I have created a guide to the most effective integra- tive application of the techniques. Some themes recur throughout, especially the guidelines regard- ing the speed/depth relationship, while others are about how best to approach a specific area. These comments are all designed to assist the practitioner in making the work attractive to many layers of a person. This style of touch gets a person’s attention because it is intelligent and coherent, not a search and destroy mission. My observation is that people are remarkably good at integrating themselves if these appropriate inputs – coherent and responsive – are provided and no overt disintegrative forces – aggressive and mechanistic – are applied.
A few general guidelines on how to generate an integrated response are given below.
■ ‘Feather’ the release into the surrounding tissues. Work at a specific restriction will be followed by
attention to the adjoining area. For example, releasing the shoulder via the subscapularis, teres major and pectoralis major could be followed by broad work in the upper and lower arm as well as the neck.
■ Constantly monitor the breath. It’s a wonderful barometer of how the organism is responding. Even the most stoical, masochistic person will catch their breath when the work is overwhelm- ing their organic well-being.
■ After working to release the primary, obvious stuck areas, spend time on the antagonists to those muscle groups. This will awaken the nerv- ous system from its slumber and give an obvious and rapid increase in proprioceptive acuity. This leads to better control of the joint through all its range.
■ Get permission to work into painful, guarded areas. This can be verbal or via a curious, non- invasive quality of touch that waits for tissue per- mission before proceeding. Of the two, the non-verbal is the most reliable. People will say things that are not true in an attempt to please the therapist.
■ Always do some work bilaterally even if the sec- ond side is only touched for a short time. There is ongoing debate about the need to always work bilaterally. I do because I find it creates an imme- diate sensory integration that makes the changes feel coherent rather than bizarre. The sense of walking in circles after a thorough release of one lower extremity can be a good way to show off the effectiveness of MFR. But sending someone out into the world with that degree of proprio- ceptive imbalance is counterproductive.
■ Use the movements given here, or the ones that you’ll make up as you go, to fully involve the person in the work. This enables them to modu- late sensation and assists in neural repatterning. ■ Watch for signs of exhaustion from too much
input: glazed eyes; reluctance to participate with assisted movements; weakening, tremulous voice; diminishing, rather than increasing, coordina- tion; attitudes of resignation such as jaw clamp- ing and pursed lips. If exhaustion is observed, finish soon.
■ In just about all sessions it’s good to use the releases to the suboccipital region, or broad neck work, to make sure the head has a feeling of con- nection to the rest of the body. The incredible
concentration of muscle spindles here means that this site can act as the source of system-wide high tone. This ongoing tonus is possible even after deep and effective release in other areas. ■ Base the amount of work to be done on the inter-
nal and external resources available to the client. At one end of the spectrum there are deep-seated disturbances to the whole organism, conditions like fibromyalgia or chronic fatigue, where only a small amount of light direct technique work (five techniques, including feathering, or less in a ses- sion of 15 minutes) should be done in the first session. Get feedback at the next session about the outcome and discontinue the direct technique MFR approach if exhaustion, inflammation or pain is produced. More robust people will respond favorably to more input (15 or more in a 1-hour session). Input refers to the number of contacts, not only depth.
■ Allow time in every session for a period of self- awareness in standing and walking before the client leaves. Ask for reports of what they feel and notice. These do not have to be complicated or complex. Simple reports will assist with inte- gration and clarity of state of mind and body. Pay attention, with eye contact and receptive body language and communication encouragers like nodding and appropriate verbal responses. Recent studies strongly support the value of appropriate non-verbal behaviors in the thera- peutic setting. Body lean, open versus closed body posture, eye contact, smiling and tone of voice all influence patient satisfaction when interacting with health professionals.1These types of contact acknowledge the value of the client’s self-sense even if objective tests will also be applied to ascertain the efficacy of a treatment. Be personal and supportive. Give them a chance to verbalize their sensation and awareness. Many clients go into a deeply relaxed state as a ses- sion progresses. You’ll have to decide whether or not this dreamy, drifting state is how you want the session to develop. It’s certainly desirable when addressing deep-seated autonomic strain that is con- stricting the entire organism. You may want to focus exclusively on this aspect of restriction in a number of sessions. Perhaps it will be most useful to wait for a sustained rebalancing of the ANS before tackling functional activities and reeducation.
However, if you plan to involve the client in neuromuscular reeducation in the same treatment, you may wish to avoid going too deeply down into a PNS-oriented state. Using more active client movements will orient the session toward function rather than drowsiness. A combination of some myofascial release followed by functional activities that immediately utilize the new potentials can be very effective, especially with children. MFR to the ankles and feet can be supported with work on a balance board. Detailed work on the neck and head can be supported by subsequent suggestions about how to sit and work at a computer terminal. The list is almost endless. The proprioceptive and coor- dination changes brought about by MFR will enable a deeper, more authentic connection with suggestions about new postural positions. Simplic- ity of instruction coupled with a strong anchoring of the education in sensation is the key to success.