years ago, I was one of them. therapists, osteopaths, and massage practitioners coach clients to resolve their Refusing to believe it should take months therapists: he felt he was finally getting own pain by restoring normal joint range of adjustments or massage to get results, results. Though Dr. Moore seemed satisfied, of motion in space. The techniques employ I turned to Rolfing® Structural Integration there came a time when I wasn’t. Results to the client’s weight-assisted, active, vectored (SI). Like so many clients, I fell in love with me are about pain resolution, not human stretching of painful tissue, in the context it from the first session. By the third session, evolution. Wanting even better ones, I asked of a pre-stressed whole-body fascial net. I had decided to become a Rolfer. As a new Dr. Moore’s permission to expand what I Structural pain, which usually resides in the Rolfer in 1983, I landed on a strange planet – was doing. He agreed to let me try working connective-tissue system, often alters that Little Rock, Arkansas – where the inhabitants differently, with parts of the Rolfing series; system to the point where simple massages, weren’t especially interested in becoming and from that experiment grew the work I do and train others to do today. www.rolf.org Structural Integration / June 2013 27 ON PAIN

Currently, our sixteen-member faculty further their personal evolution. Pain is why when performed correctly. The trainer has trained 1,525 Rossiter practitioners we go to doctors, chiropractors, massage recognizes when the client is either cheating worldwide. The Rossiter System is taking therapists, physical therapists, and finally to make an exercise easier or endangering people out of pain in fourteen countries – to structural integrators. Because the source himself. Part of the job is to perceive when from North America, the U.K., and Western of most structural pain is the connective- the client should advance to harder exercises Europe to Israel, South Africa, India, Japan, tissue system and structural integrators and then to push the client to work harder. and Guam. Most coaches are in private have been trained to understand connective The coach needs to watch the client’s eyes, practice, and many focus on athletes. tissue more than anyone else, structural palpate the quality of the client’s movement, integrators readily grasp the logic and and assess the client’s degree of participation. How the Rossiter methods of the Rossiter System. But – the The greater the client’s awareness, the greater System Was Developed look and feel of Rossiter work is nothing the client’s willingness to participate. like that of traditional SI. My time with Dr. Moore gave me the The first task of either a personal trainer or a freedom to go into untapped and unknown A Rossiter practitioner is a coach – not a Rossiter coach is restoration of mobility. For areas of connective-tissue work. I was therapist. Rossiter coaches do not cure or the personal trainer, only after mobility is looking for better, quicker, and longer- rehabilitate anyone. We do not focus on reestablished should strength be addressed lasting results. I took chances. The first step the etiology of the client’s pain. Instead, because, in the absence of adequate mobility, was deconstructing the Rolfing Ten Series. we provide firm guidance to help the client strength training or even daily activities I wanted to know cause and effect – the unravel what is almost always a body- can injure the client. The Rossiter coach exact result of each thing I did; and I created wide pattern of disorder. A Rossiter coach addresses mobility by getting the client a database to track the outcomes of my does not necessarily understand how the to restore space in the body’s connective techniques. The second step was verifying techniques work, but that understanding is tissues. The client might not understand that 1) without client involvement, nothing largely unnecessary to relieving pain. What exactly what is happening, but still feels happens; and 2) without movement, is necessary is to get the client to follow the result of immediate pain relief. If a nothing happens. instructions. Not every client is willing at technique fails to produce results – i.e., if The work was challenging for clients; but first. However, once they’ve experienced the pain is still there – the coach knows the while some disliked the process at first, significant pain relief in only a few minutes, work is needed elsewhere and moves on. they start listening. they got over it once they felt the results. The Client – the Smartest In fact, many clients wanted to stay ahead The analog to a Rossiter coach is a personal Person in the Room of the pain enough to return for preventive athletic trainer who watches the client care. These were the ones who would perform exercises and knows how a When it comes to the client’s body, the have been hard pressed not to continue particular exercise or stretch should look smartest person in the room is and will the job or activity that had created the pain, and rather than getting to a point where drastic measures such as surgery or retirement would look like good options, they used Rossiter work for prevention and maintenance. These clients were also the inspiration for what became the industrial and athletic applications of the work. Eventually, the techniques were organized into tool kits to address specific body areas, such as the elbow, shoulder, knee, or low back. Each tool kit has several techniques, which, if applied in sequence, address most of the pain problems commonly encountered in that body area. The assortment of tools in each kit also provides a range of challenge or difficulty so that the work can be tailored to each client’s abilities and tolerance. Today, the tool kits have been converted to iPad and iPhone applications, with an Android application now in development. Premises Underlying Rossiter Work The Rossiter System addresses just one thing – pain. Pain is why people show up. In thirty years of practice, never have my clients asked to be realigned with gravity to Figure 1: An example from a typical Rossiter workout. Note the PIC’s locking action.

28 Structural Integration / June 2013 www.rolf.org ON PAIN always be the client – or the PIC (Person in Charge), as we say. The PIC’s connective tissue has the innate ability to recover from injury and abuse. PICs get results in their connective tissues as a result of their own work. If the coaches were to do the work, the work would stay in the workout room with the coaches. If the PICs do the work, the power of doing it themselves lets the work go with them. What does the coach do? To help PICs get out of pain, the coach shows them how, gives them the tools, and then gets out of their way. Coaches control the environment, the room, the floor, the field. The coach cannot and does not control the PIC, but should inspire the PICs to work their hardest to get out of pain. Yelling and cheering are tried and true ways to get people beyond their comfort zones to achieve the best results possible. A well- Figure 2: The coach contacts and stabilizes the PIC with his feet. timed shout of encouragement at a difficult moment can make all the difference in a session – or “workout,” as we call it. not months. Recovery from chronic pain was a complete accident.) Now, I teach doesn’t take a long time; it takes the PIC’s using my feet only. It’s much easier on Execution of concentrated effort within a short time. both the coach and the PIC if the coach a Rossiter Technique This means never procrastinating. If the transmits weight through a limb designed PIC takes a shortcut, the coach makes the to bear weight. For any Rossiter technique to be effective, PIC backtrack immediately. If the PIC misses the how is as important as the what. The something, the coach makes the PIC go get Dimension general sequence is this: it now. We live and move in three spatial dimensions. The element of dimension is • The PIC is positioned on a mat on the Time is also about pacing. Because a about reclaiming the space the PIC could floor. technique is only as effective as the PIC’s occupy before the pain set in. Rossiter level of involvement in the process, its • The coach steps on the painful body part work uses a testing system to identify with pacing should be slow enough for the PIC to transmit weight, through the foot and specificity those spaces that the PIC cannot to engage fully in a deliberate movement. with precision, into the PIC’s connective- occupy without pain. Keeping the PIC tissue system. Time is not about how long the PIC has been moving at a slow and deliberate pace, the • The PIC pre-stresses the connective- in pain: with the PIC’s hard work, almost coach directs the PIC to occupy currently tissue system with a full-body stretch any structural issue can be resolved, no painful spaces in order to reclaim them. matter how old it is. we call locking (see Figure 1). This is where locking comes in. Locking • The PIC moves the painful body part, Power is the PIC’s active full-body stretch of the connective tissue away from the body area according to directions, against the The amount of power put into the technique being worked. This makes the rest of the resistance of the coach’s weight. determines the speed of recovery. Power body a fixed point against which the PIC comes from the coach’s weight, as well Performing a technique correctly requires can move. Locking anchors the painful as the PIC’s efforts. The addition of attention to four elements: body area from the inside, with every weight maximizes the impact of the PIC’s fiber of the being, while the area is being • Time – urgency, immediacy and pacing. connective-tissue stretch. Weight delivers stretched and stabilized from the outside by pure energy to the PIC’s body, and that body • Power – how much energy is directed to a combination of the coach’s weight and the knows best what to do with it. How much the PIC’s connective-tissue system. PIC’s movement. The combined actions blow weight? As much as the PIC can tolerate and open restricted boundaries and can disrupt • Dimension – restoring enough space in still be able to execute the move. For best aberrant patterns that have been in place the PIC’s body. results, the coach should use body weight for months or even years. It’s as if the PIC is only and never push on the PIC. • Movement – having the PIC do the work. ironing from the inside out the wrinkles that Time To contact the PIC, the coach uses a foot – living has formed in the connective-tissue not a hand (see Figure 2). That’s one reason system. It reestablishes the PIC’s naturally The first element, time, is about condensing the work is done on the floor instead of on accessible space almost immediately, and the the duration of recovery to a minimum. It’s a table. I started using my feet twenty-four PIC reclaims the full pain-free dimension of about getting results right now – in minutes, years ago. (How I learned to use my feet movement and being.

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By contrast, without locking there is no Unfortunately, the usual remedies are shots techniques that can be executed right at the engagement of the body beyond the painful and surgery; and despite the high cost of workplace in only a few minutes per session. area being worked. There is no fixed point these treatments, the workers are not pain- For a sense of the economic benefits the against which the PIC can work hard, no free for long and are prescribed increasingly Rossiter System has brought to the work place for the rubber to meet the road. invasive and damaging treatments. In place since 1990, consider the results from Without locking, the disengaged 95% of most industrial facilities, this story plays one of the world’s largest manufacturers the body will quickly re-establish whatever out not with a single worker, but with a of ready-to-assemble furniture, which had connective-tissue dents and wrinkles the PIC substantial percentage of the entire work experienced major increases in workers’ is working locally to remove; and whatever force. When workers’ symptoms recur, compensation claims despite having results the PIC achieves will not last long. absenteeism increases, and productivity instituted positive ergonomic changes. declines. Eventually, those workers with The company instituted an on-site Rossiter Movement the most skill and experience are forced System program, and in the program’s The PIC does the work by stretching to into involuntary early retirement – to the second year, the company’s claim costs were the limit of a reach, assisted by the coach’s economic detriment of themselves and the 70% lower than they had been the year prior weight. The vector of the reach is precise and employer alike. Of course, the individual to the program. This was true even though targeted, while the extent and duration of the workers suffer more than economic harm. the company had grown nearly 45% – from action are governed by the PIC’s immediate They suffer diminished quality of life for about 1,900 employees to nearly 2,700. Lost limits. As the coach encourages the PIC to years, as they take the pain of their jobs work days went from 685 to 30 – down 96%. challenge each day’s and each minute’s limit, home to their families and out into their Finally, claim cost per hour worked went the PIC regains the connective-tissue length leisure and community activities. from 12 cents to 2 cents. and range of motion required to reclaim What’s worse, in the smaller or rural dimension. Often, the PIC will need to work towns where industrial facilities are often Relief and Prevention of with multiple vectors in order to regain 2 located, the usual approach to occupational Pain in Athletes normal and natural movement. repetitive stress injury (RSI) has the potential Once athletes start down the grim path of If we stretch any connective tissue hard to cripple not only a plant, but a once- shots and surgery, they’re on borrowed enough or long enough, it will eventually thriving community. After fifteen to twenty time, risking perhaps years of competitive become painful. In Rossiter work, we are years’ operation, the employer, undoubtedly activity. Because athletes are disciplined and looking for that limit. It doesn’t take long to drawn to the town in the first place partly motivated, they should be among the easiest see who is serious about getting out of pain: because of its healthy labor pool, discovers clients for anyone to help recover from injury serious PICs test their own limits often. that the local hospital’s bottom line is or overtraining. Unfortunately, however, improving at the expense of his own. And, Applications residual pain often prevents full recovery the plant has disabled so many bodies that – either by continually recurring or even by The Rossiter System organizes individual fresh workers are increasingly hard to come getting worse. On the whole, trainers do not techniques into short protocols – workouts by. Preferring a healthy work force to a have the proper tools to address the pain and of ten to thirty minutes’ duration – for PICs thriving hospital, the employer relocates and rest does not resolve it. For the professional who came to be in pain from activities they takes his jobs with him. athlete, this pain signals the end of his career. are not going to stop doing. Some protocols The safety officer of one furniture are designed for use in factories and other This Too Does Not manufacturer felt as if he were accumulating Have to Happen workplaces, while others are for athletes. a huge bone pile out back out of folks who However, these same protocols may be used could never do their work again. He hated Tennis enthusiast Cathy Gorbett attributed in the traditional clinical practice setting. seeing his friends and neighbors drop her 2010 singles and doubles championship Relief and Prevention of out of the work force. His company, like in Steamboat Springs, Colorado to Rossiter employers everywhere, was losing maybe Coach Ruth Nottage, who fixed Kathy’s Pain from Repetitive Stress five to ten of what should be workers’ most knee just before the tournament. Ruth 1 in the Workplace productive years. The problems would start reported, “Cathy was blown away by the Many workers develop structural small, as things that should be very easy to quick and remarkable results she had.” problems as a result of the work they do. recover from; but the “cures” of shots and Sometimes it’s just that simple – fixing a Occupationally induced carpal tunnel surgery eventually made them all worse recent problem the day of the event. until people too young to retire could no syndrome, shoulder pain, low back pain, Other times, the Rossiter System is a means longer handle their jobs. and hip pain are endemic in industries for the athlete to regain full mobility such as poultry and meat processing; None of this has to happen – not the human following a longstanding problem. In the parts manufacture and assembly; cutting suffering, not the economic losses, not the golf world, distance hitters, called “long and sewing; data processing; furniture community degradation – and none of it drivers,” are the heavy lifters. Professional manufacture; and virtually any kind of should happen ever. There is no excuse for long driver Jeff “Critter” Crittenden, one of assembly-line task. Warehouse workers, it. My twenty-three years’ experience in golf’s best, had not fully recovered full arm retail clerks, and others who walk or stand the field indicates that the vast majority of rotation following a bicep tendon injury – on concrete all day are also vulnerable, occupationally induced RSI can be relieved even after a year of physical therapy. He was particularly to back or hip pain. and prevented from recurring through unable to use his left arm effectively and was in pain when he got to Rossiter Coach

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Chuck Lubeck. Two moves later, out of pain how to get out of it. The emotional distress System’s powerful second-paradigm pain- and his arm rotation restored, Critter won of feeling left out of life doesn’t rear its ugly relief methods. the Dixie Classic Long Drive tournament, head any more. and he credited the win to Chuck and the Endnotes Though the Rossiter System is not Rolfing Rossiter System: SI, it is derived from my training and 1. In the parlance of the Rossiter System, I [had] yet to regain full rotation in experience as a Rolfer. This body of work the series of workplace protocols are called ® that arm until I allowed Chuck to enlists the traditional SI premises of 1) Quantum Pain Relief . introduce me to a Rossiter Workout. working with the whole fascial net; 2) using 2. In the parlance of the Rossiter System, He applied weight to my arm and gravity (i.e., weight and the client’s sense of the series of athlete protocols are called directed me to move it around in it); and 3) tapping into the client’s capacity PainSlayer® and the PainSlayer Series. specific motions and voilà. I was to self-organize. It also affirms some suddenly able to do what I had not truths familiar to Ida Rolf’s heirs: without For general information on the Rossiter System, been able to do since before my movement, not much happens; and without to find a Rossiter Coach in your area, or to injury. I was able to fully rotate my client involvement, not much happens. learn about becoming a Rossiter Coach, visit arm and went on to win the Dixie Though Rolfing SI is not second-paradigm www.therossitersystem.com. Classic Long Drive event that very work, its teachings underpin the Rossiter day. I’m sure Chuck had everything to do with my winning that event and I can’t thank him enough. Rossiter work can be used preventively ™ in athletic training, just as it is in the A Rolfer’s Pelvic/Lumbar workplace. As reported in The Professional Skater in 2011, maintaining competitive Joint Restriction Algorithm figure skaters’ flexibility and mobility is key to injury prevention and better An Interview with John deMahy performance, and the Rossiter System has proven itself an invaluable component By Mollie Day, Certified Rolfer™ and Rolf Movement® practitioner of off-ice conditioning. Similarly, for two different high school baseball teams, the For ten years prior to training in Rolfing® “no” type questions, usually set up in a Rossiter System was used regularly for six Structural Integration (SI), Certified Advanced flow chart, to guide you quickly to the most consecutive years as a means to prevent Rolfer John deMahy worked as a nurse in an effective treatment. As we know in Rolfing injury. In those six years, no pitcher on emergency room (ER) trauma center. This [SI], there is a hierarchical relationship in the either team was ever injured. Ask any experience gave deMahy an acute understanding body’s structures. If you try to put someone’s baseball coach if that’s not amazing! of how to create order in the midst of chaos. Later, head on his shoulders without organizing as he began to study spinal mechanics through the support in his feet and legs, it’s not going Conclusion Rolfing SI, it was deMahy’s ER experiences to work. In the ER, you treat the wrong thing Whether coaching a whole assembly line, a that led him to develop an algorithm – a chart of first and the patient might die. In Rolfing [SI], struggling athlete, or an ordinary SI client, ordered tests and procedures based on the body’s you treat the wrong thing first and you’re the most rewarding moment is seeing the flow – for the treatment of joint dysfunction in not as effective in organizing the structure. look on the face of a person who gets up the pelvis and spine. MD: So understanding the ER triage system and can’t believe the pain is gone – that the Mollie Day: Before we discuss the details helped to you to understand a system of pain the person expected to have to live of your algorithm and its techniques, would order for joints in the pelvis and spine? with forever and take meds for to boot is you tell me how the method came about? actually gone! Someone who’d been forced JdM: During my advanced training in 1989, What’s the relationship between what to give up a job, sport, or hobby gets to go Jan Sultan and Michael Salveson introduced happens in the ER and in a Rolfing session? back to it. Relationships that were under me to the world of spinal mechanics – how stress because a spouse couldn’t even bend John deMahy: When someone is rushed the joints function. Watching them work, over, much less help with the chores or into an ER in critical condition, there are a it was easy to see how this was going to participate in travel and play, can recover. vast amount symptoms and information radically change my Rolfing [work], which People who had stopped being able to make about the patient that have to be assessed and involved strictly fascial work at that time. I love because of the pain, now can. People analyzed before you take action . . . now! In became totally engrossed in studying the who had to stop exercising or even walking an auto accident you might be dealing with spine and pelvis. Spinal mechanics can can shed the excess weight they gained. fracture, lacerations, bleeding, head injury, as seem very complicated. I found myself well as a cardiac emergency. Life and death spending more time of my session trying to Liberated from the fear of doing things can depend on how fast assessments are figure out what was going on in my client’s that had caused pain before, folks who made and treatments delivered. Algorithms, spine, than actually working. That was had lost interest in life suddenly have the such as the Advance Cardiac Life Support about the time I started remembering my confidence, as well as the ability, to get back algorithm, bring order into the chaos. These ER experience, thinking that all my patients to doing things they’d given up on. Why? are sets of specific assessments, “yes” and would have died had I worked this slow. Because even if the pain returns, they know

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I realized that I needed an algorithm to strategy that first addresses the cause of fascia in the legs and pelvis or through navigate the spinal mechanics. I needed a these compensation makes the goals of the sacral manipulation, it’s torqued the next tool to quickly organize specific assessments Recipe easier to achieve. time you look. The sacrum appears to be and treatments so I could get on with the completely unstable. In yoga there are MD: What is the hierarchical order of the business of structural integration. So I many asanas that can put uneven stress algorithm? combed the literature for information, broke on the pubic symphysis. With this setup, it down to digestible chunks and applied JdM: Foundation precedes mobility and mobility when an aggressive stretch pushes the pubic Rolfing principle to what I found. precedes locomotion. So first we address [issues symphysis joint beyond its physiological of] the foundational joints, which are the barrier, the joint locks. So, a poorly trained MD: Why are the joints so important to the pubic symphysis and innominate shears. or over-zealous yogi can easily find herself work? Why not just follow the “Recipe”? Second, when those joints are functional, with a superior or inferior pubic symphysis JdM: The majority of acute low back pain we go to joints of mobility: lumbar facets restriction. In the algorithm-based principles is cause by or exacerbated by pelvic or and sacral-iliac joints. Finally, we address of the body, foundation comes before lumbar joint movement restrictions. These locomotion through the innominate rotation mobility: The pubic symphysis comes first. restrictions are caused by a neuromuscular in the walking cycle, at the ilio-sacral joint. But, in this example, the Rolfer [was] trying reflex, which occurs when the joint is pushed to solve a problem of mobility without MD: Would you give a clinical example beyond its physiologic barrier. You might say establishing foundation, namely a functional of how a Rolfer could manage pelvic joint the joint locks to keeps it from dislocating, pubic symphysis. mechanics in this ordered way? but also from returning to its functional MD: What you’re saying is that you range of motion. These alterations in joint JdM: Let’s use the example of a yogi with can normalize sacral movement – the function not only cause pain but also a habitual low back pain. You discover that sacroiliac joint for example – but if the pubic constellation of compensations, which can her sacrum is torqued and one leg appears symphysis is out then the sacrum will de- greatly alter the structural pattern. So a shorter that the other. But, no matter how stabilize again? many times you try to balance it through

Negative Seated Sacral Flexion Test Negative

Positive Positive bilaterally on one side (Both PSISs move quickly)

Neutral Prone Sacral Assessment Neutral Prone Sacral Assessment

Sacral base Sacral base posterior anterior Bases anterior Bases posterior (restricted side) (restricted side) L.I. angles L.I. angles posterior anterior

Inferior lateral Inferior lateral angle Inferior lateral angle angle posterior & superior posterior anterior & inferior (on restricted side) (restricted side) (restricted side)

Bilateral Bilateral Posterior Anterior Unilateral Anterior Posterior Sacral Torsion Sacral Torsion Anterior Nutated Sacral Sacral Sacrum Torsion Torsion

Retest Retest Retest Retest Retest

Figure 1: The sacral section of the Pelvic/Lumbar Joint Restriction Algorithm.

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JdM: Correct, and sometimes it happens Sacral-illiac restriction is detected with a “Can what you’ve done in your laboratory before your client leaves the office. Before seated flexion test. With the client sitting on can be reproduced in another lab?” This is a the mobility in the sacrum and lumbars the bench you place your thumbs bilaterally reproducible strategy. can be addressed, the foundation must be on the PSIS. Instruct the client to roll forward There is a sense of confidence that develops stable. The algorithm moves you quickly starting at the head with the pelvis moving as you become able to understand and through assessments and treatments. Then last. Remember that the sacrum is part of the explain why the client was in pain and what you still have time address the Fourth-Hour spine and should be able to move with the you are going to do to get [him] out of pain. line, the abdominals, piriformis, et cetera. spine before engaging the ilium. So if one I always ask my clients, “You have seen Then you would want to do movement PSIS begins a superior movement before the lots of practitioners, has anyone explained education to improve core stability to other, the SI [joint] on that side is restricted. to you why you’re in pain?” The answer is reinforce the symphysis. Then you would ask the client to lie prone usually no. So I pull out my models and on the table, to palpate the sacrum. Compare MD: How do you fit the algorithm into a explain it all. The sense of relief that you the sacral base in relation to anterior and Rolfing session or series? see in your clients’ eyes, when they finally posterior for rotation. Then compare the understand why they’ve been hurting and JdM: If I suspect pelvic or lumbar joint inferior lateral angles for rotation, then how it is going to change, is very rewarding. restriction, I will go through the assessments caudal and cephalad for side-bending. With of the algorithm. If there are no joint this information in your hands the algorithm MD: You and Jon Martine have taught restrictions, I will know in three minutes, points out the name of the specific restriction together. What is the relationship of your the amount of time it takes to test the joints. and an effective procedure. algorithm (joint manipulation work) and If there are restrictions, it will take me his neural manipulation work? MD: What is the technique you use to fifteen to twenty minutes to bring a client mobilize the joint? JdM: Neural and joint work dovetail through the whole algorithm. And I still together perfectly. This is really seen when have forty for the rest of the session. And JdM: I use muscle energy techniques first there is pain or paresthesia along the lumbar I will get more accomplished in the time developed by Fred Mitchell Sr. D.O., and I and sciatic dermatomes as in sciatica. After remaining: once the joints have returned to reinforce these techniques with principles the spine and sacral movement is normalized their normal movement pattern, the neural of Rolfing [SI]. The technique works by and the area is fascially decompressed, there reflex is gone; joint inflammation and pain stimulating a different reflex to temporarily is sometimes still pain and paresthesia along are quickly relieved or greatly reduced. override the reflex holding the joint. The the dermatomes. The effect that neural client is moved into a position just before If someone comes in to your session, manipulation has on pain, parasthesia, and the joint restriction is engaged in every no matter what “hour” [of the series], motor function is simply amazing. And plane; flexion or extension, rotation, and if he is having joint restrictions in the besides, it is really fun teaching with Jon. side-bending. Then the client is asked to pelvis or spine, what you’re seeing gently pull away from the restriction against John deMahy, R.N., Certified Advanced Rolfer, is not the primary structural pattern. an unyielding hold from the practitioner. began his career in emergency and orthopedics Compensations stemming from restrictions When the client lets go a post-contraction nursing. He has had a robust Rolfing practice in the axial skeleton overlay the primary relaxation reflex is stimulated. At that point in New Orleans since 1989. Greatly influenced pattern. This could include things like there are a few seconds in which you can by the work of Philip Greenman D.O., John is leg-length discrepancies, rotations, and freely move the joint back into normal range. the author of Joint Restrictions in Structural side-bends. If this is the case, and you Once in normal range of motion, pain and Integration. This text presents his simple go into your session without addressing inflammation are quickly reduced. and effective algorithm for the assessment and the restriction, then you’re wasting time treatment of joint restrictions in the lumbar chasing compensations rather than MD: You teach this work, so you obviously spine and pelvis. He is a graduate of the Rolf primary pattern. believe other Rolfers can benefit from it. Institute® (1985) and Louisiana State Nursing MD: Would you give an example of how JdM: When you first start studying spinal School (1978). John taught kinesiology at you look at the sacroiliac joint and how you mechanics, it can be overwhelming. You the University of North Carolina Charlotte. present that in your manual? start looking at the sacrum or spine and He continues to teach continuing education think: there could be anything wrong in there! in manual therapies as well as anatomy and JdM: The manual is designed as a resource But when you learn the architecture of the kinesiology at various yoga teacher trainings. to use during a session, while you are joint, you see that there are only certain learning. The algorithm chart (see Figure 1) Mollie Day practices Rolfing SI and Rolf movements available in each joint. And lies open on your desk, as a road map, Movement® work in New Orleans. She is when you study the architecture of the guiding you through tests and results. It also educated in visceral, neural, and joint- skeleton, you learn that there is a hierarchical guides you to the specific restriction and manipulation techniques through the Barral order to the way joints function in relation to suggested procedure. There is a page number Institute and in craniosacral therapy techniques one another. To learn a strategy for handling at each step so that if you can’t remember through the Upledger Institute. Mollie’s practice that information, I created the algorithm. For how a step is performed you can quickly stems from her education and experiences in me, it is beneficial in that it saves time and go to the appropriate page. There you will medical anthropology, manual therapy, yoga prevents confusion. I’ve tested it myself for find an image of the dysfunction, and/or a and qi kong. Alongside the healing arts, Mollie eighteen years, and I’ve taught it to other photograph and detailed description of the facilitates other transcendental experiences Rolfers who are also using it effectively. diagnosis and treatment. through writing poetry and meditating in One of the standards of scientific research is: wilderness places.

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At this stage, having already exhausted your Thawing Frozen Shoulder: manipulation options around the shoulder itself, you must look beyond the shoulder Addressing the Imbalances that Drive the Dysfunction restrictions and assess the rest of the client to tease out the source of the client’s issue. By Matt Hsu, Certified Rolfer™ and Remember, you’ve already spent time ® Egoscue Certified Posture Alignment Specialist manipulating the fascia and affecting the musculature directly related to the shoulder, Debbie had originally come to me with rotation and attempting to relax the internal so you can basically rule this out as “the some knee and hip problems that she had rotators). Frozen shoulder sufferers often cause” of the problem. Almost invariably, been experiencing while hiking. Her knee have limited ROM in pretty much all planes I have found that frozen shoulders most and hips were now feeling fine, she told me, of motion, so it’s common that you’ll find improve by paying attention to the rest of the but she had a new problem. A fall off her that you are working the entire rotator body: specifically, what’s happening around bicycle resulted in a diagnosis of “shoulder cuff and the other muscles that have not the spine (and, by extension, the pelvis). encapsulitis,” and now, after six months of been given the privilege of entry into that rest, massages, and two bouts of month- much maligned group of four. Work on the The following are two quick tests you can long physical therapy (PT) regimens, her pectorals, on the trapezius, along the lateral perform to begin the investigation process. range of motion (ROM) had improved only border of the scapula where the serratus If these tests are positive, you have a couple slightly. She was frustrated and wondered anterior can lock the scapula to the ribs, intervention options to explore. if there was anything I could do for her. and into the axillary region can all be useful. Test 1: Static After fifteen minutes, her ROM increased I’ve found that working around the shoulder Paraspinal Prominence dramatically – she was both shocked and in this way can often yield significant ROM thrilled. Over the next few weeks, she Stand behind your client, as she stands improvement (a few clients of mine and regained the rest of her ROM. What helped however she normally stands. Palpate the others have reported 80% improvement her shoulder “thaw” was a perspective on paraspinal musculature. It’s very likely from manipulation alone). However, there frozen shoulders that I’m going to share that you’ll find one side of the paraspinals appears to be a limit to how much ROM here. is clearly more prominent. Typically, improves at this stage; and there are times the paraspinals on the ipsilateral side of It seems that every few months, someone when this stage of intervention provides the frozen shoulder will be much more walks into my office with “frozen shoulder.” almost no benefit whatsoever. Based on my prominent in the lumbar and low thoracic Sometimes it’s a self-diagnosed case (i.e., observation of postings to the Rolf Forum spine, though I have seen the prominence “I can’t move my arm past here”), and LISTSERV; emails from other Rolfers; and make it all the way up to the medial sometimes it’s been diagnosed as “true” massage, PT, and medical literature, this is border of the scapula. If you find this clear encapsulitis by a medical professional. a common barrier to success. I have seen difference in the stiffness and prominence Regardless of whether the client has many solutions to busting through this limit of the two sides, your interest should now bothered to get a medical professional to offered from Rolfers and across various be in the coordination of the kinetic chain as give the shoulder dysfunction a rather fields. Some are not particularly palatable your client abducts at the shoulder. grave-sounding name, the two-stage (unless you consider hanging mercilessly approach I present here has generally from the affected arm until the soft tissues Test 2: Standing Arm Abduction proven quite effective for the majority of simply “give in” and allow for better ROM Your client can do this with or without a clients who report having some version of to be an option). Some require a significant shirt on, but it is helpful to see it without the “frozen shoulder.” investment in technological gizmos that do shirt. Stand behind the client as she stands not approach an efficacy rate that satisfies with feet parallel to each other a fist’s width Stage 1 - Focus on me. So these are not things I generally do. the Symptomatic Site apart. Have her raise her hands and arms Since Debbie had already been through out to the side, instructing her to tell you The first stage involves straightforward PT and had described receiving numerous when she feels pain or discomfort in the manipulation on the areas directly related manipulations all around the shoulder shoulder. As she raises her arms, pay close to the shoulder. The majority of Rolfers are from her physical and massage therapists, attention to the orientation of the rib cage already familiar with this approach, so a I decided that doing more of the same was and shoulder girdle and to the prominence quick summary will be presented here (for unlikely to produce any different result. of the paraspinal musculature at lumbar and a more in-depth exploration, Erik Dalton’s Stage 2 - Address the Rest thoracic levels. What you will typically see is “Fix Painful Shoulders” blog post1 is a that even before the client reaches the painful good start). Depending on the individual’s Germane to this stage is the old quote: part of the motion, the paraspinals on the specific ROM limitations, you address the “Where you think it is – it ain’t.” Just because ipsilateral side of the frozen shoulder will fascia of the relevant musculature. For a shoulder is frozen does not mean the be much more prominent, indicating that example, a shoulder with limited internal shoulder is the problem. The name “frozen they are far more active than the muscles and external rotation will benefit from shoulder” traps us mentally into thinking on the contralateral side. This activity pulls work on the rotators. Rotational capacity the problem is the shoulder. The lack of the rib cage and shoulder girdle into rotation can be enhanced with assisted movements motion there is certainly a quality-of-life and makes it impossible for the humerus to with targeted work on the antagonists (e.g., problem, but the source of that problem need articulate properly within the glenoid cavity. gently bringing the shoulder into external not be found right where the symptom lies.

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You can replicate this experience for pattern. (This positioning for a frozen right going to suddenly go back to symmetry, so yourself by doing the test on your own shoulder with prominent right paraspinals I proceeded to the exercise phase. with a little exaggeration. Follow the same is what is shown in Figure 1.) You now work instructions as above and see what your slowly and methodically on the prominent Air-Bench natural range of motion is. Now, drop your paraspinals, getting assistance from your The “air-bench” is an exercise that athletes arms to your sides and twist your torso 20 client’s body position. The twist you have from various sports have experienced degrees to the right so that your sternum is put your client in encourages the stretching and many Asian Americans know as a facing a bit off to the side but keep your face and relaxation of the paraspinal muscles punishment parents hand down for getting and shoulders squared up facing forward. you’re working on. a B on a test (not mine, thankfully). It is also Now abduct at the shoulders again and known as the “wall sit” or the “phantom After as little as thirty seconds and as see what happens to the ROM. Unless you chair.” It’s typically cursed as a horrific long as five minutes, have the client have some very flexible shoulder joints or killer of the quadriceps group, but for our stand up again and reassess ROM in her are a particularly good compensator, you’ll purposes, it will be a useful way to try to shoulder. If she notices improvement, you find that your right shoulder lost many remove the rotational pattern in the spine have now made a solid connection in her degrees of motion as a result of that twist. and restore motion to the shoulder. mind (and yours) that the twisting in the Try turning to the left and repeating the spine is limiting the shoulder. If there is experiment to see what happens. Have your client stand with her back against the wall. Have her keep her butt against the The importance of what you just learned cannot wall as she slowly walks her feet away from be overstated. A twist in the torso will affect the the wall. She will be sliding down the wall function of the shoulder joints. until her hips are bent to about 100 degrees and her knees are bent to about 100 degrees; Once you have confirmed that the her knees should be directly over the ankles paraspinal musculature is functioning or a little bit behind them (see Figure 2). asymmetrically, your next step is to find a Instruct her to keep her lower back pressed way to restore symmetrical function that into the wall and the majority of her weight does not compromise the shoulder. This can on her heels. Have her hold this position for sometimes be easy, and it can sometimes one to two minutes. If that’s not possible, take a few months. However, for the sake go in small increments up to a minute. This of your client, you want to be able to see if position makes it very difficult for the spine there is a “quick fix” that not only relieves to maintain rotations and gives the back and some of the shoulder symptoms but also body a quick taste of what it’s like not to be clearly demonstrates the interrelatedness rotated (or to at least try not to be rotated). of the paraspinals and shoulder function. Once she has completed the allotted time, Debbie’s left shoulder was the frozen one. have her stand straight and then repeat Her torso was visibly rotated. Her whole standing arm abduction. Very often, you’ll upper body was twisting to the left (right find that she will be able to be abduct higher shoulder and chest more forward than the than before. Should the air-bench fail to left). The paraspinal muscles of her mid Figure 1: The “A-position” is a modified provide any noticeable improvement, you and lower back on the left side (ipsilateral sidelying position that puts a twist in the can try the next exercise to see if you can side to the frozen shoulder) were much spine. It can become uncomfortable in the get any ROM improvement. more prominent than those on the right, neck after a few minutes, so it’s best not indicating a big, big muscular imbalance. to have a client in this position too long. For Debbie, this exercise produced more dramatic results. The shoulder wasn’t Intervention no improvement or you reach a plateau perfect, but the underlying back issue was “A-Position” Paraspinal Work of improvement from manipulating the clearly being addressed. paraspinals in this position and in other At this stage, putting someone into positions (as you deem appropriate for your Upper Spinal Floor Twist the “A-position” and performing some client), then it would be a good idea proceed For the “upper spinal floor twist” (see asymmetrical work on the paraspinals to to a different mode of intervention to see if Figure 3), have your client lie so that the encourage a release of the holding pattern the paraspinal disparity can be eased with side with the more prominent paraspinal will be useful. Position the client in a positions/exercises that gently demand muscles is down on the floor. Have her bend way that forces the spine to rotate in the symmetry. Below you’ll find two that I often hips and knees to 90 degrees, and position direction opposite her usual pattern. If use to restore some symmetry. her arms straight out from the chest with your client has a frozen right shoulder and With Debbie, the A-position manipulation palms together; her head can relax on the paraspinals that are tight and prominent produced an immediate improvement floor (A in Figure 3). Keeping the knees on the right side, you would have the client in her shoulder ROM. After another few together, have her bring the top hand up lie down on the left hip with the hip and minutes of prone back work, I had her toward the ceiling, then all the way over knee flexed to 90 degrees and the chest stand up, and she had still some more toward the floor (B in Figure 3). Do not and arms down on the table. This puts the improvement, but not a significant amount. allow the knees to slide apart through the spine into left rotation, counter to the usual Her paraspinals did not feel like they were entire ROM. If her knees do slide apart,

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balance with proper, targeted exercise drew ever nearer. In her fifties and still is advisable. wanting to be able to work on upholstery projects and do volunteer work with horses, For Debbie, addressing the paraspinal she did not consider this great news. asymmetry helped unfreeze her shoulder noticeably. She was able to move her She came to see me on the recommendation shoulder much better, and careful of a friend of hers who had finally gotten progression into exercises that challenged relief from her back and leg pain after her shoulder mobility (without allowing for enduring two failed surgical attempts. paraspinal compensation) over the next few Lorna was skeptical that anything could weeks got her to the point where she could be done given the medical diagnosis, but do the yogic “reverse namaste” position was willing to see if something could help. without discomfort again. By addressing the paraspinal asymmetries A Final Story and retraining her body to coordinate different regions, it took about forty-five When Lorna walked in, she was unable minutes for her to be able to move her to lift her left arm out to the side beyond arm through almost the full ROM. It took about 30 to 35 degrees from her body. She another month for her to fully regain physically couldn’t do it because of the pain. motion and control. She also couldn’t lift her arm out in front of her beyond about 40-50 degrees without Remember: “Where you think it is – it ain’t.” more pain in the shoulder joint. An MRI by Endnotes a doctor showed an old rotator cuff injury – Figure 2: The air-bench exercise. which he deemed too old to repair – as well 1. Available at http://erikdalton.com/ as signs of bone spurs within the shoulder fix-painful-shoulders. have her reduce how far she’s reaching so joint. The doctor told her that if physical Matt Hsu is a Rolfer, Egoscue Certified Posture that the knees can stay together. Instruct therapy didn’t help, she should consider Alignment Specialist, and NASM Corrective your client to breathe into the lower back surgery to clear out the bone spurs. After Exercise Specialist in San Diego, CA. He is the and into the ribs. The muscles and fascia of four weeks of rotator cuff strengthening tech geek behind websites4rolfers.com and is a the lower back will gradually allow her to exercises and some painful attempts to co-teacher for Seeing Made Easy, a class focused rotate fully through this exercise. Have her restore ROM, she was no better off than on simple, straightforward postural analysis. hold this position for sixty to ninety seconds when she had started. The surgeon’s blade then switch sides. Once the other side has been done, switch back to the first side and do that one more time. Then have her stand up and repeat the standing abduction test. A Figure 3: The upper spinal floor twist, with If there is still no improvement, there is A showing the starting a host of other exercises and positions to position and B the attempt, but presenting them all is beyond ending position. the scope of this article and, without further training, is likely beyond the scope of many Rolfers’ practices. Discussion If there is marked improvement from the paraspinal work you’ve done in the A-position and/or from either or both of the exercises, you have very strong evidence that more work to restore symmetry of B function to the paraspinals will help unlock the shoulder, and that should become your focus. Your efforts can focus on restoring balance to the paraspinals, as well as to the hip stabilizers that may be holding the pelvis in a rotation that forces the paraspinals to begin a counter-rotation. If you find that manipulation over the course of a few sessions does not continue to provide any benefit, referring the client to someone with expertise in restoring muscle

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related. Most common are “slip-and-fall” Third-Party Payments and motor-vehicle-related injuries. By Clay Cox, Certified Advanced Rolfer™ Slip-and-fall type injury usually involves a private party being injured, somehow, You can’t always get what you want. through no fault of his/her own in/at a The Rolling Stones business setting. The company’s liability insurance company usually pays the case pretty quickly unless some sort of fraud Overview allopathic physicians, nontraditional is suspected. A simple receipt will usually practitioners are often chosen. As a result, suffice for you to be paid. A “third-party payment” (TPP) is where more alternative and complementary someone/some entity, other than the client, practitioners are given provider numbers Motor vehicle accidents (MVAs) are the bulk pays for the client’s treatment. More often with little bureaucratic complications. of PI cases. It is important to investigate the than not, it will be a workers’ compensation Workshops are given to all interested particulars of these cases carefully. Whiplash fund, the defendant’s attorney in a motor parties to bring them up to speed regarding Injuries (Forman and Croft, 1988) and vehicle incident, or an insurance company compliance with forms and language Motor Vehicle Collision Injuries (Nordhoff, in a personal injury case. particulars. Most of these practical aspects 1996) as well as others will be very Workers’ Compensation apply to most other states systems as well. helpful references. We will look first at workers’ compensation, In dealing with the federal workers’ It is very important to evaluate all PI/MVA or the TPP systems that handle treatment compensation system (administered by cases for any evidence of misrepresentation for injuries that occur on the job. These the Department of Labor and mostly of the facts of the incident and/or the include state systems (for subscribing concerning benefits for federal employees), extent and type of the injuries claimed to employers and state employees), county the administrative caseworker nurse will be sustained. Medical reports, tests and systems, and federal systems, as well refer the client to you at the client’s request. imaging reports, as well as police accident as private corporate systems. In most After becoming an approved provider, reports all provide information that will cases necessitating treatment, it is held the process is pretty similar to most TPP help you through this maze. In most cases as common wisdom to allow the injured processes: submit appropriate billing and where fraud is suspected, attorneys will be person to choose his own practitioner. The treatment notes. With the Feds, payment involved, and if you are to be compensated thinking behind this is that there will be a will be rendered through direct deposits it will often take a year or two for these cases quicker response to treatment. into your bank account, and will again be to be settled. (It is very rare for workers’ determined by a fee schedule. compensation cases to involve fraud as they Laws and procedures will vary state by are usually well-investigated by agents of There is a special category of workers’ state, and differ again for federal cases. the company involved.) Attorneys are not compensation cases called “long-term Providers must generally apply to the usually involved in TPP cases unless the care awards” or “lifetime care awards.” system and have an assigned provider bills are not getting paid by the insurance These cases come about when a workers’ number before beginning TPP work in these company. If you are getting paid and the compensation hearing officer determines systems. Further, pre-approval to treat may client retains an attorney, the bills stop being after the client’s attorney has presented the be required, and payment will usually be paid until the case is settled. Most insurance case that the specific practitioner should determined by a fee schedule of allowable is for the state’s required minimum. If be awarded special consideration in this amounts, covering sessions of no more than you have exhausted these funds, more case to treat the client on a long-term or sixty minutes. The information you need often than not, there were broken bones permanent basis for a given frequency. to start with should be readily available at or blood loss involved in the case. Often, These cases have been in the system for the relevant Department of Labor website. “pain and suffering” will become an issue a significant amount of time, usually This author has been paid for services in settling the case. Most of the time these years, and the record shows that the by workers’ compensation systems in considerations are evident at the onset of practitioner’s work is the most efficacious Pennsylvania, New York, and California, the case and its evaluation. These cases will treatment available for the client’s long-term as well as Arizona. more often than not involve attorneys, but condition. This decision is usually based this is not the bulk of our cases. In Arizona, the state where I work, the on several factors – primarily long-term first person to treat the client, after the intractable pain, historical levels of pain What Care Does TPP Cover? emergency room physicians or the first medications contraindicated for long-term responders, is designated the treating use due to organ stress/risk for failure, TPP is very rarely made for palliative care. physician/practitioner. If a client comes to or the practitioner’s work being the most These entities pay for actual, measurable, you who is already seeing a physician, you cost-effective long-term care for the patient positive change such as improvement in the will have to get that provider’s permission given the circumstances of the case. client’s ability to perform activities of daily and referral as well as that of the workers’ living, increased range of motion, functional compensation agency that you will be Personal Injury restoration, reduced need for prescription medication, and reduced need for allopathic dealing with for payment. Cumbersome, Personal injury (PI) cases are another form medical intervention. These changes must but doable. Because of the state’s large of TPP. These are cases where someone be documented throughout the treatment population of Native Americans and their has suffered an injury that was not work reluctance to get treatment from traditional duration. Documentation starts with the

www.rolf.org Structural Integration / June 2013 37 ON PAIN client completing a case history form from would read: 723.1 Neck Pain or 724.2 Low to be concerned about policy limits. There your office. After reviewing this form with Back Pain as described by the client.) is little chance that you will run up $15,000 the client at his/her initial office visit, a of treatments for a “no blood/no broken You will do an initial examination, usually relevant physical examination is performed bones” case even with multiple clients in moderate in duration, billing under and the results recorded. the same vehicle. CPT code 97001 or 97002 for follow-up Compensation is paid, as a matter of course examinations. Structural integration is best If the client has a number of practitioners in Arizona, for brief reexaminations to note described as Manual Therapy (CPT code is involved in the case, be in good conversation and measure changes made as a result of 97140) and is measured in fifteen-minute with your client and approximate moneys treatment. This is the only objective tool to increments for a maximum of four units spent on the case to be safe that the policy determine if your case plan is appropriate or (one hour). The fees for these services are limits have not been exceeded. (The if the plan needs to be modified. When there based on what is usual, customary, and insurance company will not give this is a lack of expected progress made with a reasonable for your individual locale. information to you, only to the client.) One given treatment plan, a modified treatment (Some third parties or states may not accept way to attempt to avoid these situations is course is then detailed. SOAP notes are a Rolfer using some or all of these codes. to ask the client to make partial payments written on each treatment appointment and In some cases, Rolfers may only bill under on each visit. There are many benefits to a reexamination is performed at the end of 97124, the CPT code for massage therapy. this practice in all PI cases. The remaining the course of treatment relevant to the case. Again, consult with the third party or with balance for the treatment visits will be billed an experienced practitioner in your area if to the insurance company. Billing you are new to TTP.) There are other ways, as well, to handle When billing for TTP cases, treatment notes Finances payment for services with PI cases. A will generally be requested (you will need medical lien or letter of protection can your client’s signed authorization to release Workers’ compensation cases and cases be drawn up by commercial entities for the notes). The SOAP format is standard. where the “Med Pay” component of the a nominal fee and filed with the county (A web search can quickly bring the reader client’s automobile insurance policy is recorder’s office. This process does not up to speed.) A variation in this format is in effect are paid upon presentation of guarantee payment in a contested case. If where a “Treatment” section is added. This appropriate billing forms and treatment your client loses the case, there is no money is especially valuable for complementary notes in the traditional SOAP format. It is for anyone on your side: client, attorney, or and alternative practices whose modalities common to include a “Treatment” section practitioners. It does, however protect you may not be as well known in the industry in the daily notes delineating just what from the hassles that are inevitable when as traditional treatments. treatment was rendered. dealing with attorneys who may ask you In billing, the standard is the Health If the client did not have Med Pay, then to reduce the amount you are owed for a Insurance Claim Form or HCFA-1500 the other party’s insurance company will variety of reasons. format used currently. (This form and receive the billing and the treatment notes. When a PI case goes into litigation, the instructions are also available on the In this case, payment is rendered after time between treatment and funding often internet or from office supply stores.) To use all treatment has been completed by all increases to two to three years. In litigated this form, the reader will need to familiarize practitioners and physicians and the client cases, the client’s attorney generally asks him/herself with the Current Procedural is released from further care. for an amount calculated as three times Terminology or CPT codes as well as the If there are contested issues in the case, the loss (i.e., the cost of treatment, physical International Statistical Classification of then the client, his/her attorney, and the losses, and time off work). In settlement, Diseases and Related Health Problems or defendant’s attorney receive the billing and one third goes to the client, one third to ICD-9 codes. (Both of these code books notes. Payment is rendered after the case is the practitioners, and the remaining third come with instructions and are available settled. Frequently cases are settled without to the attorney. In working the case to get for free on the web.) The CPT code helps the added expense of a court hearing. more money for the “pain and suffering” of describe what you are doing to help the the client, attorneys are willing to cut their client. The ICD-9 helps describe why you Fees for Service share by a percentage and often ask that are doing what you are doing. If your client has chosen the “Med Pay” the practitioners do the same. The problem Only physicians may diagnose. The option on his/her auto insurance policy, you is that what the attorney is cutting is often emergency room or previous physicians can be paid as you bill. When the incident bloated billable hours, while practitioners will have rendered one or more diagnoses is serious but there are “no broken bones are asked to reduce their fees earned for that practitioners can work with. In many and no blood,” usually the case is settled for direct services to the patient (i.e., time spent cases, practitioners can simply record the the limits of the defendant’s policy, which is bent over the treatment table). client’s complaint and give the ICD-9 code usually the minimum required by state law. Also note that both attorney teams as well that best describes it; for example, neck as the defendant’s insurance company have pain (cervicalgia) 723.1 or low back pain You will also need to stay on top of the amount of money paid out on the case. a right to access all of your treatment and (lumbago) 724.2. (Commonly accepted billing records. All of these records must be lay terms are not seen as clinically derived The client can usually keep you in the loop as to how many and what type of identical. All parties get identical copies of diagnoses and have always been accepted the same information. (When records are in my filings. For example, my coding practitioner is involved in the case. If you are the sole practitioner, there will be little requested, you can charge for the cost of copying and mailing them.)

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You do not have to agree to an attorney’s It is important to remember what you are Another pitfall when the client is not paying request that you reduce your share, but, you being paid for in TPP cases: issues that were for treatment is that it may be hard for him/ do need to establish a working relationship the direct result of the original insulting her to see the true benefit of the treatments. with all parties involved in the case for a incident. It will always be a judgment call To help the client understand progress, more satisfactory outcome for all involved. as to where to draw a finite line in this vein I take measurements during the initial You do not know when you will be working of thought, but remember that the further examination and during re-exams, and with this attorney again on another case. you move into formal structural integration, share this with the client. The felt sense of You want to make it as possible as realistic the further away you move from direct the client’s stated progress will be solicited for the client to come back to you for more pain management. This will increase the and reported as well. We are monitoring treatment after the legal case has been probability that you will unnecessarily progress in subjective reporting as well as resolved. One way around this other than complicate the case with your philosophy, objective findings. flat denial – I never flatly deny working and this will reduce the chances of a more with other team members: not professional favorable judgment. Summary ethics in my opinion – and to also be Pitfalls Why get involved in TPP work at all? There compensated for having to wait to be paid are many reasons. First of all, you will be for your services is to require clients in There is one major pitfall in a managing TPP offering your unique services to a group PI cases to sign an “account service fee cases: malingering. Sometimes, the client of people who might not be able to afford agreement” where they agree to pay out can get very comfortable being paid to stay them. (Most of our clients pay for our of the settlement a 1½% monthly fee on home from work and/or receive treatment services with discretionary moneys. It is a monies due, compounded monthly until without having to pay for it. This may mean select group who has that money available.) the case is settled. This fee is compensation that the client was not injured to the extent Second, it will expose you and your practice for the extra paper work, phone calls, and that he/she initially reported. It could be to another level of professionalism. Often, accounting necessary in these cases. In a that the client has recovered faster than you will be coordinating treatments with year this fee will add up to 18%. With this anticipated. It also could be that the case as other professionals and providers in the money you have some room to negotiate presented was fraudulent from early on – community. You will be dealing with with the attorney. It is strongly suggested though your case history taking and initial companies and agencies regarding care that you do not negotiate with your fees physical examination will usually ferret out and compensation. You will become for direct client services. Remember that cases of malingering. more educated as to the workings of the only banks and lending agencies can charge healthcare world of which you are already This situation provides a conundrum: interest. The account service fee is the a member. Through this, you will be in order to have much success at all in amount of money needed for the treating educating a large group of professionals treating clients in these types of cases, office to keep the case open by office about your life’s work. You will be creating a you must first believe in what they say. staff, compile notes, coordinate treatment professional network for increased referrals The pain is genuine. The stated losses are with other practitioners, handle attorney and providing a matchless set of services real. The amount of suffering experienced phone/correspondence time, and manage sorely needed in the healthcare field. is the difficult parameter to deal with in accounting for the case. Finally, you will be providing a component these cases. Once you start doubting your of help and healing to people in need. Treatment Overview client’s word, you have started losing the safe vessel for treatment. How to avoid Clay Cox received his basic and advanced Rolfing It is beyond the scope of this paper to this pitfall? Training, treatment, and training from Jan Sultan, Peter Melchior, and address how to manage the client’s more documentation is the answer. Learning how Emmett Hutchins. He has been practicing complete recovery through the blending to test for the presence of pain generators, Rolfing SI since 1979. He subsequently trained of formal structural integration work treat them efficaciously, and test for the with Mary Burmeister, John Upledger, and and direct and specific pain-management progress in treatment, and documentation Jean-Pierre Barral. efforts. That being said, some overview of make the difference in understanding your the matter is offered. case. They can also make the difference Bibliography A functional understanding of the client’s between getting paid and not. Foreman, S. and A. Croft 1988. Whiplash overall need is paramount throughout MVAs that have the fewest complications Injuries: The Cervical Acceleration/Deceleration the duration of the case. You have been are “rear-end motor vehicle accidents” Syndrome. Baltimore: Williams & Wilkins. invited into the case because of the client’s (REMVAs), where the potential client pain and suffering, but at some point in Nordhoff, L. 1996. Motor Vehicle Collision (“target” in the MVA) is a licensed and the course of treatment overall progress Injuries: Mechanisms, Diagnosis, and insured driver who was legally stopped and will be limited by the lack of order in the Management. Gaithersburg, Maryland: wearing a seat/lap belt at the time of impact, client’s structure. It will become necessary Aspen Publishers. and where the “bullet” vehicle driver was to begin a reciprocating strategy where also insured at the time of the incident. It you begin to integrate establishing order also helps the case if the other driver was in the client’s structure with corrective cited as responsible for the incident. If these and restorative pain-management efforts. cases are selected carefully and properly Your efforts should not be palliative nor secured, treatment fee recovery should run aesthetically oriented. near 100%.

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is especially well-suited for understanding Who Moves? how freedom can arise during the simple act of walking. If we want to catch a glimpse of ® By Jeffrey Maitland, Ph.D., Advanced Rolfing Instructor the extraordinary in the ordinary, we need I would believe only in a God who knows how to dance only recognize what is always and already so: right here, right now, as we are moving Nietzsche through our world, in the always ongoing free flow of one movement into the next, Abstract move when and where we want to. But the simple act of walking can become a have you ever wondered how you move portal through which we come to realize our This paper is a phenomenological your body, how you actually experience freedom and place in all of this. investigation into how we, as self-movers, moving your body? To answer this question experience ourselves moving our bodies. you must contemplate how you experience How to Run Through an examination of walking your movement as you live, breathe, and Down a Mountain meditation, its purpose is to understand accomplish it. The question is asking In order to catch our first glimpse how how an activity as mundane as walking for your point of view as the one who is liberation can arise from the simple can provoke an experience of human moving, not for the point of view of an moment-to-moment free flow of everyday freedom. Describing how we move our observer who is watching you move. Hence, movement, let’s look at a familiar experience. bodies is surprisingly more difficult than for example, a neurological explanation The following description of running one might imagine. When we look at the of how you move is not an answer to down a mountain comes from a person commonly accepted way to describe our the question. moment-to-moment movement, we find who was just beginning to explore Zen. confused descriptions that are too narrowly This question is surprisingly difficult to The simplicity of his experience reminds conceived to capture our experience of answer. When we make the attempt, we us of other similar kinds of experiences. movement. To make matters worse, closer discover that not only do we have difficulty The universality of these experiences also inspection of our experience also reveals describing how we move our bodies; we are suggests that we are closer to realizing our that we cannot even locate the mover of also at a complete loss as to where to find freedom than we might have suspected. our body. Many of these confusions can the mover. We say with great confidence, This description of running also provides be cleared up by employing a distinction “I move my body.” What could be more us with just a hint of what is possible when from phenomenology between reflective self-evident than the knowledge that you we are able to transcend the confines of our and pre-reflective consciousness. As a result are the mover of your body? But where limited human self. is this mover? Can you locate the self that of clarifying these issues, new insights and The first time I saw the Colorado moves your body? If you cannot locate the more illuminating descriptions of how Rockies, I was an out-of-shape graduate mover, is it even possible to describe how we move become possible. These gains in student. A friend took me on a hike into you move your body? clarity, in turn, provide us with a way to the mountains. When we finally reached understand how walking can be a portal to Upon first hearing these questions, we are the top, my legs ached and my throat experiencing the depths of human freedom. frustrated and have little idea how to answer. was on fire with my breath. After a short The Enigma of Self-Moving But if you stay with your initial puzzlement, rest, we started down. To my surprise, drop your thinking mind, and open yourself my friend began running down the Of all the things that inhabit this vast to really experiencing who moves and how mountain. Being so uncertain on my universe, nothing is more enigmatic than you move, you could experience something feet and unsteady on the sliding gravel, what is closest to us – our own nature. We truly remarkable. Like similar numinous I cautiously, and with what I thought know ourselves to be conscious beings, questions, their answers have to do with was great care, placed one foot in front of capable of both abstract thought and realizing our freedom – not through words, the other, simultaneously probing each complicated emotions. But as soon as we but in direct experience. There are many rock and pebble to make certain it would try to say what consciousness is or how it ways to experience true freedom. But, as we not slide. As a result, I repeatedly fell exists, we quickly find ourselves embroiled are about to see, one of the more surprising down. Finally, I gave up all caution and in a morass of philosophical confusion. ways is found in the Buddhist practice of decided to follow my friend’s example. Things are not much different in our walking meditation. With complete abandon and at the same attempts to understand our emotions. But time perfect precision, I ran down the perhaps the most surprising capability that Since Zen Buddhism is not a form of faith- mountain. When a rock slipped under slips through our fingers when we try to based monotheism, strictly speaking it is my foot, I was able to leap in precisely grasp it is our ability to move. Everything not a religion. It can better be understood the right direction so as to never fall or moves. But we are self-movers who have as a practice or discipline designed to break my stride. Without there being no idea how it is that we move. awaken us to the true nature of what is. time for calculation, my body knew The fact that Buddhism is a practice and exactly, with unerring awareness, what For the most part, we move through space, not a religion means that it tends not to be to do. When I reached the foothills, my appropriating gravity, each movement subject to religiosity, filled with unverifiable legs no longer ached and my throat flowing freely into the next, without ever claims, or steeped in dogma. As a result, and lungs were no longer on fire. I was giving it a thought. Generally we do not an examination of the Buddhist practice of exhilarated. A few years later, when I have to think about how we move, we just walking meditation (in Japanese Zen, kinhin) began jogging, I was able to find again

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this joyful freedom that resulted from giving it any thought whatsoever, without moving our body can be understood on the abandoning myself to movement. first willing my arm to move, my whole model of moving an object. Nothing could body participates in a fusion of flesh and be further from the truth. For example, Although this example is a somewhat intention as I simply move my arm to pass picking up our arm is nothing like picking shallow experience of how freedom can arise the salt. Without first willing your arm to up a shovel. When we move an arm, we do in the mundane activity of running, it does move or thinking about it, saturated with the not experience it as picking up and moving give us a tantalizing taste of what is possible. intention to receive the salt, your whole body a separate isolated object. Rather, our entire Notice, the more the student thought about participates in the movement of your arm. body participates in the movement and how to move, the more he fell. His thinking- Your intention to receive the salt and the act we experience the arm’s moving as both self was too present. Finally when he let go of receiving it occur at the same time in the the fulfillment and manifestation of our of all caution, he simultaneously let go of the same movement. intention. Our arm moves in such a way that confines of his self. He stopped thinking, and it orients our whole body unified in an action just ran. He was suddenly free of self. He As our example clearly demonstrates, our saturated with the intention to accomplish was no longer running – he was being run. typical everyday way of moving does not something. We clearly do not experience take place in two phases. At the moment of Looking more closely at the description, our arm as an isolated mere thing that we receiving the salt, your reaching for it and we also discover two ways of moving: mysteriously sling into moving by means your intention to receive it are one and the one that is bound up with thinking too of our will. Movement, flesh, and intention same action. In actuality, intention, flesh, much and another that is free of the self occur simultaneously as one unified action and movement are not separate. Rather, and its fixations. The transformation from involving the entire body as it orients toward they are fused together in one unified action thinking too much to dropping the self is accomplishing something. Movement is the involving the entire body in our attempt the transformation of the one who moves, visible activity of mind. to achieve a certain result. The decision or, what is the same thing, the realization to act and the resulting action occur at the But when all is said and done, the most of freedom. What is the difference between same time in the same movement. In our telling argument against the I-will-it-to- these two ways of running? Who moves? everyday way of moving, the two phases move description comes from the simple Unfortunately, the most common of the I-will-it-to-move theory are collapsed recognition that it ignores our typical understanding of how we move our bodies into one unified activity in which the will experience. Our experience shows us, again does little more than confuse an already to move and the act of moving occur at the and again, that the way we typically move confusing topic. It turns out to be much too same time as the same action. minute-to-minute is not a matter of first narrowly conceived to grasp how liberation willing our body or some part of our body As a way of adding authority to their can arise from the simple moment-to- to move and then moving it. We simply view, some are tempted to dress up their moment free flow of everyday movement. do not always find two distinct phases: an account with a little neuroscience and claim, Since the most common answer is the most act of will and then an action that follows. “First, I desire to move my arm. Then the confused, we need to see through how Just think how peculiar we would look if brain and nervous system take over and it informs our thinking before we try to our walking were dominated by having to move my body.” But no matter how much understand walking meditation. first will each step and then moving. We detail you fill in about how the brain and would look like some sort of herky-jerky nervous system take over, you cannot I Will It to Move marionette. Or perhaps an even better escape the fact that this answer is just a and It Moves example is Jacques Tati’s lovable character, slightly more complicated variation of the Mr. Hulot, whose stop-and-go, haltingly When asked, most people say that moving I-will-it-to-move theory we just looked at. indecisive walking seems to go in multiple is simply a matter of willing yourself Throwing a little science into the mix adds directions at once, as if he were being driven to move and then moving. This answer nothing to its explanatory power, because by seemingly contradictory intentions. amounts to saying that all movement occurs the theory is based on the very same in two phases: first, willing our body to one-sided description. Thinking about Moving move and then moving it. For the purposes of our discussion, we can call this answer Not convinced by the I-will-it-to-move Normally, our minute-to-minute ways the I-will-it-to-move theory. answer but unable to say why, many people of moving are performed as a seamless defiantly throw their hands up and declare, fusion of intention and flesh where the To see why this description does not apply “I just move!” While such a response is desire to move and the resulting act is one to all movement and why it cannot grasp not really an answer, it often expresses the and the same movement, and where each the appearance of freedom in walking suspicion that there is more to moving than movement flows freely into the next. This meditation, let’s look at a simple example. is stated by the I-will-it-to-move description way of moving only happens when we are Imagine we are eating a meal together. With and the frustration that comes from trying not attending to it or not trying to make your first bite you notice that your food is in to describe a whole-body orientation and ourselves move in new ways. The exquisite need of salt. You have the idea, or perhaps movement in which intention and flesh are free flow of movement disappears the just feel the urge, for more salt. You ask me to somehow fused into an inseparable unity. minute you think about it. Furthermore, pass the salt. My decision to pass the salt and The I-will-it-to-move view probably attending to our movement while moving the act of passing it occur simultaneously is usually an indication that something as one and the same movement. Without seems suspicious to many because it also suffers from the unspoken assumptions of is wrong or that a movement is new to thinking about what I am doing, my eyes us. Consider how much we have to think find the salt and my hand follows. Without metaphysical dualism: mind and body are two separate and distinct entities and that about what we are going to do before we

www.rolf.org Structural Integration / June 2013 41 PERSPECTIVES do it when we are recovering from injury discipline of phenomenology is much more reflective experience that we, either through or learning a new dance step. suited to the job of understanding these two self-deception or lack of interpretive skill, forms of movement. misinterpret to ourselves and others Thus, the kind of movements partially in reflection. Self-deception is a willful captured by the I-will-it-to-move theory are, Consider some examples. Suppose you reflective misinterpretation of pre-reflective for the most part, performance difficulties are completely engrossed in a game of experience that we convince ourselves to be that require our thought before movement. basketball, or in the midst of giving an true over time. What the I-will-it-to-move description inspired performance of a piece of music, or also brings to light is that movements that lost in the beauty of a flower, or frightened The pre-reflective/reflective distinction involve performance difficulties have two by a loud noise. In each of these experiences does not just apply to what we call mind. phases. The first phase is about the intention you are orienting pre-reflectively. You are Properly considered, it applies to the to move in a new way, and it usually not thinking about what you are doing, orientation of our whole being, body and involves planning and thinking about how yet you are not unconscious. You are all. We can reflectively think and act on our we are going to move. Although there is a conscious and aware and can easily recall experience. We can also pre-reflectively tendency to construe the first phase as the your experience. Even though you are not assess our present situation and move cause of movement, a moment’s reflection thinking, you are consciously participating toward or away from whatever is coming reveals that it is actually the reason for it. with what is unfolding. our way, and never give it even one The second phase is practicing and trying thought – except later when we reflect on Later, in reflection, when you separate to move in the new way. what happened. from lived-experience, your self appears Oddly, even though the moment-to-moment, and you think about what happened. Your At this point in our discussion, it is probably free flow of one movement into another is our descriptions usually take place in the past already clear how the pre-reflective/reflective most common experience of movement and tense and the words “I” or “me” typically distinction applies to our two forms of the one closest to us, it is also the movement show up in your descriptions. Reflecting movement. Our ubiquitous experience of the we have the most trouble recognizing and on your experience, you might say, “That free flow of moment-to-moment movement describing. Part of the reason we have was the best performance I have ever given. is properly understood as a pre-reflective trouble getting a handle on it is because it Did you hear the quality of tone I was able experience. The two-phased movement is the kind of movement that only appears to achieve?” About appreciating the beauty that we uncovered through investigating when we are not attending to it. You cannot of the flower, you might comment on its performance difficulties is a clear example of think about this kind of movement and do it. color or fragrance. You might describe in reflective experience. You can only live it. The moment we attend some detail the most exciting moments in to it, it disappears and becomes an object of the basketball game. When you think about Moving without Self scrutiny for reflective thought, and the more or reflect on pre-reflective experience, you Many of us spend so much of our days we think about it, the less free our movement step out of the flow of lived experience and thinking about this and that that we becomes. Unlike performance difficulties objectify it. completely miss the flow of pre-reflective (such as learning how to dance or walk The word “object” means “that which is moment-to-moment freedom of movement after an injury) that require thinking about thrown before” and the word “subject” that is, for the most part, our constant how we are going to move, the ubiquitous means “that which is thrown under.” experience. If you dig yet deeper into the free flow of movement that fills our days In reflection we become a subject kind of movement that does not involve requires just the opposite – that we do not contemplating an object. We find ourselves thinking, you will also discover that there think about it. For the most part, however, no longer participating with what is is no enduring self or entity that moves we are only vaguely aware of the unified free unfolding, but rather separate from and your body. As we make our way through flow of the whole body in movement. As a thinking about our experience. We find the world dealing with the obstacles and result, we tend to miss just how exquisite ourselves “thrown under” the dominion difficulties along the way, nothing seems our moment-to-moment flow of movement of an object that is “thrown before” us. more certain than that I am the mover of can be and how much of our days are alive Pre-reflective experience, therefore, is my body. But if you try to locate the mover with it. both pre-subjective and pre-objective. of your body, you cannot find it. The more It’s Not Unconscious Either In reflection as we separate ourselves we consider this question about who moves from lived-experience, the participatory the body, the more ridiculous it seems. How Interestingly, our rather circuitous understanding of pre-reflection falls apart can it be that there is no self that moves my investigation into the experience of self- into the subjective and the objective. body when it is so obvious that I am the movement has revealed two ways of mover of my body? Who is the mover, after moving. One way requires thinking about The pre-reflective/reflective distinction is a all, if not me? how we are going to move before we actually philosophical distinction. It is not, therefore, Even when faced with the inability to find move, and the other more ubiquitous way the same as the psychological distinction a continuous self-subsisting self, the claim of moving occurs in the absence of reflective between the unconscious and conscious. that there is no continuous self that moves thought. The observation that our free The pre-reflective is not the unconscious the body still seems wildly counterintuitive. minute-to-minute movement does not mind and the reflective is not the conscious But look again. Nowhere in your pre- involve thinking suggests to some that mind. The psychological distinction is more reflective experience of the free flow of it is unconscious. But as it turns out, the narrowly conceived than the philosophical. moment-to-moment movement do you reflective/pre-reflective distinction from the The unconscious is that aspect of our pre- find a continuous self-entity that moves

42 Structural Integration / June 2013 www.rolf.org PERSPECTIVES your body. There is just the pre-reflective intentional whole. It is not a thing we and the tree, and there is no pre-reflective or orientation of your body, fully aware, inhabit, but a condition for inhabiting reflective orientation. But, in the next instant assessing and negotiating its way through things. Because it is deliquescently graced when your self resurrects commenting on the obstacles, joys, and difficulties of its with mind it is capable of assessing, the magnificence of the tree, a distance and world. There is no separate self-subsisting negotiating, and making its way through a difference manifests between you and the self doing the movement. There is only the the world without engaging in reflective tree. Even when you are looking at the tree inseparability of intention and flesh, where thought or presupposing a self-entity. When pre-reflectively, a sense of a distance and a the intention to move and the act of moving all is said and done, you are not other than difference still exists between you and the are simultaneously manifesting in one and your body. And, of course, it is you who tree. But when we return to zero, we are the same movement. moves your body – it’s just not by means of completely one with the tree, the reflective a self-entity or any kind of continuous self. and pre-reflective have disappeared, and Our movement mostly occurs at a pre- there is neither distance nor difference. reflective level where the intention to move KABOOM! and the actual movement are experienced as Unfortunately, we all too easily lose track one and the same action. At the pre-reflective With the recognition that there is no of how we become one with everything level, there is no reflective self in play: there self-entity moving our body, we seem to and mistakenly believe that our self is an is only pre-reflectively conscious, intelligent, have arrived at a fundamental insight of enduring entity that is the essence, center, purposeful moving. Later when you think Buddhism concerning the existence of and foundation of what we are. Just as we about or report on what you were pre- the self. But let’s look more closely. The mistakenly perceive our self to be an entity reflectively doing, you introject a self into Buddha’s discovery actually goes to the having duration, we also we mistakenly your experience. You say, “I moved,” and very origin of self and world and, hence, perceive our body and all existing things falsely believe your reflective self was there to the origin of the pre-reflective and as having a self-subsisting nature that all along. But clearly, a reflective self cannot the reflective. As a result, pre-reflective endures. This mistake is at the heart of be present in pre-reflective movement. experience and the Buddha’s experience our suffering. cannot be the same. But, as we are coming to Your self is neither continuous nor any kind see, sometimes something as simple as pre- Why Did Bodhidarma of entity. Other than where your body is, reflective walking can transform itself into Walk to China? your self has no specific location. There is a numinous experience of the source, thus no internal control center where it sits and demonstrating how pre-reflective activity When our everyday pre-reflective moves your body. Instead, your body is can be a gateway to freedom. movement is practiced as a form of saturated with mind and intention. Mind meditation, it can grant us access to the and body are implicated in each other. Whether we realize it or not, we and the Zen experience of freedom and allow us to Even at the pre-reflective level your bodily totality of what is are always returning to know that we are dying and resurrecting in orientation and movement is infused with zero, dissolving into oneness, and being love moment by moment. Zen Buddhism is an awareness of your surroundings as you reborn. Imagine you are leisurely walking not a faith-based religion or a philosophical make your way through our shared world. down the street. Suddenly and without system. Since it is a non-dogmatic, practice- warning, a car backfires behind you. based discipline that emphasizes first-hand Thus, the answer to the question “Who KABOOM! For an instant, you and the experiential verifiability, it is an ideal moves?” becomes more transparent. On kaboom, time and space, subject and object, practice for studying walking meditation. the one hand, if you mean by “self” a become one. At zero, there is no self in place Zen is an intense course of study involving continuous self-subsisting entity, then to record the passage of time. Then, just as a number of practices, including long hours there is no such thing that moves your suddenly as everything became one, your of sitting meditation (zazen) punctuated body. On the other hand, if all you mean self reappears and you begin thinking about with walking meditation. by “self” is the non-continuous sense of what just happened. “Oh man! I thought identity that only appears when we reflect that was a gun being fired.” The practice of Zen is not designed to on our movement or experience, then the provide the practitioner with a comforting manifestation of a reflective self when In the same way you died and resurrected set of beliefs or an alternative explanation we are having performance difficulties or with kaboom, throughout your day, in the of the nature of reality. Rather, it is designed thinking about our movement is how self very first moment of meeting the things and to offer an alternative to explanation by primarily appears in movement. Otherwise, people of your world, you instantly become allowing the practitioner to solve the riddle there is very little in the way of a reflective one with them and then just as quickly of life based on his own direct experience self involved in moving our bodies. separate. When you were strolling down of reality.1 In a sense, the practitioner wakes the street you were sometimes orienting up to the way things truly are and his place We easily recognize how we structure our pre-reflectively and sometimes reflectively. in all of this. The practitioner develops the day-to-day activities by means of reflective But when the car backfired, all sense of self, ability to know the love that permeates the thought, but are mostly oblivious to the role identity, as well as your pre-reflective world cosmos and manifest the wisdom that knows the pre-reflective plays in our day-to-day simply disappeared in oneness and love. the activity of the source. He knows it not activities. As a result, we almost entirely because he believes it or has theory about it, overlook the kind of bodily intelligence that Whether we realize it or not, it is the same when we first meet anything. For example, but because he has a direct experience of it. is always at work in our daily life. Although This kind of knowing sets him free. we do not normally associate thinking with in the very first moment you see a tree, you the body, our body is a psychobiological and the tree become one. As a result, there is Walking meditation is an important part no distance and no difference between you of everyday practice in the Zen monastery,

www.rolf.org Structural Integration / June 2013 43 PERSPECTIVES and was also incorporated by the Buddha warning, something shifted in me. Up It is useful and instructive to realize how into his daily practice. How far back before until that moment I felt as if I were this description differs from our usual the time of the Buddha this practice goes, confined in a completely oppressive ways of walking. Clearly, the I-will-it-to- nobody knows. What we do know is that space, burdened with numerous aches move description does not even begin this simple practice can often have profound and pains and emotional traumas and so to capture being-walked. But even our results, especially when it is combined with exhausted that I could barely see straight. pre-reflective consciousness can be so other practices, such as sitting meditation. Then, suddenly I was wide awake, swamped with feeling that it obscures feeling as though I were completely the potential for freedom that lives in the There are many benefits that come from at home, unburdened and alive, full heart of our everyday ways of moving. walking meditation. Zen retreats are usually of peaceful clarity, and luxuriating in To make the point with an extreme seven days long, with each day often the expansiveness of the softest, most example, consider the plight of a paranoid beginning at three o’clock in the morning and spacious energy imaginable. I felt free person who is condemned to feeling his ending around nine or ten o’clock at night. for the first time in my life. My mind paranoia pre-reflectively. After a few days of this daunting schedule was like the great expanse of the sky. My your legs, back, and other structures can Whether we walk by ourselves or with consciousness was no longer dominated start to ache, spasm, or fixate. Walking can others, whether in the city or hiking by thinking. There was no me doing the help to alleviate or ameliorate these kinds a mountain trail, instead of just being walking. It was as if something much of problems. It also can help keep the joints walked, we find ourselves occupied with vaster had taken over and was doing of the low back (lumbar spine and sacroiliac endless concerns, ideas, plans, worries, the walking. I was enraptured by the joints) mobile and free of pain. But one of anticipations, and random thoughts. We mere act of walking. I was not walking the more important purposes of walking are often so caught up by the flow of – I was being walked. How could I have meditation is to bring the experience of thoughts and concerns that we barely even passed over this way of walking in my sitting meditation into action. register the fact that we are moving with day to day life? I remembered similar utter freedom as each movement flows As a way to take our second tentative step experiences when jogging. But that was unencumbered into the next. Whether we toward understanding how freedom can nothing compared to the freedom I was realize it or not, moment by moment, one manifest through walking, let’s look at how experiencing now. step after another, we are appearing and it showed up for a beginning Zen student: Walking free of the fixations of my disappearing, dying and resurrecting with After twenty five hours of travel and self brought with it the most delicious the totality of what is in the free flow of one a sleepless plane flight, I arrived in sense of freedom I had ever experienced. movement into another. Japan at seven o’clock in the morning Moment by moment, step by step, the dead tired. My good friend was there to in-here and the out-there turned out Gateway meet me. We had to run errands all over to be the same here. Step after step It is possible to wake up to the wonder of Tokyo and arrived at my friend’s house I was being walked free of all cares what is always happening – provided you late that night. I was so depleted that I and troubles at every level of my are willing to surrender to your everyday could not form words anymore. I fell in being. I felt clear and bright, as if my way of walking so completely that you bed totally exhausted. entire being had undergone a profound perceive how the true state of affairs comes cleaning, and was subsequently filled We rested the next day and on the to presence in the ordinary. You will not with the greatest sense of freedom following day set off for my first Zen find this freedom in pre-reflective action imaginable. Instead of resting during retreat. I was still quite exhausted and alone. But as we have repeatedly seen, the breaks, I spent every remaining somewhat worried by the thought of pre-reflective action can be a gateway to rest period in walking meditation, getting up at three o’clock in the morning the freedom of being-walked. If you give allowing myself to be carried away by for seven days. The retreat turned out to yourself over completely to pre-reflective being walked. be more difficult than I had ever imagined action, then, right here, right now, in the possible. The pain in my legs from sitting Right here, within our everyday way of simple act of walking you can become the cross-legged was intense and it was all I moving, is an ever-arising, utterly simple effortless peace of being-walked and know could do to stay awake. way to realize our freedom and place in all the boundless freedom and unencumbered of this. Even though this experience was love that appears when you become one Even walking meditation was difficult. just the beginning for this Zen student, with the numinous activity of the source. This particular temple supplied straw it rather dramatically demonstrates how sandals that we were required to wear Endnotes the mundane activity of walking can be during walking meditation and walking transformed into a profound experience 1. The idea of providing an alternative to in the temple. Unfortunately for me, of freedom. He had the advantage of explanation comes from Henri Bortoft’s the largest were half the size of my foot. beginning his retreat exhausted, and at explication of Goethe’s qualitative science Walking in them was quite painful and the end of his rope. The retreat pushed of nature. I appropriated his phrase in awkward. As a result, I had trouble him beyond his limits, he held on until he order to make an important point about the staying in step with the kinhin line. couldn’t any longer, and then he simply nature of Zen practice. In so doing, I have Exhausted and in pain, I kept at it. let go and surrendered his limited human changed its original meaning. See Bortoft’s On the morning of the third day during perspective – thus demonstrating how The Wholeness of Nature: Goethe’s Way toward walking meditation, quietly and without something as simple as walking can a Science of Conscious Participation in Nature. profoundly open the doors of freedom. New York: Lindisfarne Press, 1996.

44 Structural Integration / June 2013 www.rolf.org REVIEWS

analysis of methodology and relationships; understanding of the normal, and Mintz Reviews details of structure; questions to ask; things discusses the realities that make Rolfing to do; encouragements and admonitions. SI such a formidable healing process. It has long asides covering various aspects Removing all other influences on the work, Structural Integration of anatomy, physiology, body systems, it makes it quite clear why Rolfing SI is by Andy Crow, fascia, gravity, energy and mass, thixotropy, not osteopathy, not craniosacral work, not Certified Advanced Rolfer™ symmetry, and even chapters on business physical therapy. It demystifies “mystery (Crown-Omega Publishing, 2005) and ethics. The book is massive in its scope. school” concepts.

Reviewed by Allan Kaplan In reality, it would take far more than T h i s b o o k i s Certified Advanced Rolfer™ an hour to cover all Crow suggests in a very logical in session: that’s where the art and experience its organization. When I did my basic training in Rolfing® come into play, discerning what is actually Numerous arcs Structural Integration (SI) back in the necessary and appropriate for that client at get launched that 1980s, we students amassed binders full the moment, and what will be evoked and neatly wrap up. of photocopies of notes and outlines evolve with what Peter Melchior called “the It builds nicely of the “Recipe” from previous classes. element of time.” So, while the book is not a from one concept At that point, our canon consisted of substitute for experience, it can be a useful tool to the next, and typewritten notes from a few classes by for the novice or experienced Rolfer. it has a profound Emmett Hutchins, Peter Melchior, Tom conclusion. Mintz Crow’s style is unique: it’s a mixture of tongue- Wing, and Stacey Mills, as well as other has clearly thought fundamental Rolfing in-cheek humorist, evangelist, and carnival miscellaneous cheat-sheets that were concepts through to a very deep level, barker (sometimes reminding me of the label floating about. The next generation of indeed to a masterful level. I was familiar on a bottle of Dr. Bronner’s Pure-Castile Soap fledgling Rolfers referred to Clinton with the concepts, yet he deepened my shouting “18-in-1 Uses! We’re All-One Or Kramer’s “A Searcher’s Handbook,” another understanding. Many of the ideas in the None!”), which might not be for everyone. oft-photocopied document of class notes Rolfing world that I previously thought Don’t get me wrong – Structural Integration from the era. And now, there’s Andy Crow’s of as frustrating and incomprehensible really is bulging with valuable info, but the Structural Integration. mythic lore are now usable in my Rolfing author’s obvious enthusiasm for his subject, C r o w h a s room because of his lines of thinking and embroidered freely with “Rolfian” dogma and p r o d u c e d a simple explanations. myth, may be overwhelming to some (excerpts nearly two-inch- from the book on his website give a feel of its You may not agree with all of the ideas thick brick of flavor). Speaking from the standpoint of a in the book. I didn’t at first, but soon felt better than five technical editor, I think Structural Integration compelled to rethink each contentious hundred pages would benefit from a round with a keen editor idea. As the logical progression played that is born of the who could condense, clarify, and focus some out, each idea made more sense. I was very halcyon days of of its repetitiveness, still pounding away with moved by the discussion titled “The Next Rolfing SI, back Crow’s points without sacrificing his personal Generations” (starting on page 115), about in the late 60s and voice and intention. But as it stands, it’s still a Ritchie’s version of how the work might early 70s when wealth of info and a reminder of the origins of be taught. today’s senior guard was a bunch of young our work. (Structural Integration is available devotees of the master, Dr. Ida P. Rolf. This book is also for the SI community as a from www.andycrow.com.) From testimonials by others who were whole – beginners to advanced practitioners. there, Crow’s eyewitness account gives It has the potential to heal philosophical rifts. an accurate, honest feel of the times and Foundations of It does this not by arguing a philosophy but teachings in the Rolf community of the Structural Integration by presenting in depth the basic phenomena era. His book is chock-full of the words of that allow SI to occur. In whichever camp you Dr. Rolf and a spectrum of the old-timers, by Ritchie Mintz, have pitched your tent, you will see that as as well as relevant quotes from a multitude Certified Advanced Rolfer™ you do your style of SI, you are doing what is of others, such as Newton, Einstein, (self-published, 2012) described in this book, truly the “foundations of structural integration.” There has been a Confucius, Aristotle – you name it. Reviewed by Wiley Patterson, M.D. Certified Advanced Rolfer™ long-standing lack of clarity regarding these At its heart, Structural Integration is a concepts, and I believe it has led to decades teaching tool, a great addition to any basic Ritchie Mintz’ Foundations of Structural of contention within our community: there’s class. As Crow puts it, “This book is not a Integration is designed especially for nothing like the truth stated clearly to ‘how to do it’ book. It is not a manual. It beginning structural integrators. It talks clear up misunderstandings. (Foundations is more than that. This book is a process.” about basic Rolfing Structural Integration of Structural Integration is available from Indeed, it is his version of the Gospel of (SI) theory and covers in-depth many of www.RitchieMintz.com.) Ida, with his own impressions added for the mysterious koans that baffle beginning good measure. The bulk of the book is an Rolfers, such as gravity buoys us up and outline of the Recipe, with repetitions of lumbodorsal hinge. It is quite powerful in its its protocols, session goals, and hallmarks; simplicity. Rolfing SI requires a profound

www.rolf.org Structural Integration / June 2013 45 INSTITUTE NEWS Online Registration Now Open Conference Entrance Fee Standard Rate $375 (Friday Evening, Single Day and Social Ticket rates also available.) Register by mail, by fax or online at member.rolf.org, For assistance, contact: Membership Services Phone: (800) 530-8875 x102 Email: [email protected] Conference Speakers and Events Friday evening, August 9, 2013 Meet & Greet Social followed by the Opening plenary session featuring Jeff Maitland, PhD, CAR Saturday, August 10, 2013 Morning plenary featuring Dr. Stephen Porges, PhD

Sessions featuring Karl Humiston, MD, CR Tessy Brungardt, CAR Cathy Ulrich, DPT, CAR Dr. Stephen Porges, PhD Brooke Thomas, CR Lidia Garner, RN, MS, CWCN, COCN

Wine & Chocolate Tasting Saturday Evening Dance Party Sunday, August 11, 2013 Morning plenary featuring Karl Humiston, MD, CR

Sessions featuring: Dr. Georgette Maria Delvaux, DC, CAR Ellen Freed, CAR Keith Economidis, MSOM, L.Ac., NCTMB, CAR Master Chen The Hotel Boulderado Use Booking ID 12047 for Conference Rates Reservation Line: (800) 433-4344 Conference room rates for a single night range from $189-$325. Other lodging options available at www.boulderlodging.com 46 Structural Integration / June 2013 www.rolf.org INSTITUTE NEWS Congratulations to the New Graduates

USA – December 2012 Faculty: Bethany Ward (Instructor), Robert McWilliams (Assistant) Students: Nir Ben Or Tiomkin, Anne Bruce, Deb DeAngeles, Zachary Frank, Yuichiro Fujiwara, Danielle Lafaille, Emily Moody, Mayuko Nakashima, Maya Ray-Schoenfeld, Bill Stiefel, Stephanie Thurman, Stephen Waddell ABR – December 2012 Faculty: Paula Mattoli (Instructor), Alfeu Ruggi (Assistant) Students: Rachel Ceschin, Patricia O. Gonçalves Zamparini, Susana Z. Granzotto dos Reis, Maria Cecília F. Raphael, Patricia Carla de S. Amaral, Valéria de Sales Lima, Renata Sartori, Makiko Tsujimoto ABR-Bali – December 2012 Faculty: Raquel Motta (Instructor), Gillian Kok (Assistant) Students: Kasper Anderson, Laura Covington, Yee Fen Gan, Sook Fun Chen, Robert Gadjoš, Narvir Kaur, Hooi Koon Ong, Frederic Le Minez, Naoko Mori, Jeff Otto, Ross Paulovich , Leo Righi, Sarah Robarge, Akiko Shinohara, Audrey Yeoh, Jamie Yoon USA – March 2013 Faculty: Ray McCall (Instructor), Robert McWilliams (Assistant) Students: Jillian Ardoin, Brandon DeWane, Kelly Diamond, Hyrum Feriante, Dixie Frank, Shinichi Izuchi, Fiona Lauer, Shinichiro Miyagawa, Beth Pagel, Kyle Rawlins, Susie Shults, Andrea Sutcliffe, Torrey Trover, Lacie Wortham ERA – March 2013 Faculty: Giovanni Felicioni (Instructor), Fuensanta Munoz de la Cruz (Assistant) Students: Alberto Almazán Tavero, Abdelghafour Ben Brahim, Peter Bollinger, Martin Egeberg, Satomi Furukawa, Cathy Heitz, Wojciech Karczmarzyk, Richard Loiseau, Tiziana Lunardi, Janine Margelisch, Fabio Palma, Juusi Pellonpää, Marta Pichardo Rodriguez, Laurence Tison, Ruxandra Tomescu

Is it possible that the foundational ideas of SI are actually quite simple?

Structural integration is not a technique or series of techniques. It is a vision of the body’s design. It is a thread of ideas about how the human body structure can achieve the evolution of millennia in 10 hours. No other modality or discipline I know of on Earth offers this tantalizing possibility. This book is the story of how human bodies, my own and countless others, show up for me. It is intended to be a conversation that asks more questions than it answers and invites new worlds of speculation about what the human body is and how we can evolve it to higher levels of function. What goes unrecognized and unappreciated is that the underlying source of most structural pain is the collapse of the body structure in gravity. This requires a new way of seeing and understanding. With any luck, the 21st century will provide the space for a new definition of what it means to have a “together” body. We need a way of explaining structural integration to ordinary Foundations of Structural Integration everyday people in an ordinary everyday manner. It is time to say by Ritchie Mintz our Mass in plain English. When we can do that, Ida Rolf’s dream that her ideas would permeate the culture will be reality. That is the Self published, illustrated, 124 pgs. space that can generate the large number of practitioners that we, $29.95 + s/h as a planet, need in order to achieve the leap of evolution that is available for us. Foundations of Structural Integration contributes www.TXschoolforSI.com to that future. Free sampler download

www.rolf.org Structural Integration / June 2013 47 INSTITUTE NEWS Class Schedule

BOULDER, COLORADO HOLDERNESS, NEW HAMPSHIRE GERMANY

Phase I: Foundations of Rolfing® Rolf Movement Certification: Phase I Structural Integration Rolf Movement Teacher Practicum July 7 – August 17, 2013 June 10 – July 22, 2013 July 16-22, 2013 (no July 19) Instructors: Rita Geirola, Konrad Obermeier, Coordinator: Adam Mentzell Instrutors: Kevin Frank/Gael Ohlgren Giovanni Felicioni September 2 – October 14, 2013 Rolf Movement Certification: Phase II Coordinator: Michael Polon Orientation, Perception, and Resonance October 7 – November 29, 2013 Phase I: Accelerated Foundations of August 22-28, 2013 (no August 25) Instructor: Pierpaola Volpones Rolfing Structural Integration Instrutor: Kevin Frank Phase III July 28 – August 10, 2013 Instructor: John Schewe LOS ANGELES February 10 – April 3, 2014 Instructor: Harvey Burns Phase II: Embodiment of Advanced Training Rolfing Structural Integration & Rolf Movement® Integration November 4-21, 2013 SOUTH AFRICA March 10-27, 2014 April 1 – May 23, 2013 Instructor: Jan Sultan w/Lael Keen Unit I Instructor: TBA Principles Instructor: Jane Harrington September 9-27, 2013 & October 7-25, 2013 BALI Instructors: Marius Strydom/Michael Polon April 1 – May 23, 2013 Instructor: Thomas Walker Phase II: Embodiment of Unit II Principles Instructor: Mary Bond Rolfing Structural Integration ® August 19 – October 10, 2013 & Rolf Movement Integration April 7 – May 30, 2014 Instructor: Thomas Walker / Michael Murphy Instructor: TBA May 6 – June 27, 2013 Principles Instructor: Carol Agneessens Instructor: TBA Unit III October 21 – December 19, 2013 Instructor: Bethany Ward Dual Training Phase III: September 1 – October 24, 2014 Principles Instructor: Jon Martine Clinical Application of Rolfing Theory Instructor: TBA & Rolf Movement Certification Phase III: Clinical Application of Rolfing Theory October 7 – December 12, 2013 Instructor: TBA June 17 – August 9, 2013 Instructor: Kevin McCoy Anatomy Instructor: Jon Martine BRAZIL October 21 – December 20, 2013 Unit III w/ Rolf Movement Integration Instructor: Larry Koliha Anatomy Instructor: Michael Murphy March 4 – May 9, 2013 Instructor: TBA Advanced Training

May 20, 2013 – June 7, 2013 August 19-30, 2013 Instructor: Ray McCall w/Jon Martine

Rolf Movement® Certification: Cranial Sacral, Neural Remapping and Rolf Movement Integration

October 14-19, 2013 Instructors: Jane Harrington/Suzanne Picard

48 Structural Integration / June 2013 www.rolf.org Contacts

OFFICERS & THE ROLF INSTITUTE® EUROPEAN ROLFING BOARD OF DIRECTORS 5055 Chaparral Ct., Ste. 103 ASSOCIATION E.V. Boulder, CO 80301 Patricia Pyrka, Executive Director Kevin McCoy (Faculty/Chairperson) (303) 449-5903 Saarstrasse 5 (262) 337-1530 (800) 530-8875 80797 Munchen [email protected] (303) 449-5978 fax Germany www.rolf.org Peter Bolhuis (At-large/CFO) +49-89 54 37 09 40 [email protected] (303) 449-2800 +49-89 54 37 09 42 fax [email protected] www.rolfing.org ROLF INSTITUTE STAFF [email protected] Audrey McCann (Eastern USA/Secretary) Diana Yourell, Executive Director (443) 850-2728 Jim Jones, Director of Education JAPANESE ROLFING [email protected] Vanessa Gordillo, Assistant to Education Heidi Hauge, Manager of Membership ASSOCIATION Nicholas French (Western USA) Gena Rauschke, Accountant Akiko Shiina, Foreign Liaison (214) 357-7571 Trace’ Scheidt, Enrollment Manager/ Omotesando Plaza 5th Floor [email protected] Financial Aid Officer 5-17-2 Minami Aoyama Minato-ku Tokyo, 107-0062 Benjamin Gunning (Central USA) Ray Viggiano, Clinic Coordinator Japan (414) 336-8107 Linda Weber, Office Manager www.rolfing.or.jp [email protected] Carah Wertheimer, Admissions Advisor Susan Winter, Manager of Marketing & PR [email protected] Michael Murphy (Faculty) (650) 559-7653 AUSTRALIAN GROUP CANADIAN ROLFING [email protected] The Rolf Institute ASSOCIATION Maria Helena (Lena) Orlando 5055 Chaparral Ct., Ste. 103 Kai Devai, Administrator (International/CID) Boulder, CO 80301 615 - 50 Governor’s Rd. +55-11 3819-0153 USA Dundas, ONT L9H 5M3 [email protected] (303) 449-5903 Canada (800) 530-8875 (416) 804-5973 Hubert Ritter (Europe/Past Chair) (303) 449-5978 fax (905) 648-3743 fax +49-30-4435 7473 www.rolfing.org.au www.rolfingcanada.org [email protected] [email protected] [email protected] [email protected] Wanda Silva (At-large) (904) 294-3335 ® [email protected] BRAZILIAN ROLFING ASSOCIATION EXECUTIVE COMMITTEE Dayane Paschoal, Administrator Peter Bolhuis R. Cel. Arthur de Godoy, 83 Kevin McCoy Vila Mariana Audrey McCann 04018-050-São Paulo-SP Brazil EDUCATION EXECUTIVE +55-11-5574-5827 +55-11-5539-8075 fax COMMITTEE www.rolfing.com.br Valerie Berg, Chair [email protected] Duffy Allen Ellen Freed Russell Stolzoff Rebecca Carli, Rolf Movement® Faculty Sally Klemm, Advanced Faculty Ray McCall, Interim FDRB Liaison Michael Murphy, Faculty Rep to the Board Suzanne Picard, Phase I Faculty Pierpaola Volpones, ERA Non-Profit Org. U.S. Postage PAID Boulder, CO OF STRUCTUR A L I N T E G R ATIO N Permit No. 782 5055 Chaparral Ct., Ste. 103 Boulder, CO 80301