My Multi-System Approach to Massage and Bodywork

Timothy Dykes for Unsplash

Over the years, I’ve come to realize that no single modality fully describes my approach to bodywork. I practice Swedish massage. I use acupressure and techniques drawn from table shiatsu. I incorporate rocking, compression, movement, stillness, and other forms of sensory input. But none of those things, by itself, quite describes what I do.

I think that’s because I don’t experience the body as a collection of separate parts—or bodywork as simply the manipulation of muscles and connective tissue.

When I put my hands on someone, I am paying attention to multiple systems at once: muscles and fascia, certainly, but also breath, rhythm, nervous-system response, sensory input, patterns of tension and release, and the person’s own response to what is happening. I’m also drawing from more than one way of understanding the body, including Western anatomy and physiology and Eastern traditions of acupressure and meridian theory.

Over time, I’ve come to think of this simply as my multi-system approach to bodywork.

The Body Is Not a Collection of Parts

When someone comes to me with a tight shoulder, an aching hip, or tension in the neck, I am certainly interested in the muscles and connective tissue involved. But I am also interested in what is happening around them.

How is the person breathing? Are they bracing? Can they receive pressure without tightening against it? Does rocking allow something to soften that direct pressure does not? Does stillness settle them, or does movement feel better? Sometimes the most useful information comes not from the place that hurts, but from how the body responds when I work somewhere else entirely.

This is one reason I draw from several forms of bodywork. Swedish massage gives me broad, flowing movement and direct work with muscles and connective tissue. Acupressure gives me another way of approaching the body through sustained pressure and points along traditional meridian pathways. Table shiatsu—a form of shiatsu adapted for the massage table—contributes compression, rocking, stretching, and rhythmic movement. Over the years, I’ve also become increasingly interested in the effects of stillness, repetition, rhythm, and other forms of sensory input.

I don’t necessarily decide in advance which “system” I am going to use. I listen with my hands, observe the person’s response, and adjust as we go.

More Than One Way of Understanding a Body

My approach also brings together traditions that understand the body in different ways.

My training in Swedish massage is grounded largely in Western anatomy and physiology: muscles, connective tissue, joints, circulation, the nervous system, and other structures and processes that can be observed and studied. Acupressure and shiatsu come from a different lineage, one that describes the body through meridians, acupoints, and Qi—a concept traditionally understood as vital energy or life force moving through the body.

I don’t think these systems have to be made equivalent in order for both to inform my work.

A meridian is not simply another name for a nerve, blood vessel, or fascial pathway, and Qi does not need to be translated into a Western physiological mechanism in order for me to engage with the tradition it comes from. At the same time, I am interested in what contemporary research can tell us about touch, pressure, movement, sensory input, pain, and nervous-system regulation.

For me, the value lies partly in remaining curious about where these different ways of understanding the body intersect—and where they don’t.

The Nervous System—and the Person Attached to It

Of course, bodies don’t arrive on the massage table by themselves. People do.

Each person brings a different nervous system, sensory history, set of preferences, and way of responding to touch. Pressure that feels grounding to one person may feel overwhelming to another. Rocking may be deeply settling for someone and irritating to someone else. Stillness can feel spacious—or uncomfortable. Even the same person may respond differently from one day to the next.

This is why I don’t believe there is a universally “relaxing” massage technique. The receiver’s response matters.

Part of my work, then, is paying attention to that response. I notice changes in breathing, muscle tone, movement, sound, and other subtle cues. I ask questions when I need more information. And I leave room for the receiver to tell me what feels useful, what doesn’t, and when something needs to change.

Over the years, I’ve become increasingly interested in regulation and co-regulation: the ways one nervous system can affect another through presence, pacing, rhythm, voice, touch, and even silence. This has also made me more aware of my own state when I enter the treatment room. If I am asking someone else’s body to settle, I need to pay attention to what I am bringing into the space myself.

Bodywork, in this sense, is not simply something I do to another person. It is an interaction between two people, with the receiver retaining agency throughout.

What About Qi?

Qi is a little harder for me to put into words.

In traditional East Asian medicine, Qi is commonly understood as a kind of vital energy or life force, moving through pathways often described as meridians. It is a concept I was introduced to through my study and practice of acupressure and shiatsu, and one I have worked with for many years.

But what, exactly, am I experiencing when I think I am perceiving Qi?

Is it warmth? Pulsation? Changes in muscle tone or breath? Subtle movement beneath my hands? Is it information my nervous system is gathering through touch without my consciously identifying every component? Or is there something about the experience that these physiological descriptions don’t adequately capture?

I don’t know.

And I am increasingly comfortable with not knowing.

What I do know is that after many years of working with bodies, there are things I perceive through my hands that are difficult to reduce to a single anatomical structure or physiological process. Sometimes a person—or a particular area of the body—feels different beneath my hands before I can say precisely why. I may notice warmth, density, resistance, movement, stillness, or simply a sense that something has changed.

I can observe those experiences without needing to turn them into scientific claims. I can also remain curious about them without dismissing them because I cannot measure them.

For me, Qi lives somewhere in that curiosity: between an ancient system of understanding the body, the sensory information I receive through touch, and the parts of human experience I am not yet able—or perhaps do not need—to explain.

What I Bring to the (Massage) Table

Technique matters. Training matters. Knowledge of anatomy, physiology, acupressure, and the many ways a body can respond to touch matters.

But after more than two decades of doing this work, I have come to believe that how I am with someone matters, too.

I bring my attention to the table.

I listen with my hands. I pay attention to changes in breathing, tissue, movement, sound, and rhythm. I notice when something seems to invite more pressure and when it seems to ask for less. I notice when movement feels useful and when stillness does. And sometimes I simply wait.

I also value intentional silence. There are times when conversation is welcome and important, but I don’t believe silence is an empty space that needs to be filled. Silence can give the receiver room to notice their own experience without having to explain it, perform it, or even understand it.

Holding that kind of space requires something from me as well. I need to be present enough to notice my own impulses—to hurry, to fix, to fill the silence, to assume I know what another person needs—and not automatically act on them.

This is part of what I mean by co-regulation. I am not regulating another person’s nervous system for them. I am attending to my own state while creating conditions in which another person may feel safe enough to settle, soften, become curious, or simply be where they are.

And none of those responses is required.

The person on my table retains agency throughout the session. They can ask for more or less pressure, request a change, speak, remain silent, move, stop a technique, or decide that something simply doesn’t feel right. My role is not to override those signals in pursuit of what I think should happen. My role is to listen and respond.

Facilitating, Not Healing

People sometimes use the word healer to describe bodyworkers. I have never been entirely comfortable with it.

I don’t believe that I heal another person. Bodies have their own capacities for adaptation, recovery, regulation, and change. People also bring their own histories, resources, limitations, choices, and ways of making meaning from their experiences. I can participate in that process, but I cannot claim ownership of it.

I prefer the word facilitator.

My role is to create conditions that may support something useful: less pain or tension, greater ease of movement, a sense of settling, increased awareness, or simply an hour in which someone can experience their body differently.

Sometimes something shifts. Sometimes it doesn’t. Sometimes what changes is not what either of us expected.

That is another reason a multi-system approach makes sense to me. I am not looking for one technique, one explanation, or one outcome. I am paying attention to a whole person through multiple ways of understanding and working with the body—and responding to what I find.

After all these years, perhaps that is the simplest description I can give of my work:

I pay attention.

I listen with my hands.

I remain curious.

And I leave room for the person on the table to show me what happens next.

“May your choices reflect your hopes, and not your fears.” --Nelson Mandela