Download THE PHENOMENON OF ADAPTATION

THE PHENOMENON OF ADAPTATION
We work hard as massage practitioners to give therapeutic and stress-reduction massages. Our goal,
of course, is to serve the health and well-being of our clients, but we also want to build our practice
to the point where we have enough regular clients to provide us with both professional and financial
satisfaction. This can prove to be a very real challenge for all of us, whether we are self-employed
or employees at a spa or a medical office. A client is one thing. A loyal clientele is another. Once
you get someone on the table, how do you keep them there?
Let’s take a look at one common scenario.
You were referred a new client, Mrs. C., whom you have been seeing on a weekly basis for
two months now. She told you regularly how much she enjoyed the massage, how “gifted” your
hands were, how much she looks forward to the next session. Then, suddenly, Mrs. C. stops visiting
you (does it sound familiar?). It would be easy to simply label her as a "non-loyal client." However,
it is a common mistake to transfer the blame to the client when the real blame, in fact, lies much
closer. The real blame lies right between our own hands. It is the massage practitioner who lost the
opportunity to have – and to keep – this client as a regular and loyal client. “Nonsense!” you may
argue. “How is it the therapist’s fault if a client ends up to be a flake?” Although I agree that we all
deal with some real nutcrackers from time to time who do flake out, a very common reason why a
practitioner fails to retain one’s clients is because he or she is not fully mindful of The
Phenomenon of Adaptation. Mrs. C. got bored. She would tell her friend who referred her to
you, “I loved his or her massages at first, but after a while, they didn’t do anything for me anymore.”
Or, “They all started to feel the same.”
What Mrs. C. and you, her massage therapist, may not be aware of is the degree to which the
"boredom" Mrs. C. has come to experience during her massages is physiologically based, and is the
result of a series of mechanisms whose workings can be scientifically explained. To discover these
workings, and to better understand this phenomenon of adaptation, we need to look in some detail at
certain nuts-and-bolts aspects of how the autonomic nervous system responds, in measurable ways,
to massage.
What causes the phenomenon of adaptation?
The majority of clients visit massage practitioners to maintain wellness and to reduce their
level of stress. One's stress level is under the control of the autonomic nervous system, which
manages all body functions without our conscious participation (as, for example, our heart rate or the
flow of blood through our muscles).
The autonomic nervous system consists of two divisions: the sympathetic and the
parasympathetic nervous systems. Both divisions control the body's functions by constantly
interacting with one another. The sympathetic nervous system is the stress system. It is activated
during emotionally or physically stressful situations, as well as generally during the waking hours.
The parasympathetic nervous system has the opposite effects. It is more active during periods of
relaxation, as well as generally during the sleeping hours.
In a healthy body, both divisions act upon the organs and tissues as a plus and minus,
constantly balancing each other's effects, with the overall result of their interaction equaling zero, i.e.
stress reduction. For example, if the sympathetic nervous system increases the heart rate, the
parasympathetic system then decreases it. If the parasympathetic nervous system triggers
bronchoconstriction, the sympathetic nervous system then produces bronchodilation.
When the relationship between the sympathetic and parasympathetic nervous systems
becomes unbalanced, the sympathetic nervous system increases its activity, resulting in sensations of
stress: physical tension, anxiety, morning stiffness, chronic mild pain, etc. This is the tipping point
when a person under stress will decide to seek massage, or to practice yoga, meditation or aerobic
exercise. These all result in a decrease in the activity of the sympathetic nervous system, and thus in
one's level of stress.
Modern medicine has come to understand chronic stress as a primary trigger of chronic
disorders in the human body. Thus, owing to its effective stress-reduction impact, massage is an
important (and grossly underutilized!), tool of preventive medicine.
The practitioner works with soft tissue, which contains millions of sensory receptors that are
activated during the massage. The peripheral receptors – receptors of touch, pressure, vibration,
and temperature, as well as muscle spindle receptors and Golgi tendon organ receptors – all send
sensory information into the spinal cord. This sensory information is primarily processed in the
posterior horns of the spinal cord by spinal neurons. The spinal neurons are responsible for the
further conduction of sensory information to other parts of the spinal cord and to the brain.
Massage impacts the central nervous system and restores the balance between the
sympathetic and parasympathetic divisions through the activation of the peripheral receptors in the
massaged area, and subsequently, of the spinal neurons located in the segment of the spinal cord
responsible for the innervation of that area.
Each type of peripheral receptor has its own threshold of adaptation. A perfect example of
this is the continuous application of a particular massage stroke in the same area. The client
experiences the first strokes as sharper and more distinct, as compared with when same strokes in the
same area are conducted for one minute or more. Adaptation of the peripheral receptors (in this
case, touch and pressure receptors) is the result of their desensitization.
The spinal neurons in the posterior horns of the spinal cord also have their own threshold of
adaptation. After prolonged repetitive stimulation of peripheral receptors, the spinal neurons reach
their own threshold of adaptation due to the consistent flow of (harmless) sensory information they
receive from the peripheral receptors of the massaged area. Thus, the desensitization (that is, the
attaining of the threshold of adaptation) of the spinal neurons occurs secondarily to the
desensitization of the peripheral receptors brought about by the practitioner's strokes.
How do peripheral receptors and spinal neurons overcome adaptation?
Whereas peripheral receptors are able to shake off their adaptation and restore their full
working potential very quickly after a repetitive stimulation has ceased (the moment you stopped the
application of effleurage, for instance), spinal neurons, on the other hand, stay adapted for a while
after sensory information has ceased to flow to them from the peripheral receptors.
When spinal neurons reach their threshold of adaptation, they allow less sensory information
to reach other parts of the spinal cord and the brain itself. As a result, the balancing impact of your
massage strokes on the relation between the sympathetic and parasympathetic divisions of your
client's autonomic nervous system is now lessened.
Returning, once again, to our (so unfairly labeled) "disloyal" Mrs. C., let’s consider that the
practitioner has developed an hour-long massage routine that he or she (let’s pretend it was you) uses
on all clients from session to session. For Mrs. C., as a new client, your personal style feels new and
exciting, and she really enjoys the first few sessions. Mrs. C. has a regular weekly appointment with
you for 8 weeks, and every week she comes into the same room, at the same time, and experiences
the same massage routine. Her peripheral receptors, therefore, send a flow of the identical sensory
information to the posterior horns of her spinal cord, and with each new session of the same massage
routine her spinal neurons reach their threshold of adaptation sooner into the session, and remain
adapted longer.
Then Mrs. C. hears from her girlfriend about a new massage practitioner in the neighboring
spa, decides to try her massage, and absolutely loves it! This new practitioner very likely conducted
a massage routine generally along the same lines as yours, however the variations of her personal
style kept Mrs. C.'s spinal neurons from quick adaptation. Boom! A new and exciting experience
for Mrs. C., about which she will certainly tell all her friends! Unfortunately for you, it is too late.
You just lost a regular client, as well as all the positive word-of-mouth that goes away with her.
What’s sad is that Mrs. C. was your client to lose, and her nervous system's adaptation – her
"boredom" – was yours to prevent!
How do we control, and thus prevent, the phenomenon of adaptation?
It’s like a relationship. When we start dating, it all begins with an initial interest, followed by
a liking of what we experience, enforced with the excitement of what’s coming next, leading to a
certain personal commitment. However, sooner or later the honeymoon (when everything is
naturally exciting by the newness of things) is over and we have to become conscious of using our
intuition and creativity to keep our relationship interesting and lasting.
Based on my personal experience, pizza and champagne at home used to work for my wife
for a while. Then, thanks to my sharp intuition, I had to add some dining out experience. Then I had
to quickly learn that dining out could no longer include pizza joints. I had to surprise her, and she
had to surprise me. That is what kept, and continues to keep, our marriage growing. The same with
my clients. I can never expect or take for granted their experience of my massage as “the best ever”!
I must always be fully aware of The Phenomenon of Adaptation. And so should you be.
The best solution to successfully building a practice that will keep your clients interested and
coming back is a richer, more varied technical repertoire. There are 60 variations of 7 basic
massage techniques, but when practitioners compose their massage routine, they often use only a
very limited number of them, applied over and over again. A limited technical repertoire and a
never-changing massage routine are two major factors which contribute to the adaptation of one's
clients' spinal neurons and thus, their boredom. It undermines the therapist’s practice. Conversely,
by investing in a variety of techniques and routines, a massage therapist ensures that their clients will
remain fascinated with their work and, just as importantly, that their own level of interest in and
excitement for what they do will continue to grow.
Variety doesn't mean that you need to visit all 60 variations upon your clients each time you
work with them. That would be quite senseless. The solution, thankfully, is much simpler. So let’s
discuss in practical terms how to control and, thus, prevent the unwelcome phenomenon of
adaptation.
Let’s say you have developed an hour-long (or 1 ½ hr) massage routine that you enjoy
executing and are proud of. Great! This is the foundation of your practice. To control the
phenomenon of adaptation, you simply need to incorporate one or two new variations into each day's
massage routine, switching these around daily with other variations (if one), or combinations of
variations (if two).
For example, you decide that for all your clients today you will incorporate into your
massage routine ridging friction and scrolling kneading. In such a case, you add both techniques to
the massage of each segment of the body. Tomorrow, within your regular routine, all of your clients
will receive two different variations from the previous day: for example, stretching friction and
mobile kneading.
If you have 5 to 7 such gourmet sets of massage techniques, you can incorporate them into
your routine and constantly rotate their application on a daily basis. Alternatively, for clients who
see you on a weekly basis, you can function along the lines of an added Special Combo of the Week.
In this way, your regular clients will never reach the threshold of adaptation and feel bored; each
time they see, you will be surprising their peripheral receptors and spinal neurons in some different
way. Your ever fresh and original work will be the Talk of the Town. Your clients will remain
captivated by your exciting, surprising massages and you will retain the opportunity and privilege of
exerting a positive influence on their lives. Heck, you may even get Mrs. C. back.