Tuesday, April 10, 2012

In Attunement

"Learn to regard the souls around you as parts of some grand instrument. It is for each of us to know the keys and stops, that we may draw forth
the harmonies that He sleeping in the silent octaves."

- Anonymous     


The process by which the phases of attention among two or more people and the environment come into harmony through resonance or cohesion (union) of their interpersonal brain activity, especially from physical touch. This includes the capacity of a massage therapist to direct attention consciously among his/her body-mind, the body-mind of the client and the environment. This usually occurs at a slow tempo in order to stabilize the autonomic nervous system. Attention naturally focuses and unfocuses rhythmically during a massage. Attunement is a foundation for establishing safety and trust in a therapeutic relationship (Siegel D. 2007: The Mindful Brain)

Social Neuroscience

In Traditional Eastern Philosophy, we refer to attunement as energetic connection, an intersubjection of the aura, the chakras, the Qi or the Ki - depending on the discipline of course. In Modern Western Medicine, it is established to be a "social neuroscience" based on evidenced-based research. In the latter, it is about understanding neurological self-regulation and integration of the self's mind-body to the other - which in our case: us to our client/patient. It has two components: (1)The Internal self-regulation through interoceptive (self) awareness of the body from the inside of it - your own heart rate, your own breathing for example; and (2) Socially, in relationships, through exteroceptive processing with the special senses such as seeing, touching and hearing others - in this case Massage Therapy. 

The kind of "attunement" that we can establish with our client is based on the quality of the therapeutic relationship we have towards them, which is in turn based on ethical behavior, clear boundaries and our capacity to pay attention to his or her own body and mind. Research has proved time and time again that this quality impacts the central nervous system of the clients and patients! That means our techniques - no matter how good, our communication - no matter how professional are not enough! For a therapeutic relationship to last and for a treatment to be effective, we need to be "attuned" to our clients! We need to be connected. Our attention to our own body, mind and spirit should be as much as the attention we pay our clients! And it should always be sincere and empathetic.

Our nervous system naturally focuses and unfocuses attention in a rhythmic pattern within a range of possible tempos of the massage we give. "We" as massage therapists need to integrate this knowledge in the neurobiology of interpersonal relationships at a clinical level (the ones we learn in school and the ones from previous experience) - regardless of whether you lean more towards its Eastern or its Western philosophy. We need to understand that a therapeutic relationship based on safety and trust includes the process of attunement. Attention, Intention, Empathy, Kindness: four of the most important part of an effective "attunement". They are the same with any helping profession.

For some people, attunement is second nature, it is their inborn talent. They already have the neurological pathways for it. But for those who don't, according to Siegel (2007), in his book: "The Mindful Brain": there are effective ways that we can establish "attunement", if we are still on the process of learning them:
·       Use conscious breathing to center attention to your own body: When using deep or vigorous techniques, pause periodically and observe the client’s/patient’s breathing.
·       Stay mentally and emotionally present with the client/patient while working: Be aware of how attention moves periodically between the body-mind of the therapist and that of the client/patient.  

·       You - the therapist should be aware when attention is separated from self or client/patient for prolonged periods and regularly settle attention back into the therapist body, listen with your intuition as well  as with your eyes and hands!
·       Be aware of the impact of your emotions on your ability to maintain a therapeutic relationship and perform massage therapy: If you are in a bad mood, you will certainly give a bad touch - not to mention a bad vibe.
·       Always monitor the speed or tempo of your own sensations, thoughts and feelings: Slow them down as needed in order to achieve attunement.
·       Always regulate the tempo of the massage to build resonance and sustain it over time: Take your time, it is hard to be "attuned" if you are in a rush.

Excerpts for this post is taken from: Siegel D. The Mindful Brain, New York: W.W. Norton; 2007.

- Leo Feraer-Oporto     

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