Taking Care

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Health providers encourage patients to  “take care.”  Taking care should be empowering and not another burden to carry. When you actively take care of yourself, it does not mean that you are letting the practitioner dump everything on you or that you are expected to handle confusing and distressing medical issues by yourself. It means the provider is handing the gift and responsibility of well-being back to you.

Calibration
A good health provider can model caring by the way they calibrate the modality that they practice.  Here are examples of how a therapist can hone your self-care, drawn from two of the modalities that I most rely on: Massage Therapy and Qigong/Tai chi.

Massage
Massage therapists use touch to shine a spotlight on places of dis-ease, but more importantly, to shine the light of awareness on places of “ease” in your body. After a series of sessions your ability to feel and take refuge in places that feel good increases. Those body regions of refuge expand after repeated sessions, while areas of discomfort become less intense and smaller as they diffuse and are absorbed into healthier tissues. The most effective massage therapists will never make you grimace through painful pressure. They know that you are far more likely to experience longer lasting and quicker acting results when they massage right up to the edge of tension without forcing past. This technique establishes awareness and the possibility of release without increasing tension, strain and pain. After experiencing the ease with a professional, you may find that you can get in touch with your body in a new way using your own hands. You may even be able to feel the knots melting underneath your hands, or your own energy pulsing beneath your fingers, as it releases. And you may want to reinforce this knowledge by having your therapist give you a good working over. Let this become your once-a-month, twice-a-month or weekly treat to take care of yourself.

Qigong/Tai chi
Qigong/Tai chi is a movement meditation enhanced with imagery. At its most basic level, Qigong is a practice of following  the continuously changing sense of life force energy as it moves through you. Self-practice reinforced with weekly or biweekly group practice/classes are ideal to build Qi (energy) and one’s connection with self, others, and nature. A good Qigong coach teaches and encourages you with this loving practice.
The word master, as in “Qigong Master” is somewhat intimidating – it implies a lineage that has been passed down and teachings that cannot be adjusted in any way. However, Qigong literally means “energy work” (Qi = energy and gong = work, so we’re actually learn to “gong our Qi”). This energy work is an iterative process, and naturally changes over time by the people who put it in to practice. The best Qigong coaches or tai chi instructors encourage students to develop a solo practice that meets their individual needs.
For example, when I practice the pose “Carry tiger to the mountain” and feel the incredible release in my body as my hands reach up to release my burden/the tiger’s spirit into the sky, that body sensation is how I understand the form.  The pose “Holding up two mountains” is honed to my exact needs when I feel just how much to extend my arms in order to express “right place, right time”.
I am not the first to adapt Chinese movement forms for personal needs. The Yang family adapted Tai chi to reflect a health generating form from the twisting, powerful Tai Chi movements expressed by the Chen family. Qigong and Tai chi were the original Chinese medicines, before acupuncture, before herbs. Movement practice doesn’t depend on any outside substance or procedures– just an increasing trust of one’s own body and how it wants to move.

Compassion
Once you have chosen therapeutic modalities to support your unique needs, what else does taking care mean? In colloquial language, “take care” is often used to mean “WATCH OUT!!!” Sometimes when you leave on an airplane, friends and family cry out: “Take care!” They really mean: “Take care not to get killed on the airplane! Take care not to get hijacked!” However, taking care is so much more than a warning. Taking care can be like the soft brush of a mother’s hand on your cheek. Say to yourself: “There, there, I know it hurts, but I am here for you.” You can be your own best friend on the journey towards wellness.

Most of us are nicer to everyone else than we are to ourselves. When we practice accompanying ourselves with love and kindness throughout the day, whether things go well or not, it can translate into all sorts of benefits, some tangible, some not. This loving practice can build a resiliency to carry us through to the next thing in our lives.

Taking care of yourself compassionately can be the intentional path to try the next step proposed by a practitioner even if it seems scary or strange. Taking care can involve following through on exercises or lifestyle changes that support the healthier you. And taking care can be giving yourself a break when you are sick of only eating rice and vegetables every day and decide to splurge on a piece of chocolate for a special occasion!

Communication
Taking care is not blindly letting a therapist dictate significant lifestyle changes. Patients are not empowered when a doctor simply hands out a bunch of pills, although sometimes medications can be a necessary jump start towards wellness. Similarly, people don’t feel stronger when handed out a bunch of prescriptions of what they have to do – for example, lots of exercises or food restrictions without consideration of how to implement the lifestyle changes in real life. No one can live on kale salad and mushrooms alone or 3-6 hard hours of cardio every day—unless it gives them joy.

In my mind, dogged adherence to rules is little better than downing a bunch of drugs. Asking hard questions of my practitioners about how I can do what I am asked to do makes me feel stronger. Communication is empowering.

Choice
Last but not least, taking care involves exercising choice. The power of expectation and choice is illustrated by one of my favorite research studies, ever. Kalauokalani, D. et. al. (1) studied 135 patients randomized to receive either massage or acupuncture as treatment for low back pain. Before being assigned to either group, participants were asked to describe their expectations regarding the helpfulness of each treatment on a 1 to 10 scale. Patients who expected that massage would help more than acupuncture were more likely to feel better with massage, and vice versa. General expectations about getting well did not effect how well patients recovered. This study demonstrates the importance of selecting how you care for yourself.

In summary, taking care involves lots of “ vitamin Cs” :

  • Calibration or fine-tuning knowledge about your body,
  • Compassion and self-kindness,
  • Communication,
  • Choice

The last “C” is for Continue.  Continue to apply any and all Competencies you gain.

(1) Lessons from a Trial of Acupuncture and Massage for Low Back Pain, Kalauokalani, D., Cherkin, D.C., Sherman, K.J., Koepsell, T.D. and Deyo, R.A. SPINE volume 26, Number 13, pp. 1418-1424 (2001)