From Jivaka Journal, 2006, by Laura Hoge

When a person loses a loved one, s/he embodies a host of physical, emotional, spiritual and psychological symptoms of distress. Often times, the weight of the loss is compounded by months of anticipatory caretaking, an exhausting process that can deplete a person’s energy to the point of illness. Some emotional symptoms of this depletion may include, but are not limited to, restlessness, emotional numbness, nightmares, cognitive impairment and lack of motivation. Physical symptoms may also impede function. Some of these include, but are not limited to, suppressed immunity, weight loss, muscular tightness, joint pain, digestive distress and/or an exacerbation of preexisting physical conditions.

Using traditional Thai massage to treat grief related energy depletion, practitioners can effectively help their clients to release emotions and alleviate physical symptoms. This is accomplished through a combination of knowledgeable soft tissue manipulation and compassionate intention. In the following case study, a client’s overall grieving process was addressed.

Case Study

In order to illustrate the effectiveness of addressing the energetic imbalance caused by grief with Thai Massage, the following case study is presented.

Patient History

The client is a 42-year-old female with a history of stress induced gastrointestinal disorders and sciatica. Her husband had recently died of an inoperable Glioblastoma (brain tumor). The length of his illness was more or less four months from time of diagnosis to time of death. The deceased underwent an ineffective protocol of both radiation and chemotherapy and was unconscious for the last week of life.

Shortly following funeral arrangements, the client became increasingly irritable, had isolated herself to the point of depression and was undergoing cognitive therapy and meditation instruction by a Zen influenced psychologist. She had begun a course of anti- depressant therapy (Prozac and Klonopin as needed) approximately one week prior to receiving Traditional Thai Massage Therapy.

For two months following funeral services, the client felt increasingly fatigued and cut back on the amount of exercise she was doing. She would have liked to have decreased the dosage of her medication, but found it effective in relieving symptoms of anxiety. She was plagued by the mental picture of her sick husband and was often irritated by the fact that she “couldn’t remember him when he was well.” She was also upset that her friends could not understand what she was going through and “never said the right thing to make her feel better.” When they tried to reach out and socialize, she became unavailable, emotional and exhausted. This upset her very much.

When I met the client, she presented as being very nervous and in digestive distress. She complained of lack of sleep and asked if it would be okay if she got up from the mat every so often to use the restroom. She complained of hip/low back and radiating sciatic pain and appeared weepy. The client was also having trouble staying asleep at night and found herself sluggish and cognitively “foggy” during the day as a result.

Treatment Modifications

I initially treated the client on the floor of her living room, though I would have preferred a smaller space to create a more nurturing environment. The living room was adjacent to a restroom though, which was necessary, as she often had to run to relieve herself. Chronic diarrhea was a problem for her, so I propped her torso up and increased the angle at the hips, which seemed to relieve her abdominal discomfort.

The prone position was not an option because of her gastrointestinal issues, so instead I used pillows to prop her on her side while manipulating the energy lines of the back.

Treatment Notes

Once the client was comfortable, I began the first few treatments with some light foot manipulation and joint mobilization at the ankle. The client was hypersensitive to pressure initially so most of the points on the foot were done lightly with a steady focus on metta. When it came to joint mobilization, (i.e. rotating and stretching the ankle joint) she found it difficult to release the full weight of her leg. This was eventually achieved with light shaking and prompted inhalations and exhalations of breath. I ended up spending over fifteen minutes on the feet at the start of the first few sessions because it gave her room to transition into the massage without me being physically invasive. It also enabled her body to become accustomed to the feel of manual support. At the start of our sessions, she would occasionally experience cramping in the internal arch of her foot. This stopped after the third or fourth treatment.

During treatment, I manipulated all 10 major meridians of the body and then concentrated specifically on Kalatharee and Sahatsarangsi-Tawaree Sen to address the emotional aspects of her grief as well as the physical manifestations of it in the form of gastrointestinal problems and sciatica. Eventually, light abdominal manipulation was incorporated to inspire proper digestion. Though I did incorporate some of the yoga stretches into the massage (i.e. lateral hip stretches, abduction and adduction of the hip joint, quadriceps and iliopsoas stretches), my main focus was in helping the client to release energetic blockages by means of acupressure (jap sen) along the aforementioned meridians. I also addressed digestive distress with hot herbal compresses on the abdomen and treated her sciatic pain with jap sen along the sacroiliac joint and outer thigh.

Sessions were concluded with a 20-minute head and neck massage with a primary focus on jap sen to the third eye point with the hope that it would relieve some of her problems staying asleep. I also used many of the points associated with Itha Pingala Sen and incorporated gentle neck mobilization into the massage to open up Kalatharee just above the axilla. The client often said that she felt her hands “tingling” while I mobilized her neck. Since Kalatharee runs down the arms and out each fingertip and thumb, this led me to believe that it had a positive effect on that specific energy line.

During sessions where her trapezius muscles were noticeably tense, I placed herbal compresses in that area while I focused on other parts of the body. This loosened the muscles and helped me to deliver deeper acupressure to the region toward the end of treatment.

Results

The patient received a total of 12 massages and during that time there was a noticeable improvement in her ability to sleep through the night without interruption. Though her digestion is still affected greatly by her mood, it has definitely improved to a point where it no longer interrupts the massage sessions. In the past month, she has begun to make appointments to see friends and socialize. She says that her sciatica only bothers her when she is in the car for a length of time and no longer keeps her up at night. She rarely experiences neck pain and attributes this to the constant use of herbal compresses and application of heat. I have recently segued this client out of weekly massages and into a steady yoga and meditation practice. This is complimented with consistent visits to her psychologist and she is attending a bereavement support group.

Conclusion

Though this particular client received Thai Massage in conjunction with western pharmacological and psychological therapies, she believed that her weekly massage sessions were effective in addressing both the physical and emotional complications of her grief. I would not recommend the use of Traditional Thai Massage as a sole treatment for those who have just lost a loved one, but I do believe that with a compassionate and trusting relationship between client and practitioner, a client can more effectively navigate the storm of emotions and physical symptoms that normally occur during this time. I encourage family members, psychologists, psychopharmacologists, etc. to incorporate this or a similar type of energy work into the protocol for addressing grief and grief related complications. I believe that it helps to expedite the processing of overwhelming feelings as well as encourages re-identifying one’s self in what can be a shocking and changed world for the client.