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Last week while preparing for a presentation on listening, I leaned back in my chair at the computer wondering what story I could tell about listening deeply. Not just involuntary hearing but truly listening to the meaning of the words. Listening with my heart as well as my ears.

My heart burst open and I started to cry. I heard my mother say "I made soup."

My mother had severe crippling arthritis, scoliosis and heart disease. Her physician was an osteopath and she combined acupuncture, herbs, supplements and homeopathic medicine in her health care. She never went to the hospital .She would simply stay in bed for days at a time.

Cooking was very painful for mother so friends would bring food or take her out to eat most of the time. This was her program for the last 20 years of her life.

I*n her last few months every time Mother called me she would say "honey, I made vegetable soup. It’s so good!"

My response was always , "Great Mom." I actually remember being somewhat bored by these conversations and not really interested in her soup.

I harbored a well of anger with my mother and didn’t work through that before she died. It clouded all our communication.

Last week, 16 years later I got it. "I Made Soup"meant, honey I’m out of bed today; Im feeling strong and I was able to cut vegetables. It’s a glorious day!"

" I Made Soup" was a statement of mother’s courage and independence and her ability to push through her suffering .

Deep Listening is a practice and a philosophy developed by Pauline Oliveros. It is said in this practice that listening deeply requires the temporary suspension of judgment and a willingness to receive new information. It is a process of learning.

Truly listening allows us to not only hear what someone says and, what they think, but allows us the understanding of what it means to them and why it matters. There is perhaps no greater way to show our respect than to truly listen to someone.

Many blessings and please share your listening stories . Your stories mean so much to the community.

Irene smith

www.everflowing.org

Reading the Massage Magazine special issue on pain relief I am reflected into how working with pain differs in my hospice massage practice from more traditional modalities.

A couple of months ago I was working with an intern at an inpatient hospice. We went into see a woman with cerebral palsy who was not on our list of referrals.

Sabrina had spent most of her life in hospital wards. Her body was a roadmap of surgeries and called out loudly for tenderness.

Sabrina spoke of her legs and back being in great pain. She continued to speak of her discomfort as I positioned myself sitting comfortably at the foot of her bed. As I slowly lifted the sheet to assess her right leg my heart shed a tear for the dwarfed limb that was exposed.

I cupped my hand around the thigh and softly spoke," I am honored to offer this limb some tenderness....I feel your leg loves the attention.... I’m so glad we’re here."

While gently holding and tenderly petting this leg Sabrina replied, "If someone had done that years ago I might still be at home."

I covered the leg as Sabrina asked me to touch her back. Although she was in a lot of pain she requested that a nurse position her onto her side so I could touch the exact spot.

After positioning was completed I sat comfortably behind Sabrina on her bed, uncovered her back and with Sabrina’s permission I came very close. With one hand slipped under her head pillow as to hold her, I simply laid my other hand on her back and said, "Oh I know you have been in pain for a long time. I'm so glad we’re here."

As I became comfortable, slowly exhaling, I felt Sabrina going to sleep. Her pain had been validated. She expressed her gratitude before the silence..

After a couple of minutes I slowly removed my hand from underneath her pillow and changed places with my intern.

The Everflowing intention is never to remove pain from someone’s body. The intention is to validate and honor the symptom ology that is being experienced, and to create an environment where the client’s anxiety about having pain can be eased.

We are in a culture that insists that pain is something we have to get rid of. We essentially make pain wrong therefore when pain appears we are afraid of it getting worse; we defend ourselves, hold ourselves tightly. We want the pain to go away. This directs a profound degree of energy to the pain, and creates anxiety.

As an Everflowing practitioner, I want to create a resting place as I walk into a room or up to someone’s bed; a place of stillness first, and then a place of very gentle movement like a breeze or a soft wave of water as the tactile relationship begins. A place where there is no resistance; a vulnerable place.

This is achieved through slow body movement, slow speech, slow audible breathing; and my willingness to find my own place of physical comfort; just being comfortable and breathing as I slowly speak to my client. I am just a witness.

This resting place, this alternative rhythm, eases a lot of tension in the room. There appears to be more empty space and the client might begin to find comfort as well.

If I can stay grounded and comfortable in body and mind then the static and resistance has been broken. The cycle has to reestablish itself.

This change in the pain cycle can cause a decrease in the pressure being experienced by the client and give the client an alternative strategy for coping with the pain.

Pain is multidimensional when someone is dying and may be my client’s most familiar response to his or her condition. I cannot assume that alleviating it is the kindest strategy. I feel I must validate the existing relationship and give models for reestablishing a more compassionate communication with ones self and one’s environment.

This is the Everflowing approach to pain. I look forward to your sharing your approaches and stories.

Blessings

Irene Smith www.everflowing.org

I have been concerned for a long time about the way the field of hospice massage is growing. As with any therapeutic intervention that becomes mainstream ,the integrity of the field is suffering.

Practitioners with the desire to serve ;however without sufficient training to work with dying persons, are being hired by program co ordinators that have no knowledge in what is needed to facilitate a safe massage program.

I am alerted to hospice programs taking on massage practitioners that have no training in adaptations from working with healthy people on a massage table to working with seriously symptomatic persons in beds.

Many hospice co ordinators are corporate administrators who believe that a massage certification is all a practitioner needs to massage hospice clients.

Although some schools have continuing education programs for working with the dying, massage schools do not teach working with dying persons in core training as a general rule. Sometimes the topic will be minimally addressed in a geriatric or oncology course.

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Twenty seven years in hospice massage gives me the experience to outline what have proven to be challenges in this field ,and areas of training needed for safe relationships between clients and practitioners, and organizations

If you are a massage program co ordinator, educational director for a massage school, or hospice massage practitioner these are a few of the areas that require knowledge in this field.
*Hands on precautions as pertains to massage not nursing.

*Modification of standard massage techniques to meet the needs of the physically and emotionally fragile client. This includes; intention, amount of pressure facilitated through the hands, the speed of technique delivery, and the duration of a session.

*How to adapt massage for working with people in beds and chairs; including body mechanics for the practitioner. Practitioners need to know how to comfortably reach the client to prevent injury to themselves.

*How to gather sufficient information for treatment assessment.

*How to work in a home setting. This involves working in a bed; being with family; communicating with other team members; reporting; setting limits ,and what to take as equipment.

*How to cope with the emotional impact of clients dying which includes personal coping strategies as well as support systems.

This is a specialized field of service that requires practitioners to have sufficient information, supervision and support for the safety of the client and the massage practitioner.

If you are an administrator , educational director or practitioner reading this please go to my website www.everflowing.org and check out the educational resources. Resources are available to give you the information you need. You may download articles for free that will serve you well. You may also ask questions on this site.. Go ahead use me!!!

Many times patients are so hungry for touching, and practitioners are so hungry to make a difference that they don"t recognize the difference in a safe and unsafe session. It’s up to the integrity of the schools, co ordinators and teachers in this field to see that wisdom prevails.

Blessings

Irene Smith www.everflowing.org

Greetings,

The attached link is to an Everflowing you tube trailer showing a touch exercise during a Touch Awareness in Caregiving day long workshop . The participants are hospice caregivers . The person being touched is a piece of clay. The sculptor[ the person touching] was creating the upper torso ,face and head. The voice is me, Irene Smith, in a dialogue that has been added. What you hear is not the instruction to the participants.

I would love to hear your comments

https://www.youtube.com/watch?v=jc6DKfXXyZE