The streets of Krakow (2012)
Author Archive
A trip to Poland
Thursday, April 12th, 2012SI and Shingles
Tuesday, March 6th, 2012A practitioner writes,
I did a session last week with a client (69 post L mastectomy many years ago- otherwise healthy) who was preparing for a meditation retreat. We did a gentle spinal session which focused on the mid dorsal hinge (this has been a project we have been working on post 12 series).
Two days later she developed L sided back pain – T10ish area. She saw her chiropractor twice, who said something had opened up around her heart and lung tissue and it was “too much for her system to handle”. She did not go on retreat, but instead did a “self retreat at home” where she meditated 4-6 hours each of the 3 days. The pain ebbed and flowed and she journaled.
When she came in today she read her journal entries to me and as a conclusion, said ” my core is weak on every level”. That seemed to make perfect sense to both of us and she is ready to “do the work”.
When she undressed, there is a large rash, with blisters wrapped around her left side. There is no pain, no itching. I looked up shingles on line (I know nothing about shingles). and it looked exactly like it. Her spine has moved out of the flexion position to upright – that came about this morning.
So she is off to call her doctor and I am writing to you all.
My questions are:
1. Can back stripes “bring out of dormancy” the shingles virus.
2. Can shingles (on a more metaphorical level) come out as the core becomes activated? – such as a cleanse?
Anatomy Trains Moves into NeuroEnergetic Kinesiology
Thursday, February 9th, 2012
As we continue to apply our knowledge of the Anatomy Trains myofascial meridians, that which we discovered through Manual Therapy, to the world in which we live and Movement Therapy, we are gaining a more precise understanding of why and how things like yoga, Pilates, dance and other forms of physical therapy can have such a profound impact on our physical being. When we consider the whole length of each of these meridians during movement, we have the ability to safely and optimally extend the range of motion and improve our physical performance. Of course, differences will vary from person to person, but this contributes to what we are now calling Fascial Fitness.
I frequently receive questions from graduate students in physical therapy, kinesiology and other disciplines about Anatomy Trains and Fascia. One such student from the American College of NeuroEnergetic Kinesiology recently wrote to me to inquire about the range of motion for the Fascia (Anatomy) Trains for a course they are preparing. They use Advanced Acu Touch on Acupuncture Points, and they have already watched several of the Anatomy Trains DVDs. The student wanted to know if we have specific movements for each of the Anatomy Trains lines that will activate them for use in their work. They were looking specifically for movements relating to each line and the actual range of motion to activate them, especially in the Deep Front Line.
I responded that in chapter 10 of the book, Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists, we use forward bends to test, stretch, and activate the Superficial Back Line, backbends for the Superficial Front Line, side bends for the Lateral Lines, twists for the Spiral Lines, as well as for the Arm Lines and Functional Lines.
Deep Front Line stretch
As with any program, repetition is key, as is working within your comfort zone so as not to cause injury. This may vary significantly from person to person. It is also worth noting that moving in a smooth, fluid-like fashion, and in multiple directions – not just in single-directional planes – will have a greater affect on the fascia than the old-fashioned hurky-jerkey movements of weightlifting and certain aerobic exercises. While there may be many ways to address, stretch and move each individual myofascial meridian, not one of these works on its own, just as no single muscle works on its own!
I am always thrilled to see the far-reaching applications and implications of the work we have done to collectively share our understanding of the human body. Thank you, all, for your continued interest in Anatomy Trains!
Fascial Work and Pregnancy
Monday, October 24th, 2011Are there contraindications with fascia work and pregnancy?
Of course, and very interesting ones. Briefly though and worst case first:
1) If there were a miscarriage in the first trimester (often happens around 10 weeks) or a premature delivery in the last trimester, and it was ascribed to the bodywork you did, you would feel badly even though it is highly unlikely your work would have had anything to do with it. Best to work on women who want and feel good about their pregnancy, and in the middle trimester by preference. If the pregnancy is not wanted or in any way physiologically difficult, I proceed much more cautiously.
2) In the final trimester, the hormone relaxin is beginning to loosen the connective tissue net in the body, so that the ligaments of the pelvis can relent to let the baby through – but it acts on tissues all over the body. This is a two-edged sword – it is a great time to get unusually good change because the fascia is pre-softened, but not a great time for heavy work as you can unbalance their system.
3) If you know what you are doing, you can help prepare the adductors, bottom of the pelvis, sacrum, diaphragm, and belly for the work of delivery. Those with visceral skills can help reduce any adhesions that would interfere with labor. Again: careful because of the softened tissue – do not put a lot of strain on the pubic symphysis or SI joint ligaments. The contraindication is against heavy-handed work that could put in imbalance; work slowly and always toward balance.
4) Myofascial work during pregnancy should be limited to preparation for birth or relief of pain. The mother’s body is already undergoing major structural change during the childbirthing year – now is not the time to try to impose a reconfigured posture or do a general course of myofascial work – save that for the post-partum months.
Ode to Peter from Big Sur
Wednesday, October 12th, 2011
Peter Melchior
But for me Peter’s ‘home’ was always Big Sur, no matter how many more years he domiciled in Boulder. When I first came to Big Sur in 1974, Peter was already gone, waiting in my future for our intersection in Boulder, the new home of the Rolf Institute. I was newly-Rolfed then, and an enthusiastic neophyte of the Human Potential Movement. After a day of teaching / assisting in the spiritual boot-camp of an Arica training up the road in Ventana, we would come into the famous Esalen baths after midnight. It was allowed, but it felt like sneaking in – a glimpse into the cradle of all this new work: Rolfing’s deep journeys into the body, the radical cracking open of Gestalt, the promise of peace in Alan Watts’ full-catastrophe approach to Zen meditation. It was all new and exciting.
Big Sur
One night in the old cement baths, I met John Lilly up close and personal, stoned on ketamine and soft of body, hip, hair, voice, and eyes with the female hormone he was reportedly injecting. We had a long and silent conversation. (I met him many years later in London, not long before his death, still strung out on K, but very male, very thin, crew cut white hair, like nothing so much as an old oak with a masterful voice – “You a wrestler?” he boomed, as soon as he saw me. Of course he had no memory of our previous encounter, as I did.)
Ida I had met the previous spring at the ratty conference room of the Dawn Dee Motel on Santa Monica Boulevard, where Jan Sultan ‘Rolfed’ me twice a week after her class finished. I met Peter in my fraught admissions interview at 200 Abbey Place, where he gently but firmly told me to wait – but he ended up being both my auditing and practitioning teacher. For my final phase in ’76. We were with Ida for the morning lecture and demos in her advanced class, and then with Peter for the afternoon. His childlike innocence in front of Ida, working under her watchful and abrupt tutelage (now up on YouTube at http://www.youtube.com/watch?v=mJxajGLepyQ) belied his shamanic calm in the afternoon, when he had the six of us, including the physiatrist Dr Frank Wenger, well in hand – a steel hand in a velvet glove.
I was square in the middle of the hippie era, but I had done my homework on the beats, reading Dharma Bums and Been Down So Long It Looks Like Up To Me. Richard Farina held a special place in Peter’s musician rebel heart, as did Joan Baez. For some reason, I guess ‘cause I played music, he told me many stories of the early days in Big Sur – like folkie ‘Joanie’ Baez rockin’ out with ‘Dancin’ in the Streets’ up in Monterey.
Peter was one of the few living members of the ‘West on One’ Club. Highway 1 swoops around the ridges and into the canyons from Carmel to Morro Bay with a cliff on its western edge for most of the way, so the driver losing attention through fatigue or intoxication generally got into the West on One Club only by way of being a posthumous member. Peter fell asleep at the wheel one night, and went over the edge toward the sea, but luckily hit a tree and lived to climb back up, have 5 children, and a long and influential career.
When I got back to Esalen in the 90’s to teach a workshop, a landslide had taken the famous old baths down the hillside to the sea, and the new ones were much ‘nicer’, higher on the hill with new plumbing and a bigger view, but it was a disappointment to me, because of the treasury of memories the old tubs had. The workshops too, at that time, seemed prosaic, the consciousness deflated, the energy moribund. It seemed an era had disappeared.
Now I am back, with the ‘uh-ohs’ decade over and the twenteens begun. The baths have been restored in their old spot over the ocean. The update still leaves the feel and sense of the original baths that Michael Murphy parlayed from a family inheritance to a world-affecting center, and son Mac shows every sign of continuing.
Peter – I want to tell my old friend – they’ve done a good job. The crazies and iconoclasts are still here trying to awaken the world, as well as the smelly and beautiful youths with outlandish hair, startling body art, and charming accents, whose world is just unrolling before them. Some are hangers-on, some are cleaning up the kitchen, some are working the expanded gardens, a few still tending to the Gazebo School. Yes, they all have iPads, and the jargon has changed, but I see my ’74 self very clearly reflected in their starry eyes. Even though the Hollywood types in their shiny cars abound and there are a few new galleries for questionable art along Route 1, the Big Sur Inn is still here, and Nepenthe. Like Bali or Greece, it is still easy to shed the tourists by going just a bit off the beaten track.
Esalen itself has a bit of a new feel – that’s the nature of a change agency – but the essence of exploration and opening up is back, while the names – Rolf, Maslow, Porter’s Yurt, Gazebo school – echo back from your time here. The fog has lifted for today, and I am looking out among the sparkles for a spout or the tell-tale back of a gray whale. But my mind’s eye is looking back on your silent wisdom, when you were leviathan in my life, where the things you didn’t say had more influence on me than even the minimal maxims you did utter with that little laugh to (and at) yourself. Such a force for good, in my life and so many others, your inner silence has been my ‘Umbrella for a Hard Rain’.
That was his book of poems, the one Allen Ginsburg threw over his shoulder – Peter reported, with his same little laugh – with the brief critical review: ‘Archaic drivel!’ – but I liked them. He gave me a copy, lost in my many moves since, sad to say. Poet, raconteur, teacher, friend – Peter, you embodied the Esalen spirit. Even though you have left that body behind, the spirit endures.
The skeleton is a political statement
Monday, October 3rd, 2011The classroom skeleton is a political statement – join my ‘Equal Rights for Cartilage! movement.
I am fond of making this observation – made it this weekend in San Francisco. Of course it’s a bit of a ploy, but here’s why I say so:
1) The main point is that ‘the skeleton’ doesn’t exist as a framework in the real body. Absent the soft-tissue, the skeleton would clatter to the floor in irretrievable pieces – even the cranial bones would scatter and the pelvis fall apart without the ‘grout’ of the sutural fascia. The ‘shingles’ of the facet joints lock over each other, but without the ligaments and the discs, this would not be enough to hold them together.
Add the ligaments
and the bones would mostly hold in a general relationship, but of course the whole thing would sag and fall. The muscles would drip off without the restraining (tensegrity) of the superficial and attaching fasciae. The body is a tensegrity (or at least ‘tension dependent’) dance between the myofascialature and the skeleton. The classroom skeleton makes it seem a steady frame on which the muscles can be hung, on-by-one, till it can move. Not so. Bones float in the soft-tissue, pushing out against it; soft-tissue pulls in, holding it together and holding it up in a tough but delicate tension-compression balance.
2) The hardware on a skeleton gives many false impressions – the bones of the feet wired together with no movement at the sub-talar joint, giving the casual observer a false idea about the ankle in eversion and inversion. The fibula would fall without wire ties, etc. And then there’s that metal rod up its bum from sacrum to skull. Modern skeletons seem to have given up wiring the ribs to the neck (which at least imitated the scalenes) for an entirely unrealistic rod between the front of the throacic spine and the back of the sternum – talk about a spear through the heart!
The scapula is usually nailed to the rib cage, giving the impression that the arm appendage starts at the gleno-humeral joint, instead of the sterno-clavicular joint.
Most cheap skeletons have U-joint hardware at the shoulder and hip, which works well enough for most demonstration purposes, but spoils our sense of the biomechanics of the rotator cuff and the psoas complex. More expensive models have gone to flexible spines and bungee cord joint connectors, which, though they give up the ghost sooner than the metal hardware, are much more accurate in ball and socket mechanics.
3) But the worst of all is the choice of which cartilage to include and which to ignore. Most include the pubic symphysis, the intervertebral discs, and the costal cartilages between the ends of the ribs and the sternum. Some plastic skeletons include the knee menisci.
Most skeletons wire the hyoid bone to the front of the neck vertebrae, which is accurate positioning, but inaccurate in function. None to my knowledge include the laryngeal crichoid, or tracheal cartilages under the hyoid, which extend down into the bronchae and bronchioles before terminating in the (epithelial) alveoli. Neither are the ear nor nose cartilages or the linings of the eustachian tubes included.
Of course most bones start as cartilage and are progressively ossified, so the decision of which cartilages to include is a matter of convenience and production costs, which I appreciate. But nevertheless, it is a political statement of inclusion and exclusion. An inclusive skeleton would have these cartilages of the throat and chest, and would suggest a ‘visceral’ skeleton (an idea I lifted from Jon Zahourek) to add to the axial and the two parts of appendicular skeleton. This visceral skeleton would include the ‘breastplate’ of the sternum and costal cartilages, the pulmonary cartilages mentioned – the entire upside-down tree of the respiratory and vocal superstructure, plus the hyoid, mandible, maxillary, palatine, zygomatic, nasal, and lacrimal bones – mostly derived from the proto-gill arches of the embryo. The head scratcher in this would be the vomer: firmly in the nose, it seems part of this visceral skeleton, but it could also be seen as the ‘spinous process of the sphenoid ‘vertebra’.
A Short Bibliography
Monday, September 19th, 2011To follow my line of thought in the bodywork / movement field:
The Thinking Body, Mabel Todd
Rolfing, Ida Rolf
Amazing Babies (DVD), Beverly Stokes
Fascia and Membrane Technique, Schwind
Trail Guide to the Body (no profundity here, but a very useful book)
The Heart of Listening, Milne
Sensing, Feeling and Action, Bainbridge-Cohen
Embryogenesis, Grossinger
How Life Moves, McHose and Frank
Primal Health, Odent
Touching, Montague
And, selfishly, Anatomy Trains and the Kinesthetic Dystonia set.
Take the Anatomiken and Equiniken course(s) from Jon Kahourek
General
Operating Manual for SpaceShip Earth (or Critical Path, or Utopia or Oblivion), Buckminster Fuller
Ida Rolf Talks, Feitis (ed.)
Picture Palace, Paul Theroux
Einstein’s Dreams, Lightmen
Journey to Ixtlan, Castaneda
Meetings with Remarkable Men, Gurdjieff
Boyhood with G
urdjieff, Peters
Right now:
The Evolution of the Head, Leidler
The Brain That Changes Itself, Doidge
Muscles and Meridians, Beech
The False God of Symmetry
Friday, September 16th, 2011Recently I met a young personal trainer and bodybuilder, clearly bright and very much into his art and its contemporary science. In his attempts to bring his body to the peak of balance, he told me how careful he was to work equally with his right and left, exercising both sides the same, one for one. He had extended this to his daily life, alternating the hands with which he brushed his teeth, which leg he put into his trousers first, and even – forgive me, but it shows the depth of his dedication – wiping his ass alternately.
I wonder how this is going to work out for him. For one thing, is it possible to so equalize one’s life? Does he, for instance, have an English car that he drives on alternate days, so that his shifting alternates with his steering? And even English cars have the accelerator under your right foot with the brake to the left, as with American cars. Like it or not, the world is made for right handed and right-footed people, and equality is probably as elusive in the somatic world as it is in the cultural. Though this guy is making a good stab at it.
I suspect that for this young man, it is his ‘Year of the…’, as I call it. For bodyworkers, it often manifests as a particular area of the body. “Tom, it’s the feet, it’s all in the feet, if only we got the feet right, everything would fall in the place, you should just teach the feet.” I smile indulgently down at them from the great height of my age: been there. I had my year of the feet, my year of the neck, my year of breathing (actually, that was at least three years, each a number of years apart, as I got into breathing at greater and greater depth).
But we all have these temporary but valuable enthusiasms. I too had my year of trying to balance right and left, or at least a long Engllish summer. My Rolfer® colleague and I went out on Primrose Hill looking over the London Zoo each evening after work for the endless twilight, throwing a Frisbee for hours exclusively with our left hand (we are both right handed). I certainly got better at throwing and catching with my non-dominant hand, but it was always a relief to return to the immediate skill and connection I have with my right hand.
I am strongly right handed, even though I am left-eyed. Likely there are native differences in the degree of such lateralization, my daughter is much more ambidextrous than either of her parents.
But lateralization is interesting in itself. If we look at the three major whole-body systems, our fibrous body (the musculo-skeletal system if you must, but that term is fascia-dissing) is actually the most anatomically symmetrical, each muscle and bone pattern is repeated right and left. The neural body – the nervous system taken as a whole – is anatomically symmetrical, but functionally lateralized, such that 10% or so are left-handed, south-pawed (and gauche and sinister as well). Set against the 90% of us who are right handed. The brain is clearly lateralized as the split-brain experiments and the reports of Oliver Sachs have so clearly shown us.
But the third whole body system – the vascular – is the most lateralized anatomically, in other words, the organ system. Nearly everyone has his stomach, heart and aorta on the left, and the liver, a larger lung and the ascending colon on the right. There are people who are reversed, a mirror image, all the same organs but right and left reversed – it is called situs inversus. Because not everyone is autopsied, we don’t really know how prevalent this is – estimates range from 1:10,000 to 1:25000. But either of these figures is far lower than the 90-10 ratio of lateralization in the nervous system alluded to above.
Early embryological twisting throws a lasso loop in the large intestine and swerves the liver right and the stomach and heart left, putting one half of the vagus nerve in front and the other half into the rear. This is a… – nay, this is the underlying asymmetry of the body, unavoidable, even desirable. You have to hang 27 feet of gut tube from 3 feet of spine, so some asymmetry is inevitable.
This organic asymmetry definitely accounts for the difference between the two domes of the diaphragm, and may account for the right hip anterior / left hip posterior anomaly seen in so many of our clients, and as yet unexplained (at least, to my satisfaction).
Often what I am going for in my clients who are unbalanced is not visual symmetry but a good functional marriage between their left and right sides.
So go, my friend, balance that neuro-muscular system for all you’re worth; it certainly looks good on you. But please understand that from the point of view of the ancient organic system beneath the muscles, your entire neuro-muscular chassis is just a convenient vehicle – a jet pack, so to speak – designed to get better food and better sex for this very asymmetrical tube who invented both your hands – whichever one is next – to wipe its nether end.
Working with Older Clients
Thursday, July 7th, 2011Susan Carbin Hardee, one of our recent graduates, wrote this short essay about working with senior citizen clients:
A question I ask is, “What can we offer our older clients?” Though their connective tissues are often less hydrated and less malleable, (and changes harder to see in a photograph) they can nevertheless experience great depth of change within themselves. My class model “Wilma” was a friend of Tom’s who is 70 years old. Her comments ran to: “I have so much more energy, I feel taller, I feel wonderful and better than I have in ages, my balance is improved, my breathing is so much better and my anxiety has diminished significantly.”
Wilma’s new love is “Harold,” 76 years old. Harold also went through the twelve series during our training. They were in the clinic room at the same time, and it was sweet that they have this budding relationship and were approaching something so bold and different together. He has a Ph.D. in applied math or something, and has followed unusual growth paths through his life. Tom imagines Wilma would not have agreed to the 12 series without his encouragement. This can be a time for older people to begin new directions and settle old issues somatically. It was a positive experience for both of them, I believe that put a spring in their step. The phrase I used when writing to Tom was “a new kind of after-12 photo”. Usually people are in their underwear and it may be hard to see their glow coming through!
Harold was the classroom model of Eduardo Colon, another student in the class. He wrote, “I’ve done traditional physical therapy work with many older clients but I wasn’t sure what to expect before I went through the 12 series with Harold. Postural problems can be developed over a lifetime and with age, become more resistant to change. While we achieved modest improvement with his posture and overall range of motion, I found the results of the work to be profound when working with postural issues due to medical problems.
“I kept in mind that I’d be working with less hydrated tissue, heightened sensitivities and sometimes a larger list of pathologies to consider when approaching the work. I’d be stimulating physical and mental sensory to a level he was most likely unfamiliar with. With age, we can become conditioned mentally and physically, becoming less susceptible to change, and we develop more defined comfort zones, so I’d need to be very aware of his response and communicate the process consistently.
“Harold’s structural imperfections of note included excessive forward head posture, a left shoulder prone to dislocation, and lateral rotation in the right leg. I made a few modifications to the work due to a recent surgery, using a lighter touch in the affected area. This modification was even more so for his own sense of well being and comfort than it was to prevent any type of injury.
Harold was hesitant to receive the work at first, and reported slight discomfort. It was difficult to gain his trust and open his mind to the experience, but as we experienced results, the collaboration between us strengthened. After session 4 (spiral line session) we began to notice dramatic improvements in his leg. This shocked me because Harold has a rod in his tibia and screws in his ankle, and I was unsure how it would effect the treatment. By the end of the 12 series, the difference was night and day, the lateral rotation in his leg was gone.
“I was unsure if Structural Integration could make such a significant change with an older client, but surely enough the results are there. It was very reaffirming to me, and reassured me that SI can bring results no matter who you are or who you are working with.”
Creating a Structural Integration Practice
Friday, June 24th, 2011The following is my accumulated wisdom about starting and building a practice in SI. One the one hand, I have built a number of successful practices – about 20 or so, both residential and visiting, during my 28 years of practice. On the other, I have known good practitioners who had a lot of trouble getting going, so this list is perhaps incomplete because of factors of which I am not aware.
All my practices have been solely Structural Integration, so some of this may not apply to those of you who combine modalities.
But I hope this is useful anyway.
Locating yourself: The first question is, where to practice? If you are already ‘home’ with no plans to move, then move to the next section.
There are three basic categories: a city, a town, or rural (City = 500k or more, Town = 50 – 200k, anything less than that is essentially rural).
If you locate in a large city, plan on concentrating on one group of clients for a while, like yoga students or some such, as it is simply not possible to have your fingers in all the pies at the beginning. Build a reputation in one group and the others will eventually filter in. It can take time (and a money reserve) to build a practice in a city, unless you have an ‘in’, a link (see below). In a city, it really doesn’t matter how many other practitioners are already there, there’s room for you regardless.
If you locate rurally, plan to take all comers, and perhaps to work on a sliding scale of fees. Be especially careful about dual relationships, as they are unavoidable here – your clients are also your friends, or your shopkeeper or mechanic at least, so different rules of interaction apply. If there are other SI practitioners in your rural area, make friends and stay friends – you share a lot more than you compete.
Perhaps the best place to locate for a beginning practice is a moderately sized town.
Here there are two categories: the way desirable and the average. The way desirable includes Asheville, Aspen, Boulder, Kihei, Santa Fe, Sedona, Taos, and the like. If you locate in one of these places, bring a bankroll, as starting a practice will take a year or so. There are usually more practitioners (SI and others) than the population will bear, so you are left with working with the rich visitors / residents (again, you need a link to start) or working with the rest of the supporting crew. Since these are often living hand-to-mouth, this often involves a period of trades or freebies before the money starts to roll in. Once established, of course, you have a very desirable practice, but be prepared to invest some time.
The non-flashy small city / large town is the easiest and to my mind the best place to get started. It gives you a wide variety of practice experience, a chance to gain confidence and skill while paying off your debts, in a place you are not necessarily committed to for the rest of your life or practice.
Obviously, the number of competing SI practitioners can be a factor here, but don’t be scared off by one or two others. Count the number of chiropractors in the phone book, and divide by four to see roughly how many SI practitioners a town will support. In a more educated or hip town, reduce the ratio to 1:3.
In a town of this size, you can have your finger in a lot of pies – the local sports scene, arts scene, therapeutic and medical community – a spread you simply cannot maintain in a large city. This gives you breadth of client experience, no bad thing for the beginner.
Landing cold in a town where you know no one is sobering. But you have a valuable and marketable skill, and you want to share it. People like this work, and they will pay you for it – you just have to let them know.
Ultimately, being where you love is important, and if you really want to be somewhere, go there and make it work. On the other hand, perching for a few years in some town that means less to you, but where you will get lots of work experience, is no bad thing either. You can then arrive at your chosen dream with more confidence.
Working overseas: While it is a wonderful thing for an American to live for a time outside our superficial consumption-driven, convenience-laden culture, it is not as easy as it once was for Americans to just land somewhere and start a practice. I did this 25 years ago, and it was easier then. In London, I built my practice from scratch; in most other cases, I had some form of captive audience or an ‘in’ – a local contact who delivered my a batch of clients or at least an audience to listen to my pitch.
Since that time, many things have happened – there is more regulation of alternative medicine, in the European countries at least, and much more native competition has been trained in. Working under the table is harder than it once was. Countries in Asia and South America are probably still easier practice in this way, but then you have their economy to think about.
Finding clients: Now that you are located, how do you find clients?
Here’s what not to do: Put your card up in the health food store and an ad in the local New Age or straight paper, and sit home waiting for the phone to ring. This goes nowhere. In fact, I advise against doing either of these things in the beginning.
A website might be a bit better these electronic days than these two strike outs, but:
Facebook is undeniably valuable – not around when I opened practices, but these days, essential – and worth the time you need to put in it. If you have a well-connected contact where you are arriving, maybe they will let you use their email list. Any and all these things are fine, but:
Practices are built on personal relationships. All the following suggestions simply lead to opportunities for building the relationships that make practices hum and thrive. Breaking the initial ice is the hardest part.
First, though, preparation: Aim high, then take what you get. Invest in high quality business cards or printing for your practice materials (like the ‘Getting the Most From Your KMI Sessions’ piece), and/or for your practice space itself. It is false economy to take a grotty practice space because it’s cheap, or to have flimsy or badly printed materials to describe your work. If one of these economies is unavoidable, make sure the rest of your presentation counterbalances that aspect. This shows basic respect for yourself and your work.
Having prepped in this way, take anyone who comes. Think long and hard before you turn down a client. A raging paranoid, yes. Almost anyone else is a good candidate for learning and expanding your skill. I was 12 years in practice before I started deflecting potential clients. Just be honest and humble about the promises you make, especially to the very ill or the desperate (see the sociology lesson below).
Go to parties. Don’t stalk partygoers, but do have a few cards in your pocket. Such gatherings are prime places to establish relationships where you can share your enthusiasm for your work. No need to push – “What do you do?” is a standard question for an American to ask a new acquaintance.
Take classes, or join a club: Taking a class in something you like – yoga, martial arts, Pilates, whatever – or join a club like biking or chess or another of your genuine interests. Same procedure as above.
Speak at groups or classes: Your community is full of groups who need a speaker for meetings. Divorce Perspectives, health clubs, New Age groups or stores, even Rotary, God bless ‘em – these groups are great places to hone your skills at presenting SI. Also, yoga or martial arts or dance group classes may let you come and speak briefly to them before or after a class. (See lecture / demos below.)
Be prepared for a flat reception, but make sure you put your number up somewhere or leave cards around. It’s a big step for most folks to commit to something new in full view of their peers, but a few will call you privately after the event.
Get you and your practice editorial copy: The most effective and least expensive advertising is a story in the body of the paper. You’re new in town; the publishers are looking for new stories. Contact all the papers or local mags and rags, and see if you can get an article printed. Sometimes they take a while, but it is a surprisingly worthwhile investment of time.
Do presentations or lecture/demos: This is like speaking to a group, but you organize it yourself for the public. If you have no ‘in’ – someone who likes you who is bringing loads of people – then prepping for this is hard work. How often do you go out for an evening to hear a lecture from someone trying to sell you his or her service? But if other ice-breakers are not working, this can get you the few folks you need to get started. These lecture/demos are good to do when you first get settled. Especially do this if you get some copy in the local rag (as above). Take an ad for your lecture demo in the same issue that your article appears (this will make the editor happy also).
This is the time to pepper the town with posters – the health food store, the coffee shop, the theater, library, drugstore, any place where people gather. Repeat your postering, as they are often covered over shortly. Unblushingly twist any arms you can to get people there – the more the better, even if they are already friends, and especially if they are already clients. Clients are your best mouthpieces. And talking about this work to a group of three people can be deadly – but do it if you have to.
The rules for lecture/demos are few but strong:
1) Have some materials out, as some people will be shy and simply take some stuff along to read.
2) Have some food or drink there – a bowl of fruit and water is fine if you can’t afford more, but it gets people talking.
3) Be brief in your talk – 20 minutes max, then open it up for questions. People want to hear about the benefits, what it will and will not do, they want to know you are not crazy or sadistic, and they want to hear your enthusiasm. Long explanations about fascia and the recipe are likely to fall on deaf ears. Talk from your experience, as a client or as a practitioner. This works, and nothing else does.
4) Before questions begin to dwindle, offer to show the work on someone. I’m sorry, but if given the choice between a geeky guy and the pretty girl, take the pretty one. I don’t know why, but I have often been presented with variants of this choice. Believe me: to get more clients, take the more ‘normal’ one.
5) Do about 10 minutes worth of work, 20 max. They want to see you are not going to rip their flesh off the bone. Usually I do first session work around the sternum and ribs, as this often produces visible changes in the breathing, but iliac crest and trochanter, foot work, or bench work can be fine too, depending on your model’s pattern. If there’s big change, your day is made. If not – well, it’s only been a few minutes work, the effects are cumulative, and so on. Either way, bring the event to a close soon after your work is done.
6) Have your appointment book handy. Do not be shy to make appointments on the spot.
Giving freebies: This is a dubious strategy which I seldom used, but others have used to great advantage. The danger is disrespecting yourself and giving so much away that it gets hard to draw the line and start to charge. Never give away more than one session per customer. In the rare times when I did offer a free session, I often take a careful history and talk about what the person wants, and then give a demos worth – 15-20 minutes or so – of work, and leave them to think it over. Other practitioners give the initial interview and assessment for free as a matter of standard policy. Having the prospective client in front of a mirror where you can point out their structural pattern, compensations, and imbalances is quite effective in enrolling them in the idea of structural change.
Approaching the busy practitioner: One place where freebies are very effective and worthwhile is with the busy practitioner. Find out who the busy folks are in your town. This can take some digging on your part, as they are so busy they don’t need to advertise. This could include a doctor friendly to alternatives, a chiropractor, a PT, a psychotherapist, a yoga or dance teacher – anyone in the healing or movement education trade. It is perhaps more difficult with someone who could conceive of themselves as competitive – another SI practitioner or massage therapist – but hey, nothing ventured, nothing gained.
Get hold of this person – in person if possible, rather than just the phone – and offer them a session so that they can understand what it is you are doing. Be prepared to offer it on their terms – on their time, maybe at their place – they’re busy! If they like what you do, they will be the most likely people to refer clients on to you – their most difficult, chronic and intractable people, probably – isn’t that who you would refer on? If you have success with any of these people, then more referrals are likely to come your way. Stay in communication – not bothersome, but reporting back in on this client or that. In this way you build a network. If you can and it’s appropriate, refer other people back to them,
Forging links: The above way of linking with successful practitioners is one way of forging links. Forging links, getting connected, making friends, getting an ‘in’ – however you want to put it, this is the most important sine qua non of building and maintaining a practice.
Some of you have heard my story of arriving in London, deciding to start a practice there, and going out to a seminar where the leader had invited me to come and ‘share’ about my work. The seminar (est, if anyone remembers) was run with a lot of ‘enrollment’ rigamarole, and I got to feeling stroppy and rebellious. I never did stand up to share about my work to the 100 or so people attending the seminar, but my stroppiness attracted the attention of the guy sitting next to me. He and his wife gave me a ride home, and they were among my first clients. They must have sent me 30 people in the next few months.
The point being that one good contact is worth 50 lesser ones. This one happened by accident, essentially, but I have learned to look for these ‘opinion leaders’. So now, for my last bit of wisdom, to the sociology lesson:
A sociology lesson: Those who study the spread of innovative ideas among groups tell us that there are three sub-groups within any given group you care to identify: the innovators, the opinion leaders, and the followers. (Understand that any one person might be an innovator in one group, and simultaneously an opinion leader in another group – the roles are fluid.) If you define the group as your potential clients, everyone wants to get the opinion leaders in the community onto their table, as the followers all watch the opinion leaders, and do what they do or what they suggest.
The trick here, the essential understanding, is that the opinion leaders never do anything first; they watch the innovators, and if the innovators have a good experience, the opinion leaders will give it a try. So in any given group, you have to convince the innovators first. Most people go for the opinion leaders first, and wonder why they can’t convince them. Go for the innovators first.
So who are the innovators? The crazy, the desperate, and the artists. The people who are a little nuts are often less comfortable in the social life, and therefore risk-takers. The folks who have intractable pain, or are ill with something that no one can figure out are also prepared to try something new in hopes that it will break the logjam. Artists are by definition out there and prepared to think differently. Go for these folks first; the opinion leaders will come if the innovators have a successful experience, and the rest will follow as the night the day.
Maintaining contact: Finally, in order to maintain your practice, it pays to maintain contact with your former clients. A six-month follow up call or letter, the occasional ‘press release’ when you do some new training or have a new practice address or something (anything) to announce – any of these will help remind folks that you are there, and spur them to come in for some follow-up / advanced sessions, or send someone else in need of your services.
Employment situations: All of the foregoing was aimed for those with private, self-owned practices. Some of you may find yourself as an employee, as in a chiropractic office or a spa or a multi-disciplinary clinic. Since I have not been in those situations myself, I cannot be very helpful, but I imagine that much of what’s here still applies.