Sunday, August 14, 2011

The Body Speaks

Traditional Thai massage is one of my favorite things in Thailand. A typical Thai massage is often a great treat for senses - lying in a room filled with aroma and dim light, having soft Thai clothes covered on body, and experiencing the massage from toe to head – those often make the most enjoyable moment during the journey.
Before getting a Thai massage, communication was one of my concerns, because most massagists do not speak English very well. Some of them were able to use simple words to give directions, such as “sit” and “turn over”; some of them could not speak English at all. This means that I was not able to tell massagist how I feel and what I would like her to do. But later I found out that communication was not an issue that I should worry about, because my body can speak for me. For example, when a massagist was massaging my leg one day, she caused pain to my ankle because that area was hit by a stone one week ago. I did not cry out or even say a word, but I contracted my muscles and took a sharp breath. Surprisingly, the massagist immediately changed her touch from strong to soft so that the pain did not happen any more. Later, I realized that the training and experience they had allowed them to accurately read body signals and quickly make responses.
So, why did I spend so long to talk about Thai massage in a clinical blog?
This is because, during my clinical experience in Thailand, I realized that music therapy could be so similar to a massage.
Before having practicum with children in Thailand, communication was my biggest concern: I was never good at communicating with children, especially young children who could not understand English or Chinese at all. However, I totally changed my mind after working with a young girl in Sirindhorn hospital. In the beginning of the session, the client was very cooperative and engaged. She enjoyed music a lot and could often understand our directions when giving hand gestures and modeling. The only issue we were concerned was her right arm was not as functional as left arm; moreover, she seemed not willing to practice her right arm. In a drumming application, she could use her left arm to chase and play the drum very well, but when I put the mallet in her right hand, she stopped engaging and often wanted to change hands. I tried to make her keep using right arm, but still failed.
- If I’m facing an American child right now, I can use reinforcement to motivate her. But what can I do now?
It was my first thought at that moment, which made me a little bit upset. The session moved on to a parachute application. All therapists and her mother helped her move the parachute together. According to our original plan, client should go under the parachute while therapists and parents were holding the parachute up and play with peers. However, because of the language issue, she could not understand what we wanted her to do. We tried to model her to go under the parachute, but it was not very effective.
At that time, I suddenly saw a turtle toy that we brought to session. I picked it up and put it on my hand. Then, when the parachute was raised, I went under it and used the toy to touch her toes.
- She looked down and found the toy. She opened her eyes wide, and a big smile was showed on her face.
She liked it. Will this be a chance?
The idea came out without thinking too much. The parachute was raised again, and one more time, I touched her feet with the turtle. She giggled and tried to reach the turtle with her left hand. Then I knew the toy could be a great motivation for her. I picked up a bell stick and put it in her right hand. She looked confused and didn’t know what to do. I reached to her, made the turtle nod its head on the bell stick to make sound, and pulled it back. She watched what was happening. After a few times, she suddenly understood what she could do, and the magical moment happened - she moved her right arm, and knocked the bell on the turtle.
What happened after this changing point was amazing. My awesome teammates immediately responded and began to sing a turtle song to cooperate. I used the turtle to cue her move her right arm up and down and cross the midline. The session was expended at least 10 more minutes. Our little client kept playing with the toy using her right arm; she was so happy and so excited that she did not even feel tired. Just like magic happened, the problem that bothered us didn’t exist any more!
At the end of that session, I lay on the floor, and began to feel shameful about myself. How could I use the difficulty of verbal communication as an excuse to escape? I recalled what my supervisor told me before I had my very first session, “The only thing you need to remember is, when you enter the room, it’s all about them, and nothing about you. Then you’ll be fine.” I finally understood that. If I put all my focus on the clients, read their body, read their responses, be concerned about their needs … there is no way of not making a good session.
Question: Have you ever met a situation that language did not work at all? What did you do to communicate?

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