Shari Sunshine, LMT, On Chronic Pain

Shari Sunshine, LMT, is an acupuncturist, massage therapist, teacher, and meditator who has spent more than 35 years living, working, and teaching massage and bodywork.  She is the co-founder of Ashland Massage Institute and Syntropy International.  Recently, while visiting Nepal, Shari fell and hurt her back.  This article is the product of her insight into the self-healing that she accomplished while recovering in bed for a month in a guesthouse in Kathmandu.

Chronic pain:  When the habitual tendencies, even relatively new habits that were originally caused by recent injuries, resist change because of not knowing that a re-organization would be ultimately beneficial, less painful and provide graceful, more functional movement.

Chronic pain is the very same phenomena whether it occurs on the physical, emotional and/or mental levels.  It is called ignorance in Buddhist terminology.  It is simply a lack of the capacity to know or understand that the present pattern of movement, emotional state, mental evaluation is painful or causes suffering, and that a simple, or even a minute change in the ways the muscles move, or the mind evaluates, will alleviate the pain.

This change is brought about by first becoming aware of the habitual pattern by meeting it gently.  What does this mean?  It could mean becoming aware with the assistance of a massage therapist gently touching the area, softly massaging the area, slowly moving the area within its chronic capacity, or moving the area oneself in ways that show the body the limitations that have become habitual.  Once the awareness is there, the body can begin to make choices.  Questioning the necessity of the limitation is a key to knowing if the limiting conditioning can be released.  At first, the body believes that letting go of the holding pattern will cause pain because in the past, when there was acute pain and inflammation, certain movements were painful.  After the acute phase, the movements may be pleasurable, but the body only remembers the pain response and until shown otherwise, will hold onto the pattern it believes will not cause pain.  Once shown that the movement, or the release is pleasurable, the body will enjoy the new possibility.  Remembering the new possibility requires practice, just like releasing conditioned emotional patterns require practice, as do mental patterns.  There is no difference in the process ultimately.

It is much easier to allow new changes in the physical, emotional and mental bodies when one has a basis of practice prior to an injury, an emotional upset or mental tension that might occur in stressful circumstances.  Actually, I suppose the first step is to clear away, as much as possible, the habitual patterns that have already accumulated, like purification practices, yoga, movements, qi gung, or cleansing diets.  Although these karmic tendencies are rarely completely eliminated, and must be constantly practiced, at least when situations occur after the purification practices, we are able to call upon our previous practice deliberately and in a timely manner to assist in the healing process when necessary.  Without prior practice, the body/mind will automatically go into patterns that may be ultimately dysfunctional, harmful to the healing process.

There are many “spiritual practices” to be found.  There are many disciplines that assist the body/mind.  There are countless possibilities to be discovered right in your own neighborhood, or in the world at large.  All of the practices are practices.  That means that in order to benefit from them, we must do them over and over again, like training in any discipline.  It may take years to come to a place of ease in certain yoga postures, and once that ease is discovered, one must keep practicing the asana in order to continue to benefit from the posture.  If the practice ends, so does the benefit.  This is also true of all “spiritual practices”.  It is interesting to explore and discover which of the many thousand disciplines fit ones own personality. It is sometimes difficult to continue to practice a discipline for a long time.  To benefit from any of these disciplines, one must continue to practice in order to really find the value of the practice when it is most needed, as in after an injury, an emotional upset or stressful situation.

With practice and opportunity to understand the possibilities, the body/mind will always choose the most functional option, the opportunity to move through life with openness, trust and clarity.  Without having a practice, the body/mind will most likely continue to acquire dysfunctional tendencies that accumulate until there is chronic pain; mental, emotional or physical.  When this happens, the learning process to eliminate the suffering requires unlimited patience and compassion.  This is also beneficial.

Ultimately, the pain lacks existence once the light of awareness has been brought to the area and movement in a functional manner is realized/practiced.  In other words, the actual (chronic) pain, suffering, is but a memory, which is no long relevant to the present moment.  This is also true of all of the suffering that arises in the body/mind.  It is true that the pain once existed, but it is not true that it must be maintained by conditioned response.  Once this is realized, then there is only blissful awareness and joyful release of the conditioned response.

The Dharma Of Bodywork

Encouraged by our teachers, by each other, and by our own inner wisdom, Middleway Method massage therapists practice bodywork as an expression of the Dharma.  We feel inspired to do this because we recognize that the Dharma in the West is more likely to thrive and spread in the realms of bodywork, psychology, ecology, and education than in the realms of religion, mysticism, and esoteric philosophy.  For all of us, it is important that we continue to study and practice the Dharma in the time-tested, lineage-supported traditional ways, and so practicing bodywork as an expression of the Dharma is not intended to replace the lineage practices, but rather to express and embody the blessings and awakenings that have opened within us as the result of those living lineage practices.

Chogyal Namkai Norbu often teaches about skillful means with respect to individual capacities, as direct and practical manifestations of the compassionate wisdom that arises from formless natural state.  It is Dharma practice to walk kora and chant mantra; it is Dharma practice to constrain one’s karma through the rigid conduct of the monastic life; it is Dharma practice to bear witness to the five poisons within oneself, and then to transform them through compassionate understanding into the five wisdoms; it is Dharma practice to recognize the natural state and thereby disperse the necessity for accepting one thing and rejecting or transforming another.  Where are bodywork and bodywork education within the continuum of conduct, contemplation, transformation, and direct recognition?

At first glance, it may seem that the various styles of bodywork are corollary to the various practices on the Stages of the Path. For example, for a client who has no experience working with their own body-awareness, direct manipulative and circulatory techniques in which the therapist does the work and the client passively receives may seem corollary to things like receiving blessings and chanting mantra in hopes that some external force will make one’s life and future lives better.  Similarly, for a person who either naturally knows how to work with their own body-awareness, or has learned how through experience, the neuromuscular techniques in which the therapist merely makes suggestions and the client does the work seem corollary to the contemplative and transformative practices of the Great Vehicle Path of the Bodhisattva.  And lastly, when both practitioner and client have some capacity to recognize the natural state, then the most subtle “energy work” techniques seem corollary to Mahamudra and Dzogchen states.  While this model does make a certain amount of sense, it suffers from a fatal flaw: in all cases we are working within the context of the therapist/client relationship, and for that reason, the model does not fully support the client in becoming a self-actualized, self-motivated practitioner on the Path, but rather always the subject of the therapist’s activities, even in the context of the most subtle work.

Massage and bodywork students’ experiences with developing mindfulness and compassion on their way to becoming therapists are much more direct and more thorough than most clients’ experiences under the guidance of even the most skillful therapist.  Working with students, we can teach directly, while working with clients, we support and encourage them as they discover things on their own.  In other words, the seeds of compassion, mindfulness and even some recognition of the natural state are better germinated, watered and fertilized in the teacher/student context than in the therapist/client context.  Put another way, being a client is the first stage of the path, being student of bodywork and becoming a bodywork therapist is the second stage of the path, and being a teacher of bodywork is a later stage.  In this way, the Middleway Method correlates with the traditional Stages of the Path. It goes like this:

As we have the Lesser Vehicle Sangha’s path of conduct and blessings, so we we have the path of the bodywork client interacting in a karmically favorable way with the therapist; as we have the Greater Vehicle of the Dharma’s path of study, contemplation and transformation, so we have the path of the bodywork student/client becoming a therapist; and as we have the Buddha’s pathless path of recognition, supported by the vehicles of conduct, blessing, education, contemplation, and transformation, so we have the bodywork teacher working skillfully with each individual student’s capacities.  Within that structure, we find the broad-based, universal support of the combined perfection of the Three Gems and the Three Vehicles.

The Four Noble Truths

There is suffering.

There is the origin of suffering.

There is the cessation of suffering.

There is the path that leads to the cessation of suffering.

For massage and bodywork practitioners and clients, at first glance the Four Noble Truths make sense in a simple, obvious way.  We can think of all of the ordinary physical suffering we see and experience on a daily basis: the sore muscles, the fatigue, and the anxiety of ordinary life.  The origin of this kind of suffering in our modern, first-world societies is mostly stress, and less frequently injury or disease.  We know this kind of stress-based suffering to be temporary and remediable, and it’s natural to think of massage and bodywork to be aspects of the path that leads to its cessation.  On the surface, the Four Noble Truths of Massage could look something like this:

There is the suffering of muscle pain, fatigue, and anxiety.

Stress is the origin of this muscle pain, fatigue and anxiety.

Stress can be relieved.

Massage relieves stress.

That’s simple, clear, and true.  When a person gets a good massage, it relieves some of the symptoms of their stress, like muscle pain, fatigue and anxiety.   It is for this reason that massage therapy is so popular: because it temporarily relieves the symptoms of stress.  Massage therapists can feel good about the service that they provide, because it brighten’s peoples’ days, relieves pain, and provides people with an hour or two of blissful pleasure.  While that is all true, it doesn’t constitute a Noble Truth, because massage that provides temporary relief from the symptoms of stress is not “a path that leads to the cessation of suffering.”  However, it can be.  Receiving massage from a therapist who understands and embodies the deeper path can be an opportunity for clients to discover what that deeper path is: cutting the cause of the stress at the root, so that the symptoms cannot grow.  That is the work of the Middleway Method massage therapist.

For most of us, stress most frequently arises from how we are thinking, and less frequently from what is actually happening. In other words, most stress we experience is mental stress, not a physiological response to immanent physical danger.  Mental stress arises when we worry about the future, despair about the past, want what we don’t have, and don’t want what we do have.  Those are all thoughts not related to the present moment or circumstances.  Massage therapy grounds a person into a safe, pleasant, present-moment experience where the causes of mental stress are much less likely to arise. When someone comes in to receive a massage, their future, for one hour, is one that promises to be filled with pleasure and mindfulness, their thoughts of the past are gradually overpowered by the pleasure and mindfulness of their present moment, and they so much enjoy what is happening to them that they are temporarily relieved of the stress of wanting what they don’t have.  For that hour, the causes of a person’s mental stress are reduced, and thus they are given an opportunity to view their world from a new perspective.  Massage therapy reminds a person: What is happening now is good.   This perspective is the opposite of the stressed-out one that they came into the session with, and that change of perspective is the first step on the deeper path of true relaxation.

From the perspective of a Middleway Method massage therapist, stress and the symptoms of stress are the result of the simple laws of cause and effect: the mind worries, so the body suffers.  In mindfully observing the ever-changing circumstances of our own lives and our clients lives, we come to understand that the world around us is constantly changing, much of it beyond our control, but that there are choices that we can make that promote our physical, mental and spiritual well-being.  We see, in all of the stressed-out, suffering bodies that we treat each day, that grasping on to that which will not stay with us, and reaching out for that which we cannot get always leads to pain, fatigue, and anxiety.  Reminded of this again and again throughout our day at work, we cannot help but begin to develop a new, healthier perspective on life, the world, and our place in it.  We see that grasping and reaching, as expressed in muscle tension, fatigue and anxiety, are not activities that promote well-being, while we see that releasing and giving are.  Our generosity breeds more generosity, and the heart recognizes that it’s natural will to work for the benefit of others is a good and trustworthy motivation.  It is this deeper recognition of the benefit and potential for our work and our path to truly bring about the cessation of suffering that gives us the energy, curiosity and passion to dedicate our lives to the service of others.

There is suffering – pain, tension, fatigue and anxiety – caused by mental stress.  The origin of mental stress is in grasping and aversion.  The release, relaxation and present-moment mindfulness brought about through skillful massage therapy educates both clients and therapists about the potential for lasting relief from mental stress.  Supported by mindfulness, our awareness of cause and effect, our awareness of impermanence and change, and motivated by the basic goodness and generosity of the heart, we embark, therapist and client together, on the path that leads to the cessation of suffering.

The Natural Miracle of Compassion

As a massage therapist, it is my job to spend an hour and a half with each of my clients in a very quiet room, paying very close attention to what they are feeling, and interacting with them in ways that help them feel completely safe and supported, so that they can relax.  As a massage and meditation teacher, it is my job to spend four hours a day with my students in a very quiet room paying very close attention to them in a similar way, watching what helps them relax into their natural self-confidence and inner clarity. In that way, I have spent many hours of each day for many years paying very close attention to people, learning what helps them relax, what helps them to feel safe and supported, and how they develop their own self-confidence and inner clarity.  As a therapist, I am a perpetual student of relaxation, and as a teacher I am a perpetual student of learning – so I can say that after all of these years of studying, I have learned a lot. Since that’s my work, most of the time, that’s what I write about.  But this article is not about that.  Instead, this article is about the natural miracle that happens after people relax.

In order to appreciate what I mean by “natural miracle” I’d like to ask you to take a moment to breathe one relaxing breath right now.  As you are reading, take a nice long inhale, and exhaling, let go of some held tension in your body.  Everyone can do that.  It’s completely natural.  The miracle is this: After I have spent some time with my students and clients, and they’ve breathed this relaxing breath again and again, they all begin to deeply appreciate the benefit of it, and their hearts begin to grow so warm and generous that eventually, without fail, everyone of them becomes inspired to live a life of service to others.  There is no exception to this wonderful phenomena: when people deeply relax, the next step, naturally, is for compassion to be born in their hearts.  All of us are this way.  When one person does something truly kind and supportive for us, and we feel the relaxing breath that arises in us because of their kindness and support, then as soon as we are feeling better, as soon as we are feeling relaxed, we immediately and naturally feel inspired to give the gift of that support and relaxation to others.

When I first started teaching massage therapy, I used to wonder, “How do I teach compassion?  I feel this very strong care and inspiration in my heart, and I know that I cannot do anything with my life but serve others, because doing anything else wouldn’t feel right, but how do I inspire that same strong motivation in my students?” I used to think that my teachers must have had some special magic power that they could inspire such a profound and unyielding compassion in me, but as I learned how to effectively teach relaxation, I noticed that compassion arises naturally from it.  Phew!  I don’t need to have magic powers. The miracle of compassion arises naturally in everyone who feels safe and supported.  All I have to do is keep doing my work, and my students and clients all become more and more inspired to spend their time caring for others. Breathe and relax, breathe and relax, and the compassion arises, like seeds in rain and sun.

Over the years, I have noticed that people who choose to study the Middleway Method are already motivated by their own natural compassion.  It’s what brings them to study in the first place.  My students come to me with a story that often goes something like this: “I have always been the person who takes care of everyone else in my family.  I’m always giving them massages, and they keep saying that I should become a professional massage therapist, so here I am!”  Oftentimes, these caring people are a little bit exhausted, overextended by their sense of obligation to others.  They want to find a way to express their care without tiring themselves out, and also earn a living doing something that they love.  The interesting thing is that just as often as that is the case, it is also the case that the first and most important lesson that these dear souls have to learn is how to care for themselves. Sound familiar?  Of course it does. The truth is that it is easy for me to predict that you are one of those caring people, because it has been my observation that ultimately everyone is one of those caring people.

As I said before, without fail, when one of my students or clients finally sinks deeply into their own relaxation and self-care, then compassion naturally arises in their hearts.  And, it appears to me that almost everyone is overextended, exhausted from trying so hard to do good in this world.  We often criticize ourselves and others for striving too hard for material gain, but underneath the so-called superficial exterior of the search for material wealth is a deep personal search for self-worth.  It appears to me that all human beings are motivated in this way, and all human beings ultimately find that self-worth through doing service work for others.  Our true relaxing breath, our true relief, is the relief from our fruitless and tiring striving when we find work that clearly and deeply benefits others.  Ahh, says the soul, now I am finally doing what I was put here to do!  Knowing that this natural compassion lives in the hearts of each and every person that I touch, I feel great joy and personal fulfillment doing my work, as I lay my hands gently on that part of them that cares, and direct that caring inward, toward their own heart.

“Love heals” is a tired axiom, but only because it is true.  What I find interesting is that the first step is always to learn to love and care for oneself.  As an ascetic monk, the Buddha practiced severe self-denial, to the point of detriment to his body and his mind.  Then, after a kind person offered him some rice and some milk, the starving Buddha regained his health, and compassion for others was naturally born in his heart. It was then that he taught the Middle Way, the way of kindness to oneself and others.  Middleway Method Health Educators are those who offer the rice and milk, those who recognize others’ need for support, and giving that support, make it possible for ever more compassion to arise naturally in the world.