Positive Health Online

The massage student who, choosing this question on The Massage Training Institute’s exam paper, describes the importance of nice ambience, soothing music and fluffy towels gets no marks. This is an anatomy and physiology exam and the deceptively simple question requires an answer that demonstrates understanding of the physiology of the stress response, and how massage may decrease sympathetic nervous system (SNS) activation and facilitate a switch to parasympathetic and the feelings and sensations we call relaxation. There also needs to be a discussion of ‘massage’: what sort, how it is applied, where and with what kind of intention, plus an explanation of how touch stimulates Merkel’s receptors, Paccinian corpuscles and so on in the skin, as well as how this information is transmitted via the spinal cord to the brainstem, cerebral hemispheres and hypothalamus, that little area of the brain that regulates the balance of the autonomic nervous system.

But then most of us, if placed supine in a warm, quiet, dimly lit room and covered up, will begin to relax. The brain equates lying down, warmth and safety with sleep. So maybe all the parameters that we put in place before the massage treatment do play a significant role in establishing a parasympathetic nervous system response, even before hand has contacted body. And when that happens, the initial touch is registered on a very basic level as ‘ this is good for me and I like it ‘ or ‘ this is not good for me, stop it’. We share this level of discrimination about incoming stimuli with other mammals (Damasio, 2000). Human beings, lions and rabbits are averse to extreme temperatures and toxic food, for example, preferring optimum warmth and good food. All of this is the business of the so-called ‘old brain’ or limbic system. The extra facility that our four-legged friends don’t have is the ability to remember and compare. The sensations of being massaged are routed as well to the cerebral hemispheres, where gentle rocking of the spine, say, stimulates the neural pathway associated with the semi forgotten memory of the cradle in one person and of a recent bad sea voyage in another. For this reason, the effect of massage is unpredictable.

Recently I came across two new therapeutic techniques that employ bi-lateral stimulation of the brain, and this has led me to wonder whether another mechanism might also be operating in the ‘massage is relaxing’ phenomenon. EMDR (Eye Movement Desensitization Therapy) is an internationally recognized and well-researched treatment for trauma (Shapiro, 2001). Focusing on the worst part of the trauma memory, the body feelings and sensations and the accompanying negative thought, such as ‘I’m going to die’, while the brain receives bilateral stimulation from eye movements, tapping alternate knees or listening to sounds in one ear then the other, removes the level of traumatic arousal. In a training video, a woman who had nearly gone through her windscreen in a road traffic accident, and is clearly distressed in the first EMDR session, is seen saying at the beginning of the fourth one ‘Do we have to go through this again? It’s so boring!’ Although no one knows exactly how this works, it seems that there is a shift from a particular memory accompanied by high emotional and physiological arousal, to being just an ordinary memory, with corresponding decrease in SNS activation.

Holosync technology also uses bilateral brain stimulation to achieve states of deep meditation very quickly. Developed by Bill Harris at The Centrepointe Research Institute in Oregon, Holosync technology sends tones of slightly different frequencies into each ear, masked by ambient sounds. The brain, in its attempts to adjust, goes into the brainwave patterns associated with relaxation (alpha), deep relaxation (theta) and deep sleep (delta). As Bill Harris says, everyone has a nervous system threshold above which they become overwhelmed by too much input. Over time, using the meditation tapes, the threshold for activation of the SNS is raised.

Which led me to wonder about the role of bilateral stimulation in massage. When we effleurage someone’s back, the pressure, speed and contact of each hand on either side of the spine will not be completely identical. Perhaps this varying input to the brain from the right and left side of the body, that also occurs when we massage the neck, torso, and face – anywhere where two hands are working simultaneously either side of the midline – is responsible for the shift many people experience during massage into that state between waking and sleeping, a state associated with alpha waves and increased serotonin production.

Massage is relaxing? I am now wondering what other neurophysiological mechanisms might be involved in this response that we take so much for granted.

References

Damasio A. The Feeling of What Happens. Body, Emotion and the Making of Consciousness. Vintage. London. IBSN0 09 928876 1. 2000.
Harris B. Thresholds of the Mind. Centrepointe Press. Beaverton. Oregon. ISBN 0-9721780-1-5. 2007.
Shapiro F. Eye Movement Desensitization and Reprocessing. Basic Principles, Protocols and Procedures. 2nd Edition. The Guildford Press. New York. ISBN 1-57230-672-6. 2001.