It was a huge vindication of the time I had taken away from work to help prevent the spread of the virus, and of the measures I had put in place to protect against it during my return to work. More than that, it was a vindication of the work I had done over years cultivating and sustaining relationships with my clients that offered them an experience of safety.<\/p>\n\n\n\n
You might be thinking, \u2018We know trust is important, Tim. Tell us something we don\u2019t know.<\/em>\u2019<\/p>\n\n\n\n I get it. I\u2019m right there with you. I\u2019ve always known that trust is central to every single aspect of what we do, not only as a foundation for safety but as an aid to healing. But to hear it from my own clients\u2019 mouths, especially after the destabilising events of the last few months, brought it home in a way that was vivid and real. Trust was right there in the room with us, out in the open \u2013 not just an abstract concept but something that we could both feel in the moment.<\/p>\n\n\n\n I got to thinking about what I can do to make sure that my clients continue to feel this sense of trust, and how I can make trust a focal point of my work. There are some really practical things we can do and some things that we can develop in ourselves, based on theory.<\/p>\n\n\n\n In his book The Placebo Effect in Manual Therapy<\/em> (2015)<\/a>, Brian Fulton offers a great, evidence-informed overview of how we can help our clients to trust us. Some of the \u201cobvious and not so obvious things\u201d (pp115-6) he mentions are:<\/p>\n\n\n\n PD reflection idea:<\/strong> What do you do to foster your clients\u2019 trust in you? What could you add to this list? Have there been times when you felt like you might have broken trust? What did you do to repair it?<\/em><\/span><\/p><\/blockquote>\n\n\n\n Fulton notes that people, depending on their history, will have different capacities for trust. He uses attachment theory as a lens for thinking about how easy or difficult it is for people to trust (p114).<\/p>\n\n\n\n Some people find it natural to trust others because their formative relationships (especially with their parents) have left them with the deeply held belief that people are generally trustworthy. In attachment theory, these people are deemed to possess a \u2018secure\u2019 attachment style. A majority of people exist somewhere on the spectrum of secure attachment.<\/p>\n\n\n\n People whose caregivers were unreliable, especially when they were very young, may struggle to warm to you or to relax during treatments. With these people, any breach of trust can register as reconfirmation that others can\u2019t be trusted, which means they feel a need to remain constantly alert to external threats and are more likely to withdraw when their needs aren\u2019t met. Attachment theory names this attachment style \u2018avoidant\u2019.<\/p>\n\n\n\n Conversely, some people with inconsistent caregivers respond by crying out or clutching in an attempt to have their needs met. As adults, they can come across as boundary-pushers or overly dependent, both of which can really test our ability to keep relationships appropriately professional. In attachment theory, this way of relating to others is referred to as \u2018ambivalent\u2019 or \u2018anxious\u2019.<\/p>\n\n\n\n With anyone, though, the principal of trustworthiness is a guiding light. An experience of a safe, trusting relationship can help to chip away, even a tiny bit, at deeply held beliefs around distrust, and even provide a model for how to relate to others in a way that is about authentic connection above all else.<\/p>\n\n\n\n PD reflection idea:<\/strong> Think about what you learned about trust growing up. It can even be helpful, if you can, to ask your parents or caregivers about what you were like as a baby. Then learn more about attachment styles here<\/a> or here<\/a>. What might your attachment style be? How might your attachment style impact on how you work with clients? Do you sometimes find it difficult to trust them? Are there clients you think might have struggled to trust you?<\/em><\/span><\/p><\/blockquote>\n\n\n\n It was a gift for me to learn a few years back that I have a predominantly avoidant attachment style. I tend to keep a distance between myself and others because I expect them to respond negatively. It\u2019s easy to see how this has crept into my work with clients. Sometimes, especially when a client is new, I expect that I will inevitably disappoint them, which can lead me to overcompensate by trying to be all things to them. It has taken time to learn to be more myself with people, to acknowledge my strengths and accept my limitations, and to let my guard down a little. Of course, this has extended into all my relationships. (I think I\u2019m even doing it a little bit right now!) It has become more about my \u2018way of being\u2019 than about affecting any particular \u2018professional approach\u2019.<\/p>\n\n\n\n Which leads me to\u2026<\/p>\n\n\n\n Feelings of trust are held in our bodies, and neuroscience is helping to bring us closer to understanding how we hold and process those feelings. In particular, the work of Stephen Porges on Polyvagal Theory, which goes back as far as the late 1980s, has done much to unravel the science of human connection.<\/p>\n\n\n\n In Polyvagal Theory, the term \u2018neuroception\u2019 is used to describe the signals we receive from our environment and<\/em> from our own bodies that tell us we\u2019re safe or in danger. It\u2019s not only about what\u2019s happening inside our bodies but about what happens between<\/em> our bodies when we\u2019re in contact with others. The neuroceptive feedback we get when we\u2019re in relationship with other people is constantly updating and shifting. Those shifts in turn affect the other person\u2019s shifts and on it goes.<\/p>\n\n\n\n Furthermore, the way we receive those signals depends upon our past experiences, especially traumatic ones.<\/p>\n\n\n\n For example, if I raise my hand and you\u2019ve never been hurt by another person before, you may interpret this to mean that I\u2019ll be asking a question or hailing a cab. On the other hand, if you\u2019ve been traumatized earlier in your life, you may interpret the intention of my raising a hand with a sense that I\u2019m about to strike you.<\/em> <\/p>(Siegel, 2010, p21)<\/cite><\/blockquote>\n\n\n\n One of our tasks as massage therapists is to \u201ctrack the nuances of neuroception\u201d (Dana, 2018, p38) in ourselves and remain open to them in our clients. This is how we attune to our clients, and how we can monitor the waves of safety and threat that occur when we\u2019re in contact, and thereby manage trust.<\/p>\n\n\n\n And when it feels like a client has reacted in a way that we find hard to explain \u2013 or indeed that we<\/em> have had an inexplicable reaction \u2013 recognise it not as a reflection on either of you but as one of the inevitable mis-attunements of neuroception that can happen when two people are in contact, each one with their own in-built safety-seeking system activated. We can\u2019t really explore these mis-attunements with our clients the way a psychotherapist might, but knowing that they occur can help take the sting out of experiences when we feel like we\u2019re not being trusted or, indeed, if we\u2019re struggling to trust a client.<\/p>\n\n\n\n PD reflection idea:<\/strong> I\u2019ve barely touched on this massively complex and illuminating theory here. If you\u2019re neuroscientifically minded, consider reading some of Porges\u2019 own work. There\u2019s a ton of remarkable writing here<\/a>. What else can you take from Polyvagal Theory into your massage work? What questions does it raise for you that you could explore further?<\/em><\/span><\/p><\/blockquote>\n\n\n\n I hope this has offered some fresh perspectives on trust. There\u2019s a lot more to be said on both the theories I\u2019ve mentioned here and a lot of potential applications for us in massage therapy that have yet to be explored, but it\u2019s exciting territory.<\/p>\n\n\n\n Dana, D. (2018). The Polyvagal Theory in Therapy: Engaging the rhythm of regulation<\/em>. Norton: New York<\/a><\/p>\n\n\n\nThe Practical Stuff<\/strong><\/h4>\n\n\n\n
The Theoretical Stuff<\/strong><\/h4>\n\n\n\n
The Even-More-Theoretical Stuff<\/strong><\/h4>\n\n\n\n
References<\/strong><\/h4>\n\n\n\n
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