Science reports on Fascia Congress Happily, Science Magazine has seen fit to report on the International Fascia Congress which took place in October 2007 at the Harvard Medical School Conference Center in Cambridge, MA. Researchers and clinicians from 23 countries gathered. I was in attendance and gave an oral presentation to conference-goers on one of my favorite topics, superficial fascia. The Second Fascia Congress is planned for October in Amsterdam, The Netherlands. I've submitted a couple of abstracts for that as well, and hope to be presenting there in October 2009.
Here are four articles Part 1, Part 2, Part 3, Part 4 by Gil for structural integrators, first published in the Hellerwork journal, Tensegrity News.
Professional Growth through Human Dissection This is an article I wrote which was published in similar form in Massage Magazine in the fall of 2006 (Issue 126).
ABSTRACT FOR GIL'S ORAL PRESENTATION AT FASCIA CONGRESS
Demonstration of the Integrity of Human Superficial Fascia as an Autonomous Organ
by Gil Hedley, Ph.D.
Background: Superficial fascia (AKA the adipose) is almost universally dissected regionally and discarded in the pursuit of deeper structures. Often it is dissected without differentiating it from the skin. Due to these two factors, the autonomous, organ-like integrity and continuity of superficial fascia has not been previously demonstrated. By developing a method for dissecting the entire superficial fascia simultaneously, I demonstrate heretofore overlooked fascial continuities raising questions for further investigation.
Methods: Using scalpels, first the entire skin of a female cadaver is differentiated from the underlying superficial fascia. Next the superficial fascia is incised to the depth of its transitional interface with the underlying fibrous deep fascia on a mid-sagittal anterior line for the torso and two to four centimeters medially from the midline of anatomical position for the limbs. Hands, feet and head are excluded due to practical difficulty of execution. Finally the superficial fascia is differentiated and reflected from the underlying deep fascia circumferentially in total from these incisions and reflected as a unity from the body.
Results: Admitting the exclusion of the hands, feet and head/neck tissue matrices, the superficial fascia of a female cadaver is demonstrated off the body as a continuous, whole body tissue layer with a range of tissue depths and predictable differences in fibrous densities.
Conclusion: Some human forms are sufficiently endowed with a depth of superficial fascia sufficient for easily demonstrating the integrity of that tissue complex as an autonomous organ. Every human form without exception presents this tissue layer in some degree. Replete with its own nervous, vascular and lymphatic endowment, its own complex, elastic and resilient connective tissue matrix, actively contractive smooth muscle fibers, and abundant fatty deposition, the superficial fascia layer bears within itself all of the properties of a discreet and vital organ of the human body which, despite its overwhelming relative size and import, has been heretofore generally overlooked or misunderstood as relatively superfluous by conventional dissection methods. In consideration of its demonstrable unity and integrity as here shown, the structural, physiological and energetic properties and functions of superficial fascia recognized both as a discreet and ubiquitous human organ, as well as in relation to other types of fascia, require much further study. Top of page
SCIENCE Magazine, "the world’s leading journal of original scientific research, global news, and commentary," has an excellent write up about the recent First International Fascia Research Congress in its November 23, 2007 issue (vol. 318, pp. 1234-5).
The article by David Grimm is titled "Cell Biology Meets Rolfing − A diverse group of researchers wants to create a new discipline from scratch by bringing together experts in fascia and deep-tissue massage."
A few points from the article...
"The meeting, held here [in Boston] last month, would be the first dedicated to the soft part of the body’s connective tissue system − an important but medically neglected organ. It would bring together top scientists from fields as diverse as cell biology and biophysics, but it would also include alternative medicine practitioners..."
This conference was a first venture within the field of the human fasciae to bring together scientists and clinicians and it was not at all certain that getting these two diverse groups together would satisfy everyone or produce constructive collaboration. Quoting Thomas Findley, MD PhD, the Executive Director of the conference, "Practitioners want to know the science behind what they’re doing...and scientists want to see clinical applications of their work." Partap Khalsa, DC PhD, program officer with the U.S. National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) stated, "You need people who can do good basic science and clinicians who can inform them about their experiences...It’s the only way to advance the field."
Yet, by the end of the second day, it was obvious there was a meeting of minds. So much so that a leading researcher in biomechanics, Peter Huijing, PhD, of Vrije Unvesiteit in Amsterdam has agreed to help organize the next conference in Amsterdam in 2009. "Huijing says he also learned new things from the alternative therapists − and he found that he had something to teach them as well."
It should be noted that Dr. Huijing, himself, was originally skeptical of the feasibility and value of such collaboration. "Huijing plans to give a larger spotlight to practitioners and to explore even more of the basic science. He’s adding days, and he’s reserved an auditorium for 1000 people − twice the size of the room at this year’s event. ‘I have a feeling it could be very big,’ he said."
For online access to article (via subscription) go to Science Magazine
PART ONE: INTRODUCTIONS~~~~~
Steve: Gil, what's your background/training?
Gil: While studying for my doctorate in theological ethics at the Divinity School of the University of Chicago, I started craving embodiment. I studied Tai Chi, then massage, then got certified as a Rolfer back in 1993, about the same time that I completed my work at the university. No sooner did I start to practice than I realized I craved two things: an even deeper understanding of what lay beneath the skin, and a deeper understanding of psychodynamics from a spiritual orientation. I felt pursuing these interests would make me a better practitioner. To address the second interest, my wife Karen and I embarked on a 4 year program at a healing school in NYC, the IM School of Healing Arts. To address the first, I set up an opportunity to dissect a cadaver with some fellow Rolfers. I had some previous experience working with cadavers in the lab studying alongside a friend who was in medical school. I leveraged that experience to create a new one.
Steve: So how did it go?
Gil: It blew me away! I learned a lot in those weeks, and reeled in awe at the wonder of human form. I particularly learned that I didn't know squat about the anatomy I was touching, and I was hooked. I immediately planned to develop the experience further. Just seeing what you touch can be an extremely powerful learning experience. Touching underlying structures while you see them ups the ante even more!
When I returned to the lab the next year, it was with a clear intent to shift the method of dissection from a medical style region-by-region approach to a new method which would be coherent with the whole body philosophy of structural integration. That's how the layer by layer method was born. After over a decade of refining, I'm at a point where I'm ready to describe the approach even more broadly as integral anatomy.
Steve: OK, you've got two sentences: what's "integral anatomy?"
Gil: Integral anatomy is a study of the whole person, by the whole person, which consciously approaches its subject with the physical body as an entrance point for discovery. The physical body is studied itself as a whole, layer by layer, moving past mechanical models of form for more organic ones. The goal of integral anatomy is integration, both of the layers of the body, and the levels of the person, physical, emotional, intentional and spiritual. Oops, that was actually three sentences, with a bunch of conjunctions.
Steve: You're forgiven! So what are you up to these days?
Gil: Well, six years ago I set out this lofty goal to publish a multi-genre series called Reconceiving Our Bodies. So I wrote the first in the series, and called it Reconceiving My Body. I figured I should start with myself, walk the talk, as it were. That is a fun book exploring what it means to generate a new experience for one's self of bodily life, with me as the example. The second title in the series was to be called Integral Anatomy. Meanwhile, the concept of integral anatomy matured quite a bit, and now that "second volume" has turned into a book still-in-progress, as well as a website (www.gilhedley.com), as well as a production company (Integral Anatomy Productions, LLC), as well as a DVD series of laboratory-based dissection exploration of human form from this layered, integral perspective. Three DVD volumes are published as of 10/31/7, with a fourth on the viscera expected in the new year.
Steve: My, how your child has grown!
Gil: And still rarely lets me sleep through the night! I am proud of this project, and believe it will come to be seen as an important contribution from the world of healing and structural integration to the wider therapeutic community.
Steve: You are a busy fellow! Are you still offering dissections and having a practice too?
Gil: I gave up private practice some years ago to devote myself entirely to teaching and administering my Six-Day Intensive Hands-On Human Dissection Workshoptm. Folks who want to get together with me in person in the lab and do some dissection themselves should stop by www.gilhedley.com and check out the Workshop Schedule page there. With three growing homeschooled kiddies and these production projects underway, my travel schedule is more limited than it used to be, but I'm still out there about 6 weeks a year.
Steve: Thanks for sharing with us, and good luck with everything. I'm sure the structural integration community will be interested in all that you are up to.
Gil: Thank you! Folks will be in "fascia heaven" with this stuff. Top of page
PART TWO: COMMENTS ON SUPERFICIAL FASCIA~~~~~
Steve: Gil, welcome back!
Gil: Thanks for asking me to chat again!
Steve: So what exactly do you mean by "superficial fascia," and why are you obsessed with it?
Gil: Superficial fascia is the loose, areolar connective tissue immediately deep to our skin, where fat is stored in lesser or greater amounts depending upon a variety of factors. Some refer to it simply as the adipose layer. I, along with lots of other anatomists, call it superficial fascia in contrast to the deep fascia, or fascia profundus, which is deep to it and covers the muscle layer. It is my Everest. I conquer it because it is there!
Steve: Have you always felt this way?
Gil: Well, if you mean has it always been a challenge to understand and appreciate that layer, the answer is yes. Having trained in structural integration over at the Rolf Institute, I acquired a sort of professional preference for dealing with the deep fascia that is typical of this field. When I began to practice, it was the shiny silvery layer around the muscles that I wanted to contact and work with. Deep fascia has a slow and steady quality, very organized and gridlike, and therefore appealing to my tidy, male and anal retentive side. Superficial fascia, on the other hand, is highly variable in both structure and distribution from person to person and from one area of the body to another. It is messy relative to deep fascia, emotionally charged, and culturally "problemetized" in the worst way. Consequently, it has taken me a lot longer to get a meaningful grip on it, as it were.
Steve: Did it "gross you out?"
Gil: Exactly! When I first started doing dissection, and I came to that layer, I didn’t really appreciate it or understand it much at all. It was the scary part of dissection for me: when I was coming back for round two or three or four, that’s the part I was dreading the most. At the same time, I am mature enough to know that the stuff that freaks me out in life is probably the richest place for me to stretch further into myself, and I was up for the challenge, and just kept coming back to the table until I had quite completely transformed my relationship with superficial fascia as a part of myself.
Steve: So repetition was the cure?
Gil: Maybe. Along with a willingness to grow, and to approach the (t)issue many different ways. It’s flatly impossible from a regional anatomy approach to ever really comprehend in a meaningful way the integrity, inherent beauty, and complex functionality of the superficial fascia. In medical school, the students approach an area with a list of structures they need to reveal and identify with a view to memorizing named tissues and passing a timed test. The superficial fascia is encountered again and again, region by region, as a frustrating obstacle on the road to other things, and it goes straight into the bucket, to put it crassly. It doesn’t even make it into the drawings in the anatomy books. Where the atlases use actual photos of cadavers, they choose forms with the most thin adipose layer possible to minimize their effort in demonstrating structures considered more important in the tidiest manner possible.
For my part, I decided that, seeing as most forms have a fairly generous complement of adipose, it’s disingenuous to attempt to understand, teach or present the story of human form without giving a solid chapter to this ubiquitously present whole body layer, which in the real world of human relationships is a very significant player. Everyone who intends to touch the deep fascia, muscle, viscera or fluid systems of the body must do so through the (skin and ) superficial fascia. If we have judgments about fat, we need to look at that if we really intend to facilitate integration: our own, or another’s. One way to move from judgment to appreciation of the layer is to encounter it for what it is, rather than what we think it is. When I started going into appreciation mode around the superficial fascia, I started learning from it at a whole new level, which has allowed me to become even an "advocate" for a healthy relationship with what is intrinsic to our structure. The distorted relationships with superficial fascia in our culture need to be healed. The more we hate it and try to get rid of it, the more we get. It is simply a more psychodynamically astute approach to accept rather than judge, and grow from there.
Steve: Grow thinner, preferably!?
Gil: If that’s what you need! I could stand to gain a few pounds myself. I am the person who, under famine conditions, would be the first to go. Adipose can function as resource at many levels. Kings’ and queens’ wealth has been traditionally represented in sync with their girth. For many centuries and in most cultures, excessive thinness represented poverty and ugliness. It’s only in our contemporary advertising culture that a woman with the figure of a twelve year old boy--heroin sheik--has been served up as an ideal of beauty and perfection. It’s an impossible and destructive "ideal" because fat belongs on our body. It is a built-in quilt, a fabric of extreme intelligence, the functions of which we have barely scratched the surface in understanding.
Steve: Wow. That’s a lot to think about.
Gil: Yup! Go for it! I actually have a nice article coming out in the Nov./Dec. ‘07 issue of Spirituality & Health on the subject for the broader public, and cover it in detail in Vol. 1 of The Integral Anatomy Series. It helps a lot for the hands-on professional to actually see what I am talking about on the body, in detail.
Steve: I’ll pick that up! Thanks Gil!
Gil: My pleasure. Top of page
PART THREE: COMMENTS ON DEEP FASCIA~~~~~
Steve: Hey Gil! We’re back at it!
Gil: I’m always glad to have a chance to talk this stuff up.
Steve: We spoke a bit about superficial fascia in our last chat. How has your work in the lab influenced your thinking on deep fascia?
Gil: Well, when I did my training, the concept of deep fascia that I had in my mind was basically an image of the IT band running up and down the outside of my leg like strapping tape (which I can actually see on my own leg, by the way). While the fibers of the IT band do pretty much live up to that reputation, my understanding of deep fascia overall has become much more nuanced from having explored the shifting textures and range of the tissue throughout the body.
Steve: So can you fill in the picture for us a bit more too?
Gil: Sure. At the level of physical description, the deep fascia represents a major shift in texture as you work your way into the body from the outside. By comparison, the skin is this highly organized layer which represents the apparent outer limit of the physical (as opposed to the energetic) body. It is a continuous fabric covering the entire form, which never "goes deep." Skin can have more or less depth in itself (a few to several millimeters), but as a texture, it sticks to the surface. The skin is the skin of the superficial fascia, and the scalpel goes dull differentiating the two. When you grab yourself by the skin, the superficial fascia always comes along for the ride, and what you are really lifting is the skin and superficial fascia (SF) away from the SF’s relatively looser relationship with the deep fascia beneath it. So the deep fascia, like the skin, is again a more thin and grid like layer than the superficial fascia, which is relatively loose and "fluffy." Also, like the skin, the deep fascia covers the entire body, but it does so deep to the SF. Unlike the skin, however, the deep fascia extends itself beyond its covering aspect over the muscle, and sends arching fibrous sheets right on down to the bone.
Steve: So when I drag on skin, I’m dragging the superficial fascia, which is in turn sort of slipping on the deep fascia, but when I drag on deep fascia, I can drag on down to the joints and bone?
Gil: Exactly! Both the skin and the deep fascia as sheety, covering layers have myriad tiny fibrous relationships with what’s deep to them. You cannot, however, follow the texture and tissue structure that we commonly call "skin" down to the bone. That particular texture is limited to the surface. The body is one form with many textures, all connected but not "the same" just because they are connected. Let’s run with an image like an orange or a grapefruit here. The texture and consistency of what we call the skin is limited to the surface, which has that soft whitish stuff on its underside when peeled (akin to citrus-superficial fascia). Then comes the thin, opaque layer surrounding each segment. When that layer dries a bit it gets kind of crackly relative to the juicy part within. When you separate the segments, you can see their coverings go deep to the center of the fruit, and within each segment the covering reiterates on a thinner and less fibrous scale to surround each little cell. The deep fascia does the same for us.
Steve: So deep fascia is everywhere!
Gil: Well, no, not quite! For my part I limit the term "deep fascia" to the fibrous covering or "bag" layer and the major intermuscular septa that scroll between that fibrous covering and the periosteal coverings of the bone. The septa share the same texture as the covering aspect, and can be followed as a direct textural continuity. There are other continuities above and below the deep fascia, but they don’t feel the same or look the same. The epimysium for instance, is sometimes distinguishable from overlying deep fascial coverings of muscle tissue, while being related to it through light fuzzy fibers or sometimes tougher adhesions or anchors. The epimysia are generally much thinner and transparent than the generally more fibrous and opaque deep fascia. I emphasize "generally" because sure enough, sometimes the muscle cells are directly covered in tough fibrous tissue, sometimes there is a sliding surface between a tough fibrous layer and an epimysial layer, and sometimes the deep fascia itself is not particulary tough and fibrous at all, but is itself more like the thin epimysial wrappings. The fun for me is in noticing and feeling and discovering the qualities of these layers as they transition and change from one area of the body to another. Visual learning boosts my comprehension big-time. Call me Ida Rolf’s "doubting Thomas." I gotta see it, I gotta feel it, and then I get it--after the twentieth time, usually!
Steve: Given that, you’re pretty fortunate to have spent as much time in the lab as you have.
Gil: You’re a rare fellow to recognize that as my good fortune, and I agree! Lots of folks would like to see what I’m talking about as well, but are not so inclined to go to the lab themselves. That’s why I produced the DVDs.
Steve: You distinguished between the physical and the energetic above. Can you elaborate what you have in mind there?
Gil: Yeah, that was a bit vague. By the physical, I tend to be referring to what’s still there on the dissection table when what we generally perceive as "life" to be gone. A person is this spectacular energized animate life-form: an ongoing real-time experience of mind over matter. When that particular animating energy departs, there is still "energy" present in the material form--that much we got from Einstein. So I like to distinguish between the energy or spirit of the person, the energy inherent in a particular "inanimate" shape, and the energy which is particular to, say, the yet more basic atomic structures of the universe. An egg shape, or a vortex, or a liver for that matter, have particular energetic patterns, qualities, and characteristics that can be distinguished from the properties of other shapes. So does deep fascia, to return to the above. I find deep fascia in itself to have a particularly steady, "single minded," unemotional quality to it, whereas the superficial fascia is more charged and provocative, relatively speaking. I don’t see folks wrestling with issues of love and hate when they encounter deep fascia the way they do with the superficial. That doesn’t mean that contacting it and facilitating transformation of the tissue quality of a person’s deep fascia can’t have an emotional impact. Of course it does. Every meaningful intervention will impact the whole person. I’m just noting that when artificially isolated, these are some of the different qualities that seem to present themselves over and over to my observation. Studying deep fascia in the lab has basically given me an opportunity to meet the tissue in itself, as well as a chance to understand that tissue relative to what surrounds it. It has also given me a chance to have my own experience and to observe and share in the experiences of others, and to track that a bit. Cool stuff!
Steve: Thanks, Gil. I hope we can talk some more on all of this.
Gil: You bet! Top of page
PART FOUR: COMMENTS ON CRANIAL AND VISCERAL FASCIAE~~~~~
S: Hey Gil!
G: Hey Steve!
S: So what do you mean specifically when you refer to "cranial and visceral fasciae?"
G: Well, I mean to refer to the fibrous and serous linings which define the spaces of our viscera and central nervous system. There is a pattern that repeats from area to area. From the outside in, there is an outermost fibrous layer, then a serous layer, then the "skin" of the organ itself. With some variation of course, this is the basic pattern we see.
S: Sounds like deep stuff. Is this out of the range of the average practitioner’s touch?
G: Nope. These tissues are completely accessible either through touch or movement, and I am hoping to raise folks’ consciousness about these layers, since you’re working them anyway. In fact, our every breath, our every heartbeat, represents a movement of these layers, with relative ease or not.
S: I’m ready: raise my consciousness!
G: Okay!. Let’s start with the fibrous layer. The dura lines the cranium and spinal column, the endothoracic fascia lines the thorax, the outermost sack of the heart is the fibrous pericardium, and the belly is lined by the transversalis fascia. We can image the head, chest, heart and belly each as a space defined by a fibrous balloon. These fibrous balloons are sometimes periosteal layers, like the dura and the endothoracic fascia (where is coats the ribs and sternum), and sometimes they are the tendonous aponeuroses of muscles, like the transversalis fascia (of the transversus abdominus muscle) and the endothoracic fascia (where it coats the inner surface of the innercostal muscles). The fibrous pericardium is actually more like an upward out-pouching of the central tendon of the diaphragm: its fibers comingle with the fibrous outer wrapping of the heart-space. The heart space and the diaphragm are one.
S: So we’ve got a bunch of fibrous balloons marking out these body cavities.
G: Right. And since they are apiece with our muscles and bones, well, they are directly implicated by our work with these structures. Flex or extend your spine, and you are stretching the dura. A broad palm dragging on the belly is stretching on the transversalis fascia. Pressure on the chest wall is distorting the endothoracic fascia. Take a good deep breath and you are implicating them all together and the fibrous pericardium as well. Once you know what’s there, you can address these baglike layers consciously. And the fun doesn’t stop there!
S: Go on!
G: Well, each of these fibrous balloons has adhering to its inside surface a serous membrane.
S: Refresh us on serous membranes.
G: Sure. The serous membranes of our body are balloon-like connective tissue layers which, because they are themselves coated with a thin mesothelial layer on their deep surfaces, exude a small amount of fluid which lubricates their surface so they can slide a bit.
S: I thought you just said they were adhered to the fibrous balloons?
G: Right. On the outside of itself the serous membrane adheres to the fibrous bag, and the inside of the serous membrane is generally a sliding surface, relative to the skin of the organs within the given membranous sack. So, when you contact those outer fibrous layers, you are implicating the outer serous layers as well. Sometimes due to various inflammatory stresses these outer serous layers get stuck to the surface of the organ with which they are supposed to be sliding, and these adhesions limit movement. This can ramify to stillness in musculoskeletal structures, and on and on.
S: Sounds like a drag.
G: You are too much! Literally, the drag generated by adhesions of the serous membranes lining the fibrous balloons and surfacing the organs can be relieved by introducing movement through touch. Anyway, a lot of folks who attend to the visceral and cranial membranes have a hard time getting a grip on this stuff based on what they can piece together from the books, so I devoted the entirety of Volume 3 of The Integral Anatomy Series to making these fasciae comprehensible visually, in case the verbal descriptions and line drawings leave you scratching your head. I see these linings as incredible piezoelectric connective tissue balloon bags glowing within us and pulsing with our every breath, participating in the communication of particular frequencies of information instantly throughout the whole body. Raising our consciousness of these layers enables us to integrate them into ourselves more fully and to incorporate strategies of touch into our hands-on work that facilitates their integration, healthful movement and expression. They are also just neat to look at.
S: Thanks for keeping us in the loop!
G: My pleasure! Top of page
PROFESSIONAL GROWTH THROUGH HUMAN DISSECTION~~~~~
Professional need and the willingness to stretch myself prompted me to take up the challenge of human dissection as a massage therapist some years ago. I was trading sessions with a friend, and while he was working with me, I remember hearing him say "Blah, blah, blah blah blah, your liver." Right then, I had one of those "AHA!" moments we all have at turning points in our lives. When I heard "liver," my mind raced. "My liver? I have a liver! Where is my liver? Is he touching my liver? If he is touching my liver, am I touching people’s livers too? But I don’t know anything about livers! What do I really know about anything? I need to study anatomy if I want to touch people intelligently and effectively. I want to do some more dissection!"
I immediately set the goal for myself to get involved in a dissection opportunity where I could dissect a whole human body. I urgently wanted to see exactly what I was touching, whether on purpose, or by accident. A year earlier I had expressed an interest in dissection to a friend in medical school, who then invited me to keep him company while he studied in the lab. I was happily surprised to see that my professional training at that point, as a massage therapist, had actually prepared me well: I knew my muscles and bones pretty well, at least, and I was comfortable handling the human body. As it turns out, this combination of knowledge is a huge head-start in the lab. Top of page
In retrospect, pretty much everything else besides the muscle and bone had remained invisible to me. Now I wanted to know EVERYTHING that I was touching, whether muscle or bone, fascia or viscera. What I thought I knew even about muscles was sorely limited by the stylized drawings in the books, two dimensional pictures creating the illusion of a perfectly symmetrical "muscle man" instead of the whole body in its real, lived-in and compensated complexity.
As you begin to encounter the whole human form, as opposed to lists of regionally abstracted "parts," you are suddenly confronted with all this other stuff on the table, in the dead and in the living: blood vessels, nerves, and fascia, organs and adipose, twists and turns, scars, artifacts, and the signatures of emotional history and inspiration scripted there in the flesh. That’s the stuff we’re touching, whether it made it onto the test or not! Just because it’s not covered thoroughly in our trainings doesn’t change the fact that it’s there, awaiting our recognition, acknowledgement, and understanding. Top of page
About a year later I created an opportunity for myself and some fellow practitioners to dissect a whole cadaver in the lab. We had a fantastic time, and I remain grateful for the incredible gift we received and opened during that exploration. When I returned to my practice, I felt like my fingers were turned into X-RAY feelers. My mind had entirely new synapses formed visually to account for the textures I was feeling. I worked with more self-assurance in places where I had been timid before, and I was more careful in areas that I now knew deserved a more delicate approach.
So my exploration in the lab was driven from the beginning by a professional need for knowledge to support a hands-on practice, as well as a personal desire to connect to the depths of my own body. The professional and personal interests, the desire to become a better practitioner and develop and mature as a human being as well, often occur together for the touch professional. It is this confluence of interests that draws many into therapeutic modalities like massage and structural integration. Over the past decade of teaching massage therapists in the dissection laboratory, I have found the dissection process presents an ideal "container" for folks to challenge themselves, and find added value, at these multiple levels. Top of page
By way of example, Mary Rose is a certified massage therapist, artist, and the originator of Comfort Touchtm, a style of massage that gives special consideration to the physical and emotional needs of the elderly and/or ill client. Twice having attended my workshop, Mary Rose comments that "studying dissection gave me information about the human body that has enhanced the quality of my massage practice in a number of ways. It allowed me to see inside the human body, and gain a much fuller appreciation of the anatomy of the tissues, organs and structures as they relate to each other. This applies directly to my ability to palpate and acknowledge the living bodies I touch in my practice."
"It was an awe inspiring experience to see and appreciate the magnificent design of the human body from an aesthetic perspective. It inspired me, not only as a bodyworker, but also as an artist. The process of dissection itself feels like a rite of passage into the deeper layers of oneself. Working from the integral approach you have developed, acknowledging the layers and interrelationships of the structures, I now feel those layers and relationships within myself, even as I move in the rest of my life. Also, my experience in the lab was totally validating of the specific type of bodywork that I do. I gained such an appreciation of the superficial fascia of the body, which is rarely talked about in most anatomy classes." Top of page
Bonnie Thompson is a Colorado based LMT, CNMT, and Certified Instructor of Neuro Muscular Therapy who has developed a major practice in Colorado Springs. A three-time veteran of my workshop, she now pursues her own independent dissection projects, researching and developing applications for her own clinical techniques.
When I asked Bonnie what kind of impact dissection has had on her as a massage professional, she told me "I have hundreds of hours of continuing education in my career. When people ask me what class I would recommend the most I say human cadaver dissection. Every modality has a philosophy by which they approach the body, but without the understanding of anatomy it is all about memorizing a protocol rather than applying it to a base knowledge."
"To palpate and see the "reality" of the body gave me a confidence in palpation I could not obtain by looking at books. I have taught and practiced massage since 1987 and the confidence I have has come through the gift of cadaver dissection. The most important part to me is how it changed my confidence in the treatment room. I have a knowing in my hands because of the hours I have spent exploring the human body."
Marty Ryan, a massage therapist from Seattle, has developed a practice specializing in abdominal massage. For him, his ability to "see better into the body" as a result of his dissection workshop experience "has allowed me to better communicate my work, on all levels, to my clients. This is much different than studying anatomy from 2D illustrations, especially the relationship of connective tissue within the architecture of the organs and muscles." Top of page
Here, then, is a "starter list" of advantages to the massage professional achieved through taking
up the challenge of human dissection, all of which translate into better treatments:
While some have always wanted to get involved with a dissection, others may have difficulty imagining themselves actually doing dissection. Yet massage therapists are people who actually make use of anatomical knowledge on a daily basis in their practices. While you may have forgotten some of the words you learned to pass your tests back at massage school, your hands have a "felt" base of knowledge which is extremely valuable in the lab. Your average pre-med entering the lab for their first year medical school gross anatomy laboratory experience is utterly unprepared for what they are about to do, as compared to a massage therapist. Straight A’s in organic chemistry may help you pass your MCAT’s, but it’s the body-handling skills of the massage therapist that move those professionals very quickly and successfully into the process of dissection. Furthermore, the personal maturity that the average massage therapist must exercise to simply make it through a day of their practice is an advantage which transfers immediately into the multiple levels of challenge which one faces in the cadaver laboratory. Top of page
Some of those challenges include working closely with a group of colleagues in a team effort, respecting and making room for the different styles and approaches within any such group, and owning your own feelings as they inevitably arise in both a group dynamic and the dissection process itself. Most folks approach the prospect of doing dissection with some degree of excitement mixed with fear. People wonder if they will be able to handle facing death in the cadaver form, they fear whether their knowledge base is adequate to the task, and they fear that the smell or the process itself will somehow overwhelm them. These fears are primarily a function of anticipating the unknown, and are quickly dispelled on Day One. Top of page
Most students, if anything, develop an attachment to the donor form with which they work. The form comes to be seen very quickly for the tremendous gift and opportunity that it presents. Cadavers are models of the human body, transformed by death and the embalming process into a reality quite new and utterly distinct from the living fullness of a human person. Getting to know a cadaver, as it were, is truly a compelling adventure, and whatever reservations folks have in anticipation are very soon overcome by their overwhelmingly intense interest to learn more.
The most satisfied students are the ones with "beginner’s mind." Whoever approaches human dissection for professional growth will certainly find themselves "filled up" by the process, regardless of their initial knowledge base. The human body is literally a universe. For the "somanaut," who navigates the body, there is no getting to the bottom of inner space! Humility comes in mighty handy in the lab, as we find ourselves put gently in our place by the enormity of the subject matter and task. Top of page
With respect to the extremely practical facts of the lab environment, measures can be taken to make the work easier on your health. Simple practical self-care, such as taking breaks when you feel tired, getting a good night’s rest, and drinking a lot of water pretty much cover that issue. Aromatherapy also goes a long way towards addressing air quality issues.
Frankly, the most valuable assets that anyone can bring to the lab are the courage to explore, a desire to learn, the maturity to own your own experience, and the permission from yourself to integrate what you learn at your own pace. These, along with the working knowledge base of the massage therapist, make the ideal skill set for undertaking a dissection experience in a manner that will facilitate both professional and personal growth. Top of page