Contact High

June 2005

Inside a dimly lit treatment room smelling faintly of vanilla and ylang-ylang, massage therapist Robin Ehrlich tells me the story of a 29-year-old client who slowly and tearfully extricated herself from the clutches of bulimia during weekly stints on the table. The woman was tall and thin—the sort who manages to juggle a full-time job with weekend dinner parties at her Manhattan apartment. She found Ehrlich through her psychiatrist, who had suggested that she supplement her talk therapy with the touch kind. At this point in the story, Ehrlich looks as though she might cry. Her voice lowers to a near whisper. “Months into her recovery,” she says, “this woman told me that massage helped her finally deal with all the pain that she had been stuffing down deep into her body.”

Ehrlich can sound more evangelical than Billy Graham when asked about the power of physical human contact. This is hardly surprising considering she’s been the director of New York City’s Eastside Massage Therapy Center since 1983. But in this case, science is firmly on her side. In the West, massage has been largely reserved for knotty shoulders and pulled hamstrings, but it has also been shown to be a successful adjunct treatment for diabetes, Parkinson’s, and spinal cord injuries. Perhaps even more striking is what a rubdown can do for a less tangible condition: a bruised body image.

Much of the groundbreaking work on touch medicine has been conducted through the aptly named Touch Research Institute at the University of Miami School of Medicine. In 2001, a study led by institute directory Tiffany Field, PhD, and psychologist Sybil Hart, PhD, an associate professor of human development and family studies at Texas Tech University in Lubbock, tracked 19 young women with anorexia. While all of the subjects continued the standard psychotherapy, 10 also received two 30-minutes full-body massages a week for five weeks. After just one treatment cycle, the massage group demonstrated reduced anxiety, lower levels of the stress hormone cortisol, and elevated amounts of dopamine, a neurotransmitter responsible for controlling emotional response. The same study on bulimic patients conducted three years before at the Institute also turned up promising results, showing postmassage decreases in cortisol and increases in calming dopamine and serotonin. And though neither study lasted long enough to monitor weight change, both showed tat massage yielded something just as important: a measurable decrease in body dissatisfaction.

Field found that moderate-pressure massage (“pulling, rubbing squeezing, and gentle acupressure”) was more effective among her subjects than, say, light stroking. In general, she discourages practitioners from talking (whether chitchat or therapy) during the session, in part to help patients fully absorb the tactile benefits as well as because touch therapists who try to delve too deep risk “getting in over their heads.”

Still, massage therapists have different ideas about what works. Adela Basayne, the former president of the American Massage Therapy Association, who practices out of the Kartini Clinic in Portland, Oregon, tends to remain silent while giving rubdowns, but she might prep a body-image client by first talking her through a guided meditation. Asking the client to shut her eyes, Basayne has her “imagine she’s on a river traveling through her body,” she says. The idea is toe help these clients feel every inch of flesh from the inside rather than obsess over how they look from the outside.

Meryl Fury, a registered nurse and certified massage therapist in Kenosha, Wisconsin, uses “targeted energy work” on clients who are uncomfortable in their own skin. Placing her hands over the areas from which she senses tension, Fury might toss out a prompt like “I feel a lot of tightness here How would you describe it? Does it have a color?” Other times she’ll wait for the client to take the initiative. Fury believes her subjects have reached the root of many body- image issues this way—whether they be a result of divorce or a nasty comment about one’s appearance. “The body doesn’t lie,” she says. “When someone reconnects to her physical self you can have huge revelations in one session.”

This ability to make massage clients feel better immediately is a claim conventional therapists can’t always make. According to study author Hart, even anorexics who initially refused full-body treatments “found tremendous relief from foot, hand, and neck massage” This begs the question, Is touch therapy potentially more effective than talk therapy? Field believes the3/re two sides of the same coin. “They work in such different ways that I prefer to think about what massage adds to talk,” she says.

Psychiatrist Estelle Toby Goldstein, MD, teaches medical pathology to would-be massage therapists at the Mueller College of Holistic Studies in San Diego and has been recommending massage for years to women with body issues. “Not everybody communicates best in words,” she says. “I started understanding certain patients more completely when I encouraged them to try massage because the therapist could tell me how they felt about being touched. It seemed magical, as if people were somehow storing memories or emotions in their bodies not accessible by normal conversation.”

As for the neurochemical changes reported by Field’s team, Goldstein says, “The lowering of cortisol levels and the increase in dopamine probably happen.” But she adds that numerous other factors (“even the time of day”) could potentially affect these amounts. Physiology aside, sums up the benefits this war “I’d imagine that anytime you’re touched by another human there’s this immediate sense that your body is okay the way it is—that you’re not disgusting.”

I volunteered to donate my body (and its myriad issues) to Ehrlich’s massage table. Petty as it sounds, I’ve nursed an on-again off-again obsession with the fat around my belly since grade school. In my early twenties, I flirted intimately enough with disordered eating to prompt worried phone calls from friends. Now that I’m 32 (and a dessert-loving size 6), my fierce preoccupation has simmered down into the kind of nagging uneasiness that makes me cringe when my fiancé lovingly cups my gut with his palms.

In other words, I feel only a little disgusting some of the time. If massage therapy can help those trapped in the stranglehold of a true eating disorder, what can it do for someone like me, who feels a warm wave of nausea when her navel presses too hard against the front of her jeans?

“You won’t meet a single woman who doesn’t have some kind of body-image issue,” Ehrlich assures me, alluding to the successful, well-heeled Manhattanites (and occasional leggy models) who patronize her practice. Unlike the 29-year-old bulimic client, most arrive without a psychiatrist’s referral, seeking help for garden-variety woes such as lower-back pain and 60-hour-a-week jobs. Their insecurities typically unfold in a trickle of self-deprecating remarks about puckered thighs and curvy hips. “When you hate even a little piece of your body, you disassociate yourself from it,” Ehrlich says. For these women, nearly any type of massage can be an immensely helpful, often silent way of reconnecting with their flesh and bones. Put more plainly, touch reminds us that we’re sensual creatures.

If her clients don’t raise the body-image red flag, neither does Ehrlich. She prefers to keep quiet and let the women on her table zone out. Arms folded stoically over my middle, I pepper her with questions to stall taking off my clothes. When women do make their body issues known, how does her technique change? How does she treat someone who fixates on, say, her arms? In addition to traditional Swedish-style kneading, Ehrlich borrows a Reiki technique that she calls therapeutic holding. “I wrap both hands around the top of the attn. gently squeeze, then repeat, moving down the length of the arm,” she says. “We’re transmitting positive energy from therapist to client arid driving the message into the arm that you’re okay the way you are.”

When Ehrlich leaves the room, I undress—slowly, nervously—before slinking beneath two thin white towels, facedown on the table. The pale flesh around my middle spreads slightly against the urface, and I’m suddenly acutely aware of the banana and yogurt I ate for breakfast. While I’m no stranger to massage, I’ve allowed no one near my belly fat, save for the occasional doctor.

For the first 20 minutes, Ehrlich doesn’t even approach my middle. She starts with my feet, gently pressing into the soles before working her fingers into the soft spots under my Achilles tendons. She unknots a gnarled muscle in my calf then migrates north, spending a good 15 minutes kneading my neck, shoulders, arms, and fingers. I feel my stress dropping precipitously. Her palms migrate down my back— then to my hated love handles, mashing them, alternately, up toward my rib cage and into the tops of my hip bones. By the time she asks me top over, belly side up, my abdominal flesh feels downright luxurious. She scoops it up at the sides and pulses it in toward my navel in slow, smooth circular motions. I’m not sure why I feel so good, so…connected. Only days later, when we recap the massage, does it sort of make sense. “The goal with techniques like these is to make the person feel encompassed and nurtured,” she says. “I never use prodding motions on women who. are uncomfortable with their bodies.”

I leave Ehrlich’s office, a bit lost in that haze of vanilla and ylang-ylang. For the rest of the afternoon—even on the mean streets of New York’s Upper East Side—I almost pity the women whose skin stretches taut and girdlelike across their midsections. Of course, this is just one treatment, and I must admit that some of my renewed sensuality evaporates along with the lush film of massage oil. But for that night, when my fiancé wraps his arms around my waist, I suck in only a little.