Massage therapists balking at proposed continuing education changes

POSTED: 7:00 PM WED, JANUARY 5, 2011
BY MARYLANDREPORTER.COM
BARBARA PASH

Massage therapists are balking at proposed changes to their continuing education requirements, which they say would increase the cost of licensing by adding additional training requirements.

The changes were approved by the Maryland Board of Chiropractic and Massage Therapy Examiners last February, and published last month in the Maryland Register. The required 30-day public comment period ends Jan. 18, when the proposed changes go to the state Department of Health and Mental Hygiene for a final decision.

“There is widespread opposition to the changes within the massage therapy community,” said Cher Hunter, a licensed massage therapist and member of the board of the Maryland Chapter of the American Massage Therapy Association. The group is spearheading a letter-writing campaign to get the department to reject the changes.

Hunter contended that the proposed changes would limit the options for continuing education. Massage therapists need to get 24 hours of continuing education credit for each two-year license renewal period.

Under the proposed changes, only courses determined by the board to meet professional standards are acceptable for continuing education credits. Courses given by the National Certification Board for Therapeutic Massage and Bodywork and by Maryland schools accredited by the Maryland Higher Education Commission would not be accepted — unless approved by the board at least 90 days before the class starts and for a $25 per credit fee. Hunter said this red tape and expense would limit the number of courses and deter national providers from entering the state scene.

“The Maryland changes are much stricter than most states’ requirements,” Hunter said.

The proposed changes would also increase the cost of massage therapist licensing by adding requirements for CPR and first aid training. Hunter estimated this would cost $100 per renewal period, creating an economic hardship. She said the state’s nearly 4,000 massage therapists already pay significantly for their licenses.

“The initial fee is $450 for the state process and $225 fee for the national certifying examination, making the $675 for a state license the most expensive in the country,” Hunter said. In addition, therapists pay $250 every two years for license renewal, plus the cost of continuing education courses.

James Vallone, executive director of the Board of Chiropractic and Massage Therapy Examiners, said that the proposed changes are consistent with the 2008 statute that combined massage therapists and chiropractors under a single board.

The act also changed massage therapy from a practice requiring certification to one that is licensed, and gave the board responsibility for regulating it.

“The proposed changes emanate from that” act, said Vallone.

The board “has to develop implementing regulations that affect that statute,” Vallone continued, “and a review is required by the state to keep the regulations in compliance with the profession and the board’s budget.”

Vallone said the board has been getting “some comments” from the massage therapy community, but that is to be expected whenever changes are proposed. These changes would make massage therapy continuing education requirements consistent with requirements for chiropractors.

Vallone acknowledged that all continuing education units will have to be approved by the board to get credit. “That being said,” he said, providers have “several different options” to enable them to pay a single, $25 fee for multiple offerings.

“The board looked at the cost — whether it would diminish the availability of quality courses — and came to the conclusion that it would not,” said Vallone. “We are not eliminating any certifying agency.”

www.ProfileMassage.com

Shaky Evidence Behind Massage Therapy for Autism

(Reuters Health) - Massage has become a fairly popular alternative therapy for autism, but there is only limited evidence suggesting it is helpful, a new research review shows.

Researchers say some studies did find benefits -- for instance in language and social skills -- but small patient samples and other problems make the results unreliable.

Autism spectrum disorders (ASDs) are a group of developmental disorders that, to varying degrees, hinder a person's ability to communicate, socialize and build relationships.

There is no cure, but special education programs and behavioral and language therapies are standard. Often, parents also turn to alternative approaches for additional help, including special diets or art and music therapy.

In general, massage or "touch" therapy is thought to have both physical and emotional benefits. For children with autism, it could have effects on the nervous and hormonal systems that may help ease some of their difficulties, explained Dr. Myeong Soo Lee of the Korea Institute of Oriental Medicine in Daejeon, the lead researcher on the new study.

And parents seem to be putting some hope into that idea: Two recent U.S. studies of children with ASDs found that 11 percent to 16 percent had undergone massage therapy.

But whether it actually works is unclear.

In their search of the medical literature, Lee and his colleagues found only six clinical trials that tested massage therapy against standard therapies for children with autism.

There were some promising findings, Lee said. Children who received massage plus special education, for instance, improved their social abilities and "daily living" skills, like dressing and feeding themselves.

And those who had massage added to language therapy made bigger strides in communicating than those who had language therapy alone.

However, all of the studies had fundamental shortcomings, according to the researchers: None included more than 50 children and they lasted only between one and five months.

There were also problems in the studies' methods that put them at a high risk of bias. In some cases, for example, the researchers assessing the children knew which ones had gotten massage therapy and which ones had not, so they might be more inclined to see progress in the former.

The bottom line, the researchers write, is that "firm conclusions cannot be drawn" as to whether massage therapy aids children with autism.

On the other hand, the researchers are not advising parents against finding a massage therapist with experience in working with children with autism.

If parents are interested in the therapy, Lee said, he knows of no serious potential risks of massage for children with autism. But as far as effectiveness, more rigorous studies are warranted, he and his colleagues write.

SOURCE: bit.ly/ggn3tm Journal of Clinical Psychiatry, online December 28, 2010.

Jackson Wy Massage

(NaturalNews) The health and wellness benefits that massage offers are more abundant than once thought. Emerging research points to a growing list of advantages that range far wider than simple anxiety, tension, and pain relief.

One of the most interesting benefits uncovered is a possible link to improved immunity. Studies have shown that those who receive regular massage have lower cortisol levels in their saliva. Cortisol is the "stress" hormone, and it is linked to a lower immune function.

Cortisol actually kills off the cells that are necessary for healthy immunity. Lowering this hormone in the body not only can lead to greater immune response to foreign invaders, but it also leads to lower stress and anxiety levels. Lowering cortisol levels has also been linked to a greater ease in losing weight and keeping it at a healthy level.

The mental health benefits from lowered stress levels and regulated anxiety are probably worth it alone. However, there are even more advantages your body reaps from getting massaged regularly.

Studies have indicated that regular massage helps with hypertension. Massage helps reduce anxiety, which contributes to high blood pressure. This is probably a part of the reason that it helps to regulate blood pressure.

However, there is also another factor that contributes to this function. The vagus nerve actually helps regulate a person's blood pressure, and massage helps to stimulate this nerve into action.

The more obvious benefits of massage are its excellent ability to temporarily reduce and manage pain. It can be used to relieve muscle pain, pain associated with nerve damage, and even joint pain. The manipulation of the soft tissues helps increase circulation, which may aid in healing as well.

Enhanced circulation also leads to better skin tone and healthier soft tissue. This enhanced circulation and manual pressure also helps to deliver oxygen and vital nutrients to the cells.

Massage is even believed to help enhance the elimination of toxic substances which are transported out of the body by the lymphatic system. This lymphatic drainage, while beneficial, needs to be helped along by you. Hence, it is always recommended that one drink plenty of purified water after a massage, to push the toxins through the elimination process quicker.

Overall, massage is a great way to reduce stress, unwind, and enjoy some "you" time. It's important to remind yourself of the other benefits that massage offers if you start to feel a little guilty about it. Massage can be an excellent complement to an otherwise healthy lifestyle and diet.

Sources :

http://www.newsweek.com/2008/09/03/...
http://www.holisticonline.com/massa...
http://spas.about.com/od/massa2/a/m...

Learn more: http://www.naturalnews.com/029522_massage_benefits.html#ixzz19LvWRp1B

Hope for Hungry Children, Arriving in a Foil Packet

By MICHAEL WINES

Published: August 8, 2005

MARADI, Niger, Aug. 7 - In the crowd of riotously dressed mothers clasping wailing, naked infants at a Doctors Without Borders feeding center just west of here, Taorey Asama, at 27 months, stands out for a heart-rending reason: she looks like a normal baby.

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Michael Kamber for The New York Times

A mother feeding the food supplement Plumpy'nut to her child in Tibiri, Niger. It is distributed to mothers of severely malnourished children.

Niger's Dying Children

Groups Aiding Niger (August 4, 2005)

Many of the others have the skeletal frames and baggy skin of children with severe malnutrition. The good news is that a month ago, so did Taorey.

"When she came here, she was all small and curled up," said her mother, Henda, 30. "It's Plumpy'nut that's made her like this. She's immense!"

Never heard of Plumpy'nut? Come to Maradi, a bustling crossroads where the number of malnourished children exceeds even the flocks of motor scooters flitting down its dirt streets.

At this epicenter of Niger's latest hunger crisis, Plumpy'nut is saving lives, perhaps including Taorey's.

Plumpy'nut, which comes in a silvery foil package the size of two grasping baby-size hands, is 500 calories of fortified peanut butter, a beige paste about as thick as mashed potatoes and stuffed with milk, vitamins and minerals. But that is akin to calling a 1945 Mouton Rothschild fortified grape juice.

Since the packets came into the hands of relief organizations during the Darfur crisis in Sudan, they have been revolutionizing emergency care for severely malnourished children who are old enough to take solid food, by taking care out of crowded field hospitals and straight into mothers' homes.

The prescription given to mothers here is simple: give one baby two packets of Plumpy'nut each day. Watch him wolf them down. Wait for him to grow. Which he will, almost immediately: badly malnourished babies can gain one to two pounds a week eating Plumpy'nut.

"This product, it's beyond opinion - it's documented, it's scientific fact," Dr. Milton Tectonidis, a Paris-based nutrition specialist for Doctors Without Borders, said in an interview here. "We've seen it working. With this one product, we can treat three-quarters of children on an outpatient basis. Before, we had to hospitalize them all and give them fortified milk."

Traditional malnutrition therapy hospitalizes the tots, nursing them to health with steady infusions of vitamin-laced milk. Then they are sent home with powdered milk formula to complete their recovery. It works well, but milk is costly, must be mixed from water and is prone to spoiling.

And when mothers prepare the formula with the dirty water all too common in impoverished villages, babies get sick.

In comparison, Plumpy'nut - the name melds the words "plump" and "peanut" - costs less than the milk formula, has a two-year shelf life and need not be mixed with anything. Its sealed packaging and thick consistency make it a poor home for disease-causing germs that thrive in milk.

Perhaps most revolutionary, however, is that mothers, not doctors, can give it to their toddlers. That not only reduces costs, but also frees the doctors to treat the sickest children, who often suffer not just from malnutrition, but also from diseases like malaria or dysentery.

The usual course of treatment is four weeks of Plumpy'nut, costing about $20, along with grain-based food like Unimix, a vitamin-packed flour that can be made into the porridge many Africans eat. But some children return to health in as little as two weeks.

The product is the brainchild of a French scientist, André Briend, who had labored in vain for years to concoct a ready-to-eat nutrition supplement, until serendipity - a bottle of the popular Nutella breakfast spread on his kitchen table - led him to try a paste instead using candy bars and other kinds of food. Later, Nutriset, a French company that specializes in making food supplements for relief work, began packaging the formula under the name Plumpy'nut.

For three months, Doctors Without Borders has been handing out week-long supplies of Plumpy'nut, 14 foil packets in a black plastic grocery sack, at its five outpatient feeding centers in Maradi and 21 centers elsewhere in Niger.

Not everyone gets it: newcomer babies are weighed and measured, and only those whose weight is dramatically below normal for their height qualify. Those who are too ill for outpatient care go to a nearby field hospital.

About 700 babies are being treated in Maradi, and about 130 more arrive for screening each day, of which perhaps 80 are accepted and given an ankle bracelet - their ticket, so to speak, good for a weekly trip to the center for more foil packs, bags of grain and cooking oil. Across the area of hunger in Niger, about 5,000 children spread across 32 feeding centers are being given the packets.

Theodore Bitangi, a 33-year-old nurse who oversees the Maradi feeding centers, says that the program is growing almost as rapidly as its patients.

"When they come in, the state they're in, they look like embryos. They're so small sometimes," he said. "And after taking Plumpy'nut, they look like real babies."

Mothers who have been feeding the paste to their babies would hardly disagree. "As soon as I got him home, he started eating it - every day, aggressively," Idrissa, 24, who has no last name, said of her 2-year-old son. "And after three days, I could see a big difference. The change was abrupt." Her son, who refused to open his eyes before starting the Plumpy'nut regimen one week ago, has added fat under his sagging skin and, when his packet is finished, cries for another.

"I don't know how to express it," Idrissa said. "I'm so happy."

Raham, 45, who has no last name, walks an hour each way to the clinic from her village, Madata, to pick up a weekly bag of Plumpy'nut for her year-old son, Safia Ibrahim. "It's no problem to walk that far," she said, "because it's for the health of my baby. And there's nothing to eat in our village."

One of the virtues of Plumpy'nut is that it can be made almost anywhere with local materials and a slurry of vitamins and minerals prepared by Nutriset. Versions of the same product are being manufactured in Malawi and in Niger's capital, Niamey, and Nutriset has welcomed the notion of local partners - from charities to women's groups - who might make Plumpy'nut under license or even as franchisees.

Which raises a question: if Plumpy'nut is good enough to give malnourished children in food emergencies, why not give it to the countless thousands of children in Niger who are hungry when the world's attention is directed elsewhere?

The United Nations reports that 150,000 children under age 5 in Niger are severely malnourished, and another 650,000 moderately malnourished - all together, about one in five. Malnutrition is a factor in 60 percent of deaths of children younger than 5 - and in Niger, more than a quarter of all children never reach their fifth birthday.

Fourteen packets a week times 150,000 children times 4 weeks is a lot of Plumpy'nut. But then, says Dr. Tectonidis, it is not the mathematics, or even the nutrition science, that is the hard part. It is keeping the world's eyes focused on solving Niger's everyday hunger problem once the television coverage of this crisis has ended.

"We know what's needed in terms of malnutrition," he said. "It's just the will that's lacking."

health and wellness

Survey Finds Massage Rates As High As Medication

1 In 5 Uses It
By Lloyd de Vries

(WebMD) For the treatment of pain, Americans rate massage as highly as medications, a new survey shows.
Conducted by an independent research firm, the annual survey is the ninth commissioned by the American Massage Therapy Association (AMTA).
It shows that one in five U.S. adults got a therapeutic massage in the last year. Three-fourths of them would recommend it to others — one reason for the body therapy's growing popularity.
Among those who actually had a massage in the past year, 28 percent say massage therapy gives them "the greatest relief from pain." Another 28 percent say medication gives them the greatest relief. Chiropractic comes in third at 11 percent, followed by 8 percent who got the most pain relief from physical therapy, 3 percent who said acupuncture was best for their pain, and 1 percent whose pain best responded to biofeedback.
Survey Findings
The survey, conducted by Opinion Research Corp. International in Princeton, N.J., surveyed a national sample of 1,014 U.S. adults. The poll has a margin of error of plus or minus 3 percent. It found that:
90 percent of Americans feel massage is good for a person's health.
93 percent agree with the statement that massage can be effective for pain relief.
Use of massage in people age 65 and older has tripled from 4 percent in 1997 to 15 percent in 2005.
22 percent of Americans had a massage in the past year; 34 percent had a massage in the last five years.
73 percent of those who had a massage would recommend it to a person they know.
46 percent of respondents at some time had a massage to relieve pain.
Among respondents who discussed massage with their health care provider, 57 percent said this health professional strongly recommended massage or encouraged them to get a massage.
Whole-Body Approach To Pain
Massaging sore muscles obviously reduces pain. But massage is really meant as a whole-body approach, says AMTA vice president and licensed massage therapist M.K. Brennan, RN, LMBT.
"One of the things about massage that helps pain is that it goes down to the heart of where people feel their pain," Brennan tells WebMD. "There is the overall sense of well-being one can get from the massage approach. And the stress responses in the body associated with pain, such as elevated cortisol, are reduced through massage."
For these reasons, massage can be used to treat many different kinds of pain, says Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine.
"Basically we have found massage to be effective in chronic pain syndromes in arthritis and diabetes; in depressive disorders such as ones that involve addiction like eating disorders; in chronic fatigue and fibromyalgia and other autoimmune disorders — HIV-associated diseases, too," Field told WebMD in a June 29 interview. "We have looked at the A-to-Z of medical conditions, and we have not found a single condition massage has not been effective for."
Brennan says all trained massage therapists learn the same basic techniques. As they go on to advanced training, massage therapists may specialize in one or more specific kinds of massage. There are more than 200 of these techniques, according to the Massage.com web site.
Qualifications For Therapists
Brennan recommends that a person seeking therapeutic massage look for a well-trained professional. Most states, she says, require that massage therapists be licensed or registered. And the AMTA web site maintains a referral list of massage therapists who meet certain standards:
Graduate from a minimum 500 in-class-hour massage therapy training program, or
Pass the National Certification Examination in therapeutic massage and bodywork, or
Possess a current AMTA-accepted license to practice, and
Earn continuing education credit, and
Uphold the AMTA Code of Ethics.
"If you are looking for someone dealing with chronic or acute pain issues, you may want to look for someone who does sports massage, neuromuscular massage therapy, orthopedic massage, or someone who does craniosacral work or uses strain/counterstrain techniques," Brennan says. "But any list like this leaves out some qualified professionals. The best thing to do is to find a qualified massage therapist and talk with him or her about what you want massage for, be it relaxation or pain relief. Then ask what is their experience in addressing that issue."
Brennan says weekly massage is most effective but admits that not everyone has the time or money to get massage therapy that often.
Field, however, has a solution. Though there's no replacement for a qualified massage professional, she recommends that families learn basic massage techniques.
"In our studies, we try with adults to get them two 20-minute massages a week," she says. "With kids, we use parents as therapists so they can give their children massages every night, 10 minutes before bedtime. We say this because most of the children in our studies have chronic illnesses and can really benefit from a daily dose of massage."
Sources: 2005 Massage Therapy Consumer Survey, Opinion Research Corp. International, Princeton, N.J., conducted Aug. 11-14, 2005. M.K. Brennan, RN, LMBT, vice president, American Massage Therapy Association. Tiffany Field, PhD, director, Touch Research Institute, University of Miami School of Medicine
(WebMD) For the treatment of pain, Americans rate massage as highly as medications, a new survey shows.
Conducted by an independent research firm, the annual survey is the ninth commissioned by the American Massage Therapy Association (AMTA).
It shows that one in five U.S. adults got a therapeutic massage in the last year. Three-fourths of them would recommend it to others — one reason for the body therapy's growing popularity.
Among those who actually had a massage in the past year, 28 percent say massage therapy gives them "the greatest relief from pain." Another 28 percent say medication gives them the greatest relief. Chiropractic comes in third at 11 percent, followed by 8 percent who got the most pain relief from physical therapy, 3 percent who said acupuncture was best for their pain, and 1 percent whose pain best responded to biofeedback.

Survey Findings
The survey, conducted by Opinion Research Corp. International in Princeton, N.J., surveyed a national sample of 1,014 U.S. adults. The poll has a margin of error of plus or minus 3 percent. It found that:90 percent of Americans feel massage is good for a person's health.
93 percent agree with the statement that massage can be effective for pain relief.
Use of massage in people age 65 and older has tripled from 4 percent in 1997 to 15 percent in 2005.
22 percent of Americans had a massage in the past year; 34 percent had a massage in the last five years.
73 percent of those who had a massage would recommend it to a person they know.
46 percent of respondents at some time had a massage to relieve pain.
Among respondents who discussed massage with their health care provider, 57 percent said this health professional strongly recommended massage or encouraged them to get a massage.
Whole-Body Approach To Pain
Massaging sore muscles obviously reduces pain. But massage is really meant as a whole-body approach, says AMTA vice president and licensed massage therapist M.K. Brennan, RN, LMBT.
"One of the things about massage that helps pain is that it goes down to the heart of where people feel their pain," Brennan tells WebMD. "There is the overall sense of well-being one can get from the massage approach. And the stress responses in the body associated with pain, such as elevated cortisol, are reduced through massage."
For these reasons, massage can be used to treat many different kinds of pain, says Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine.
"Basically we have found massage to be effective in chronic pain syndromes in arthritis and diabetes; in depressive disorders such as ones that involve addiction like eating disorders; in chronic fatigue and fibromyalgia and other autoimmune disorders — HIV-associated diseases, too," Field told WebMD in a June 29 interview. "We have looked at the A-to-Z of medical conditions, and we have not found a single condition massage has not been effective for."Brennan says all trained massage therapists learn the same basic techniques. As they go on to advanced training, massage therapists may specialize in one or more specific kinds of massage. There are more than 200 of these techniques, according to the Massage.com web site.

Qualifications For Therapists
Brennan recommends that a person seeking therapeutic massage look for a well-trained professional. Most states, she says, require that massage therapists be licensed or registered. And the AMTA web site maintains a referral list of massage therapists who meet certain standards:Graduate from a minimum 500 in-class-hour massage therapy training program, or
Pass the National Certification Examination in therapeutic massage and bodywork, or
Possess a current AMTA-accepted license to practice, and
Earn continuing education credit, and
Uphold the AMTA Code of Ethics."If you are looking for someone dealing with chronic or acute pain issues, you may want to look for someone who does sports massage, neuromuscular massage therapy, orthopedic massage, or someone who does craniosacral work or uses strain/counterstrain techniques," Brennan says. "But any list like this leaves out some qualified professionals. The best thing to do is to find a qualified massage therapist and talk with him or her about what you want massage for, be it relaxation or pain relief. Then ask what is their experience in addressing that issue."
Brennan says weekly massage is most effective but admits that not everyone has the time or money to get massage therapy that often.
Field, however, has a solution. Though there's no replacement for a qualified massage professional, she recommends that families learn basic massage techniques.
"In our studies, we try with adults to get them two 20-minute massages a week," she says. "With kids, we use parents as therapists so they can give their children massages every night, 10 minutes before bedtime. We say this because most of the children in our studies have chronic illnesses and can really benefit from a daily dose of massage."
Sources: 2005 Massage Therapy Consumer Survey, Opinion Research Corp. International, Princeton, N.J., conducted Aug. 11-14, 2005. M.K. Brennan, RN, LMBT, vice president, American Massage Therapy Association. Tiffany Field, PhD, director, Touch Research Institute, University of Miami School of Medicine

trigger point therapy, jackson wy, Benefits of Massage Therapy, Read More about the benefits of Massage Therapy.

• 
  'Mind-body' therapy shows promise for fibromyalgia

By Amy Norton

NEW YORK |

(Reuters Health) - A form of 'mind-body' therapy that focuses on the role of emotions in physical pain may offer some relief to people with fibromyalgia, a small clinical trial suggests.

The study, of 45 women with fibromyalgia, found that those who learned a technique called "affective self-awareness" were more likely to show a significant reduction in their pain over six months.

Overall, 46 percent of the women had a 30-percent or greater reduction in their pain severity, as measured by a standard pain-rating scale. In contrast, of study participants who were assigned to a wait-list for therapy, none showed a similar decline in pain.

Fibromyalgia is a syndrome marked by widespread pain -- including discomfort at specific "tender points" in the body -- along with symptoms such as fatigue, irritable bowel and sleep problems. It is estimated to affect up to 5 million U.S. adults, most commonly middle-aged women.

The precise cause of fibromyalgia is unknown -- there are no physical signs, such as inflammation and tissue damage in the painful area -- but some researchers believe the disorder involves problems in how the brain processes pain signals.

Standard treatments include painkillers, antidepressants, cognitive- behavioral therapy and exercise therapy. However, many people with fibromyalgia find that their symptoms -- pain, in particular -- persist despite treatment.

Part of that, according to the researchers on the new study, may be because standard treatments do not specifically address the role psychological stress and emotions can play in triggering people's pain.

That is not to say that the pain people with fibromyalgia feel is "all in their head," stressed Dr. Howard Schubiner, of St. John Health/ Providence Hospital and Medical Centers in Southfield, Michigan.

"The pain is very real," Schubiner said in an interview. But, he explained, pain and emotions are "connected in the brain," and emotional factors may act to trigger "learned nerve pathways" that give rise to pain.

Past studies have found that compared with people without fibromyalgia, those with the disorder have higher rates of stressful life events, such as childhood abuse, marital problems and high levels of job stress. There is also evidence that they are relatively less aware of their own emotions and more reluctant to express their feelings, particularly anger.

For the new study, published in the Journal of General Internal Medicine, Schubiner and his colleagues tested the effects of affective self-awareness -- a technique Schubiner developed and uses in treating certain chronic-pain conditions -- on fibromyalgia.

They randomly assigned 45 women with the condition to either undergo the therapy or go on a wait-list for treatment, serving as a control group. Women in the treatment group each had a one-on-one consultation, then attended three group meetings to learn the affective self-awareness techniques so that they could carry them out on their own.

The therapy involves an educational component where patients learn about the emotion-pain connection. They learn specific techniques -- including mindfulness meditation and "expressive" writing -- for recognizing and dealing with the emotions that may be contributing to their pain. Patients are also encouraged to get back to any exercise or other activities that they have been avoiding due to pain.

Schubiner's team found that six months later, 46 percent of the treatment group had at least a 30-percent reduction in their pain ratings compared with scores at the outset. And 21 percent had a 50-percent or greater reduction.

None of the women in the control group had a comparable improvement.

The study is only the first clinical trial to test affective self-awareness for fibromyalgia, and it had a number of limitations, including its small size. In addition, the control group received no active therapy to serve as a comparison.

That is important because it is possible for patients to benefit from simply receiving attention from a healthcare provider, or being part of small-group sessions with other people suffering from the same condition, for example.

Schubiner also acknowledged that this general "model" for understanding and addressing fibromyalgia pain is controversial.

He said that he and his colleagues have applied for funding to conduct a larger clinical trial comparing affective self-awareness with standard cognitive-behavioral therapy.

Affective self-awareness and cognitive-behavioral therapy have similarities, according to Schubiner. Both, for example, try to show patients that they have the power to improve their own health.

A key difference, Schubiner said, is that affective self-awareness asks people to "directly engage" the emotions that may be helping to drive their symptoms.

Another difference is that, right now, only a small number of healthcare providers practice affective self-awareness, according to Schubiner.

Some components of the technique, such as teachings in mindfulness meditation, are more widely available. But whether those practices in isolation would help fibromyalgia patients' pain is not clear.

SOURCE: link.reuters.com/bes55m

Journal of General Internal Medicine, online June 8, 2010.

www.ProfileMassage.com

www.ProfileMassage.com

Evidence That Little Touches Do Mean So Much

By BENEDICT CAREY - New York Times

Published: February 22, 2010

Psychologists have long studied the grunts and winks of nonverbal communication, the vocal tones and facial expressions that carry emotion. A warm tone of voice, a hostile stare — both have the same meaning in Terre Haute or Timbuktu, and are among dozens of signals that form a universal human vocabulary.

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Clockwise from top left: Jed Jacobsohn/Getty Images; Mark Avery/Reuters; Vivek Prakash/Reuters Charles; Dharapak/Associated Press

YOU FEEL ME A quick hug, fist pound, high five or belly bump can communicate a wide range of emotions, sometimes more accurately than words.

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More Mind Columns

But in recent years some researchers have begun to focus on a different, often more subtle kind of wordless communication: physical contact. Momentary touches, they say — whether an exuberant high five, a warm hand on the shoulder, or a creepy touch to the arm — can communicate an even wider range of emotion than gestures or expressions, and sometimes do so more quickly and accurately than words.

“It is the first language we learn,” said Dacher Keltner, a professor of psychology at the University of California, Berkeley, and the author of “Born to Be Good: The Science of a Meaningful Life” (Norton, 2009), and remains, he said, “our richest means of emotional expression” throughout life.

The evidence that such messages can lead to clear, almost immediate changes in how people think and behave is accumulating fast. Students who received a supportive touch on the back or arm from a teacher were nearly twice as likely to volunteer in class as those who did not, studies have found. A sympathetic touch from a doctor leaves people with the impression that the visit lasted twice as long, compared with estimates from people who were untouched.Research by Tiffany Field of the Touch Research Institute in Miami has found that a massage from a loved one can not only ease pain but also soothe depression and strengthen a relationship.

In a series of experiments led by Matthew Hertenstein, a psychologist at DePauw University in Indiana, volunteers tried to communicate a list of emotions by touching a blindfolded stranger. The participants were able to communicate eight distinct emotions, from gratitude to disgust to love, some with about 70 percent accuracy.

“We used to think that touch only served to intensify communicated emotions,” Dr. Hertenstein said. Now it turns out to be “a much more differentiated signaling system than we had imagined.”

To see whether a rich vocabulary of supportive touch is in fact related to performance, scientists at Berkeley recently analyzed interactions in one of the most physically expressive arenas on earth: professional basketball. Michael W. Kraus led a research team that coded every bump, hug and high five in a single game played by each team in the National Basketball Association early last season.

In a paper due out this year in the journal Emotion, Mr. Kraus and his co-authors, Cassy Huang and Dr. Keltner, report that with a few exceptions, good teams tended to be touchier than bad ones. The most touch-bonded teams were the Boston Celtics and the Los Angeles Lakers, currently two of the league’s top teams; at the bottom were the mediocre Sacramento Kings and Charlotte Bobcats.

The same was true, more or less, for players. The touchiest player was Kevin Garnett, the Celtics’ star big man, followed by star forwards Chris Bosh of the Toronto Raptors and Carlos Boozer of the Utah Jazz. “Within 600 milliseconds of shooting a free throw, Garnett has reached out and touched four guys,” Dr. Keltner said.

To correct for the possibility that the better teams touch more often simply because they are winning, the researchers rated performance based not on points or victories but on a sophisticated measure of how efficiently players and teams managed the ball — their ratio of assists to giveaways, for example. And even after the high expectations surrounding the more talented teams were taken into account, the correlation persisted. Players who made contact with teammates most consistently and longest tended to rate highest on measures of performance, and the teams with those players seemed to get the most out of their talent.

The study fell short of showing that touch caused the better performance, Dr. Kraus acknowledged. “We still have to test this in a controlled lab environment,” he said.

If a high five or an equivalent can in fact enhance performance, on the field or in the office, that may be because it reduces stress. A warm touch seems to set off the release of oxytocin, a hormone that helps create a sensation of trust, and to reduce levels of the stress hormone cortisol.

In the brain, prefrontal areas, which help regulate emotion, can relax, freeing them for another of their primary purposes: problem solving. In effect, the body interprets a supportive touch as “I’ll share the load.”

“We think that humans build relationships precisely for this reason, to distribute problem solving across brains,” said James A. Coan, a a psychologist at the University of Virginia. “We are wired to literally share the processing load, and this is the signal we’re getting when we receive support through touch.”

The same is certainly true of partnerships, and especially the romantic kind, psychologistssay. In a recent experiment, researchers led by Christopher Oveis of Harvard conducted five-minute interviews with 69 couples, prompting each pair to discuss difficult periods in their relationship.

The investigators scored the frequency and length of touching that each couple, seated side by side, engaged in. In an interview, Dr. Oveis said that the results were preliminary.

“But it looks so far like the couples who touch more are reporting more satisfaction in the relationship,” he said.

Again, it’s not clear which came first, the touching or the satisfaction. But in romantic relationships, one has been known to lead to the other. Or at least, so the anecdotal evidence suggests.

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