The Circle: Lab to Clinic to Classroom

July is turning to August and September is around the corner when we'll hop back into the classroom again! Get your backpack loaded, sharpen them pencils and let's learn! We have two curricula kicking off in the fall:

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The Classroom as a Lab Space

The classroom is a place to explore questions and curiosities. Clinic is a place to test our ideas and skills in the real world of folks’ needs. There is a necessary tension here and it keeps us at a growth edge. When we can embrace this our work can become both more fulfilling and effective. The dissection lab conjures questions more than it delivers answers.

One of the insights I gleaned from dissection last year was about the superficial fascia. It’s a banger of a body suit that shimmers like golden flowers. Working intentionally with the superficial fascia became part of our courses last year and shifted students’ perspectives and skill development.

I’m still thinking about the superficial fascia a year later and likely will be for the rest of my career. One thing that I have learned is that, in our work, things are never really settled. Ongoing reflection or contemplation is, in and of itself, a skill and a technique enhancer.

A Sensate Bridge

The superficial fascia is an organ, not simply sub-cutaneous fat. It is a lobular fascia that has within it adipocytes. As an organ it has functions that traverse physiological systems; immunological, endocrinal, and sensing among others. Let’s focus on the sensing qualities of this specific fascia.

On gross dissection (meaning what we can see with the naked eye) the investiture of nerves within this fascial layer is astounding. The superficial fascia is knitted into the “deep fascia” (simply the next fascial layer, which is often the muscle layer). We can see the nerves, sometimes larger groupings of nerves and other times the nerves can’t quite be seen but as the scalpel moves through the tissue you can feel them being cut, hundreds of them in a small cut. These are sensory nerves. The superficial fascia is a sensate bridge from the skin layer to the muscle layer.

If we are practicing listening based bodywork we can start our listening here, just below the skin. This will connect to the deeper structures because… they are connected, not an abstract “everything’s connected man” kinda way but in an actual way.

So, how much pressure do you need to connect with someone’s deeper tissue layers? Not much.

This is important. Just because someone has a thicker superficial fascial layer does not mean we need to use more pressure to do effective work. We only need to use enough pressure for that specific system to feel connected with and this can happen at any depth, regardless of body size.

We were discussing this in class with Gil and he asked us, “where in your body do you live?” What a question! What if some folks have a lot of consciousness in this layer? What if their system is keen to experience the world here? Why press too hard into that delicate sensing weave and overload or overwhelm it?

The crux of using less pressure and relying on connection instead is trust. It’s trust in multiple fields. We have to trust the body and we have to trust ourselves. This becomes an opportunity to work from an open question, where is the depth that this specific body I am with experiences connection and how can I connect with that? Sometimes, the person is feeling the work but we are not so we go deeper. We end up placing our needs before those of the person we are treating because we feel more comfortable. It’s hard to back up, lighten up and trust, but it can be so, so, helpful.

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Students of Tissues

One caution here, we are going to resist the “people-with” tendency that is prevalent in our field. It is not helpful to perform the generalization, “people with” and then list some sort of label or categorization. So, people with a thicker lobular fascial layer are no category. They are simply individual beings with their own body and experience of and within it. Our job is to be curious about this, not categorize or label because of it. I hear this so often in classes or talking with colleagues; “people with… are fill in the blank label”. No. People are interesting and unique and deserve to be met as such. People deserve to come to their own understandings of themselves, their ideas of their own embodiment free of labels or categorizations from the healthcare community. People are allowed to have these understandings shift and change over time just as our health or well-being shifts and changes throughout our life span. If something becomes too fixed it can also become a pathology. This is true in physical health and in cognitive tendencies.

Tissues can be teachers and we can be learners, students of the tissues.