May 9, 2024 • 51 mins
Forrest and Monica, two therapists from the town of Nelson, BC, join me to discuss the manual therapies like osteopathy, massage, and acupuncture. They share their journey from education to practice. With their stories, we have a look into the art of listening and communicating, and how these skills contribute to effective patient care.
Our discussion explores the evidence and anecdotes behind manual therapies, as we consider the challenges of marrying traditional techniques with modern evidence-based practice. With Forrest and Monica's experiences, we illuminate the significant role of human touch in evoking therapeutic responses, and how it serves as a common thread across different therapeutic disciplines. Additionally, we'll navigate the intricacies of creating a calming clinic atmosphere that promotes wellness and the importance of your approach in eliciting a desired response in patients.
Lastly, we debate the delicate balance between ethics and compassion, sharing personal stories that highlight the power of personalized treatment. Monica introduces us to the "three legs of a stool" concept in patient communication, vital for ensuring a comprehensive approach to patient care. We also touch on the emotional aspect of physical illnesses and the necessity for a safe space where clients can express and process their emotions. This episode promises not just to enlighten but also to inspire both practitioners and patients in the continuous journey of healing and self-discovery.
To listen to their podcast please search for The Healthful Perspectives.
Monica can be found at www.acunelson.com and Forrest through rebalancing.ca
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Eric (00:08):
Hello and welcome to another episode of Purves Versus
.
My name is Eric Purves.
I'm a massage therapist, coursecreator, continuing education
provider, curriculum advisor andadvocate for evidence-based
massage therapy.
In this episode, we welcomeForrest and Monica.
Forrest is an RMT and Monica isan acupuncturist, and both are
manual osteopathic practitionerswho live in Nelson BC.
(00:30):
In this episode, we discusstheir experiences, training in
osteopathy, the importance ofactive listening, better
communication strategies and thepowerful effects of the
clinical encounter.
If you enjoy this episode,please rate it and share it on
your favorite social mediaplatforms.
You can also support my podcastby making a donation.
Please visit buymeacoffeecom.
(00:51):
Slash helloob.
Purpose Versus can be found onYouTube, so please check us out
there and subscribe.
Thanks for being here and Ihope you enjoy this episode.
Hello everyone and welcome toanother episode of Purpose
Versus.
Today I am excited to welcometo you Forrest and Monica, who
are two massage therapists fromthe wonderful mountain town of
(01:12):
Nelson BC.
This is my first time evermeeting Monica Thanks for being
here and Forrest.
Some of you may know I've knownForrest for a couple years now
and they're going to be tellingus today kind of about some of
the new projects that they'reinvolved with, but also, we're
going to have a conversation,too, about some of the things
that we feel are most importantfor massage therapists to know.
(01:32):
So thanks for being here, guys.
Monica (01:35):
Thanks for having us.
This is super exciting.
Eric (01:38):
Yeah, my pleasure, Thank you.
So let's start off with firstMonica.
Just tell us a little bit aboutyou.
Who is Monica?
Monica (01:46):
Who is Monica?
Well, I live in a small littlemountain town of Nelson, bc, and
I have a practice of Chinesemedicine acupuncture.
I practice manual osteopathyand Thai massage here.
So I have a private practiceand there is a little bit of a
(02:06):
focus on pain management.
And I have some professionalathletes that I treat and I was
for a long time going to trailto work on the hockey team there
.
So I really have a passion forchronic pain and I was a teacher
at the Chinese Medicine Schoolhere in Nelson as well and I
(02:32):
love to ski and mountain bikeand snow bike and do all the fun
things that the Kootenaiprovides.
Eric (02:40):
Sounds like you're well suited to be living in the
Kootenai and in Nelson, inparticularenays and Nelson
particularly are you from NelsonMonica?
Monica (02:47):
I am not.
I'm from the coast actuallywhereabouts.
Burnaby is where I grew up, andthen I lived in Whistler and
Pemberton for quite a while toonice, nice.
Eric (02:57):
I love Pemberton and Whistler.
It's beautiful there andBurnaby's nice too.
When I was a kid, actually, mydad lived in Burnaby and so I
spent a lot of years over therevisiting him, so I'm quite
familiar with Burnaby whatBurnaby was like in the 80s
anyway was Metrotown still there.
Metrotown was there.
I think it was pretty new andthe Skytrain had just been.
Was they built?
(03:18):
they finished the Skytrain when,uh, when I was a kid, when my
dad was living there.
I remember taking the Skytrainthe first day it was ever
launched really yeah I'm, maybeI'm dating myself here, but
anyway, completely useless pieceof information.
Most people that aren't from BCprobably have no idea what the
Skytrain is well, I've had somegood times on that Skytrain.
Monica (03:41):
Let me tell you yeah, thanks, monica.
Forrest (03:44):
So Forrest, tell us a little bit about you um, I've
been living in bc now for justover 20 years and found myself
in nelson about 10 years ago.
I've been practicing registeredmassage therapies for 17 years.
Went back to school with monicaactually a few years ago to do
manual osteopathy, and I run ageneral practice here, and then
(04:08):
I also teach at the RegisteredMassage Therapy School.
I've been doing that since itopened, and then I'm also
teaching my own personal coursesand later this year I'm going
to launch an online education aswell.
And yeah, otherwise I'm a dadand I seem to wear a lot of hats
and have some pretty busy days.
(04:30):
But I'd say, like monica, Imoved to the coonies for the
mountains and the lakes andbeing outdoors and being in
nature and, uh, just trying tofigure out how to strike a
balance with that nowadays.
Um yeah, and then monica and Ifirst met a number of years ago
at a backcountry ski hub.
We never knew each other andthen we kind of linked up and we
(04:52):
realized on our first kind ofday out ski touring with each
other that all our other budsthere were high on mushrooms and
I kind of looked at Monica, Iwas like I guess we're
babysitters today and I was likeyou get the mic.
So we took off for the day andled our buddies through the
mountains and watched themfumble around and be dorks.
(05:14):
And then we connected doingthat and realized we taught at
the same college, which wedidn't know that before.
And then, ever since then we'vejust been chasing each other
around at the same clinics andgoing to school together and,
yeah, we can't seem to breakapart our friendship anymore.
We just keep hanging out.
Monica (05:35):
That's so true.
I like to say that Forrestfollows me around a little bit.
I actually did not think he wasgoing to come to osteopathy
school with me.
I actually did not think he wasgoing to come to osteopathy
school with me, and so when hesaid I'm in, I was just so
thrilled to have to have a goodbud to go through school with.
Eric (05:53):
I love that story for the osteopathy school.
Like probably pretty ignoranton this one.
It's all.
Do you guys have to can use it,mostly distance, or do you
actually have to go intoclassroom?
Monica (06:13):
Like how's that work work?
Most of it is distant, so youdo these online lectures and
then you have to go for twoweeks to toronto and do the more
practical side of things.
Eric (06:20):
Okay, such a I mean, yeah, I guess, when you're, if you're
a working professional, I guessit's easier that way to you
know, you don't have to shuteverything down.
You guys can just, you canlearn, and they just only have
to take a little bit, a littlebit of time here and there.
Did you guys?
What did you find about theosteopathy school?
Like, do you, did you find itwas worthwhile?
Forrest (06:38):
I found it a hundred percent worthwhile.
I've been planning to doosteopathy for a really long
time.
I just couldn't figure out howto.
If you knew anything aboutnelson.
It's really hard to get in andout of here, especially in the
winter, um, so it's reallystopped me from like doing the
one in vancouver, because it'slike one week a month for five
years.
I'm like there's no guaranteeyou can fly out for six months
(06:59):
of the year here, and so I'vebeen wanting to do osteopathy
for a long time.
So when Monica, you know,brought this to my attention,
she's like you can do it allonline and then we do two week
practice in Toronto and I wasabout a month away from having a
child and I was like you'recrazy, I can't, I can't do this.
And she kept bugging me aboutit.
She's like you can do it, youcan do it.
And I was all right, I'm goingand we're doing this.
(07:26):
Um, and it worked great.
The, you know, go at your ownpace, watch all the videos.
I mean there's hundreds andhundreds of hours of videos um,
and the fact that, like I run apractice, I could be learning
and utilizing things that I was,you know, watching in my
practice every single day.
So I found for me it was superuseful because I could implement
it constantly and the practicumwas what kind of finalized it.
(07:47):
For me it was like the littletidbits that I couldn't quite
suss out of the videos and outof the education.
When we did the practicum iswhen it all came together and I
was like, oh, that's thatpressure I was missing or that's
that concept that I didn'tquite understand.
By the end of the two-weekpractic I felt very ready to
start, you know, fullyimplementing the skills that I'd
(08:09):
been learning for the last year.
Eric (08:12):
I'm curious how do you like, how did it differ from,
like say, traditional massagetherapy, education?
What was, what was theadvantage of doing that, like
professionally?
Forrest (08:23):
So like, rather than being in class.
Eric (08:26):
No, just like, just in terms of like pursuing it like,
why, like what was the purposeof pursuing that, rather than
just sticking with being an RMT?
Forrest (08:34):
for me.
Like I mean years and years ago,when I first graduated, I was
primarily just doing likeSwedish techniques and after a
couple years I was gettingpretty exhausted and a colleague
of mine was doing allmyofascial techniques and he was
doing 40 hours a week andwasn't exhausted and I.
So I started switching gears along time ago and then I started
(08:55):
taking courses, courses fromNatalia, who he kind of would
describe like the way he workedwas massage therapy with an
osteopathic approach, and themore courses I took from him
over the years, I startedimplementing this much more
subtle way of you know, goingthrough the body treating and
(09:17):
just a different understandingof the depth of how tissues
relate, and it just kind ofstarted perking my interest into
the osteopathy world.
I took some other courses withsome other people.
It just seemed like everythingwas pointing me towards
osteopathy.
So like I would say there'sjust I think osteopathy really
(09:37):
focuses on like how everythingrelates, whereas I found through
my massage therapy education atleast like initially it was
very kind of like somebody walksin with a knee pain and you
just really get focused on theirknee pain, whereas osteopathy
is like okay, they have kneepain, but like what was before
(09:58):
that and what was before thatand what was before that and you
start really trying to definethe layers of compensations over
the decades, and that's kind ofwhat's I find more impactful in
the practice nowadays is reallytrying to understand how
everything connects right, yeah,I mean.
Eric (10:15):
So I'm not sure.
But you guys know, but likeother listeners will know like,
one of the things I'm reallyinvolved with is evidence-based
practice, and this and the useof research, evidence and
practice and curriculumdevelopment is kind of.
I'm always very, very curiousabout osteopathy because there
tends to be kind of two distinctschools of it.
There's kind of the old school,where everything is basically
(10:37):
tissue-based, structure-basedand it's just a lot of technique
stuff.
And then there's there's amovement now in osteopathy, and
particularly in the UK, wherethey're they're trying they're
moving away from that becausethere's not a lot of technique
stuff, and then there's there'sa movement now in osteopathy,
and particularly in the UK,where they're they're trying to,
they're moving away from thatbecause there's not a lot of
evidence to support those kindsof traditional osteopathic
approaches, and at least interms of the explanatory models
or the narratives around them.
(10:58):
How do you, how do youreconcile that those two things?
Because if you're like I, likethis approach but maybe there's
not a lot of evidence to supportit.
How do you feel about thosecontradictions?
Monica (11:12):
I think for me, if something works, I continue
doing it.
And the second I became anosteopath and started to
implement those techniques on adaily basis.
Quite simply, it just works.
And to me the proof is in thepudding.
And I'm the same as you, eric.
I do really appreciate havingthose studies to kind of back
(11:37):
like the evidence-based, butthere really is no substitute
for is it providing results formy patients?
Eric (11:48):
Yeah, no, that's no.
Yes, that's great and I thinkthat's the thing is.
Is that there's, when we lookat, say, osteopathy or massage
therapy or acupuncture, right,we look at the evidence base and
it's like, well, there's not alot of evidence that supports
that anyone is approachesparticularly better than other.
However, if we look at you knowour clinical experiences we may
(12:08):
find that, oh well, I approachpeople in this specific way or
this specific framework and ithelps, and people I get my
client send it to feel better,so that I think this is an
important thing to realize.
It's just the problem or theconcern that we have with any
approach, whether it'straditional massage, physical
(12:29):
therapy, chiropractic,osteopathy is we have to be.
I think you just have to bemindful of the, the stories that
we're thinking of, the storiesthat we're telling ourselves or
the stories that we're tellingour clients, because that's
where the evidence base, I thinkparticularly can, can influence
us in a positive, a positiveway.
Forrest (12:50):
I think that the the challenge with evidence,
evidence-based manual therapytechniques in general, is the
evidence shows that it works,but it doesn't really define why
it's working.
Like, on what mechanism is myhand resting on your shoulder
any better than me needing yourshoulder?
And that's what I can't seem tofigure out.
(13:12):
Like as I've been diggingthrough evidence and research to
create my courses to like okay,so I'm doing joint moves.
Why do joint moves?
Oh, they work.
Oh, they work.
But why are working and thatseems to be across the board
when I look at the evidence isthe why is really missing?
Like, what's the mechanism?
But we're like oh, okay, it'ssuccessful.
(13:32):
Yeah, doing joint mobs issuccessful.
Doing switch massage issuccessful.
Putting acupuncture, doingneedles, successful.
Having a conversation withsomebody and just validating
their life and hearing what theyhave to say is extremely
powerful.
Um, but what's the mechanismunderneath that, the why?
It seems to be missing in theresearch and the evidence.
(13:53):
Like they can't seem to connectthat dot fully.
Like is it neurological?
Is it endocrine?
Is it hormone?
Is it like, is it all the above?
Eric (14:03):
yeah, and the evidence from from the work I've done, it
is, I would say it would be anall of the above, right.
We know that any response fromany touch that is
neurophysiological and there's,you know, there's hormonal and
neurotransmitters and uh, allyou know, um, you know changes
in inactivity in the noiceptivesystem, like there's all these
(14:24):
things that are impacted throughtouch.
And I think, yeah, so that's.
I think, if we really look atall of these approaches whether
it's osteopathy, massage therapy, acupuncture there's a million
different stories about how theyall work that are different.
But really, if we look down toit, how they all work, that are
(14:46):
different.
But really, if we look down toit, it's it's just touch and
it's some type ofneurophysiological, neuroimmune
response, just a different wayof interacting with, with the
human.
A lot of people think thattechnique doesn't matter and I'd
say, well, it matters when itmatters, and that's I'm sure
that's what you guys haveprobably discovered in your
osteopathy training is that like, maybe you slow down, you take
a different approach, or you tryto do things or think about
(15:07):
things differently than youwould traditionally and maybe
that allows you to hold spaceand provide touch that's
different than what they've hadbefore and that's kind of what I
was gonna say that's kind ofwhat I try to teach my students
in fifth semester right now,because at this point they're
starting to put everythingtogether and now they're asking
(15:28):
but like, how do I know whichone to use for which person?
Forrest (15:31):
and a lot of times I'm like that's through experience
you start to recognize the signsbefore the person gets on the
table, about what is theapproach today that will work
best for that person's nervoussystem, or where we're meeting
with them, where they're at.
But that's a hard one to teachsomebody if they don't have the
experience to, to, to use.
Monica (15:55):
So, forrest, you really just took the words right out of
my mouth.
So, eric, I would say that thebiggest thing that manual
osteopathy has brought to mypractice is really bringing this
element of parasympatheticresponse, and I'll fully admit
that before I studied osteopathy, you know I was all about the
(16:16):
deep pressure and I was allabout the deep needling, and
after studying osteopathy Ibecame really aware of how
necessary it was to have someonedrop on my table into that
parasympathetic response, and soyou know, things like cranial
osteopathy, visceralmanipulation, those are all ways
(16:37):
that, as a manual osteopath, wecan achieve that, and I found
that when I have a patient dropon the table, that's when I get
the results.
Eric (16:55):
Yeah, cause you're giving them that, that safe space to
just kind of feel comfortableand cared for, and just turning
that and turning that volumedown on their, on their overall
system, so that way they can,way they can just be in a better
place.
Monica (17:10):
For sure, and trust is a huge part of that, and you know
, part of what we wanted todiscuss today around having
someone feel heard.
I think that thatparasympathetic response does
start the second that thatperson comes into your clinic
100%.
Forrest (17:29):
Eric, you were talking about redoing your whole entire
clinic at one point to make theaesthetics of when people walk
through the door that it lowerstheir nervous system, and so it
does.
It starts right when the personwalks into the space itself
like it does.
It starts right when the personwalks into the, the space
itself, you know.
Does it feel sterile and whiteand abrupt, or does it feel like
(17:50):
it's calming, relaxing andallowing them to like?
You know maybe?
Eric (17:54):
drop down a notch or two and that's and that's.
That's such a huge thing and Ithink that's something that
probably isn't a common thoughtfor a lot of people in the msk
world.
Is you the value of like?
What's your clinical, what'syour clinic look like, you know?
Is it you know?
Is it?
Is it a welcoming, safe place,or is it something that's like
(18:14):
full of like, really brightlights and very medicalized?
And I don't think there's aright or wrong one.
I guess it really depends onwhat you're looking for.
Forrest (18:22):
But it has to meet the individual.
Like, everybody wants somethingdifferent for the most part
it's hard to match a hundredpercent of the time.
But if you can get 70, 80% ofpeople in that head space when
you walk through the door, Ithink that's the win.
Eric (18:35):
Yeah 100, 100.
I love that.
Uh, yeah.
So, monica, you mentioned, yeah, some of the things you guys
want to talk about today waskind of about the, the
importance of kind ofcommunication skills and safety.
So let's go there, tell me alittle bit more about what you
about about that.
What are you guys thinking?
Forrest (18:53):
I I had a specific case that I was going to bring up.
Um, it was one that really kindof watching the person's
reaction in front of me was like, oh my gosh, I just hit the
exact wording that person neededto have said to feel safe and
welcomed into my space.
And I think, if I'd gone aboutit in my old forest way from 10
(19:23):
plus years ago, I wouldn't havegot them into that headspace and
we'd had a very differenttreatment and I'd have lost them
as a as a patient, very quickly.
And so I think that's where,like, the first thing that
happens is is communicationskills, and it's really,
unfortunately, communicationskills are a learned process.
They're they're super hard toteach, they take a lot of time,
(19:47):
um, but I I think what we weretalking about is like validating
people's experiences, you know,letting them feel like they've
been heard and they they're, youknow, being understood, and
that the person who is askingall these objective questions is
also being very compassionate,and I think that's super
(20:07):
important.
But it's really hard to get newlearners to figure out how to
do that.
Eric (20:15):
Yeah, it's not really taught well in school at all, at
least from my experiences as astudent as well as an educator.
You know the it's very much ayes, no kind of discussion,
rather than, like you know, tellme what you're feeling, tell me
what's going on, tell me whatbrings you in here today.
Rather, rather, it's just verymuch like this focus on like,
(20:37):
where's it hurt?
Why is it hurt, what, what didyou do?
Tell me all about it.
Let's figure out the cause andthen let's fix it.
Is that the truth.
Forrest (20:45):
I don't want to slander the CMTBC so much, but they've
really boxed massage therapistsinto this little tiny corner
where we can't ask a lot ofthings, otherwise it starts to
get viewed as like we're doingsome sort of counseling and then
we tell our students likeyou're not counselors, so we're
really reinforcing the narrativethat you don't want to get into
touchy-feely with your patientinstead of teaching.
(21:11):
Like something that I've learnedthrough.
Like I've sat in about 10 yearsworth of men's groups,
thousands of hours offacilitating and being
facilitated, and one of thethings I learned through that
was, like this active listeningskill.
So somebody could tell me 15emotions that they're currently
going through and in the back ofmy mind I am memorizing those
emotions.
Oh, need to say, if I canrepeat back 75% of what they
(21:34):
just said, they know they'vebeen hurt and they know that I
want to connect with them and soit's not even counseling it,
(21:54):
but it's learning that skillthat like, as you're talking to
somebody, you're doing twothings you know where you want
to take the conversation, butyou also need to learn how to
paraphrase and really memorizeeverything they've said to you
so you can say it back.
And it's something that, likeyou can't just learn overnight,
you've got to like be practicingit very actively.
Monica (22:17):
I love that yeah ahead, Monica.
Eric (22:19):
Do you have any doubt onto that?
Monica (22:21):
I do actually.
So in Chinese medicine weactually did do three years of
counseling studies, because wedo counsel our patients right.
So one thing that I can offerfor the listeners today is this
concept of three legs of a stool.
So that's what we always wantto think of.
And so, forrest, you touched onone of the legs of the stool,
(22:45):
which is mirroring, and theother two legs are listening,
and the third one is advice.
Now, I understand that in theRMT profession it might be a
little bit different how youdeliver that advice, but what I
like to call the two R's, whichis resources and referrals.
So these are things that we canalways give to our patients and
(23:09):
I'm pretty sure that would fitinto your guidelines as an RMT.
So referrals would be thingslike counselors, addiction
clinics, mds, grief support, andI have a list of these at my
clinic ready to go, so that it'snot like I'm fumbling around.
It's boom, here you go, this iswhat you need.
And then resources is likehypnosis podcasts, emdr podcasts
(23:33):
, books or articles that I cankind of direct the patient
toward, and so in this way, ifyou're mirroring their feelings,
like Forrest just mentioned andI can't wait to hear your story
Forrest about your patient, bythe way, but if you mirror what
that patient said and then givethem referrals and resources, I
(23:55):
believe that that's such a greatplace to start place to start
the.
Eric (24:02):
And that's such a, it's a, it's such an important skill
and such one that may not berealized, people may not realize
it's as important as it is.
I've.
Really that cause actuallycreates that connection, that
creates a strength in thattherapeutic relationship and
that that person will start togain, gain trust in you, because
you're actually like oh, Ilisten.
Like the person might think, oh, I, I, I listen, this person
(24:23):
listens to me, they understandwhat I'm going through, they
understand my, my situation,whereas a lot of times it's much
easier for us just to kind ofyeah, yeah, yeah, yeah, tell me
what's wrong, let's get you onthe table, let's do something to
you, rather than taking thatreally important time, like you
guys mentioned, to just be therefor them and even in a regular
(24:46):
question that a lot of mystudents ask is well, you know,
the person comes into ourstudent clinic and they, you can
tell they just want to get onthe table.
Forrest (24:54):
They don't want to go through all the assessments and
all that kind of stuff, and I'mlike, but it's your job to make
sure that you are, you know,creating a space that you do
what you need to do to make surethat you're effective.
And so if they're trying to rushyou through so they can get on
the table, but you're the leader, you're the one that's supposed
(25:15):
to lead the conversation anddraw them into the why you're
having these conversations.
And so I don't know, I find inthe last kind of 10 years I
spent a lot more time 15, 20minutes talking to people before
they even get on the table,because I'm digging at stuff,
I'm curious, and maybe that'spart of it is I'm really showing
(25:36):
my curiosity about what they'regoing through and I educate as
I go along, like I don't try todo a sterile environment where
I'm like, okay, we're doing X, y, z, like I'm very creative in
the moment about how thisprocess is going to proceed, and
I do that by really watching.
You know their facialexpressions, their body language
(25:58):
, how they talk to me, how theytalk about themselves, their
body language, how they talk tome, how they talk about
themselves and I think, yeah,monica's right, it's mirroring.
Monica (26:10):
It's mirroring what's going on and also taking the
lead.
I have to say I am like one ofthose guilty massage patients
that just wants to get on thetable when I go for a massage.
Eric (26:21):
So you don't want to come see me, monica, I'll just keep
talking well, I think part ofthe, the skill of being a good
clinician is trying to, you know, determine what's what's the
person want.
Because if the person, theirvalues are important and why
they come is important, maybethe person just wants a massage
and there's there's nothing.
Maybe they just want to feelgood for 45 minutes or an hour
(26:42):
or whatever.
And if that person comes inthey're like I'm just stressed
out, I want a massage, nothing'sreally, but nothing's.
My neck's a bit sore, nothing'sreally to kill, kill me too
much.
Then you know, if we start tosubject them to like a 15 minute
inquiry, they're probably gonnabe like are you freaking,
kidding me?
so I think, that's, that's partof the.
Your practice is like okay,does this person like do they
need more in-depth or do theyjust maybe they just need a good
(27:04):
massage?
Whereas if someone comes in,like you know, I'm sure, like,
of course, a lot of the clientsyou see right With like specific
injuries or complaints or longhistories of stuff, you're
probably going to want to take adeeper dive into their story
and what's going on with themand that way you can come up
with a more meaningful treatmentplan what's going on with them
and that way you can come upwith a more meaningful treatment
plan.
Forrest (27:24):
It's taken me a long time to also accept that I don't
match with everybody and thatit my job is to connect with who
I can and to keep them um, keepthem what's the word?
Faithful to me?
But I'm going to lose people along way because we don't
(27:44):
connect and I don't.
You know, throw them on thetable in the first two minutes
and start doing treatment, andyou know I'm totally fine with
that nowadays, whereas a longtime ago I wasn't fine with that
.
I would just do what the personsaid they needed, and I just do
it to try to keep them.
But I've learned over time thatI really I just want to work
with people who want to workwith me and it's not worth my
(28:06):
time to just kind of forfeit mypassion for practice because it
bores me.
Honestly, if somebody istelling me exactly what I have
to do to figure everything outand they're telling me the
sequence and I have to do tofigure everything out and
they're telling me the sequenceand I have to do a very recipe
thing.
I get bored and then my passionstarts to fade and I am not
(28:30):
nearly as effective when I'm notpassionate.
Eric (28:33):
You can't please everybody all the time and you can't be
the therapist for every singleperson, and you'll tend to
attract a practice thatrepresents you and who you are.
And and I I don't know ifanyone you know spends any time
on social media you see theamount of burnout and the amount
of concerns that people have inour profession and I think a
(28:54):
lot of it has to do is becausethey've kind of lost that
passion, because their theirpractice is very kind of recipe
based.
They're just doing the samething over and, over and over
again, and for some people Ithink they can do that, and some
people I think it it burns themout.
And you know, I'm just making atotally anecdotal statement
here, but that's, that's myimpression anyway to say the
(29:15):
story that I had.
Forrest (29:16):
Um, so mom started this .
She, she called me up and saidyou know, I need to get my child
in to see you Child being like21.
So they came in, they sat downand they were all over the map.
Like their shoulders werehunched, I feel like their body
language was dropped, depressed.
(29:36):
They were anxious, nervous,anger in them.
They just really really quitementally disturbed.
And I'm trying to ask questionsand get an idea of, like, what
we're doing today.
And as we talked and I finally,at some point, I was just like
(29:56):
hey, if you just need to sithere and talk to me, you need
somebody to listen to you rightnow.
We can do that.
I don't even need to put you onthe table.
If you don't want to lay on thetable today and you just want
me to sit here and be with you,I can do that right now and I'm
happy to do it.
And then, their shouldersdropped, they like teared up a
(30:18):
bit and they got so relieved tohear those words, like to watch
their whole body just fullyrelax and settle in was amazing
and I was like whoa, I justnailed what that person needed.
Um, I don't think they've beenreally hurt.
They go to counseling.
They're on all sorts ofdifferent types of medications.
(30:40):
It seems like they're just kindof almost falling through the
cracks of the system and noone's really like picking on or
picking up on like what theyreally need.
And it was just for me to watchthat physical change in the
person's body was so powerful.
The record for me to recognizelike my words have more
implications and moretherapeutic effects than
(31:03):
actually getting them on thetable.
And then actually, when I didget them on the table, it was a
terribly frustrating treatment.
Uh, couldn't use enoughpressure, couldn't use light
enough pressure.
They couldn't stay in oneposition for more than five
minutes.
They're twitchy and agitatedlike.
It became really quite thechallenge to navigate a
(31:26):
treatment with them.
But what seemed to really beeffective, as I kept seeing them
week after week for quite awhile, was that first 20 plus
minutes of just letting themdownload what was going on in
their brain.
That seemed to be moreeffective than the actual you
actual hands-on approach.
And it's so backwards to whatwe're taught in massage school
(31:49):
To even just advertise tosomebody like hey, I don't even
need to touch you today.
That actually goes againsteverything that we're supposed
to do as massage therapists.
But I'm a compassionatetherapist.
I'm supposed to be here to helpyou.
If that's what helps you themost, then why am I stopping it
from happening?
Just to force you on the tableto put my hands on you and I was
, you know, I think doing one ofthe other pillars Monica just
(32:11):
mentioned, like talking aboutresources and recommendations,
but the gist of the story wasjust like the power of words and
realizing how much theirnervous system dropped just from
hearing that somebody waswilling to sit with them and
just listen.
Eric (32:33):
That's very powerful for us and thanks for thanks for
sharing that story.
It's so true because if youthink about a lot of those
people, particularly people thathave been in pain for a long
time, people that live withchronic pain or chronic health
concerns, oftentimes they'redismissed or they're just not
really listened to and if youcan be that one person that
takes the time to validate them,to listen to them, and you're
(32:55):
not counseling right?
You mentioned that earlierabout the.
You know there's the worry thatwe're counseling but you're
just holding that safe space forthem, that is extremely
therapeutically beneficial.
Why would we be discouragedabout it?
Almost doesn't make sense, doesit?
Forrest (33:10):
no, and it's hard to kind of, I think, understand
what the where, that you know it.
It's not a black and white linethat you're like you, it's
there's a gray area in there andit's really hard to get people
understand, I think, as massagetherapists, what that gray area
is, that you can still workwithin.
That is very effective.
Eric (33:31):
Monica, do you want to share kind of like what's your
perspective on that?
How is that similar ordifferent for Chinese medicine
and acupuncture?
Monica (33:40):
The thing about Chinese medicine and acupuncture is that
we actually acknowledge thatthe emotions create illness.
So part of what we're doing inour assessment is talking to
them about their emotions prettypretty outright, like all
straight up, say to someone doyou experience anxiety, do you
experience anger, do youexperience worry, do you
(34:02):
experience grief?
And then, if they say yes, I'masking more questions about
those things and then, likeBoris said, I'm going to be
mirroring what I've heard andthen from there giving advice.
And so one thing I need tomention about the three legs of
the stool that we were taught isactually to make sure that
there's a balance there, right,a balance between listening, a
(34:25):
balance between mirroring and,finally, a balance between
advice.
So I find in my practice it's atricky.
It is tricky to strike thatbalance, and that's where I find
that the resources andreferrals are really, really
important.
And that's where I find thatthe resources and referrals are
really, really important.
(34:47):
But I also and I've taught mystudents this for many, many
years is I think that when weget a patient into our office,
there's this sense that we haveto rush to form a relationship
with them, and one thing I'vetaught repeatedly is that a
patient practitionerrelationship can take years to
form, and when you're not rushedto form it and you're allowing
it to to grow at its own pace,based on what the patient needs,
(35:11):
that's when you're going to bethe most effective, and I feel
like we might.
You know, in our cultureeverything's fast, right, fast
food, fast, this fast.
That Everything's fast, right,fast food, fast, this fast.
That it's really important justto slow down that patient
practitioner relationship.
And then Forrest, in the caseof your story, I think that by
(35:32):
listening, maybe right now youcan't give the right pressure to
this patient, but I think thatthe more that you are just
patient with that relationship,maybe in two years you're going
to give that optimal pressure.
And if it takes two years toget there, so what?
That's what it takes right, wehave to be patient with the
(35:55):
process and I think that's justso cool that you were able to
follow your intuition and reallygive that patient what, what he
needed.
Forrest (36:07):
What's weird is like my ethic, my ethical side of me,
felt so wrong by just sayingI'll just stay here for an hour
with you and not put you on thetable, cause like technically I
shouldn't be doing that, butthat's what felt the most
compassionate human thing to do,so, forrest.
Monica (36:27):
I don't know about you, but, and, and Eric, I'd love to
hear your perspective on thistoo.
But there's always like abalance between ethics and
humanity Right, and I have areally powerful story to share
at some point if we get there.
But for me it's almost like inmy practice, I have to balance
(36:48):
the two, like professionalethics and laws, with what I
feel is a humane thing to do.
In the end, I am always goingto follow my moral compass.
You know I'm going to balanceit with what the industry says,
but I think that following thatmoral compass is super important
(37:09):
as a practitioner.
Eric (37:13):
I agree 100% and this is actually something.
This is a whole.
We could have a whole otherepisode just on ethics.
I love talking about this stuff, so thanks for opening up that
topic there, monica.
The healthcare ethics is notsomething that we really talk
about enough.
I don't think inmusculoskeletal care.
So the first principle right,beneficence right.
So you should always be workingin the best interest of the
(37:34):
person, so you should always beworking in the best interest of
the person.
If maybe the best interest ofthe person is just to sit there
and be heard, and maybe you onlyprovide a few minutes of
hands-on treatment, I think ourI should know this, but I'm
pretty sure that in our bylawswe have to provide some form of
hands-on therapy, for it to becalled massage therapy.
But if the best interest of thepatient is to be set, to be
(37:58):
validated, to be heard, for themto, would you I think the word
used um for us was downloadtheir brain yeah, they needed.
It seemed like they wanted todownload just what was going on
inside of them yeah, and theywere okay with that and that's
what they wanted and that's whatthey found valuable and I found
my.
In my own experiences I've hadvery similar things, where some
(38:19):
of the people just want to justknow I'm going to tell you all
these things and it's okay, likeI don't care if we only get a
few minutes of hands-on stufftoday.
This is really important.
You're sitting there, you'relistening, and sometimes you
might be thinking, oh my gosh,like this person is telling me
everything and I'm not doing myjob.
But if we look at the ethicsand working in the best interest
of the person, then why wouldwe tell them no, it doesn't make
(38:41):
sense, does it?
Monica (38:43):
Absolutely, eric, and I think one thing that we can do
as health professionals is pointblank ask them and I will say
to a patient like hey, I won'tbe offended if you say no, but
is this helpful for you?
And if they say yes, that'ssomething I can then put in the
chart.
Patient said that they found itextremely helpful to just chat
(39:05):
right and then it's charted.
So if the college ever comesand assesses or audits you, then
you know it's charted that thepatient needed that 100%.
Eric (39:19):
And if it's a patient-centered treatment, then
and that's what they want andthat and that's what helped.
And you know, we're we're doing.
We're doing good work.
I don't think we could ever getin trouble for that exactly
yeah, I love that sorry for usinterrupted you no that was I.
Forrest (39:33):
I had never thought about charting that before.
So I'm kind of going oh, Icould chart that, and then it's,
it's, it's in there, it's partof the record.
Eric (39:44):
And ethically then I'm actually kind of, you know,
cross the t's and dot the i'sfor sure, because that will help
you too, right, so maybe theperson doesn't see you again for
two years.
You kind of forget, forget theforget, what happened.
And then you have that in yourin your notes and you're like,
oh yeah, this is what, this iswhat happened last time they
wanted to chat, and this is abrief thing, what they, what
(40:04):
they said, and this was thevalue, and I think it's.
I think it's a good practice,in my opinion anyway.
So question for you guys herequestion for you guys is so how
do you, how do we foster morekind of comfort and competence
in navigating thesecommunication skills?
Because obviously I think thethree of us are all been around
(40:25):
the block a while, a few times,and this stuff that we're
talking about may seem easy, orit's never easy, but may seem.
We're familiar with this, thistype of conversation, these type
of important things.
But how do we get, how do weinspire and educate other
therapists, whether it's newones or ones that have been
practicing for a while, to adoptthis more communicative
(40:48):
approach?
Monica (40:50):
I think the biggest tip that I can give, just from my
couple decades of practice, isto be more straightforward with
the patient, and that'ssomething that has taken a lot
of time.
But you know questions that Inormally wouldn't ask early on
in my career.
You know, for example, like ifif a patient starts talking and
(41:14):
you know we're talking about asubject, I will like point blank
ask them do you want tocontinue talking about this or
is it too much for today?
And so I'll give them an out.
Um, so I'm not afraid to kindof ask for what the patient
needs and and I'm constantlydoing that like is the music
okay in here?
(41:34):
Is the lighting okay for you?
Is it comfortable?
And and the more that we can bedirect and concise with our
patients, they're going to giveus the information, but we have
to give them the opportunity youforce what your thoughts um
honestly.
Forrest (41:54):
I've been trying to figure out how to just with,
like the students that I've hadover the years, how to
facilitate these types oflearnings in a way that they
could put take it, put it intopractice.
And I haven't really honestlyfigured out how to how to
educate or teach in a way thatgets learners you know whether
(42:17):
they're already practicing oryou know current students how to
learn these techniques andskills.
I just kind of advertise that,how important it is so that they
recognize that there'ssomething that they need to keep
working towards.
I just know for myself the onlyway I got to where I I am is
because I started doing a lot ofwork on myself, and that's
(42:40):
where I learned a lot of mycommunication skills was once I
started spending many, manyhours a week practicing
communication skills on myselfand on on others, in a place
where that was the point of itlike.
Like I said, I sit in men'scircles, and so the whole point
of men's circles is learning howto communicate, learning about
(43:02):
emotions and feelings.
So that's how I learned it all.
I was actually reallyinundating myself in how to do
it.
I didn't learn it throughschool.
Eric (43:16):
Yeah, I would say that most of us probably don't learn
it in school, but, like a lot ofthings, right there's, you know
, our education shouldn't finishonce we, you know, get our
license.
It should be an ongoing,lifelong process, and I love
that.
You know you talked about, youknow, working on yourself, and
that kind of self-reflection isso, so valuable and it's
(43:37):
something that we should all do,because when we're working with
the public and we're workingwith people and we're looking,
working with people that are inpain and and and and they're,
you know, they have their ownlives and their own stories it's
very, very important for us toreflect on on our own life and
how and how we can be better forourselves, and then, by being
better for ourselves, we can bebetter for those people that
(43:58):
come and see our care I couldn'tagree more, eric, yeah, you,
you hit it on the head there forsure yeah, so you guys are
let's talk, because you guysreached out to me, because you
wanted to.
You guys guys are doing your own, are going to be launching your
own podcast, so why don't youtell, tell me and the listeners
(44:21):
a little bit more about what youguys are up to?
Monica (44:24):
So when Forrest and I traveled to Toronto, we did a
lot of driving to and from ourclasses and it was pretty funny
because every day we would getinto these amazing discussions
about health.
And it just occurred to us likewow, if we press play on these
(44:45):
conversations we could reallyprovide something for other
practitioners and patients.
That would be just really goodinformation for them to have.
And so then the idea sprungabout like we should just go for
a beer and hit play and havesome microphones around and see
(45:06):
where it takes us.
But the idea is to kind of takeour combined 40 years of
knowledge and just help peopleout on their path to becoming
better practitioners better, youknow, whether it's a patient or
a practitioner.
We want to.
We want to try to give value,to help people on their health
(45:26):
journey.
Eric (45:28):
I love it, and is that coming out soon?
Forrest (45:32):
I think probably in the next month.
We've Monica has done a goodjob getting everything all kind
of set up and we've had somesit-downs to talk about pieces
that we want to kind of liketailor a conversation around.
And yeah, I think somewhere inthe next month we'll be starting
to launch doing some podcaststogether and if nothing else,
(45:57):
hopefully there's somethingfunny there.
Monica (45:59):
You can laugh along with us for a bit monica, you have
quite the infectious laugh, Imust admit so oh, thank you you
know I first would actually likedisagree, because in clinics
sometimes like I, me and mypatients get into these laughing
fits that can be heardthroughout the whole clinic and
(46:19):
I call it laughter therapy.
But my colleagues are like, ohno, monica's here again.
Forrest (46:27):
I joke with you the other day, saying I'm just glad
I don't share the exact wallwith you, and then I'm like two
rooms down.
Exactly Right you're just farenough away that it's, it's fine
.
Eric (46:38):
Do you guys have a name for the podcast?
Forrest (46:44):
uh, we're gonna go with um healthful perspectives,
healthful perspectives.
Eric (46:50):
Okay, I'll put that in the show notes for us.
Why don't you since you haveyou here why don't you tell the
listeners a little bit moreabout, uh, the courses that
you're doing and what you havehere?
Why don't you tell thelisteners a little bit more
about the courses that you'redoing and what you have coming
up?
Forrest (47:00):
uh, so over the next kind of I think about four
months, I've got a course eachmonth here in nelson, uh, so I'm
going to be doing the nextone's lumbar and sij, that one
after that's thoracic and ribs,following one after that's upper
extremity.
Um, what I'm really wanting todo is tie together more simple
(47:21):
observation assessments,palpation skills to figure out
the right approaches to whichtechniques to use for somebody
with a certain type of conditionor issue.
So it's really trying to tiethose assessments and techniques
together a bit more.
The predominant theme of like,say, techniques is going to be
(47:43):
muscle energy, joint mobs andfascial mobilizations.
Yeah, that's kind of what myaim is right now.
I've already taught quite a fewclasses in person last year, um,
and so I also love just kind ofbringing some case histories
and and just kind of watching tosee how a class can unfold, um,
(48:06):
and try to answer other healthprofessionals questions on like
what's going on in theirpractice that you know they're
needing support around and mylong-term goal is actually this
later this year, I'll belaunching an online education uh
that will have all of mytechniques and skills recorded,
(48:29):
so you can you can do onlineeducation without having to come
to to nelson yeah, nelson's notthe easiest place to get to, no
, but once you're here, it'sbeautiful.
Eric (48:41):
It is beautiful.
I've been there once, and itwas a very wonderful place.
I only was there in the summer,though, or spring, so it was
beautiful, then.
How can people get ahold of you?
Do you have a website that youwant to put a plug in there?
You?
Forrest (48:54):
can go to my website.
It's called rebalancingca.
There's a registration page onthere as well, if you're wanting
to look at the courses, or youjust send me an email from that
page and I can answer anyquestions perfect.
Eric (49:09):
And monica, what about you ?
Do you have a contactinformation?
You want to provide listeners?
Monica (49:14):
yeah, so my my website is wwwaccunelsoncom.
Eric (49:22):
And are you going to be doing any continuing education,
Monica?
Monica (49:25):
I actually have a whole curriculum written.
So it's just, you know, tryingto trying to come up with a
little bit of a plan for thenext year or two.
I think that it's my plan tokind of get this podcast
launched and then after that Iwill launch my curriculum,
because I am very passionateabout teaching.
I do love it, so I amanticipating that for my future
(49:50):
for sure.
Eric (49:51):
I love it.
Yeah, teaching is can be, youknow, if you're inclined for it,
it's just, it's infectious,almost it can become like
addicting.
if you're inclined for it, it'sjust, it's infectious, almost it
can become like addicting, justto just such a good feeling to
be there and to interact withpeople and hopefully help them
think about things differentlyor do things differently and
inspire them to pursue moreknowledge is such a wonderful
feeling, so I'm really excitedto hear that you guys are both
(50:15):
taking that, that approach, andyou've got some hopefully, some
good quality stuff coming out inthe near future absolutely all
right guys.
Well, thanks for being heretoday.
I appreciate you, uh, takingthe time to be here and to have
this, this conversation, andhopefully we can touch base
again soon.
Monica (50:34):
Thank, Thank you so much , Eric.
I just want to really show mygratitude for hosting us and
we're just so happy to be here.
Eric (50:43):
I'm happy to have you guys .
Forrest (50:45):
Yeah, Eric, thanks for all the things over the last
couple of years.
It's been great getting to knowyou and having you as a
resource and support.
Eric (50:53):
I appreciate you saying that for us.
It's been wonderful workingwith you too, buddy, and yeah,
we'll keep in touch.
Okay, sounds great.
I appreciate all you listenersfor taking the time to be here.
If you enjoyed this episode,please give it a five-star
rating and share it on all yourfavorite social media platforms.
You can follow me on Instagramor Facebook at ericpervisrmt,
and please head over to mywebsite, ericperviscom, to see a
(51:14):
full listing of all my livecourses, webinars and
self-directed course options.
Until next time, thanks forlistening.
Hello and welcome to another episode of Purves Versus
.
My name is Eric Purves.
I'm a massage therapist, coursecreator, continuing education
provider, curriculum advisor andadvocate for evidence-based
massage therapy.
In this episode, we welcomeForrest and Monica.
Forrest is an RMT and Monica isan acupuncturist, and both are
manual osteopathic practitionerswho live in Nelson BC.
(00:30):
In this episode, we discusstheir experiences, training in
osteopathy, the importance ofactive listening, better
communication strategies and thepowerful effects of the
clinical encounter.
If you enjoy this episode,please rate it and share it on
your favorite social mediaplatforms.
You can also support my podcastby making a donation.
Please visit buymeacoffeecom.
(00:51):
Slash helloob.
Purpose Versus can be found onYouTube, so please check us out
there and subscribe.
Thanks for being here and Ihope you enjoy this episode.
Hello everyone and welcome toanother episode of Purpose
Versus.
Today I am excited to welcometo you Forrest and Monica, who
are two massage therapists fromthe wonderful mountain town of
(01:12):
Nelson BC.
This is my first time evermeeting Monica Thanks for being
here and Forrest.
Some of you may know I've knownForrest for a couple years now
and they're going to be tellingus today kind of about some of
the new projects that they'reinvolved with, but also, we're
going to have a conversation,too, about some of the things
that we feel are most importantfor massage therapists to know.
(01:32):
So thanks for being here, guys.
Monica (01:35):
Thanks for having us.
This is super exciting.
Eric (01:38):
Yeah, my pleasure, Thank you.
So let's start off with firstMonica.
Just tell us a little bit aboutyou.
Who is Monica?
Monica (01:46):
Who is Monica?
Well, I live in a small littlemountain town of Nelson, bc, and
I have a practice of Chinesemedicine acupuncture.
I practice manual osteopathyand Thai massage here.
So I have a private practiceand there is a little bit of a
(02:06):
focus on pain management.
And I have some professionalathletes that I treat and I was
for a long time going to trailto work on the hockey team there
.
So I really have a passion forchronic pain and I was a teacher
at the Chinese Medicine Schoolhere in Nelson as well and I
(02:32):
love to ski and mountain bikeand snow bike and do all the fun
things that the Kootenaiprovides.
Eric (02:40):
Sounds like you're well suited to be living in the
Kootenai and in Nelson, inparticularenays and Nelson
particularly are you from NelsonMonica?
Monica (02:47):
I am not.
I'm from the coast actuallywhereabouts.
Burnaby is where I grew up, andthen I lived in Whistler and
Pemberton for quite a while toonice, nice.
Eric (02:57):
I love Pemberton and Whistler.
It's beautiful there andBurnaby's nice too.
When I was a kid, actually, mydad lived in Burnaby and so I
spent a lot of years over therevisiting him, so I'm quite
familiar with Burnaby whatBurnaby was like in the 80s
anyway was Metrotown still there.
Metrotown was there.
I think it was pretty new andthe Skytrain had just been.
Was they built?
(03:18):
they finished the Skytrain when,uh, when I was a kid, when my
dad was living there.
I remember taking the Skytrainthe first day it was ever
launched really yeah I'm, maybeI'm dating myself here, but
anyway, completely useless pieceof information.
Most people that aren't from BCprobably have no idea what the
Skytrain is well, I've had somegood times on that Skytrain.
Monica (03:41):
Let me tell you yeah, thanks, monica.
Forrest (03:44):
So Forrest, tell us a little bit about you um, I've
been living in bc now for justover 20 years and found myself
in nelson about 10 years ago.
I've been practicing registeredmassage therapies for 17 years.
Went back to school with monicaactually a few years ago to do
manual osteopathy, and I run ageneral practice here, and then
(04:08):
I also teach at the RegisteredMassage Therapy School.
I've been doing that since itopened, and then I'm also
teaching my own personal coursesand later this year I'm going
to launch an online education aswell.
And yeah, otherwise I'm a dadand I seem to wear a lot of hats
and have some pretty busy days.
(04:30):
But I'd say, like monica, Imoved to the coonies for the
mountains and the lakes andbeing outdoors and being in
nature and, uh, just trying tofigure out how to strike a
balance with that nowadays.
Um yeah, and then monica and Ifirst met a number of years ago
at a backcountry ski hub.
We never knew each other andthen we kind of linked up and we
(04:52):
realized on our first kind ofday out ski touring with each
other that all our other budsthere were high on mushrooms and
I kind of looked at Monica, Iwas like I guess we're
babysitters today and I was likeyou get the mic.
So we took off for the day andled our buddies through the
mountains and watched themfumble around and be dorks.
(05:14):
And then we connected doingthat and realized we taught at
the same college, which wedidn't know that before.
And then, ever since then we'vejust been chasing each other
around at the same clinics andgoing to school together and,
yeah, we can't seem to breakapart our friendship anymore.
We just keep hanging out.
Monica (05:35):
That's so true.
I like to say that Forrestfollows me around a little bit.
I actually did not think he wasgoing to come to osteopathy
school with me.
I actually did not think he wasgoing to come to osteopathy
school with me, and so when hesaid I'm in, I was just so
thrilled to have to have a goodbud to go through school with.
Eric (05:53):
I love that story for the osteopathy school.
Like probably pretty ignoranton this one.
It's all.
Do you guys have to can use it,mostly distance, or do you
actually have to go intoclassroom?
Monica (06:13):
Like how's that work work?
Most of it is distant, so youdo these online lectures and
then you have to go for twoweeks to toronto and do the more
practical side of things.
Eric (06:20):
Okay, such a I mean, yeah, I guess, when you're, if you're
a working professional, I guessit's easier that way to you
know, you don't have to shuteverything down.
You guys can just, you canlearn, and they just only have
to take a little bit, a littlebit of time here and there.
Did you guys?
What did you find about theosteopathy school?
Like, do you, did you find itwas worthwhile?
Forrest (06:38):
I found it a hundred percent worthwhile.
I've been planning to doosteopathy for a really long
time.
I just couldn't figure out howto.
If you knew anything aboutnelson.
It's really hard to get in andout of here, especially in the
winter, um, so it's reallystopped me from like doing the
one in vancouver, because it'slike one week a month for five
years.
I'm like there's no guaranteeyou can fly out for six months
(06:59):
of the year here, and so I'vebeen wanting to do osteopathy
for a long time.
So when Monica, you know,brought this to my attention,
she's like you can do it allonline and then we do two week
practice in Toronto and I wasabout a month away from having a
child and I was like you'recrazy, I can't, I can't do this.
And she kept bugging me aboutit.
She's like you can do it, youcan do it.
And I was all right, I'm goingand we're doing this.
(07:26):
Um, and it worked great.
The, you know, go at your ownpace, watch all the videos.
I mean there's hundreds andhundreds of hours of videos um,
and the fact that, like I run apractice, I could be learning
and utilizing things that I was,you know, watching in my
practice every single day.
So I found for me it was superuseful because I could implement
it constantly and the practicumwas what kind of finalized it.
(07:47):
For me it was like the littletidbits that I couldn't quite
suss out of the videos and outof the education.
When we did the practicum iswhen it all came together and I
was like, oh, that's thatpressure I was missing or that's
that concept that I didn'tquite understand.
By the end of the two-weekpractic I felt very ready to
start, you know, fullyimplementing the skills that I'd
(08:09):
been learning for the last year.
Eric (08:12):
I'm curious how do you like, how did it differ from,
like say, traditional massagetherapy, education?
What was, what was theadvantage of doing that, like
professionally?
Forrest (08:23):
So like, rather than being in class.
Eric (08:26):
No, just like, just in terms of like pursuing it like,
why, like what was the purposeof pursuing that, rather than
just sticking with being an RMT?
Forrest (08:34):
for me.
Like I mean years and years ago,when I first graduated, I was
primarily just doing likeSwedish techniques and after a
couple years I was gettingpretty exhausted and a colleague
of mine was doing allmyofascial techniques and he was
doing 40 hours a week andwasn't exhausted and I.
So I started switching gears along time ago and then I started
(08:55):
taking courses, courses fromNatalia, who he kind of would
describe like the way he workedwas massage therapy with an
osteopathic approach, and themore courses I took from him
over the years, I startedimplementing this much more
subtle way of you know, goingthrough the body treating and
(09:17):
just a different understandingof the depth of how tissues
relate, and it just kind ofstarted perking my interest into
the osteopathy world.
I took some other courses withsome other people.
It just seemed like everythingwas pointing me towards
osteopathy.
So like I would say there'sjust I think osteopathy really
(09:37):
focuses on like how everythingrelates, whereas I found through
my massage therapy education atleast like initially it was
very kind of like somebody walksin with a knee pain and you
just really get focused on theirknee pain, whereas osteopathy
is like okay, they have kneepain, but like what was before
(09:58):
that and what was before thatand what was before that and you
start really trying to definethe layers of compensations over
the decades, and that's kind ofwhat's I find more impactful in
the practice nowadays is reallytrying to understand how
everything connects right, yeah,I mean.
Eric (10:15):
So I'm not sure.
But you guys know, but likeother listeners will know like,
one of the things I'm reallyinvolved with is evidence-based
practice, and this and the useof research, evidence and
practice and curriculumdevelopment is kind of.
I'm always very, very curiousabout osteopathy because there
tends to be kind of two distinctschools of it.
There's kind of the old school,where everything is basically
(10:37):
tissue-based, structure-basedand it's just a lot of technique
stuff.
And then there's there's amovement now in osteopathy, and
particularly in the UK, wherethey're they're trying they're
moving away from that becausethere's not a lot of technique
stuff, and then there's there'sa movement now in osteopathy,
and particularly in the UK,where they're they're trying to,
they're moving away from thatbecause there's not a lot of
evidence to support those kindsof traditional osteopathic
approaches, and at least interms of the explanatory models
or the narratives around them.
(10:58):
How do you, how do youreconcile that those two things?
Because if you're like I, likethis approach but maybe there's
not a lot of evidence to supportit.
How do you feel about thosecontradictions?
Monica (11:12):
I think for me, if something works, I continue
doing it.
And the second I became anosteopath and started to
implement those techniques on adaily basis.
Quite simply, it just works.
And to me the proof is in thepudding.
And I'm the same as you, eric.
I do really appreciate havingthose studies to kind of back
(11:37):
like the evidence-based, butthere really is no substitute
for is it providing results formy patients?
Eric (11:48):
Yeah, no, that's no.
Yes, that's great and I thinkthat's the thing is.
Is that there's, when we lookat, say, osteopathy or massage
therapy or acupuncture, right,we look at the evidence base and
it's like, well, there's not alot of evidence that supports
that anyone is approachesparticularly better than other.
However, if we look at you knowour clinical experiences we may
(12:08):
find that, oh well, I approachpeople in this specific way or
this specific framework and ithelps, and people I get my
client send it to feel better,so that I think this is an
important thing to realize.
It's just the problem or theconcern that we have with any
approach, whether it'straditional massage, physical
(12:29):
therapy, chiropractic,osteopathy is we have to be.
I think you just have to bemindful of the, the stories that
we're thinking of, the storiesthat we're telling ourselves or
the stories that we're tellingour clients, because that's
where the evidence base, I thinkparticularly can, can influence
us in a positive, a positiveway.
Forrest (12:50):
I think that the the challenge with evidence,
evidence-based manual therapytechniques in general, is the
evidence shows that it works,but it doesn't really define why
it's working.
Like, on what mechanism is myhand resting on your shoulder
any better than me needing yourshoulder?
And that's what I can't seem tofigure out.
(13:12):
Like as I've been diggingthrough evidence and research to
create my courses to like okay,so I'm doing joint moves.
Why do joint moves?
Oh, they work.
Oh, they work.
But why are working and thatseems to be across the board
when I look at the evidence isthe why is really missing?
Like, what's the mechanism?
But we're like oh, okay, it'ssuccessful.
(13:32):
Yeah, doing joint mobs issuccessful.
Doing switch massage issuccessful.
Putting acupuncture, doingneedles, successful.
Having a conversation withsomebody and just validating
their life and hearing what theyhave to say is extremely
powerful.
Um, but what's the mechanismunderneath that, the why?
It seems to be missing in theresearch and the evidence.
(13:53):
Like they can't seem to connectthat dot fully.
Like is it neurological?
Is it endocrine?
Is it hormone?
Is it like, is it all the above?
Eric (14:03):
yeah, and the evidence from from the work I've done, it
is, I would say it would be anall of the above, right.
We know that any response fromany touch that is
neurophysiological and there's,you know, there's hormonal and
neurotransmitters and uh, allyou know, um, you know changes
in inactivity in the noiceptivesystem, like there's all these
(14:24):
things that are impacted throughtouch.
And I think, yeah, so that's.
I think, if we really look atall of these approaches whether
it's osteopathy, massage therapy, acupuncture there's a million
different stories about how theyall work that are different.
But really, if we look down toit, how they all work, that are
(14:46):
different.
But really, if we look down toit, it's it's just touch and
it's some type ofneurophysiological, neuroimmune
response, just a different wayof interacting with, with the
human.
A lot of people think thattechnique doesn't matter and I'd
say, well, it matters when itmatters, and that's I'm sure
that's what you guys haveprobably discovered in your
osteopathy training is that like, maybe you slow down, you take
a different approach, or you tryto do things or think about
(15:07):
things differently than youwould traditionally and maybe
that allows you to hold spaceand provide touch that's
different than what they've hadbefore and that's kind of what I
was gonna say that's kind ofwhat I try to teach my students
in fifth semester right now,because at this point they're
starting to put everythingtogether and now they're asking
(15:28):
but like, how do I know whichone to use for which person?
Forrest (15:31):
and a lot of times I'm like that's through experience
you start to recognize the signsbefore the person gets on the
table, about what is theapproach today that will work
best for that person's nervoussystem, or where we're meeting
with them, where they're at.
But that's a hard one to teachsomebody if they don't have the
experience to, to, to use.
Monica (15:55):
So, forrest, you really just took the words right out of
my mouth.
So, eric, I would say that thebiggest thing that manual
osteopathy has brought to mypractice is really bringing this
element of parasympatheticresponse, and I'll fully admit
that before I studied osteopathy, you know I was all about the
(16:16):
deep pressure and I was allabout the deep needling, and
after studying osteopathy Ibecame really aware of how
necessary it was to have someonedrop on my table into that
parasympathetic response, and soyou know, things like cranial
osteopathy, visceralmanipulation, those are all ways
(16:37):
that, as a manual osteopath, wecan achieve that, and I found
that when I have a patient dropon the table, that's when I get
the results.
Eric (16:55):
Yeah, cause you're giving them that, that safe space to
just kind of feel comfortableand cared for, and just turning
that and turning that volumedown on their, on their overall
system, so that way they can,way they can just be in a better
place.
Monica (17:10):
For sure, and trust is a huge part of that, and you know
, part of what we wanted todiscuss today around having
someone feel heard.
I think that thatparasympathetic response does
start the second that thatperson comes into your clinic
100%.
Forrest (17:29):
Eric, you were talking about redoing your whole entire
clinic at one point to make theaesthetics of when people walk
through the door that it lowerstheir nervous system, and so it
does.
It starts right when the personwalks into the space itself
like it does.
It starts right when the personwalks into the, the space
itself, you know.
Does it feel sterile and whiteand abrupt, or does it feel like
(17:50):
it's calming, relaxing andallowing them to like?
You know maybe?
Eric (17:54):
drop down a notch or two and that's and that's.
That's such a huge thing and Ithink that's something that
probably isn't a common thoughtfor a lot of people in the msk
world.
Is you the value of like?
What's your clinical, what'syour clinic look like, you know?
Is it you know?
Is it?
Is it a welcoming, safe place,or is it something that's like
(18:14):
full of like, really brightlights and very medicalized?
And I don't think there's aright or wrong one.
I guess it really depends onwhat you're looking for.
Forrest (18:22):
But it has to meet the individual.
Like, everybody wants somethingdifferent for the most part
it's hard to match a hundredpercent of the time.
But if you can get 70, 80% ofpeople in that head space when
you walk through the door, Ithink that's the win.
Eric (18:35):
Yeah 100, 100.
I love that.
Uh, yeah.
So, monica, you mentioned, yeah, some of the things you guys
want to talk about today waskind of about the, the
importance of kind ofcommunication skills and safety.
So let's go there, tell me alittle bit more about what you
about about that.
What are you guys thinking?
Forrest (18:53):
I I had a specific case that I was going to bring up.
Um, it was one that really kindof watching the person's
reaction in front of me was like, oh my gosh, I just hit the
exact wording that person neededto have said to feel safe and
welcomed into my space.
And I think, if I'd gone aboutit in my old forest way from 10
(19:23):
plus years ago, I wouldn't havegot them into that headspace and
we'd had a very differenttreatment and I'd have lost them
as a as a patient, very quickly.
And so I think that's where,like, the first thing that
happens is is communicationskills, and it's really,
unfortunately, communicationskills are a learned process.
They're they're super hard toteach, they take a lot of time,
(19:47):
um, but I I think what we weretalking about is like validating
people's experiences, you know,letting them feel like they've
been heard and they they're, youknow, being understood, and
that the person who is askingall these objective questions is
also being very compassionate,and I think that's super
(20:07):
important.
But it's really hard to get newlearners to figure out how to
do that.
Eric (20:15):
Yeah, it's not really taught well in school at all, at
least from my experiences as astudent as well as an educator.
You know the it's very much ayes, no kind of discussion,
rather than, like you know, tellme what you're feeling, tell me
what's going on, tell me whatbrings you in here today.
Rather, rather, it's just verymuch like this focus on like,
(20:37):
where's it hurt?
Why is it hurt, what, what didyou do?
Tell me all about it.
Let's figure out the cause andthen let's fix it.
Is that the truth.
Forrest (20:45):
I don't want to slander the CMTBC so much, but they've
really boxed massage therapistsinto this little tiny corner
where we can't ask a lot ofthings, otherwise it starts to
get viewed as like we're doingsome sort of counseling and then
we tell our students likeyou're not counselors, so we're
really reinforcing the narrativethat you don't want to get into
touchy-feely with your patientinstead of teaching.
(21:11):
Like something that I've learnedthrough.
Like I've sat in about 10 yearsworth of men's groups,
thousands of hours offacilitating and being
facilitated, and one of thethings I learned through that
was, like this active listeningskill.
So somebody could tell me 15emotions that they're currently
going through and in the back ofmy mind I am memorizing those
emotions.
Oh, need to say, if I canrepeat back 75% of what they
(21:34):
just said, they know they'vebeen hurt and they know that I
want to connect with them and soit's not even counseling it,
(21:54):
but it's learning that skillthat like, as you're talking to
somebody, you're doing twothings you know where you want
to take the conversation, butyou also need to learn how to
paraphrase and really memorizeeverything they've said to you
so you can say it back.
And it's something that, likeyou can't just learn overnight,
you've got to like be practicingit very actively.
Monica (22:17):
I love that yeah ahead, Monica.
Eric (22:19):
Do you have any doubt onto that?
Monica (22:21):
I do actually.
So in Chinese medicine weactually did do three years of
counseling studies, because wedo counsel our patients right.
So one thing that I can offerfor the listeners today is this
concept of three legs of a stool.
So that's what we always wantto think of.
And so, forrest, you touched onone of the legs of the stool,
(22:45):
which is mirroring, and theother two legs are listening,
and the third one is advice.
Now, I understand that in theRMT profession it might be a
little bit different how youdeliver that advice, but what I
like to call the two R's, whichis resources and referrals.
So these are things that we canalways give to our patients and
(23:09):
I'm pretty sure that would fitinto your guidelines as an RMT.
So referrals would be thingslike counselors, addiction
clinics, mds, grief support, andI have a list of these at my
clinic ready to go, so that it'snot like I'm fumbling around.
It's boom, here you go, this iswhat you need.
And then resources is likehypnosis podcasts, emdr podcasts
(23:33):
, books or articles that I cankind of direct the patient
toward, and so in this way, ifyou're mirroring their feelings,
like Forrest just mentioned andI can't wait to hear your story
Forrest about your patient, bythe way, but if you mirror what
that patient said and then givethem referrals and resources, I
(23:55):
believe that that's such a greatplace to start place to start
the.
Eric (24:02):
And that's such a, it's a, it's such an important skill
and such one that may not berealized, people may not realize
it's as important as it is.
I've.
Really that cause actuallycreates that connection, that
creates a strength in thattherapeutic relationship and
that that person will start togain, gain trust in you, because
you're actually like oh, Ilisten.
Like the person might think, oh, I, I, I listen, this person
(24:23):
listens to me, they understandwhat I'm going through, they
understand my, my situation,whereas a lot of times it's much
easier for us just to kind ofyeah, yeah, yeah, yeah, tell me
what's wrong, let's get you onthe table, let's do something to
you, rather than taking thatreally important time, like you
guys mentioned, to just be therefor them and even in a regular
(24:46):
question that a lot of mystudents ask is well, you know,
the person comes into ourstudent clinic and they, you can
tell they just want to get onthe table.
Forrest (24:54):
They don't want to go through all the assessments and
all that kind of stuff, and I'mlike, but it's your job to make
sure that you are, you know,creating a space that you do
what you need to do to make surethat you're effective.
And so if they're trying to rushyou through so they can get on
the table, but you're the leader, you're the one that's supposed
(25:15):
to lead the conversation anddraw them into the why you're
having these conversations.
And so I don't know, I find inthe last kind of 10 years I
spent a lot more time 15, 20minutes talking to people before
they even get on the table,because I'm digging at stuff,
I'm curious, and maybe that'spart of it is I'm really showing
(25:36):
my curiosity about what they'regoing through and I educate as
I go along, like I don't try todo a sterile environment where
I'm like, okay, we're doing X, y, z, like I'm very creative in
the moment about how thisprocess is going to proceed, and
I do that by really watching.
You know their facialexpressions, their body language
(25:58):
, how they talk to me, how theytalk about themselves, their
body language, how they talk tome, how they talk about
themselves and I think, yeah,monica's right, it's mirroring.
Monica (26:10):
It's mirroring what's going on and also taking the
lead.
I have to say I am like one ofthose guilty massage patients
that just wants to get on thetable when I go for a massage.
Eric (26:21):
So you don't want to come see me, monica, I'll just keep
talking well, I think part ofthe, the skill of being a good
clinician is trying to, you know, determine what's what's the
person want.
Because if the person, theirvalues are important and why
they come is important, maybethe person just wants a massage
and there's there's nothing.
Maybe they just want to feelgood for 45 minutes or an hour
(26:42):
or whatever.
And if that person comes inthey're like I'm just stressed
out, I want a massage, nothing'sreally, but nothing's.
My neck's a bit sore, nothing'sreally to kill, kill me too
much.
Then you know, if we start tosubject them to like a 15 minute
inquiry, they're probably gonnabe like are you freaking,
kidding me?
so I think, that's, that's partof the.
Your practice is like okay,does this person like do they
need more in-depth or do theyjust maybe they just need a good
(27:04):
massage?
Whereas if someone comes in,like you know, I'm sure, like,
of course, a lot of the clientsyou see right With like specific
injuries or complaints or longhistories of stuff, you're
probably going to want to take adeeper dive into their story
and what's going on with themand that way you can come up
with a more meaningful treatmentplan what's going on with them
and that way you can come upwith a more meaningful treatment
plan.
Forrest (27:24):
It's taken me a long time to also accept that I don't
match with everybody and thatit my job is to connect with who
I can and to keep them um, keepthem what's the word?
Faithful to me?
But I'm going to lose people along way because we don't
(27:44):
connect and I don't.
You know, throw them on thetable in the first two minutes
and start doing treatment, andyou know I'm totally fine with
that nowadays, whereas a longtime ago I wasn't fine with that
.
I would just do what the personsaid they needed, and I just do
it to try to keep them.
But I've learned over time thatI really I just want to work
with people who want to workwith me and it's not worth my
(28:06):
time to just kind of forfeit mypassion for practice because it
bores me.
Honestly, if somebody istelling me exactly what I have
to do to figure everything outand they're telling me the
sequence and I have to do tofigure everything out and
they're telling me the sequenceand I have to do a very recipe
thing.
I get bored and then my passionstarts to fade and I am not
(28:30):
nearly as effective when I'm notpassionate.
Eric (28:33):
You can't please everybody all the time and you can't be
the therapist for every singleperson, and you'll tend to
attract a practice thatrepresents you and who you are.
And and I I don't know ifanyone you know spends any time
on social media you see theamount of burnout and the amount
of concerns that people have inour profession and I think a
(28:54):
lot of it has to do is becausethey've kind of lost that
passion, because their theirpractice is very kind of recipe
based.
They're just doing the samething over and, over and over
again, and for some people Ithink they can do that, and some
people I think it it burns themout.
And you know, I'm just making atotally anecdotal statement
here, but that's, that's myimpression anyway to say the
(29:15):
story that I had.
Forrest (29:16):
Um, so mom started this .
She, she called me up and saidyou know, I need to get my child
in to see you Child being like21.
So they came in, they sat downand they were all over the map.
Like their shoulders werehunched, I feel like their body
language was dropped, depressed.
(29:36):
They were anxious, nervous,anger in them.
They just really really quitementally disturbed.
And I'm trying to ask questionsand get an idea of, like, what
we're doing today.
And as we talked and I finally,at some point, I was just like
(29:56):
hey, if you just need to sithere and talk to me, you need
somebody to listen to you rightnow.
We can do that.
I don't even need to put you onthe table.
If you don't want to lay on thetable today and you just want
me to sit here and be with you,I can do that right now and I'm
happy to do it.
And then, their shouldersdropped, they like teared up a
(30:18):
bit and they got so relieved tohear those words, like to watch
their whole body just fullyrelax and settle in was amazing
and I was like whoa, I justnailed what that person needed.
Um, I don't think they've beenreally hurt.
They go to counseling.
They're on all sorts ofdifferent types of medications.
(30:40):
It seems like they're just kindof almost falling through the
cracks of the system and noone's really like picking on or
picking up on like what theyreally need.
And it was just for me to watchthat physical change in the
person's body was so powerful.
The record for me to recognizelike my words have more
implications and moretherapeutic effects than
(31:03):
actually getting them on thetable.
And then actually, when I didget them on the table, it was a
terribly frustrating treatment.
Uh, couldn't use enoughpressure, couldn't use light
enough pressure.
They couldn't stay in oneposition for more than five
minutes.
They're twitchy and agitatedlike.
It became really quite thechallenge to navigate a
(31:26):
treatment with them.
But what seemed to really beeffective, as I kept seeing them
week after week for quite awhile, was that first 20 plus
minutes of just letting themdownload what was going on in
their brain.
That seemed to be moreeffective than the actual you
actual hands-on approach.
And it's so backwards to whatwe're taught in massage school
(31:49):
To even just advertise tosomebody like hey, I don't even
need to touch you today.
That actually goes againsteverything that we're supposed
to do as massage therapists.
But I'm a compassionatetherapist.
I'm supposed to be here to helpyou.
If that's what helps you themost, then why am I stopping it
from happening?
Just to force you on the tableto put my hands on you and I was
, you know, I think doing one ofthe other pillars Monica just
(32:11):
mentioned, like talking aboutresources and recommendations,
but the gist of the story wasjust like the power of words and
realizing how much theirnervous system dropped just from
hearing that somebody waswilling to sit with them and
just listen.
Eric (32:33):
That's very powerful for us and thanks for thanks for
sharing that story.
It's so true because if youthink about a lot of those
people, particularly people thathave been in pain for a long
time, people that live withchronic pain or chronic health
concerns, oftentimes they'redismissed or they're just not
really listened to and if youcan be that one person that
takes the time to validate them,to listen to them, and you're
(32:55):
not counseling right?
You mentioned that earlierabout the.
You know there's the worry thatwe're counseling but you're
just holding that safe space forthem, that is extremely
therapeutically beneficial.
Why would we be discouragedabout it?
Almost doesn't make sense, doesit?
Forrest (33:10):
no, and it's hard to kind of, I think, understand
what the where, that you know it.
It's not a black and white linethat you're like you, it's
there's a gray area in there andit's really hard to get people
understand, I think, as massagetherapists, what that gray area
is, that you can still workwithin.
That is very effective.
Eric (33:31):
Monica, do you want to share kind of like what's your
perspective on that?
How is that similar ordifferent for Chinese medicine
and acupuncture?
Monica (33:40):
The thing about Chinese medicine and acupuncture is that
we actually acknowledge thatthe emotions create illness.
So part of what we're doing inour assessment is talking to
them about their emotions prettypretty outright, like all
straight up, say to someone doyou experience anxiety, do you
experience anger, do youexperience worry, do you
(34:02):
experience grief?
And then, if they say yes, I'masking more questions about
those things and then, likeBoris said, I'm going to be
mirroring what I've heard andthen from there giving advice.
And so one thing I need tomention about the three legs of
the stool that we were taught isactually to make sure that
there's a balance there, right,a balance between listening, a
(34:25):
balance between mirroring and,finally, a balance between
advice.
So I find in my practice it's atricky.
It is tricky to strike thatbalance, and that's where I find
that the resources andreferrals are really, really
important.
And that's where I find thatthe resources and referrals are
really, really important.
(34:47):
But I also and I've taught mystudents this for many, many
years is I think that when weget a patient into our office,
there's this sense that we haveto rush to form a relationship
with them, and one thing I'vetaught repeatedly is that a
patient practitionerrelationship can take years to
form, and when you're not rushedto form it and you're allowing
it to to grow at its own pace,based on what the patient needs,
(35:11):
that's when you're going to bethe most effective, and I feel
like we might.
You know, in our cultureeverything's fast, right, fast
food, fast, this fast.
That Everything's fast, right,fast food, fast, this fast.
That it's really important justto slow down that patient
practitioner relationship.
And then Forrest, in the caseof your story, I think that by
(35:32):
listening, maybe right now youcan't give the right pressure to
this patient, but I think thatthe more that you are just
patient with that relationship,maybe in two years you're going
to give that optimal pressure.
And if it takes two years toget there, so what?
That's what it takes right, wehave to be patient with the
(35:55):
process and I think that's justso cool that you were able to
follow your intuition and reallygive that patient what, what he
needed.
Forrest (36:07):
What's weird is like my ethic, my ethical side of me,
felt so wrong by just sayingI'll just stay here for an hour
with you and not put you on thetable, cause like technically I
shouldn't be doing that, butthat's what felt the most
compassionate human thing to do,so, forrest.
Monica (36:27):
I don't know about you, but, and, and Eric, I'd love to
hear your perspective on thistoo.
But there's always like abalance between ethics and
humanity Right, and I have areally powerful story to share
at some point if we get there.
But for me it's almost like inmy practice, I have to balance
(36:48):
the two, like professionalethics and laws, with what I
feel is a humane thing to do.
In the end, I am always goingto follow my moral compass.
You know I'm going to balanceit with what the industry says,
but I think that following thatmoral compass is super important
(37:09):
as a practitioner.
Eric (37:13):
I agree 100% and this is actually something.
This is a whole.
We could have a whole otherepisode just on ethics.
I love talking about this stuff, so thanks for opening up that
topic there, monica.
The healthcare ethics is notsomething that we really talk
about enough.
I don't think inmusculoskeletal care.
So the first principle right,beneficence right.
So you should always be workingin the best interest of the
(37:34):
person, so you should always beworking in the best interest of
the person.
If maybe the best interest ofthe person is just to sit there
and be heard, and maybe you onlyprovide a few minutes of
hands-on treatment, I think ourI should know this, but I'm
pretty sure that in our bylawswe have to provide some form of
hands-on therapy, for it to becalled massage therapy.
But if the best interest of thepatient is to be set, to be
(37:58):
validated, to be heard, for themto, would you I think the word
used um for us was downloadtheir brain yeah, they needed.
It seemed like they wanted todownload just what was going on
inside of them yeah, and theywere okay with that and that's
what they wanted and that's whatthey found valuable and I found
my.
In my own experiences I've hadvery similar things, where some
(38:19):
of the people just want to justknow I'm going to tell you all
these things and it's okay, likeI don't care if we only get a
few minutes of hands-on stufftoday.
This is really important.
You're sitting there, you'relistening, and sometimes you
might be thinking, oh my gosh,like this person is telling me
everything and I'm not doing myjob.
But if we look at the ethicsand working in the best interest
of the person, then why wouldwe tell them no, it doesn't make
(38:41):
sense, does it?
Monica (38:43):
Absolutely, eric, and I think one thing that we can do
as health professionals is pointblank ask them and I will say
to a patient like hey, I won'tbe offended if you say no, but
is this helpful for you?
And if they say yes, that'ssomething I can then put in the
chart.
Patient said that they found itextremely helpful to just chat
(39:05):
right and then it's charted.
So if the college ever comesand assesses or audits you, then
you know it's charted that thepatient needed that 100%.
Eric (39:19):
And if it's a patient-centered treatment, then
and that's what they want andthat and that's what helped.
And you know, we're we're doing.
We're doing good work.
I don't think we could ever getin trouble for that exactly
yeah, I love that sorry for usinterrupted you no that was I.
Forrest (39:33):
I had never thought about charting that before.
So I'm kind of going oh, Icould chart that, and then it's,
it's, it's in there, it's partof the record.
Eric (39:44):
And ethically then I'm actually kind of, you know,
cross the t's and dot the i'sfor sure, because that will help
you too, right, so maybe theperson doesn't see you again for
two years.
You kind of forget, forget theforget, what happened.
And then you have that in yourin your notes and you're like,
oh yeah, this is what, this iswhat happened last time they
wanted to chat, and this is abrief thing, what they, what
(40:04):
they said, and this was thevalue, and I think it's.
I think it's a good practice,in my opinion anyway.
So question for you guys herequestion for you guys is so how
do you, how do we foster morekind of comfort and competence
in navigating thesecommunication skills?
Because obviously I think thethree of us are all been around
(40:25):
the block a while, a few times,and this stuff that we're
talking about may seem easy, orit's never easy, but may seem.
We're familiar with this, thistype of conversation, these type
of important things.
But how do we get, how do weinspire and educate other
therapists, whether it's newones or ones that have been
practicing for a while, to adoptthis more communicative
(40:48):
approach?
Monica (40:50):
I think the biggest tip that I can give, just from my
couple decades of practice, isto be more straightforward with
the patient, and that'ssomething that has taken a lot
of time.
But you know questions that Inormally wouldn't ask early on
in my career.
You know, for example, like ifif a patient starts talking and
(41:14):
you know we're talking about asubject, I will like point blank
ask them do you want tocontinue talking about this or
is it too much for today?
And so I'll give them an out.
Um, so I'm not afraid to kindof ask for what the patient
needs and and I'm constantlydoing that like is the music
okay in here?
(41:34):
Is the lighting okay for you?
Is it comfortable?
And and the more that we can bedirect and concise with our
patients, they're going to giveus the information, but we have
to give them the opportunity youforce what your thoughts um
honestly.
Forrest (41:54):
I've been trying to figure out how to just with,
like the students that I've hadover the years, how to
facilitate these types oflearnings in a way that they
could put take it, put it intopractice.
And I haven't really honestlyfigured out how to how to
educate or teach in a way thatgets learners you know whether
(42:17):
they're already practicing oryou know current students how to
learn these techniques andskills.
I just kind of advertise that,how important it is so that they
recognize that there'ssomething that they need to keep
working towards.
I just know for myself the onlyway I got to where I I am is
because I started doing a lot ofwork on myself, and that's
(42:40):
where I learned a lot of mycommunication skills was once I
started spending many, manyhours a week practicing
communication skills on myselfand on on others, in a place
where that was the point of itlike.
Like I said, I sit in men'scircles, and so the whole point
of men's circles is learning howto communicate, learning about
(43:02):
emotions and feelings.
So that's how I learned it all.
I was actually reallyinundating myself in how to do
it.
I didn't learn it throughschool.
Eric (43:16):
Yeah, I would say that most of us probably don't learn
it in school, but, like a lot ofthings, right there's, you know
, our education shouldn't finishonce we, you know, get our
license.
It should be an ongoing,lifelong process, and I love
that.
You know you talked about, youknow, working on yourself, and
that kind of self-reflection isso, so valuable and it's
(43:37):
something that we should all do,because when we're working with
the public and we're workingwith people and we're looking,
working with people that are inpain and and and and they're,
you know, they have their ownlives and their own stories it's
very, very important for us toreflect on on our own life and
how and how we can be better forourselves, and then, by being
better for ourselves, we can bebetter for those people that
(43:58):
come and see our care I couldn'tagree more, eric, yeah, you,
you hit it on the head there forsure yeah, so you guys are
let's talk, because you guysreached out to me, because you
wanted to.
You guys guys are doing your own, are going to be launching your
own podcast, so why don't youtell, tell me and the listeners
(44:21):
a little bit more about what youguys are up to?
Monica (44:24):
So when Forrest and I traveled to Toronto, we did a
lot of driving to and from ourclasses and it was pretty funny
because every day we would getinto these amazing discussions
about health.
And it just occurred to us likewow, if we press play on these
(44:45):
conversations we could reallyprovide something for other
practitioners and patients.
That would be just really goodinformation for them to have.
And so then the idea sprungabout like we should just go for
a beer and hit play and havesome microphones around and see
(45:06):
where it takes us.
But the idea is to kind of takeour combined 40 years of
knowledge and just help peopleout on their path to becoming
better practitioners better, youknow, whether it's a patient or
a practitioner.
We want to.
We want to try to give value,to help people on their health
(45:26):
journey.
Eric (45:28):
I love it, and is that coming out soon?
Forrest (45:32):
I think probably in the next month.
We've Monica has done a goodjob getting everything all kind
of set up and we've had somesit-downs to talk about pieces
that we want to kind of liketailor a conversation around.
And yeah, I think somewhere inthe next month we'll be starting
to launch doing some podcaststogether and if nothing else,
(45:57):
hopefully there's somethingfunny there.
Monica (45:59):
You can laugh along with us for a bit monica, you have
quite the infectious laugh, Imust admit so oh, thank you you
know I first would actually likedisagree, because in clinics
sometimes like I, me and mypatients get into these laughing
fits that can be heardthroughout the whole clinic and
(46:19):
I call it laughter therapy.
But my colleagues are like, ohno, monica's here again.
Forrest (46:27):
I joke with you the other day, saying I'm just glad
I don't share the exact wallwith you, and then I'm like two
rooms down.
Exactly Right you're just farenough away that it's, it's fine
.
Eric (46:38):
Do you guys have a name for the podcast?
Forrest (46:44):
uh, we're gonna go with um healthful perspectives,
healthful perspectives.
Eric (46:50):
Okay, I'll put that in the show notes for us.
Why don't you since you haveyou here why don't you tell the
listeners a little bit moreabout, uh, the courses that
you're doing and what you havehere?
Why don't you tell thelisteners a little bit more
about the courses that you'redoing and what you have coming
up?
Forrest (47:00):
uh, so over the next kind of I think about four
months, I've got a course eachmonth here in nelson, uh, so I'm
going to be doing the nextone's lumbar and sij, that one
after that's thoracic and ribs,following one after that's upper
extremity.
Um, what I'm really wanting todo is tie together more simple
(47:21):
observation assessments,palpation skills to figure out
the right approaches to whichtechniques to use for somebody
with a certain type of conditionor issue.
So it's really trying to tiethose assessments and techniques
together a bit more.
The predominant theme of like,say, techniques is going to be
(47:43):
muscle energy, joint mobs andfascial mobilizations.
Yeah, that's kind of what myaim is right now.
I've already taught quite a fewclasses in person last year, um,
and so I also love just kind ofbringing some case histories
and and just kind of watching tosee how a class can unfold, um,
(48:06):
and try to answer other healthprofessionals questions on like
what's going on in theirpractice that you know they're
needing support around and mylong-term goal is actually this
later this year, I'll belaunching an online education uh
that will have all of mytechniques and skills recorded,
(48:29):
so you can you can do onlineeducation without having to come
to to nelson yeah, nelson's notthe easiest place to get to, no
, but once you're here, it'sbeautiful.
Eric (48:41):
It is beautiful.
I've been there once, and itwas a very wonderful place.
I only was there in the summer,though, or spring, so it was
beautiful, then.
How can people get ahold of you?
Do you have a website that youwant to put a plug in there?
You?
Forrest (48:54):
can go to my website.
It's called rebalancingca.
There's a registration page onthere as well, if you're wanting
to look at the courses, or youjust send me an email from that
page and I can answer anyquestions perfect.
Eric (49:09):
And monica, what about you ?
Do you have a contactinformation?
You want to provide listeners?
Monica (49:14):
yeah, so my my website is wwwaccunelsoncom.
Eric (49:22):
And are you going to be doing any continuing education,
Monica?
Monica (49:25):
I actually have a whole curriculum written.
So it's just, you know, tryingto trying to come up with a
little bit of a plan for thenext year or two.
I think that it's my plan tokind of get this podcast
launched and then after that Iwill launch my curriculum,
because I am very passionateabout teaching.
I do love it, so I amanticipating that for my future
(49:50):
for sure.
Eric (49:51):
I love it.
Yeah, teaching is can be, youknow, if you're inclined for it,
it's just, it's infectious,almost it can become like
addicting.
if you're inclined for it, it'sjust, it's infectious, almost it
can become like addicting, justto just such a good feeling to
be there and to interact withpeople and hopefully help them
think about things differentlyor do things differently and
inspire them to pursue moreknowledge is such a wonderful
feeling, so I'm really excitedto hear that you guys are both
(50:15):
taking that, that approach, andyou've got some hopefully, some
good quality stuff coming out inthe near future absolutely all
right guys.
Well, thanks for being heretoday.
I appreciate you, uh, takingthe time to be here and to have
this, this conversation, andhopefully we can touch base
again soon.
Monica (50:34):
Thank, Thank you so much , Eric.
I just want to really show mygratitude for hosting us and
we're just so happy to be here.
Eric (50:43):
I'm happy to have you guys .
Forrest (50:45):
Yeah, Eric, thanks for all the things over the last
couple of years.
It's been great getting to knowyou and having you as a
resource and support.
Eric (50:53):
I appreciate you saying that for us.
It's been wonderful workingwith you too, buddy, and yeah,
we'll keep in touch.
Okay, sounds great.
I appreciate all you listenersfor taking the time to be here.
If you enjoyed this episode,please give it a five-star
rating and share it on all yourfavorite social media platforms.
You can follow me on Instagramor Facebook at ericpervisrmt,
and please head over to mywebsite, ericperviscom, to see a
(51:14):
full listing of all my livecourses, webinars and
self-directed course options.
Until next time, thanks forlistening.
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