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STA295: 'The New Generation Massage Therapist' with special guest Jamie Johnston · The STA Clinician Podcast

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You're listening to the STA Clinician Podcast, connecting clinicians across healthcare.
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And we're live. Hey, people. Welcome to episode 295 of the Sports Therapy Association
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podcast. Apart from the fact it's not called it anymore. We're just testing
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you. It's the STA Coalition podcast.
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I am your host, as always, Matt Phillips.
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And this episode is being recorded live on the Sports Therapy Association YouTube
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channel and Facebook page at 8pm UK time on a Tuesday.
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Right then. So in this episode, entitled The New Generation Massage Therapist,
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My special guest is Jamie Johnston, a massage therapist, firefighter,
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and educator from British Columbia, Canada.
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Many of you will know Jamie as founder of the Massage Therapist Development
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Centre, or MTDC for short, and host of the New Generation Massage Therapist podcast.
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In this episode, Jamie will be exploring the challenges of becoming a New Generation
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Massage Therapist and the shifts it takes to evolve from massive,
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from passive tissue manipulation to evidence-informed biopsychosocial care.
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He'll be discussing the topics that many in our profession have long avoided,
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including pain science, therapeutic power of movement, and in particular, mental health.
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So if you have joined us live, then I would love to see something in the comments.
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If you do leave a comment, then I can bring them up onto the screen,
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along with your wonderful logo or face, so feel free to ask us questions during the show.
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But without further ado now, let's bring up my special guest, Jamie Johnston.
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Hey, Jamie, how are you doing? Good, buddy. How are you? I'm okay. Not bad at all.
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It's been too long. I won't say how many weeks it's been, but you have been on the show before.
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I don't know what's happened. I don't know what happened for the last three
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or four years. I've been aware of your work and I followed you and a lot of
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people were very excited when I said, I'm going to have Jamie on the show. So it has been too long.
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I know. It's just a lot of people said, oh, great, Jamie Johnson,
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can't wait. So thank you very much for giving up your time. I appreciate it.
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But as people may notice from your dulcet tones, you're not from the UK.
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Where are you at the moment in the world?
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In Victoria, British Columbia. So I'm on Vancouver Island, as far west in Canada
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as you can go, basically.
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Fantastic. And how's Canada going at the moment? It's a good place to be,
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isn't it, Canada? Is it still kind of like one of the most popular destinations
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and supported countries in the world?
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We're having a lot of issues right now. I probably shouldn't get into the politics
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and what I believe around the politics, But it is still a great place to live, yeah.
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It could be worse. You could be next door, couldn't you? Which I'm sure would
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be worse, but we won't get it for politics, is it? Yeah.
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I think it's important. I think it's worth mentioning this because things are
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very different. We talked about this last time. Being a massage therapist in
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Canada, I mean, British Columbia, for example, is very different than being
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a massage therapist in the UK.
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So maybe just to let our listeners know, in case they're not aware,
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what are some of those differences and the implications of?
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Well, it depends on when you went to school and where you went to school.
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So we'll just use British Columbia where I went to school. So I went to school
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back in 2008. And back then it was a 3,000 hour program.
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So it was basically like two and a half years solid of school.
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You got like two weeks off of Christmas and a week off in the spring.
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So it wasn't like a college where you get the entire summer off in that.
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So it was going right through. And basically for us, we have the same scope
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of practice as a physiotherapist, except for we're not allowed to do anything
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with electricity or needling.
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But other than that, our scope is pretty much the same. Other than that,
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like physios go and work in hospitals and things like that.
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There's not, I think there's a little bit of massage that goes on in hospitals.
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But so like we bill insurance companies and all that kind of stuff.
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So, you know, people come in to see us and I can bill insurance.
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They're like extended health benefits directly to get paid for from their extended
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health insurance and things like that. So it's, yeah, it's, I think,
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a fair bit different than it is in a lot of other places in the world for sure.
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That is that is yeah that's so different i can hear people shuffling on their
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seats in the uk going the same as a physiotherapist surely not and it's interesting so what is the.
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What is the difference then between a massage therapist in british columbia
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who works in a spa for example where the aim is wellness and relaxation which
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is you know a great job as well,
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how do you differentiate but is there different licenses or something how do
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you differentiate between the two Yeah,
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I don't know if there is now, but when I went to school at the massage college,
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there was those who wanted to be a spa practitioner that went to school for,
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I think it was like a year.
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And then if you wanted to be a registered massage therapist,
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it was the 3,000 hour program. But there's still lots of RMTs that work in spas,
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but just the spa can bill extended health insurance for the treatments.
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So, how do the public know? Is there kind of a level which shows whether this
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person is able to work with injury and with kind of advanced diagnosis and stuff?
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Yeah. How do they know?
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So like the, like we have the reserve title of registered massage therapist. Okay.
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So if somebody is booking in, say at a clinic or something like that,
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they know they're booking in with an RMT.
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Whereas if it was somebody who wasn't, who couldn't say directly bill an insurance
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company, they wouldn't hold that title.
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So when people are booking in, they know that. And then we have a registration
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number so that when I go to that extended, like Blue Cross is a big insurance company here.
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So they have my registration number on reserve so that when I submit somebody's
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payment, they know that, oh, I'm,
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legal like i'm legally allowed to do that and i have the registration to be able to do,
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okay so it's the r it's the r before the mt which makes all the difference,
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yeah it makes it clear for the public wow that's um yeah we won't get into the
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state of or the the problems we're having over here as a as a as a profession
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but um it's it's interesting to set that scene,
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so when you are it's important as well because when we're talking tonight,
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about the new generation massage therapist in this particular episode when we
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say massage therapist we're referring to somebody who is essentially,
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operating the same as a physiotherapist just without the needling and any devices
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to electricity well i i think.
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I'm hoping that i'm being broader in my content than saying that it's just for
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registered massage therapists because i think we're,
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even if you're working in a spa i think here you're still going to have people
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on your table that are opening up about things going on in their life and
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probably wanting to have some mental health conversations and things like that,
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that we've all been told we're not allowed to, but I'm a big advocate that we
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should be having those conversations.
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It's just how we do it. So I'm hoping that the things that I'm saying aren't
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applied just to RMTs, but to Massara Serapis as a whole.
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That's a really healthy answer. I like that. Well done.
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People are joining. Some people can see us. The wonderful Cicely Islip,
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who I know is a massive fan of yours, has joined us.
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Cicely says, evening all finally getting my app together and turning up well
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done cecily congratulations on that i don't know what,
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you put into place to be able to join us tonight but that's great it worked
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and feel free to ask jamie questions if you've got some because we know your
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questions are great so thanks for joining cecily and that goes for anybody else
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who's joined us feel free to,
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ask questions or just share your own experiences and it doesn't have to be a
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question we just want to know what you guys feel because you're the guys on
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the shop floor so your experiences and thoughts are just as valuable as anything
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we've got to say so good to see you cecily.
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So I mentioned before the podcast, it wasn't always called the New Generation
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Massage Therapist Podcast. That kind of started last year at some point.
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Before then, it was with Eric, wasn't it? It was called,
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the Massage Therapist Development Initiative. That was the one, yeah.
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Which I think a lot of people know you for, if people are as old as me.
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I won't say as old as you, but as old as me.
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And I looked back at some of your earliest episodes on that and it was it was
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great because it went back to a classic kind of topic i think it was like the
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first one was the introduction the second one back in 2021 was all about releasing the psoas,
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which you know has been forever,
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kind of the the kind of if someone's still releasing a psoas then you know they
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haven't kind of quite caught up maybe with some of the changes in terminology
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it's kind of used as a benchmark isn't it so i'm interested that was 2021 2021,
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is it still an important message in your experience?
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Do you think that's something which massage therapists out there need to realize?
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Or do you think we've kind of evolved a little bit since then?
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I think I still see some comments on it in different Facebook groups and things like that.
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And I think when it comes to like talking about any tissue, saying that we're
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releasing it isn't an accurate description of what we're doing.
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So I think we need to, I mean, I could go off on a tangent about this.
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I'll try not. But I think one of the things that I've always taken to heart
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is that if we're still using that language, then technically we're not getting
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informed consent from our patient, right?
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Because the description behind it isn't accurate. So if I'm going in and saying,
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well, I'm going to release your psoas and the patient says, yes,
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I want you to do that, I'm not actually getting informed consent because I'm
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not actually releasing the psoas.
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So I think that's where our communication with people has to be better than it was in the past and.
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Giving a more accurate description of what we're actually doing to make sure,
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that that informed consent is being given and which in turn is improving that
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therapeutic relationship.
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With the people that are seeing us.
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But then on the flip side, I also know that I had a patient that came and saw
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me for, he probably saw me for 10 years and every single time he came in,
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he wanted a psoas release done.
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So I would still do it for him, like still go through the motions of doing that
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treatment because he really enjoyed it and he thought it was effective for him.
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I just changed my verbiage around what we were doing, but I still did it because
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that person found it effective. So I don't think we're wrong in actually doing
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certain styles of treatment. It's just that the description behind it has to be.
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That's really good. I'm loving that. This really is already kind of like painting
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a wonderful, you've done the wonderful outline now of the new generation massage
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therapist, a very clear background.
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And all we've got to do now is color in with a few little different colors.
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Because there's two things you did there, which are wonderful is one,
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you kind of mentioned how the language can be important to the extent that you
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said, maybe it's not informed consent, because,
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if we're telling them something we're not actually doing and they're saying,
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yeah, go ahead and do it, then that's a really interesting point.
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But then you also backed it up with if somebody enjoys doing that,
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then the evidence kind of shows if somebody enjoys something and they appreciate
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the context, then maybe that's going to change them.
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And have a benefit for it, even though in our hearts we're thinking,
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but that's not doing what you think it's doing sort of thing. So that's showing that.
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The new generation of astral therapists needs to realize both sides,
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like you say, that we need to change the verbiage, but also give patients what
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they want to a certain extent.
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What about that? Just continuing on that line, because that's really interesting.
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How do you manage it then if a patient is coming in for that psoriasis release,
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and they but they're still suffering from lower back pain or something or they're
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still suffering from hip flexor pain which they attribute and they think
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when they when they get this release from you they feel better because we know
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that you could do pretty much anything to somebody if they believe it's going
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to work then there's that kind of contextual effect which is great that's part
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of what we do it's the way we
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why we dress like we do or why we put plants in our studio or whatever but what
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about if them receiving that is,
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stopping them from maybe pursuing other avenues like sleep or like you said
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their mental health which could help them even more how do you kind of juggle with that then.
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Well, I think you can look at it and go, like, let's just say,
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I'll use that patient I was talking about before, you know, for 10 years would
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come in and do a low back treatment, work on the quads, do psoas,
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release your hip flexor work.
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So that part of it is only, say, a 10-minute part of your treatment of actually
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working on those hip flexors, right? So during the rest of the treatment,
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you've got a massive opportunity to have those conversations with people.
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And, you know, saying, well, you know, some better sleep would help you out
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or, you know, maybe doing this
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stretch at home or doing this kind of an exercise is going to help you.
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So, you know, try to incorporate that into the rest of the treatment.
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And then maybe the next treatment you go, hey, this time, let's try doing some
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isometrics for the hip flexors instead of the instead of the treatment and just
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see how you feel after that.
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Let's treat it as a little bit of an experiment to see what's going to work
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better for you like we know that you've enjoyed this in the past but,
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you know you're you're coming back two weeks later and wanting the same thing
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again so maybe we're not getting the the long-term benefit from it,
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but maybe if we tried this way we'll see how that works and just try to shape
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it a little bit via that communication and trying something different with them
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and the next time they come back in you can be like okay so after the last treatment
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when we start trying something different.
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How has it been over the past two weeks?
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And if they're like, well, I want to go back to that other thing,
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then okay, well, maybe we'll do a little bit less of it, but we'll incorporate
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an isometric into that hip flexor
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treatment and just gradually almost kind of wean them off the thing.
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But again, if you still have that patient that comes in that's like,
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no, I love getting that done, so do it, then do it for them because they enjoy it and they see benefit.
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That's really nice. That's really cool. But it's interesting because I'm listening
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to you and if I was the patient and you phrased it to me that way,
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like, maybe we'll do this. How does that sound to you?
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Then I'm like, I feel in control. I feel like you're giving me the power.
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And that's, we know what good communication is all about. And I'm like to go,
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yeah, sounds great, Jamie. Let's do it.
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But that's where the communication skills come into isn't it because i think a lot of clinicians.
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Wouldn't go about it that way they would kind of maybe say no this is wrong
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or you've no this is not helping you don't you know that you can't do that don't
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you know you've got x y and z in between you and that hip flex and and start
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giving them a science lesson and offloading the,
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the all the knowledge they have so yeah i guess that's the communication skills
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which is something i'm sure you've learned along the way and,
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and something to try and get through to your listeners on the podcast yeah and
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one of one of the things that i've always loved saying to people like especially
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if i if i had people that were really.
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Like adamant about no i need this and especially when they're coming from a
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different practitioner,
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that you know maybe they've been to what i like to call a very well-meaning
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practitioner that has said you need your so as released,
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the thing that i've always said that i have never gotten much kickback from
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is well that's great that the other person recommended that or that's great
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that this has worked for you in the past but,
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the most recent research has actually told us that doing an isometric is far
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more beneficial for it than what this is,
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and i think when people hear that one for one it builds confidence in you because
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they're like oh this this person's looking at the research and the research
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said this so let's try what the research says,
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and go with that so that can be like i've often used that as sort of like my
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entry into changing a mindset or an opinion.
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And I don't think I've ever had anybody that looked at me and went,
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well, I don't care what the research says. I want this done.
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People are always pretty open to it when you can say, well, this is what it's
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showing us now. So why don't we try that and see how it works for you.
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That's so cool. I'm really interested whether, because I'm listening to you,
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because I'm listening to you and thinking, yeah, you've started that with kind
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of a summary of their belief, a reflection. You've shown them with your opening
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statement that you've listened to them and repeated what they like or believe.
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And then you've gone with a maybe and kind of like an open-ended question.
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So it's kind of classic good communication skills, the way you've framed it all.
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Did that come naturally to you is it to do or have you done courses where you
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learned to finish with an open-ended question instead of just a do you want
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to do that does that sound okay,
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yeah no it was a lot of learning along that and funny enough i recorded a podcast
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today that was about sort of my,
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travel into this because i like i always said at the beginning like when i came
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out of college i wanted to be that sports therapist that was just going to rip
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shit up And I look back and I'm like, I have some apologies to make to past
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patients for the way that I did things.
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And it was a hard road for a long time, like watching friends and different
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people posting things on Facebook that were challenging a lot of those beliefs that we had.
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And I got really, really angry for a long time until I finally was like,
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OK, all these people are saying this.
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Maybe I should take a closer look at it. And then it was starting to read more
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research and, you know, going to the San Diego Pain Summit and meeting lots
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of people to interact with and meeting people like yourself that,
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you know, you have some chats online and different things that it's been a long road.
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To sort of get to that point and then just a lot of learning along the way.
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It's funny because i can't imagine you because this is the thing when you get
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these communication skills and i think anybody who does courses like an mi or
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something like that you realize it just affects the whole of your life because
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you start once you understand how to.
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Instead of like, oh, I can control the world, but you realize it's a partner
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or a child or a boss or a member of staff or whatever it is, or a colleague.
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And I think if you're doing it well, it does change your outlook on life quite
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a lot. You suddenly start valuing what the other person is thinking and feeling.
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So it's lovely just to hear you doing it, but I can't imagine you not being
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like that. It shows that it's worked. You know, it's really cool.
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I just want to read out. We've got a few comments here. Thanks,
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people, for leaving your comments. It shows me that hopefully the sound and
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the quality of the video is going out well tonight. That's great.
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Deborah Thurlow Rowley, the one and only fantastic educator, has joined us.
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And she says, today, my client was having many issues. She wanted fixing,
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in inverted commas. I replied, facilitating your health journey. Ah, yes, thank you.
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And then perhaps reduce sugar intake, due inflammation in the body, and so on.
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We do still get, that's the problem, isn't it? We've got to realize that patients
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are going to come in and they're going to say, I need fixing.
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That's what they think we do.
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So we've got to be really skilled at not just dismissing that,
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not making them feel stupid, not kind of jumping up onto a pedestal and becoming
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the teacher who they hated at school. It's a really important thing.
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But yeah, Debs, you're so skilled at that. You know that already.
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We've got some great people in their room today, actually.
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Yeah, some great thinkers. Cecily here as well has said, evolution is proving
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to be rare sorry to be sceptical that's okay Cecily today on FB,
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that's Facebook for the older people here I've seen melting the issues with
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the trapezius big sigh again yeah but you know what,
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And I'm having some, I don't know, I think it was on holiday.
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I was sunbathing in a bad position.
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My posture was all out when I was sunbathing. Really middle-class problems.
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And it's just led to a neck pain and this thing traveling down my little finger on the arm.
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And I'm in the car just kind of trying to push what I'm going to call a trigger
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point. Because when I pushed it, I could feel in my little finger.
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And I could feel my fingers sinking into my trapezius like butter through the pressure.
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And I thought, I'm releasing this, you know. So it's when someone's in pain,
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sometimes, and I think when you're a therapist and you're in pain,
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you realize how these words and this language, although we see them as myths
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and things that need to be busted, they kind of make a lot of sense when someone's
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trying to explain their pain.
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If something feels good, the idea of melting into your trapezius is just luxurious.
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That's exactly what you want. You want to feel like butter instead of just a rigid bit of steel.
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So I think it's tricky. I've always thought that as a modern therapist,
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we've got to be aware of why people use language and not just rip people apart
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and, you know, trying to correct it.
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Yeah. What do you think about that? So that was me going off on one of my personal
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details, but can you see things in that?
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Yeah i can and i and i think we should also acknowledge like cecily you should
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you should never be sorry for being skeptical being skeptical is a great thing,
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but but i think it like that's actually a good thing like it's one thing i think
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if the therapist is saying to the,
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to the patient oh i'm gonna melt your trapezius but if the if the patient on
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the table is like oh man it feels like you just melted that that's probably
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a very great reaction to get from that person on the table that's like,
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man, you just made me feel better by doing whatever it is you just did.
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Yeah, that's true. It's true. But I think actually thinking about it,
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Cecily was pointing out it was a, yeah, therapist was maybe coming out of that
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language, which as you've just cleared up, maybe a little bit of a yellow flag.
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Very cool. Thank you, people. Keep those questions coming in because it just
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makes it so real. I mean, I could talk to Jamie about everything and anything
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for a whole hour, but I want to try and steer towards things you guys want to
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know about. So thank you for those questions.
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Let's go to i mean a lot of your work as i've been following you especially
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with the rename of the let's talk about the rename of the podcast that was about
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a year ago so we changed it or you changed it rather into the new generation massage therapist,
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did that change the name kind of coincide with the shift you kind of wanted
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to bring about or yeah yeah i think it did,
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i was i was like debating whether to just keep the old name or to change it
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but i kind of looked and like When I look at my evolution through the career,
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I kind of look and be like,
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the old way of thinking, in my opinion, is the, oh, we're working on the tissue
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and we're doing this, we're, you know, we're doing like, we're releasing fascia,
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we're doing this is like the old generation, I think, way of thinking.
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And as we, as we progress and evolve, I think we, we start to look at,
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well, the new generation that's
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coming through, there's a lot more that we need to take into account.
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And, you know, looking at biopsychosocial and all these other things that are
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going on with people and realizing that while we are the only profession in
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the MSK professions whose title is actually a verb, we're not just treating tissue.
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We're treating the person and we've got to realize that there's a lot more to
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treating that person on the table than just pushing on their hamstring so to
22:46
me it was like well let's make it that it's a new generation a new way of looking at things.
22:51
It's very cool. It's quite a grand title. I mean, I don't know whether it sounds
22:55
as grand in Canada, but I think in the UK, the new generation massage therapist.
23:00
But I think it's clever as well, because it's the kind of title which is going
23:04
to make people go, oh, what's this about?
23:06
It's kind of great. I would, for me, I'd be like, oh no, I can't possibly call it that.
23:10
I don't know whether it was like on the table for you, like, oh, is that too much?
23:13
But I think it's really powerful because it is kind of what we're talking about, isn't it?
23:17
We need a shift. You've got to be a new generation now you can't stick to the
23:21
old kind of dialogues and things and i kind of figured that with that title
23:25
that there was probably going to be a group that got pissed off about it,
23:29
and then probably others that were like okay well i see where he's heading with
23:32
this i understand what he's trying to do so and there probably is a group that
23:35
are pissed off about it they just haven't said anything to me about it yet they
23:38
haven't heard of it one of the two.
23:41
I'm sure they heard of it it's great podcast and and you just said you released
23:44
one or you've recorded it and you're going to release it soon or the one you
23:47
yeah i'm hoping hoping it'll be out this afternoon but if not it'll be out tomorrow,
23:51
wonderful fancy do you want to give us a little kind of a,
23:54
idea of what that one was about then or is it it's about my,
23:58
my evolution okay great die on facebook to be like well maybe we should,
24:03
maybe it's me that i need to look at not the other people and making that change
24:08
and looking at the the better way of helping,
24:11
amazing cool yes and that's available just to put we'll mention this at the
24:15
end but we're talking about the new generation massage therapist podcast which
24:19
is available i'm sure on all popular podcast apps including spotify and podcast all that sort of stuff,
24:25
marvelous so that brings me nicely on to yeah a lot of your recent work and
24:30
recent episodes have kind of been around mental health and how that's becoming
24:34
like a primary focus of your messaging,
24:36
it's why do you think i think fortunately that has become quite an important
24:41
topic and focus in in the last year or so why do you think that is such an important
24:45
topic for the modern massage therapist to understand and actively address well.
24:51
I mean there's there's such a wide range of reasons,
24:56
i'll say like the first one for me is that i always say i'm in the unenviable
25:01
position that I've known 12 people in my life that have died by suicide,
25:06
and three of them were family members including one of my uncles one of my cousins
25:10
and my brother so I look at that and I'm like I know that.
25:15
People come in and they get on that table for an hour and they open up about
25:19
what's going on in their life and for so long the regulatory bodies and you know,
25:25
other practitioners or other professions have been saying well if somebody's
25:29
opening up on a massage therapist table you have to shut that conversation down
25:33
and you have to refer out.
25:35
Well, if somebody's opening up about something like that, like the one thing
25:39
with suicide is that it's preventable.
25:41
And if you're the person who is willing to go, hey, let's stop for a second
25:47
here and address it and have the conversation.
25:50
Now, this doesn't mean providing counseling or anything like that,
25:53
but being able to have the conversation where you can prevent it,
25:57
I think that's everybody's responsibility, regardless of what profession you're
26:02
in that's our responsibility as human beings is to be able to have that conversation
26:07
with somebody and try to prevent it from happening and i've i've had a couple instances in life where,
26:12
i had like some friends that were going through a hard time and opened up that
26:16
they were maybe thinking about that where i had to step in and be like okay
26:19
well you're staying here tonight
26:20
you're not going anywhere or that's not happening we're preventing this
26:24
from happening so i think that that's probably the number one reason that i
26:29
want to talk about it more because we can prevent it from happening. But also.
26:34
Part of it, I think, is also from being a firefighter and spending the past
26:38
25 years responding to trauma and sitting there going, well,
26:43
I've been responding to people in trauma on this side, and then they come and get on the table.
26:48
How do I sit in the middle of those and understand how to have conversations
26:52
around mental health and things? And like I said, have you had Keith Meldrum
26:56
on your podcast before? Not yet.
26:59
Okay, great guy. So Keith is a huge pain advocate.
27:02
And coming from a guy who has spent his whole life in chronic pain and is an advocate for patients.
27:10
We just had dinner a couple weeks ago and he looks at me and he goes,
27:13
of all the MSK professions, you guys are the ones who are best suited to have
27:17
those mental health conversations.
27:18
Because people come in and they get on your table and they vent and they open
27:23
up about life and they talk about everything that's going on.
27:28
And if every time they bring up something that's a mental health issue,
27:31
if our first reaction is to go, oh, we can't talk about that,
27:35
I need to refer you out to a psychologist or a counselor or something like that,
27:39
we're going to lose that person.
27:41
So, I mean, I'm sure everybody listening has had it where somebody's opened
27:45
up about what's going on in life and has sat there and going,
27:49
well, I don't know how to respond to this.
27:51
So I think since there's not many people that are having the education conversation
27:57
around it, I was like, well, somebody better start doing it. So it might as well be me.
28:01
So that's kind of been my approach going into it anyway, to just realize that
28:07
it's okay for us to have those conversations. It's just a matter of how we have
28:11
those conversations. Yeah.
28:13
That's very powerful. Thank you. Thank you for sharing that.
28:15
Obviously, I'm sorry that you're in the position that you are,
28:19
but also it's amazing that you're turning that around and helping other people with it.
28:23
Do you think it's interesting because there is this idea that to show empathy,
28:28
you need to have actually experienced what the other might be going through,
28:31
but then we kind of learn that's not true at all, that with the right kind of
28:35
being there and the right non-judgment and the reflective and summaries and
28:39
all that sort of stuff, you can show empathy without having had to have gone through everything.
28:43
But do you think in your case having gone through it does help you naturally
28:48
kind of show that empathy and
28:50
and show that kind of honesty to the client which helps him talk to you,
28:56
probably and i mean i've never had it where a patient on the table opened up
29:00
about having suicidal thoughts or anything,
29:03
but i definitely like i remember there was i don't know i don't know how many
29:07
stories you want in this podcast because i'll end up going overtime with it No, it's fine.
29:12
Honestly, I was teaching a first aid course at the fire hall.
29:17
And this woman came in to take the first aid course.
29:22
And she was the first one there. And we just started having a conversation.
29:25
And she goes, oh, well, all firefighters have a side gig. So what's your side
29:29
gig? And I was like, oh, I'm a psych therapist. And she goes,
29:32
really? And they said, yeah, we're talking back and forth. And she goes, yeah.
29:35
Well, she goes, do you specialize in anything? And I said, well,
29:38
we're not allowed to say that we specialize in something. I said,
29:41
but compared to the average massage therapist out there, I probably know a lot
29:45
more about pain and the interventions and things like that.
29:48
And she goes, well, I've dealt with persistent pain for over 30 years.
29:52
And I was like, really? I'm sorry that you've been through that.
29:54
And she went, can I come and see you?
29:56
And I went, absolutely. So she booked in for an appointment.
29:59
And this is where, and I love the fact that you're focusing a lot more on communication
30:04
too. She came in for that first appointment. It was a 60-minute appointment.
30:08
The first 45 minutes, we just talked.
30:11
And she opened up about the trauma she had been through in her life.
30:14
And at the end of it, like, I probably had to pick my jaw off the table because
30:17
I was just like, how are you still standing?
30:21
And looked at her and I said, you know what? We've only got like 15,
30:23
20 minutes left. Let's get you on the table so you actually get some treatment.
30:27
And at the end of it, you know, she was over on her back. And before I walked
30:31
out of the room, I looked at her and I said, how are you feeling right now?
30:33
And she looked at me and like, you could see her welling up.
30:35
And she said, for the first time in 30 years, I'm not experiencing any pain right now.
30:41
And I said, well, I said, I don't have anybody after you and I've got stuff
30:44
to do. So you lay here as long as you want and just enjoy that feeling.
30:49
And I'm like, I got stuff to do. If it takes an hour for you just laying here
30:53
and enjoying that, then by all means do that.
30:56
So I go out a little while later, she came out and came to pay and she almost
31:00
started crying. And I was like, don't cry because I'm going to cry.
31:03
And like, it was one of those points where I'm sitting there and I went,
31:07
I didn't offer counseling to this person, but we spent 45 minutes talking about
31:12
your trauma and your mental health and 15 minutes doing treatment.
31:17
Which one made the bigger difference for you? I didn't say that to her,
31:20
but I'm like, I guarantee talking made a bigger difference for her than what
31:26
that did, than what the treatment did.
31:28
And she continued to see me for about a year.
31:31
And there was, you know, a time where she came in for a treatment and we were
31:35
talking about, I don't know if you've ever looked at the annoyed group stuff
31:38
on the safety in me signals, the danger in me signals. So we were talking about that.
31:42
And, you know, she loved doing yoga. So I said, you know, start getting back
31:45
into doing yoga at home and all that and as she walked out she turned around
31:50
and looked and said i just wanted to say thank you for being one of my safety
31:53
signals and i was just like.
31:57
Like i almost started crying right yeah so it's it's those experiences along the way that i'm like,
32:03
we we got to be way more comfortable having these conversations and realizing
32:06
that people are going to open up to us and like keith says we're we're probably
32:11
the best situated because people spend more time talking to us than they do
32:15
to any other MSK practitioner.
32:17
So we'd better start getting comfortable with it.
32:22
Again, thank you for sharing that. It's so powerful. And it ties in so much
32:27
with what we said across the nearly 300 episodes of how ironic it is that as massage therapists,
32:36
the fact we spend time putting our hands on people, we see ourselves for some
32:39
reason at the bottom of the ladder.
32:41
But really, it is one of the most,
32:45
powerful places where an intervention can be made because people and it's probably
32:49
a lot of it is to do with that touch with that trust with the disrobing with
32:54
that kind of like they feel that you really do care i mean,
32:58
if someone puts their hands on you you generally feel that they care and otherwise
33:01
it's a horrible environment it's so weird isn't it if it's someone you know
33:04
and you trust it's wonderful and that's why the conversation starts so we've
33:07
had so many episodes where we should really see ourselves,
33:11
as a fantastic source of solving problems which go undiagnosed,
33:15
which aren't talked about, which are misdiagnosed and stuff.
33:19
So yeah, really, really powerful. But I'm interested.
33:24
Yes, hold on. I'm going to have to go to the comments because I've got so much
33:27
to answer that. But let's go to the comments. Let's forget about me for a second.
33:30
Let's go to the comments. But let's have a look here. So we've got some wonderful
33:33
people here joining us live as well. Some questions. I think we're going to
33:36
go back slightly to the language. There was a question here.
33:40
Thanks, Matt, says Deborah Thurlow roly question as language changes and reply
33:44
with different language it changes mindset and the ground level is there a tick
33:49
list for people to practice,
33:50
just read that again as language changes and reply with different language it
33:54
changes mindset and the ground level yes is there a tick list for people to practice,
33:59
i guess there deb was looking for yeah some some tick lists in order to change
34:04
language and open up kind of the conversations you've mentioned And what did you think? Yeah.
34:09
I think a big one is just like, look at some of the research papers on how manual
34:14
therapy actually works.
34:16
Right. And just understanding that, you know, you're when you put your hands
34:20
on people, it's not really that you're changing tissue.
34:25
It's that you're interacting with the nervous system that then makes the change
34:29
and just starting to change language around that when we're when we're helping people.
34:33
Because like I said, you could quite often have those people that have been
34:36
referred to you by other well-meaning practitioners that are saying you need
34:39
to release this. You need to release that.
34:41
And then just starting to go, OK, you know, that's great.
34:45
They sent me over, but, you know, the recent research shows us that that's not
34:50
what's actually happening, but, you know,
34:52
let's work through this, like, just as a starting point, and then,
34:56
to start to work into, like, just better communication around open-ended questions,
35:02
and I think, like, the thing I've always loved is Louis Gifford's four questions,
35:07
is having that person come in, and they want to know what's wrong with them,
35:10
so they always want a diagnosis.
35:12
And while we can't provide a diagnosis, they maybe have one.
35:15
And then they want to know what we can do to help them, what they can do to
35:19
help themselves, and how long is it going to take to get better.
35:21
So if you just practiced conversations around those four questions,
35:26
then that's going to make a massive difference to probably 90% of the people that come to see it.
35:31
That's really good. Yeah. No, it's true.
35:34
I think there is, once you evolve to realizing that you're not fixing people
35:42
physically with your hands, but you still realize you're doing an awful lot
35:47
of good, but just for different reasons.
35:49
And I think naturally there's a knock-on effect to the communication because
35:52
you stop trying to fix people by telling them what to do.
35:56
And you realize Now, again, what comes out of your mouth is part of this beautiful
36:02
relationship through communication.
36:05
And you realize that just as you ask the person permission to put your hands
36:09
on them, which is why it becomes so enjoyable. I mean, massage is enjoyable
36:12
because the client has given you permission to do what you're doing.
36:16
And communication is quite similar. If you give people permission to say what
36:19
they want to say and you show that you're listening and interested,
36:21
then suddenly conversations become much more powerful because they're in control.
36:26
They've given you permission and they know that you're actually caring for them
36:29
so there's a lot of tick lists deborah i don't like calling a tick list it sounds
36:35
like you could just do it by going through them but like jamie said open-ended
36:37
questions is one of them i think the old just.
36:41
Pausing before you want to answer or say something and just giving them that
36:45
three seconds and you'll be amazed how many times they then unpeel a little
36:49
layer and say something a little bit deeper,
36:51
that's quite difficult and sometimes you've got your hand in your mouth i think
36:55
that's a really good one or just think in your head three,
36:58
two one and you'll be amazed it feel like a lifetime to you but it just that's
37:03
what people need to actually start opening up a little bit more that silence but it's,
37:08
yeah it's a good it's not comfortable with silence,
37:11
yeah well silence i don't come to silence yeah yeah it really makes it makes
37:15
a difference we don't realize.
37:17
And sometimes if you've got permission from a client, and we do this sometimes
37:21
as a suggestion on the course, if you've got permission with a client,
37:24
then tape record the session and realize how much you are actually talking.
37:29
I'm from education, so we've always learned about teacher talking time and student
37:33
talking time, and it should be kind of like 20, 80 or 30, 70 with the latter
37:36
kind of doing most of the talking if it's going to work.
37:39
And it should really be the same in your clinic time.
37:41
And I think sometimes when we record ourselves, we realize, Jesus,
37:44
I just spend 80% of the time talking in that, which shows that you're not really
37:48
inviting them to talk about what, how they feel, what they want,
37:51
what they think the problem is. So, but you've got to get permission for that.
37:54
I think that's actually quite powerful.
37:56
I think it's a big thing too. Like with, with the patient being comfortable
38:00
to talk about what's important to them.
38:03
Like there was a gentleman that used to come to see me who was in his eighties,
38:07
who was in the Navy and he was in like an engine room fire where a bunch of people died.
38:14
And so he was diagnosed with PTSD and this kind of stuff. So he started to come
38:19
to see me. I think he came for like his first two appointments.
38:23
And I was just like, hey, like, do you want to come back in again? How are you feeling?
38:27
And he goes, no, I think I'm good. And his wife was standing there.
38:30
And she said, no, you're coming back in because when you get home,
38:34
you're a different person than before you came in.
38:37
And I think all it actually was, I don't think anything I did with my hands mattered.
38:42
It was the fact that this guy in his 80s, could talk to somebody who's also a firefighter,
38:47
who when he got on the table he could swear he could talk about how much he
38:51
hated the traffic coming in he could say whatever he wanted,
38:54
and it was without judgment he kind of got to vent for 45 minutes and i was
38:59
like yeah i don't care like i'm swearing along with him right it's just that
39:03
for 45 minutes he got to be,
39:05
in an environment where he could say whatever he wanted and it didn't matter
39:09
and he knew that if he was talking about the guys that he watched die in that
39:12
fire, he's talking to somebody who understands where he's coming from.
39:16
Like I said, I don't think what I did with my hands actually mattered at all.
39:20
So it might be that you get that person come in who just has certain things
39:24
in common with you, whether it's like motherhood, fatherhood,
39:27
your job, these other things where, you know, somebody could get on the table
39:30
and vent about dealing with their kids.
39:33
And I've never had kids and I'd be sitting there going, well,
39:35
that's why I never had them because I don't want to deal.
39:38
It's not going to be that same connection where if people can open up and have
39:42
those conversations and be confident having them with you, I think it makes a big difference.
39:47
Very cool. Yes, most definitely. Great questions. Thank you for that,
39:51
everybody in the live lounge.
39:53
I think, how do you make sure it's, I love the attention to mental health and
39:58
opening up and allowing the person to speak.
39:59
But when do you know, how do you know when you're, when you're about to step
40:04
over the line and come out of your scope of practice or crossing boundaries and things?
40:09
And how do you deal with it if it does start going down that avenue and you
40:12
realize you've got to kind of reel it back somehow a little bit?
40:15
Well, I think it's, I don't know that I have a solid answer for you.
40:21
I mean, we don't want to offer counseling, right?
40:23
And I think part of the problem too is that we're always worried that we're
40:28
going to say the wrong thing.
40:30
And like you talk about my background as a firefighter and that I've been to
40:34
lots of calls where it was a mental health crisis.
40:37
And this person is sitting there in front of me saying that they're talking
40:41
about taking their own life.
40:43
And I've never, we've never had any training through the fire hall on how to deal with that.
40:47
But you sit there and have that conversation with the person where you're just
40:51
trying to be empathetic and you're not being like, oh, you know,
40:55
well, why don't you try this? It'll make you better.
40:58
But it's a lot more talking to like, I remember one scenario where the person's
41:02
family was back in Ontario, which, you know, is a big gap from British Columbia.
41:07
And they were just having a hard time being away from their family.
41:09
And they didn't think that they were worthwhile, while, I think was the, the verbs that they use.
41:14
And, and the only thing I could say is, Hey, you know, I'm pretty,
41:19
I know for a fact, your family would be really sad to not have you around anymore.
41:24
And that's not, that's not offering counseling. That's, and,
41:27
and, you know, I could draw on the experience too, being like,
41:30
well, like I remember seeing my parents when my brother died,
41:33
you know, where I can make that conversation with the person.
41:36
So I think is, is you have the conversation anyway, and there is a good chance
41:41
you're going to say the wrong thing, but at least you're saying something.
41:45
Because sitting there and looking at the person and going, what's.
41:49
Just have to refer you to a counselor isn't helpful right so,
41:54
don't don't be afraid that you're going to say the wrong thing because there's
41:57
a good chance you are but the person who's who is opening up to you,
42:01
isn't going to get angry at you isn't going to freak out they're going to be
42:04
happy that somebody's taking the time to sit with them,
42:07
and have that conversation and be beside them and and go through that experience
42:13
in that moment with and there's like specifically when it comes to suicide,
42:17
I know there's a lot of concern out there where people go, well,
42:22
but if I say something, is it going to make them want to die by suicide even more?
42:26
And all the research shows us that it doesn't, that if you're willing to have
42:30
that conversation, it like, I don't know what the exact stat is,
42:33
but like 99% of the time, it's more beneficial than not having it.
42:37
So I think as long as you're not offering counseling, but you're just sitting
42:42
with the person and you're willing to have a conversation, then we're doing our job.
42:47
But then if you recognize that, hey, this person has the means to do it when
42:52
they get home and they plan to do it when they get home, well,
42:54
now I'm making a phone call.
42:56
Now I'm going to get the police involved or something like that.
42:58
Or, you know, I'm calling their doctor or I'm stepping in in some regard to
43:04
prevent this from happening.
43:05
So, I mean, that's obviously talking about suicide is sort of the extreme case.
43:08
But if it's just somebody who's having a tough time, just being willing to listen.
43:14
And like you said, maybe sometimes it's counting to three before you respond,
43:18
and just letting them sit in that moment.
43:20
But as long as we're not offering counseling and giving them direction on how
43:24
to handle or how to manage that thing, whatever it is, then I think we're fine.
43:29
But we still need to be willing and able to have that conversation with the
43:33
person across from us as a human being.
43:36
So maybe take the massage therapy end of it out and just be like,
43:40
I'm just a human talking to another human.
43:43
Very good that's great.
43:45
Yeah, it's true. I mean, yeah, I can understand.
43:49
Like you say, people are going to be worried that they're going to cause it
43:52
to get worse or something. But I think that's the problem with our career.
43:56
This is what I mentioned before. Like if we see ourselves as fixers,
43:59
when it comes to a conversation, we think I've got to give advice.
44:01
But the sort of conversations we're talking about really are just about listening, aren't they?
44:06
They're like, I don't know if you're familiar with Ben Weibrow,
44:10
who's a great physio, works in NHS pain clinics in England, but he wrote an
44:14
article just called sitting in the mud and that's where you literally are just
44:18
sitting with your patient,
44:20
or client in the mud with them you're not trying to give a solution you're in
44:23
mud you know but you're sitting in there with them and just allowing them to
44:25
kind of talk about what they're doing,
44:28
i think that's where the skill comes into it just resisting the same as being
44:32
a modern new generation master's therapist is get that fixing mentality out
44:36
of your head just listen to them repeat what they said a few times you're allowing them,
44:41
to voice and and hear their own thoughts and like you say nine times out of
44:45
ten if they're given the chance to listen to their own thoughts and they hear
44:48
like no one loves me no one hates me i just want to die if you kind of repeat
44:51
some of that and they hear it back to them again.
44:54
Actually it's not quite true some people do love me and they'll do hear themselves so it's,
44:59
but it's we're making it sound like it's far simpler than it is i mean you've
45:02
been through life experiences and you had some training as well you you do a
45:06
you somebody mentioned here deborah actually mentioned mental health first aid
45:09
courses You've put together something yourself, haven't you, a course to help,
45:13
practitioners feel a little bit more confident about this sort of thing?
45:16
Can you give us some details about that? I teach mental health first aid through
45:19
the Canadian Mental Health Association.
45:21
But I'm also putting together, I'm going to call it the Fundamentals of Mental
45:24
Health, which is just going to be an online course, like a self-directed online
45:28
course, just to understand mental health.
45:31
You know, people who are dealing with depression and how we can help them when
45:36
they come into the clinic, people who are bipolar maybe, you know,
45:39
people that are having different mental health issues, what we can do and what they need from us.
45:45
So that's sort of the course that I'm working on putting together anyways and
45:49
taking some of the stuff from the Mental Health First Aid course and incorporating
45:52
that in and then some of the research around it.
45:54
And I'll have some stuff where it's like people who are actually,
45:59
who deal with that, coming in and saying, Like from the patient perspective,
46:03
this is what I would want from my therapist when I'm having a depressive episode or something.
46:09
That's really cool. So patient lit as well. Lived experience is so important.
46:13
And is that something that's going to be done online? Is people in the UK can get involved in that?
46:17
Yeah. Yeah. It'll be that one specifically. It'll be like a self-directed online course. Okay.
46:22
But yeah. But between teaching psychological first aid, I teach that and then
46:26
teaching mental health first aid.
46:28
And mental health first aid is more people who have mental health conditions,
46:32
whereas psychological first aid is more like when people have been too stressed,
46:36
how to recognize that they're going over the line into a bad place if they're
46:41
dealing with too much stress in life and things like that.
46:42
So the psychological end is more trauma based, whereas the mental health is
46:46
more mental health issue based.
46:49
I guess what we haven't mentioned today, and I knew this was happening with
46:51
you because there's so much we could talk about.
46:53
We've talked about, I think someone mentioned it in the chat actually,
46:59
maybe, but we've talked about patients' mental health,
47:03
and clients' mental health, but obviously a large part of it as well in our
47:07
industry is the therapist's own mental health.
47:11
We're in a profession that's giving and giving and giving and often taking on
47:15
these problems and suffering when it doesn't work or something.
47:18
But is that something which is also going to be addressed in your course would
47:22
be valuable for collision to look after themselves yeah,
47:25
yeah and a lot of the like the stuff from the mental health first aid stuff is like you can apply,
47:30
the acronym is called algaes that you can apply that to yourself and and it's
47:34
a lot about self-care and they i think like a lot of the things when we talk
47:38
about self-care it's always like go to the gym,
47:41
go go to a yoga class go do these other things And it's rare that we ever talk
47:45
about taking care of our own mental health.
47:47
So, you know, that can be that, you know, maybe you set up a group of other
47:51
therapists that you get together once a month and have a chat or making sure
47:55
that you're getting counseling or practicing some mindfulness or some meditation
47:59
and things like that in order to help your own mental health.
48:01
But also like setting up those boundaries with patients to make sure that,
48:05
you know, things aren't going over a boundary and that you're that you're taking care of yourself first.
48:10
So much great information and i can't think of wow i can think of.
48:16
Four or five people who would be in the top of my list to have delivered that
48:19
sort of course and you're definitely up there with them it'd be definitely you've
48:23
got such well it's for your background as well you've got so much to give people
48:26
in the way you present stuff so,
48:28
details for that have you said it's not quite ready yet but if people go to
48:32
the website can they sign up for anything or send emails yeah i don't have a wait list for that yet.
48:38
I've got a wait list for like when I put on a mental health first aid course
48:41
and a psychological first aid course, but for the self-directed one,
48:44
I want to get it finished first and then I'll start promoting that.
48:47
But the other two people can go to website TheMTDC.
48:51
So it's TheMTDC.com and that's where they can find details for all of that.
48:57
Yeah, I'll have to get it to put up on there. I'm usually just sharing the links via the podcast.
49:03
All right well we'll make sure it goes into the links here as well and then
49:06
i'll gently nudge you know jamie to put it onto his shop window as well at some
49:11
point but also people can find you on facebook massage therapist development
49:15
center instagram the mtdc,
49:18
and obviously yeah loads of episodes of the new generation massage therapist
49:22
podcast which people can listen to with a new one dropping tomorrow hopefully
49:27
yeah which sounds like it's going to be all about this as well.
49:31
That was an hour, Jamie. That's kind of zoomed by. There was so much more we
49:34
could have talked about, but hopefully listener, we've given you some kind of
49:38
ideas about what the new generation massage therapist looks like.
49:44
I hope it hasn't come across as a recipe of you need to do this, this, and this.
49:48
I think when I'm thinking back to myself, it means just consider this,
49:51
consider this. Why not look at this? It's kind of, this is what it's supposed
49:55
to be, because it very much depends on the person, doesn't it?
49:58
All of us have got unique strengths and ways to help our patients.
50:02
I think too, like one of the things that I am trying to stress more with continuing
50:09
education and things like that is like the, it's quite often said that the number
50:12
one reason people come to see us is for pain.
50:16
But I wholeheartedly disagree with that. I think the number one reason they
50:19
come to see us is because of disability.
50:22
Because the pain is getting in the way of them doing the things that they want to do.
50:27
And when you go to like the World Health Organization and you'd look at like
50:30
the top five things that contribute to disability, mental health is right up there along with pain.
50:37
So I feel like it's kind of our responsibility to look at the patients that
50:43
are coming in and going, well, as much as the pain might be restricting them
50:47
from getting back to what they want to do, the mental health side of things
50:50
is probably contributing to that as well.
50:52
And whenever we can, I think we always want to try to build resilience in people.
50:56
So one of the best ways we can do that is by understanding more about mental
51:00
health and realizing that that's just as big a contributor to their pain and
51:04
disability as it is whatever caused the pain and disability to start with.
51:10
Very cool. I like that. That's a really healthy way to frame it.
51:14
That's great. Thank you so much, Jamie. No problem. I appreciate you having me on.
51:18
Thank you everyone who joined us. It feels like it's been 10 minutes.
51:21
It's Zoomed by, but that was just amazing information.
51:24
So thank you if you joined us live. Thank you for the great questions who did join us live.
51:27
If you listened to the podcast and you've enjoyed it, which I think you should
51:31
definitely have done for this one,
51:32
then do us a favor of leaving a rating or review because it simply just helps
51:38
it appear higher in google if someone puts in mental health or they put in massage therapist,
51:42
then we'll come up higher and other people will be able to benefit from the
51:46
great information which gets like jamie johnston share,
51:50
and that's so important these days one of the most common thing massage therapists
51:54
talk about is oh our industry this and our industry that and blah blah blah
51:57
we need regulation standardize it start making a difference by sharing quality.
52:02
And we're not just picking ourselves up here, but this is quality information, guaranteed, okay?
52:06
It might change in a year's time, but we're looking at the evidence we've got
52:10
now and we're hopefully gently challenging some of the older stuff,
52:15
which we've all evolved from ourselves.
52:17
So if you want to do your bit for the industry and you feel disgruntled,
52:19
then just share this. That'll be a fantastic help for the industry.
52:24
And you might even get some feedback from somebody going, oh,
52:25
thanks for sharing that. That was amazing. It's changed my life,
52:27
which will make you feel better as well. So...
52:30
And do yourself a favor as well by checking out the mtdc.com and also the New
52:34
Generation Massage Therapist podcast on wherever you listen to your podcasts.
52:39
Right, next week, August the 11th, just before I let you all go,
52:42
at eight o'clock as always on the STI YouTube channel and Facebook page,
52:46
I'm going to be joined by Andy Hosgood and Andrew McCauley, The Unbound Project.
52:49
They're going to be joining me again for an hour, which is a nice segue,
52:52
actually something that Jamie mentioned earlier on, the power of just talking
52:55
to other therapists, getting together in a little group clinicians,
52:58
bringing your problems and just realizing you're not the only one and that maybe
53:02
somebody in the group has got a solution rather than seeing everybody as competition,
53:06
realize that you can get solutions by just sharing and talking to fellow which
53:10
is what the unbound project is all about so that will be a nice segue to that,
53:14
next tuesday at eight o'clock on the sda clinician podcast so thanks everyone
53:20
again for joining us thank you once again jeremy johnston really appreciate your time.
53:23
I'll make sure it's not another 251 episodes before we get together again.
53:27
I don't know how that happened.
53:29
I think it's something to do with kids at my end. I think I'm going to blame
53:31
the kids. But I really appreciate your time, man. Really cool.
53:34
And we must catch up again sooner. Absolutely.
53:38
Right, people. Thanks very much. Until next week, take care of yourselves and
53:41
more importantly, take care of each other.