Archive for the 'Massage: The Missing Link in Addiction Treatment' Category

Nov 04 2011

Massage: Hands Down, a Treatment for Addiction Part 4

Massage in addiction treatment
In order to more fully understand the place that massage therapy holds in the treatment of addictions during the detoxification phase, it is important to look at the biochemistry of addiction in the brain. Much attention has been directed to the mesolimbic reward system, the so-called “pleasure pathway” of the brain. The area is activated in part by the release of the neurotransmitter dopamine, the chemical messenger responsible for making us feel good when we engage in any pleasurable activity. It is well known that dopamine is significantly involved in addiction and that dopamine levels are lower than average during the withdrawal process and into early recovery until brain chemistry normalizes. Therefore, any measure, such as massage, that can naturally increase the level of dopamine is a welcome addition to the standard pharmacological interventions most commonly used during the detoxification process. In addition, massage promotes the circulation of both blood and lymphatic fluid so that more nutrients are brought to the tissues and organ systems and toxins and other waste products are more rapidly eliminated.

All systems of the body function more efficiently with improved circulation and a reduction in tension of the soft tissues and musculature; this improvement has a positive effect on the mind and emotions as well. Psychologically, the withdrawal process can be a frightening, overwhelming experience. Massage can provide a sense of comfort, safety, and connection, and can begin to build trust in order to establish the therapeutic alliance so crucial in addiction treatment. Through massage, it seems possible to decrease the number of people who fail to complete treatment. Of course, massage therapy sessions must be individualized, taking into account each person’s prior history of touch and past touch therapy experience. The practitioner must always be highly sensitive to the particular needs of each person and their cultural perspectives.

As treatment progresses and the individual completes his or her detoxification period, massage can then be an excellent tool for increasing the client’s self awareness on all levels and continuing enhanced production of dopamine and other crucial neurotransmitters. It takes time for the body’s neurochemistry to normalize. People in early stages of recovery are generally lacking in self-esteem, self-discipline, and self-care and impatiently want to “be well, right NOW!” They are woefully separated from their body and mind, and often troubled with anxiety, depression, and insomnia. Incorporating massage into their treatment schedules — and allowing them to experience regularly what the relaxation response feels like — is time well spent. Massage offers clients awareness of how the body naturally provides pleasurable feelings and responses without the use of chemicals or addictive behaviors. This knowledge can be enlightening and positively influence their outlook toward a sober future.

References
Collinge,W. and Duhl, L.(1997). American Holistic Health Association Complete Guide to Alternative Medicine. New York: Warner Books.
Dossey, B., Keegan, L. & Guzzetta, C. (2000) Holistic Nursing: A handbook for practice, Third edition. New York: Aspen Publishers, Inc., p.618.
Field, T. (2002). Massage therapy. Medical Clinics of North America, 86, 163-171.
Lidell, L., Thomas, S., & Beresford-Cooke, C. (2001). The Book of Massage: The Complete Step-by-Step Guide to Eastern and Western Techniques. New York: Fireside.
Montagu, A. & Matson, F. (1979). The Human Connection. New York: McGraw-Hill Book Co., pp. 89-90.
Touch Research Institute. (2003). Massage therapy database. Available: www.miami.edu/touch-research/Massage
1.html
Various authors. (December/January 2003). Massage and Bodywork, 17, 6. Selected articles on addiction and reprints available: www.massageandbodywork.com

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Nov 04 2011

Massage: Hands Down, a Treatment for Addiction Part 3

Types and effects of massage
With so many different types of massage therapy and bodywork from which to choose, practitioners often blend several styles to fit their own individual philosophy, training, and intent (for an excellent, thorough review of massage therapy, see the ç chapter in Collinge & Duhl, 1997). Some massage techniques focus less on the manipulation of musculature and soft tissue and more on the integration and structure of all body parts. Oriental styles incorporate the principles of Chinese medicine and serve to maintain the flow of energy, or chi, through meridians, the energy circuits of the body. In addition, there are other energy-based modalities, such as therapeutic touch, where it is not always necessary to touch the body for positive responses, following the principle that the human energy field extends 2 to 4 inches beyond the skin and can be balanced by the actions and the intent of the practitioner.
Complementary medicine of all varieties is becoming increasingly more mainstream, a trend that will most likely continue. Unfortunately, limited research has been done in this area. This fact is changing, due in part to the National Center for Complementary and Alternative Medicine (NCCAM). Founded in 1992 by the National Institutes of Health in response to public interest, NCCAM (formerly the Office of Alternative Medicine) is now scientifically researching and evaluating alternative health modalities and funding independent research grants. Currently, many studies are also being conducted at the Miami, Florida-based Touch Research Institute (TRI), the only center in the world today devoted solely to the scientific exploration of touch and its application in healing disease.

Since TRI was established in 1991 by the University of Miami School of Medicine, the Institute has been responsible for research that has yielded significant scientific findings regarding massage and its effects on the body, among them: decreased pain, diminished autoimmune responses, enhanced immune response, increased alertness and performance, and enhanced growth in premature infants. Many of the effects appear to be related to the reduction in stress hormones, most notably cortisol, which occurs as the result of massage therapy (Field, 2002; TRI 2003). Several TRI studies completed in the past five years involve massage and addictions — specifically nicotine, bulimia, and cocaine-exposed newborns. These studies positively document the ability of massage to decrease anxiety, agitation, and cravings as well as improve sleep and lessen feelings of depression (TRI, 2003).

Joni Kosakoski, BSN, RN, CARN ( admit@crossroadsantigua.org ) has practiced nursing for more than 25 years, the last 10 specializing in addictions. She is a member of the American Holistic Nurses Association and The International Nurses Society on Addictions.

References
Collinge,W. and Duhl, L.(1997). American Holistic Health Association Complete Guide to Alternative Medicine. New York: Warner Books.
Dossey, B., Keegan, L. & Guzzetta, C. (2000) Holistic Nursing: A handbook for practice, Third edition. New York: Aspen Publishers, Inc., p.618.
Field, T. (2002). Massage therapy. Medical Clinics of North America, 86, 163-171.
Lidell, L., Thomas, S., & Beresford-Cooke, C. (2001). The Book of Massage: The Complete Step-by-Step Guide to Eastern and Western Techniques. New York: Fireside.
Montagu, A. & Matson, F. (1979). The Human Connection. New York: McGraw-Hill Book Co., pp. 89-90.
Touch Research Institute. (2003). Massage therapy database. Available: www.miami.edu/touch-research/Massage
1.html
Various authors. (December/January 2003). Massage and Bodywork, 17, 6. Selected articles on addiction and reprints available: www.massageandbodywork.com

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Oct 07 2011

Massage: Hands Down, a Treatment for Addiction part 2

The history of massage
Massage has played into healing since early on in human history — some sort of healing through touch, or laying on of hands, has been part of all ancient cultures and continues into modern times. The ancient Greek and Roman physicians used massage as a principle means of removing pain. In the fifth century BC, Hippocrates, the ancient Greek physician and Father of Modern Medicine, wrote: “The physician must be experienced in many things, but assuredly in rubbing” (Lidell, Thomas, & Beresford Cooke, 2001, p.10). Most modern cultures include massage within their health care delivery system, most notably in China, where separate massage wards are found in the hospital setting. Many countries, including Germany, allow massage or other forms of touch therapy to be covered by medical insurance (Collinge & Duhl, 1997). In the immediate post-WWII era in the United States, as the practice of modern medicine became more focused on technologic and pharmaceutical interventions, massage as a medical modality was passed on from physicians’ hands to those of others — most notably physical therapists. Massage gradually lost its place as a primary medical intervention, with a few exceptions, such as in the osteopathic and chiropractic medical community. The 60s and 70s inspired a new paradigm of health and healing: revived interest in holistic measures, increased self-awareness and self-improvement, as well as optimal health, wellness, and prevention practices. As a result, massage and other forms of bodywork have received renewed attention.

Joni Kosakoski, BSN, RN, CARN ( admit@crossroadsantigua.org ) has practiced nursing for more than 25 years, the last 10 specializing in addictions. She is a member of the American Holistic Nurses Association and The International Nurses Society on Addictions.

References
Collinge,W. and Duhl, L.(1997). American Holistic Health Association Complete Guide to Alternative Medicine. New York: Warner Books.
Dossey, B., Keegan, L. & Guzzetta, C. (2000) Holistic Nursing: A handbook for practice, Third edition. New York: Aspen Publishers, Inc., p.618.
Field, T. (2002). Massage therapy. Medical Clinics of North America, 86, 163-171.
Lidell, L., Thomas, S., & Beresford-Cooke, C. (2001). The Book of Massage: The Complete Step-by-Step Guide to Eastern and Western Techniques. New York: Fireside.
Montagu, A. & Matson, F. (1979). The Human Connection. New York: McGraw-Hill Book Co., pp. 89-90.
Touch Research Institute. (2003). Massage therapy database. Available: www.miami.edu/touch-research/Massage
1.html
Various authors. (December/January 2003). Massage and Bodywork, 17, 6. Selected articles on addiction and reprints available: www.massageandbodywork.com

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Sep 29 2011

Massage: The Missing Link in Addiction Treatment

People in the early stages of addiction recovery often experience an uncomfortable gap between their body and mind. Therapeutic massage can bridge that gap, and is a powerful adjunct treatment in the addiction and recovery process.

Substance abuse is a major public health problem. According to the National Institute of Drug Abuse, substance abuse costs our nation more than $484 billion per year. This includes costs related to crime, medical care, treatment, social welfare programs, and time lost from work.

Comprehensive treatment for the addicted individual is the key to turning this health crisis around. In the October 2003 edition of Counselor, The Magazine for Addiction Professionals, Joni Kosakoski, BSN, RN, CARN gives us the fuel to propel massage therapists into the realm of drug and alcohol treatment. In her article “Massage: Hands Down, a Treatment for Addiction”, Kosakoski gives us a clear and concise analysis of massage’s benefits for this population and its place in addiction treatment.

Incorporating massage into a substance abuse program is advantageous in all of the stages of quitting an addiction: withdrawal, detoxification and abstinence. The physical, emotional and spiritual components of recovery all can be directly benefited by the healing power of therapeutic touch. The nurturing contact of massage utilizes skin as the translator of the therapist’s intent. Skin, the largest sensory organ in our body, is our primary sense for connecting information from our external surroundings to our internal environment.

The Touch Research Institute in Miami, Florida has performed scientific research documenting the physiological effects of massage on the body. Kosakoski reminds us of some of their findings on massage such as decreased pain, diminished autoimmune response, enhanced immune response, and increased alertness and performance. These effects appear to be related to massage’s ability to reduce cortisol, a stress hormone, as reported by the Touch Research Institute in 2003. Several of the Touch Research Institute’s studies positively document the ability of massage to decrease anxiety, depression, agitation, and cravings.

In order to understand the connection between massage therapy and its benefit in addiction treatment, Kosakoski explains the neurological biochemistry of addiction: “Much attention has been directed to the mesolimbic reward system, the so-called ‘pleasure pathway’ of the brain. The area is activated in part by the release of the neurotransmitter dopamine, the chemical messenger responsible for making us feel good when we engage in any pleasurable activity. It is well known that dopamine is significantly involved in addiction and that dopamine levels are lower than average during the withdrawal process and into early recovery until brain chemistry normalizes.”

In 1998, the Touch Research Institute published the findings that a regular massage regimen produced long-term results of increasing dopamine levels. The fact that massage naturally increases dopamine levels, and decreases cortisol levels makes it a perfect addition to a standard detoxification program.

The neurochemistry of an addict takes time to get back into balance, so massage treatments after the initial detoxification phase is crucial. When a person uses a substance to feel good, his/her body stops manufacturing its own “feel good” chemicals, (endorphins), and the substance takes over that task. Therefore, when a person quits using an abused substance, they lose their source of feeling good. Since it takes time for the body to start manufacturing its own endorphins again, this is a challenging interim to endure. This interim is the recovering addict’s most vulnerable time to relapse.

In the 1989 edition of General Pharmacology, Kaada and Torsteinbo of Norway reported on study results that massage therapy increased the amount of beta-endorphins in the blood by 16 percent. The release of endorphins during a massage allows the recipient to feel normal, even fantastic, without the aid of a drug. This can be a powerful, even life-changing experience for the client.

On a physical level, the circulation that occurs with massage is also a desired occurrence during the detoxification process. Therapeutic massage’s invigoration of blood and lymphatic fluid allows for a more efficient exchange of oxygen rich nutrition into the body’s tissues, and the delivery of toxic waste products out of the body’s tissues. Kosakoski adds that “All systems of the body function more efficiently with improved circulation and a reduction in tension of the soft tissues and musculature…”

On an emotional level, part of an addict’s recovery process is learning to identify and manage the triggers that cause them to desire escape. Regular massage sessions can aid the client’s awareness of his or her own body, including where and when tension exists. Being conscious of these patterns is a step toward recognizing one’s own resistance, which can lead to healthfully addressing emotions associated with cravings and stress. In addition Kosakoski says that “Emotional release can commonly occur with massage, which provides a safe, non-threatening opportunity to begin the process of recovering long-buried emotions and memories.”

On a spiritual level, the deep relaxation of a massage can provide a still inner place for the recipient to connect with themselves. Being grounded, centered and fully present can be experienced when receiving therapeutic touch from a grounded, centered and fully present practitioner. A recovering addict has a whole new world opened to them when they acknowledge that they can simultaneously be anchored, present, feel good and be substance-free. As Kosakoski explains, “To allow oneself to surrender to the practitioner’s hands — to breathe fully and easily, to acknowledge and receive the gifts of nurturing, surrender and relaxation ….is an invaluable addition to the newly recovering person’s repertoire of relapse-prevention skills.”

Massage has the unique ability to affect all of our layers of being — from the spiritual plane all the way up to and including our body’s chemical composition. In the process of abandoning an addiction, these many parts of ourselves become fragmented. It is merely a matter of time before all addiction and recovery treatment programs recognize massage’s ability to mend the mind-body connection. When that happens, therapeutic massage will be integrated into addiction treatment, and clients will be optimally prepared to succeed in their recovery.

Posted by Nicole at 12:18 PM
© 2009 Institute for Integrative HealthCare Studies. This work is reproduced with the permission of the Institute. www.Integrative-Healthcare.org

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