MASSAGE MAGAZINE
Dale G. Alexander Ph.D. L.M.T.

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DALE ALEXANDER was the guest speaker at the 2003 FSMTA convention in Orlando. Recently, I had an opportunity to talk to him about his practice, his philosophy, and my concerns about the field of massage therapy.

ML: The issues I confront as a therapist, after thirteen years of practice, are generally ones of misperception or ignorance on the part of clients and/or the doctors who are treating those clients. I’m often unable to get a client to respect my opinion about a direction they could be going in with their healing because I’m battling the aura of a doctor who is prescribing or over prescribing medications; or I find that many people simply don’t want to take responsibility for their own healing, they want to relax on the table and let me fix them, to the extent they think that’s possible.

DA: Michael, I understand your frustration. Respect, however, does not come from our clients or, from physcians. It comes from our confidence and competence to assist the healing process. At this point in our collective history we are still in the process of building a broad based clinical foundation for the practice of Massage Therapy. And, this foundation is growing as people with more complex physical ailments seek us out. People are voting with their feet and with their pocketbooks. Rather than be frustrated by people’s misperceptions and ignorance, let us remember that we are still very much pioneers.

Physicians are the frog on the lilly pad of our health care delivery system. Our culture still imbues them with a kind of awe which puts them on the pedestal of having to be perfect. The relentlessness of malpractice escalations are testimony to this. Over the years, I have come to realize that the primary job of a physician is to be alert to progressions of ailments which may cause a person’s death. Our job in contrast, is to assist our clients to enhance the quality of their lives, through prevention whenever possible, rehabilitation when needed, and through assisting them to discover more clearly their life purpose.

Our primary role as Massage Therapists involves activating the body’s self-corrective capacities through the sacredness of touch yet, often it is equally important for us to be educators with our clients. To assist them to use their common sense, to tune into the wisdom of their bodies and to reclaim their capacity to make informed choices. When clients face a health crisis or chronic problem they get scared and, from their fear, they give away their sovereignty of choice to others. For any of us to take responsibility for our healing, the first task is to begin making choices “from within ourselves” rather than from outside of ourselves. Massage Therapy in all of its variations does assist this process by helping clients to feel what’s going on “inside” of their bodies.

ML: When a person comes to you and they refuse to relinquish their faith or trust in a doctor who is only interested in prescribing medication and that medication is obviously counterproductive to any healing you might be able to accomplish, what do you do? How do you convince a client to trust you or take a different approach? Or is that possible?

DA: What I find to be most effective is to express my concern for clients personally. I’ve come to realize is that it is not my role to tell anyone what to do about their health or lifestyle choices. Yet, I do help people to connect the dots. Most often, I encourage clients to ask themselves. “am I making progress with the current approach?”. From there, I assist clients to reflect on their lifestyle choices, to become more effective advocates for themselves with their physician, consider going to another physician for a 2nd opinion, and/or to seek out additional information about drug interactions from a trusted pharmacist. Sometimes I sit down with the client and review their medications in the pharmacology reference books with the caveat at the end of the conversation, “go speak with your pharmacist or doctor. We are part of the health care delivery system. Our job is to enhance our client’s awareness of their options as well as to provide an alternative form of care.

A client’s trust in us and respect for us increases as their life get better. This includes both feeling better and by embracing the “fullness” of their lives. We may still be in the Rodney Dangerfield phase of our evolution where we, “just don’t get no respect”. Yet, the remedy for this is as it has been for the past 50 years, to dedicate ourselves to assisting our clients in their healing and to building our individual confidence & competence through continuing education. It is from the results of our work that our profession continues to grow.

I’ve been in the field for 23 years now. I started out as a biology teacher and psychotherapist then transitioned into Massage Therapy as I recognized that the sacredness of touch is a core component of transformation and healing. I’ve been very lucky as a therapist to have clients come to me with chronic problems, usually after they’ve been to everyone else. My practice in Key West has grown mostly from word of mouth. We are still in the Rodney Dangerfield phase of our evolution where we, “don’t get no respect.” The remedy for this is to simply dedicate ourselves to assisting our clients in their healing. The rest will follow over time. I usually carry a waiting list of people who want an appointment.

It’s not me trying to convince people to prioritize my ideas about things. What I endeavor to do is to help clients prioritize their own internal response to what has been suggested. Because I’m not a pharmacologist what I encourage them to do is see a good pharmacist. Those are the people who have the knowledge and f there is something that’s counterproductive they will know that.

We are not doctors. If one wants to become a doctor, go do the training. I went through that dilemma myself 12 years ago and I chose not to do it because of something a chiropractor friend said to me. He said, “Dale, it gets awfully seductive to pull out that prescription pad. You have spent many years honing your palpation skills and your philosophy of healing. Do you really want to to move away from these?”

When I interview a client I try to help them realize what they’re doing that’s helping and what the interactions are. To defer to me is a losing battle. It’s better to encourage a client to be an advocate for themselves with their own doctor.

Of course there is usually far too much information to cover so I try to get a list of the medications beforehand and prepare for that. And what I’ll say is, “These are the drugs I would be concerned about if I were you.” Or, “If I were you, this is what I would do.” Something like that. We have to walk a fine line in what we say. Older people really do have a lot of things that are complex and confusing with respect to medication.

Usually if I approach someone in this manner, they listen. Yes, we don’t get the respect that doctors get but at the same time we have to be very careful not to start acting like doctors. Our primary role, as I see it, is to be educators . In general people don't have a clue as to how their body and psyche dance together as a coherent whole. That's part of my life purpose, to continue to expand my comprehension of this “wholeness” and bring it to the table day after day with my clients, allowing it to be forged by my clinical experience rather than by ideas about how it might work. Our clients are our best indicators for whether our philosophy of healing is working or is still incomplete. The part I think we can contribute to a field theory is how does the body really work? How is there a progression from these things? I’ve seen this over and over again, once you have any kind of pressure on a joint capsule, the extrinsic musculature contracts around it to protect it. That actually is the primary dilemma that people face as they transition through life. Do I move forward? Do I stay put? Or do I step back? This is preprogrammed to some degree by the sympathetic orientation to fight, flight, or freeze. Fundamentally, what people are working with in massage is unloading the sympathetic nervous system, which increases the adaptation capacity, it also facilitates a reduction in sympathetic tone to allow healing to take place via the parasympathetic waves, the cranio-sacral waves, the lungs, the heart and peristalsis. This is the core construct that I operate from. As body workers we all tend to do too much. I did this for a long time and for people with this tendency we have to discipline ourselves to develop a delicacy. To be able to feel fluid. This is where the cranio-sacral approach comes in. I actually see the visceral system in some ways as being primary to the cranio-sacral but the element of being able to feel the brain and spinal cord and the fluid as it fills and empties and to appreciate that as one of the core rhythms in the body is very powerful.

I wanted to have four cornerstones in my work and Upledger was one of them. The others were connective tissue, muscle energy techniques that allowed me to work safely with joints, the visceral and cranial work, and the other elements of energetic touch. When you have this kind of foundation you kind slide between all of these approaches and begin to work with the whole. When I teach, this is the coherency I try to offer but the truth is you can use any technique. I used to think there were techniques that were superior to others but over the years I had to give that up. That was just arrogance. I laugh at myself a lot about that.

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