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The Thinking Practitioner Podcast:
Episode 40: How To (Not) Fix It (with Cal Cates)

Broadcast date: 06/09/2021
©Copyright The Thinking Practitioner Podcast, Til Luchau & Whitney Lowe

Whitney Lowe:

Welcome to The Thinking Practitioner. Hi, I'm Whitney Lowe and this episode of The Thinking Practitioner is co-sponsored by Handspring Publishing. Handspring has become one of the preeminent publishers focused on manual therapy topics and their catalog reads like a who's who have the greatest pioneers, thought leaders and teachers in our field.

Whitney Lowe:

Handspring also offers a series of webinars called Move to Learn. They were free 45-minute segments featuring their authors, including one from Til. So, head on over to their website at handspringpublishing.com to check those out. And be sure to use the code TTP at checkout for discount on their amazing books. Thanks so much Handspring. So, Til, good to see you again this afternoon, and we have a guest with us today.

Til Luchau:

We do. Cal Cates is with us today. All right. How you doing, Cal?

Cal Cates:

Hey, guys, I'm good. How are you?

Whitney Lowe:

Pretty good.

Til Luchau:

Any day is a good day when we get to have a conversation with Cal.

Cal Cates:

I feel the same.

Til Luchau:

And I want to say in a minute I say a little more about why Cal I wanted to have this conversation with you and Whitney, but let's give you a chance maybe to say something about yourself. You do a lot of things and what would you like people to know about you in this context?

Cal Cates:

Oh, man. Well, I mean, it really is not at all lip service to say that this is probably going to be the most fun I have today talking with you two. And I have so enjoyed ... Til, I think you and I tend to connect more specifically about some things. But Whitney and I, I feel like we have developed this really great ability to have a good-natured banter about things that we can find what we agree about in a thing, even though maybe at least half of it we don't agree about and that has always been really valuable to me.

Til Luchau:

The world needs a lot more of that, I think.

Cal Cates:

It's a missing skill.

Til Luchau:

I have wonderful constructive debates with you about things that I feel like always come out of them with different perspectives and looking at things through different lenses, and it helps me grow a lot more that point, too.

Cal Cates:

Agreed.

Til Luchau:

So, yeah, always think we all need more of that.

Cal Cates:

Yeah, I feel actually it's a good segue because I feel like for folks who don't know me, I'm the executive director of Healwell. And I think a lot of people think Healwell, is oh, they're the hospital massage people. And we certainly that is a lot of what we do, oncology massage and hospital massage.

Cal Cates:

But we really were working to foster a space where those kinds of conversations can happen more regularly, not only in the massage profession, but we work across disciplines, creating interdisciplinary education opportunities, where nurses and social workers and massage therapists and physicians and all these different people who are caring for people can share what they've learned and share what their challenges are, and really creating a space that in the social justice world, we talk about brave space rather than safe space.

Cal Cates:

And I think that brave space takes a degree of responsibility that I'm not sure everybody's willing to take on. But it is a space where it's agreed that lots of discomfort will happen. But that respectful discomfort that is ultimately in the service of all of us becoming more awake and more alive. So, really looking at those places where we're not able to connect or where appears that we're not able to connect and saying, so what's happening here, and how do we just slow this down and move.

Cal Cates:

There's a woman in the social justice sphere who talks about moving at the speed of trust. And I feel like that is not the speed that our society moves at. And I think we're really in a deficit of trust with each other with our systems. And slowing down is really the only way that we're going to get there. And I don't even want to say get back there. Because I don't know that we've been there. And that's part of what's hard about it. So, yeah, in a sort of expansive nutshell with lots of tendrils hanging off it, that's what I feel like you should know.

Til Luchau:

That's great. And thanks, because I also want to just acknowledge that Healwell that is our newest sponsor here on The Thinking Practitioner.

Cal Cates:

Woohoo.

Til Luchau:

Yeah. And that was our idea. We approached you and said, "Hey, we have some compatibility with what you're talking about thinking about it." And personally, I've always admired your willingness to steer toward the deep waters and really ask the tough questions and feel and think them through together. So, I'm really pleased that you have signed on to help us do our podcast.

Cal Cates:

It was an incredible honor and compliment that you reached out to us. And yeah, we're really glad to support the show.

Til Luchau:

And then I just also want to mention that you're an accomplished podcaster yourself. You do your Interdisciplinary podcast with Kathy Ryan, as well.

Cal Cates:

Indeed, yes.

Whitney Lowe:

That's a great podcast. We strongly recommend people take a listen there.

Cal Cates:

Thank you, guys.

Whitney Lowe:

I certainly enjoyed it.

Til Luchau:

And then, you also have an online retreat coming up that I want to hear about before we end.

Cal Cates:

Okay.

Til Luchau:

But I got interested in the conversation with you here today because of the article I read way back in 2018. And that's when I first basically heard your name and realized you were out there thinking and writing and doing these things.

Til Luchau:

And that 2018 article was Death, Dying, and the Breakability of Us All, and Massage and Bodywork. Would you mind telling us something about that article, now here three years later, or wherever it lives for you now?

Cal Cates:

I would love to. I don't know that I'd ever written a feature before. And I remember when the opportunity came up, I thought, gosh, what am I going to write about. And I sat down, and it really sort of wrote itself, which anyone who writes knows that that's often when the good things happen is when we get out of our own way. And you step back, and you go, "Whoa, that was in there?"

Cal Cates:

But I feel like it got such a positive response. And it was honestly so fun to write, which I think people, when you think about death, I think our culture is still very death averse. And the idea that you could have fun exploring death, and really, in that article, I was sort of highlighting that we imagine ourselves as solid and permanent, and that it's part of what sets us up for burnout as caregivers and just, in general in our lives to sort of miss the whole point that we just think that how I am today is how I will continue to be.

Cal Cates:

And the assumption that there's always going to be more time to insert things that you think there might be more time for that you're not doing now, because you can do it later. And my massage career, quite by accident, I wound up working with people who were at the end of their lives kind of from the beginning. So, this has been almost 17 years that that's the type of work that I've done with massage primarily.

Cal Cates:

And it just really changed my whole perspective on life. I can't say it changed my perspective on massage because it's always been my perspective. I went to a school that I think really allowed me to have a transformative experience.

Cal Cates:

I'd still sort of taught me technique. But I took that technique immediately and moved into a space of sort of snuggling up to other people's suffering. And that changed the way I looked at what I could do. And what was mine to do as a massage therapist.

Whitney Lowe:

I'm curious to when you talk about that in terms of a few different aspects of that. But let me focus first on, can you tell me some ways in which you saw that, how did those changes actually impact what you're doing in an individual client interaction for example? Is there something that changes an overall mindset or what is it that you really feel like most influences the way you work now from those experiences that you've had?

Cal Cates:

Yeah. I think my approach has evolved as I have over the years, but it's so much honestly less about doing and it's very much about listening, whether it's to what the person is saying, what they're not saying, and really paying attention to my really human desire to have an agenda.

Cal Cates:

And that when you put your hands on a client, when you're about to work with them, your brain really wants to create a map about where you're headed and to be willing to get to someplace on this person's body and realize, oh, the plan I made, maybe we're not going to get to the end of it or maybe this plan doesn't even make sense, given what I'm learning now.

Cal Cates:

And being at the bedside with dying people is a really great way to practice that because no two people die the same way. And whether it's emotional or environmental, or whatever it might be, they're always things that you go, "Oh, I never would have guessed that was going to happen." And that can only happen if you get out of the way. And I feel like our culture is not good at the idea of waiting or allowing outcomes to unfold. We prize people who create outcomes.

Cal Cates:

And so, to be in a space of not knowing doesn't typically feel like a place that's going to get you a promotion, or that's going to get you more clients, but it definitely gets you a better life and a more real life. And I think for me, that's really been the key is feeling that in myself. And working with people who thought they had more time and didn't has made it really hard for me to go back to sleep in a spiritual way.

Til Luchau:

[inaudible 00:10:34] I read it over again this morning, one of the lines that I highlighted again was being a massage therapist in the modern world is a total setup. I don't know if you remember the context you're writing that in.

Cal Cates:

And I can tell you what I thinking about.

Til Luchau:

Yeah, tell me. Because you're leading up to that I think a bit is now. Tell me what you know.

Cal Cates:

Yeah. Well, people come with things that didn't happen in an hour. And they want you to fix them in an hour. And our schools lead us to believe that that's the thing we can do. And that to have a full practice, that's what you need to do. And so, you have to hopefully pursue on your own.

Til Luchau:

Schools, SI schools and continuing education. So, yeah.

Cal Cates:

Absolutely. I mean, continuing education is a worst perpetrator.

Whitney Lowe:

It is. I think so.

Cal Cates:

This is the technique that will, whatever. Yeah.

Til Luchau:

All right, that you're saying was a setup.

Cal Cates:

So, when people come to us, no matter why they think ... Yeah, because I think that we missed the point. I think that when people come to a massage therapist ... So right now, my son is practicing this thing where he's 10, he's going to be 11 in a month. And he spent a lot of time at grandma's. And I think he spends a lot of time at grandma's because grandma lets him use his screen kind of all the time.

Cal Cates:

And at the other two houses where his parents live, he doesn't get to do that. And my ex-wife said, I said, "I think he wants to be over there more because there's not a lot of rules and whatever." And she said, "No, I asked him." And he said, "No." And I was like, "What 10-year-old is going to go, 'Yeah. I'm going where there's no structure.'" I mean, seriously.

Cal Cates:

And so, I feel like this kind of connects because when people come for massage, they're not going to say, "I'm here to be treated kindly and for you to see me completely." A, because nobody says that. And B, because they don't even know that's part of why they're coming. They're coming because they pulled a hamstring or because they have neck pain, or whatever it might be.

Cal Cates:

And so, we skip over the really deep human need to connect. And we have this story that you are either present and connected, or you're addressing the issue. And I know that there's that horrible pejorative term out there ortho bros. If I'm an ortho bro, I can't also be compassionate and present with the people I work with. And I don't believe that. And I feel like we're really missing an incredible layer of our ability to be of service to our fellow humans when we look at each other like a collection of parts.

Cal Cates:

And I feel like our continuing ed in our foundational education really supports this idea that we're not a whole. We are this attachment, this insertion, this functional ability, and we specialize and we get smaller and smaller when we reduce ourselves and each other down to inaccurate beings.

Whitney Lowe:

One of the things that this brings up for me, this kind of like taps into some of the conversations you and I are always having about education and what we need to do to fix many of those problems in there. So much of what you're describing I think is absolutely critical for the best clinical outcomes for anybody that you're working with is just being with them in a therapeutic context, in a compassionate way.

Whitney Lowe:

And I always kind of go back to this question of how the hell do we teach this kind of stuff? Because a lot of it really comes out of individuals doing personal work on themselves and basically learning to just be that place, be in that place. And I have always struggled with how do you convey those concepts to people about? For me, I actually I have to admit, I've never heard the term ortho bros before.

Cal Cates:

You haven't? Whitney you're an ortho bro.

Whitney Lowe:

I was going to say, I probably will be called one of those.

Cal Cates:

You're king of the ortho bros.

Whitney Lowe:

And at the same time, what doesn't get conveyed I think often in my approach is the many years that I spent studying meditation, spiritual practices, compassionate actions with other individuals that totally influenced the way I interact with a client just as much as my knowledge of kinesiology and biomechanics, et cetera. And that's so hard to teach. It's so hard to get those pieces across.

Til Luchau:

And I want to go back for a second to the setup idea and stay with that just a little bit because don't clients want to be fixed? Don't they come to us with a problem that they really want us to eliminate? And don't we, in our best of intentions, desire to help fall into that and want that, too?

Cal Cates:

Well, yeah, I mean if your client jumps off the Brooklyn Bridge, you're going to jump off after them. I think this is one of these things that we actually my colleague and I, Kerry Jordan, wrote an article again, for Massage and Bodywork a couple years ago about, I think it was called Tell Me More, and it was about intake and how the client is not always right.

Cal Cates:

And then this is another disservice that our education does to us is that we have to find a balance between to be a successful massage therapist, you do need to develop a spirit of entrepreneurship, I think, and maybe less so than when I went to school because you can actually work for a franchise, you can work for a company and provide massage. So, maybe you don't need to run your own company, but that we're sort of taught how to be a massage therapist as though it's a service industry. And in the service industry, the client, the customer is always right.

Cal Cates:

And in medical school, they don't tell doctors that if your client come, if your patient comes and tells you they think this is what's wrong, you better just give them this pill that treats that condition. But that's what we do, as massage therapists, I think a lot of us say, "Oh, you think it's this. I'm going to address this."

Cal Cates:

And I think we have to be willing, I mean, it's so funny, Til and I were talking before we got on about how to move forward as people as a profession in the world, we have to be willing to lose things. And I feel like we're so afraid of losing clients that we do what clients tell us they want instead of what we know might be of greatest service to them.

Cal Cates:

And we're afraid to stand in the truth of what we've seen from our own experience and what we might understand from what they're saying, and not saying again, and what their tissue is saying.

Cal Cates:

And inviting them into a place either by the way we work with them, or even sometimes with things that come out of our mouths to just, I hear what you're saying, and I hear that you want to be able to do X, Y and Z. This is the way that I work. We're going to try this. It didn't happen overnight. We're probably not going to change it overnight. But if you'll trust me, this is where we can go.

Cal Cates:

And I think it's very dependent on your practice setting and the pressures from if you have a supervisor or manager, if you're doing a 15-minute hour for people who are paying a discounted price. And I mean, there are setups in the ways that we work logistically as well.

Cal Cates:

But I think we really have to, if we're going to integrate into health care and be on par with health care providers, we have to start thinking that way. And this is one of the key ways that we don't do that.

Til Luchau:

Wait, wait to start thinking what way because so many health care providers, especially saying the physical therapy space here in the US, complain about the limitations of a defined set of treatments. When you start thinking like that, you're saying?

Cal Cates:

I think we need to hear what clients are telling us and listen to the whole story. And I think this is the beauty of where we are right now in massage in this way. Because in the health care picture, PT was so "successful" in getting into insurance reimbursement, and that whole part of the structure, that now if a person has knee pain, you have to work with their knee. If you work with their hip, you've got to really work hard to justify. If you work with their shoulder to address their knee pain.

Cal Cates:

Where, as massage therapists, I think the push pull of us moving into the space of reimbursement and integration and health care is, trust me to practice my discipline. Trust me to know that this person's ankle pain is coming from their right hip, and that I will hopefully affect positive change for this person. But I will only be able to do that if you allow me to use everything I can perceive from my own experience and training.

Cal Cates:

And I think a lot of other health care disciplines are limited by the ways that we're willing to reimburse and by the ways that consumers are taught to consume health care.

Til Luchau:

Or what if it's either, I'm just kind of thinking a little bit, what if we don't even have to fall back on trust me, but what if, what if we go to what if. Things aren't always as they seem, what about an experiment? We'll work your hip. Let's see what happens with your knee.

Cal Cates:

Absolutely.

Til Luchau:

So, it becomes less like, can you please trust me and my expertise and my knowing, and more like, could we actually step outside the box a little bit and experiment and see what you notice, what could happen for you.

Cal Cates:

Yeah. And I think that we have to be taught. I mean, this goes back to Whitney's point that the problem is that self-awareness is not a concept, it's an experience, right?

Cal Cates:

And so, how do we slow down our teaching enough to allow people to transform and know themselves. Because as a person right out of massage school, you probably don't even maybe have the experience to be able to go on a journey the end of which you don't know where it will be with the client.

Cal Cates:

But it wouldn't even occur to you to suggest that if a person comes in with this pain in a specific area, that you might actually touch them in another place to affect that. I mean, we've all had those people that, "No, no, I told you the pain is in my shoulder." And you're like, "I know. Turns out your shoulders connected to these other things."

Til Luchau:

No, actually, I come from a tradition where the tyranny might tip the other way.

Cal Cates:

Interesting.

Til Luchau:

Where no, we assume it's not the knee. And if we aren't able to untangle it from a holistic perspective, we're missing it as well, which is an interesting switch on the Newtonian model. Because there's a tyranny of holism as well, where we realize that sometimes maybe that's just the need, for goodness' sake, sometimes.

Cal Cates:

Well, I think it's the tyranny of certainty, right? It's like, if you are certain that it's never localized, that if the certain person says it's their knee, that it's got to be something else, then you're missing the point. And if you're certain that it's always the knee, we just want to know. I mean, that's really where we fall down is just our really human desire to be right.

Whitney Lowe:

And fundamentalism, too. I think just the desire to always have your perspective, your system, your modality, whatever be the capable of answering those things the way you want to have them answer. Fundamentalism exists in so many different avenues for us professionally, personally, et cetera.

Cal Cates:

Yeah, it does.

Til Luchau:

But somehow, I'm not satisfied yet. I'm sorry.

Cal Cates:

Okay. No problem.

Til Luchau:

And I mean, I have my own ways of doing it. And it's one of the biggest things I think about and try for, but I still want the two of you to kind of help me think through this. Clients want a result. And what we haven't mentioned is, I think, the fact that sometimes we have to help redefine that result. We've said, "Okay, so trust me, maybe this will make your knee better if I work with your hip." You said, "We can't be certain."

Til Luchau:

But sometimes, it's almost like we have to help move the goalposts of the clients, reevaluate what they're even hoping for and what they're wanting, especially, let's say, I mean, I'm ... this is why I'm interested in talking to you, Cal, especially if what I'm facing is something that's going to end my life.

Cal Cates:

Yeah. I mean, I think this circles back around to another way that being a massage therapist is a setup. Do you ever go to a psychotherapist one time? No. But people come to a massage therapist one time or once a year on their birthday or when it hurts.

Cal Cates:

But we don't get to enter into a relationship with ... Some of our clients, we don't get to enter into that ongoing relationship that allows us to. I feel like you just described another type of experimentation, as you sort of you see where people are starting. Some people really need you to spend that first hour with their knee. So, they feel heard and they need to see that did or didn't work. I mean, I will work with your knee and maybe even though I think it's something else turns out, it benefits you.

Cal Cates:

But we try it maybe once, twice, three times. And if working directly where they're wanting you to work isn't working, then you've established this, I hear you and I'm willing to do it your way and what do you think? If you're still coming back, now we're cultivating a relationship that allows us to really be in conversation about what will be most useful.

Til Luchau:

And sometimes it's even let's redefine what we mean by working.

Whitney Lowe:

Absolutely.

Til Luchau:

Because if the touchdown becomes is your knee pain still there, they're going to get up and shake their leg and see if their knee still hurts.

Cal Cates:

Right.

Til Luchau:

And you think this binary kind of either I fixed it or I couldn't, still and we're getting more clever and maybe more holistic about how we're trying to fix it. But still, we haven't moved the goal at all in that case.

Whitney Lowe:

And I think, Til, this taps into what you and Ruth were talking about in a previous episode, too, in discussing clinical reasoning that I really see a lot of clinical reasoning as an if-what sort of prospective like if I do this, and then what happens that tells me something. And that's how we can kind of get that entrainment with the client to get them on our side of seeing those different types of things.

Whitney Lowe:

But what you're saying, too, I think is so pertinent that if you think something is not somebody's knee, for example, and they come in and say they have knee pain, and you think it isn't, and you don't address that for them, they will have a dissatisfied experience. And that's not going to be therapeutically productive, most likely, because they're just going to feel like, "Oh, they didn't listen to me, again, somebody ... Other health care professional didn't listen to me and didn't do things."

Whitney Lowe:

So, it's almost like there's a certain degree to which you go through those processes and see how they result. And then, you're able to say, "Well, we did this, and that didn't happen." Like Cal, you were saying, let's explore further in another place or something?

Cal Cates:

Yeah. Well, and I think that this is a place where we make ourselves too important. I mean, you spend an hour with this person, and they go home wearing those same crappy shoes, or they go and they sleep on their same crappy old mattress.

Cal Cates:

When we're working in the hospital, particularly when we're working with patients in the ICU because they're on continuous monitoring, and you can actually watch what happens while you're working with a person, we're really clear with the therapists who come through our courses that when you go into the electronic medical record and you record what happened, that you don't say, massage caused a decrease in heart rate, an increase in oxygen saturation. You just say, observe change during my visit. Because that might have happened whether or not you were there. There's no way to know.

Cal Cates:

So, when we say, "Oh, well, their knee pain is gone. I must have done it right." You may have helped. And also, they may have gotten new shoes or maybe they got out of that crappy relationship or we're one piece of this really multifactorial experience of being a person in a breakable body.

Til Luchau:

And what do you think about this idea that I think maybe just to oversimplify my working hypothesis, if I can fix it, why not? Because there's a lot of things we can do that just make things feel better rapidly, and sometimes lasting sense. But if I can't, actually, that's where it gets interesting.

Til Luchau:

And so, then I get more creative, maybe I refined my clinical reasoning, maybe we take a different approach, maybe we get more empirical or deductive or we get around in different ways. But then, along that continuum, at some point, it moves toward, again, shifting the expectations from the symptom going away to living well, even in the face of the symptom.

Cal Cates:

Yeah. I mean, I think we're definitely in the same church, if not in the same view. And I feel like there is not a single therapist or person that therapist might treat, who won't benefit from that therapist being more self-aware, and by noticing your expectations, noticing your agendas. I mean, because we have them in and out of the treatment room. It's not like these are unique behaviors that we engage in when we're working with clients.

Til Luchau:

Do you see your work at all as helping clients accept what's happening?

Cal Cates:

Absolutely.

Til Luchau:

Okay, so what's your one quick trick about doing that?

Cal Cates:

Well, I guess what I will say is my secret tip is that it doesn't happen with my face hole. I don't tell them to accept and relax and surrender to what's happening with them. I work with their body in a way that says whatever's happening here is okay.

Cal Cates:

And maybe when they ask me questions where they want a definitive answer, I answer in a way that allows them to create their own answer. There's certainly some skills that I've stolen from my social worker colleagues in terms of open ended questions and allowing people to explain themselves to themselves.

Cal Cates:

I think it's just so seductive as massage therapists, we want to perceive ourselves as experts on bodies. And when our clients ask us from a place of fear, or a place of concern, what's happening here, we just make crap up and we might not know what's happening. And that doesn't make us bad practitioners.

Cal Cates:

So, I think if any level of acceptance or surrender is supported by the way I work with people, it is what happens with my hands, what I do and don't ask them to do. But it's not actually when people say take a deep breath for me, I just tense up. I'm going to take a deep breath for you. I'm going to keep breathing so I don't die. This isn't about you at all.

Cal Cates:

And then I'm like, "Are we getting into nocebo here?" So, yeah, I think you can do that, but it's not because you tell them how to meditate or how to breathe or any of that stuff.

Til Luchau:

Yup. Yeah.

Whitney Lowe:

This is just a question that just came to mind as we were talking about that whole process with the breathing thing. I often hear massage therapists come up with some very colorful and creative narratives about what they're doing.

Cal Cates:

Oh, yeah.

Whitney Lowe:

Like, pretty far out on the plane of accuracy. But the clients don't necessarily know that may or may not be what's really happening there. Do you think there's any detriment to that if that helps further the client-therapist bond and connection with each other or something like that?

Whitney Lowe:

And then like, oh, yeah, I really get that sense or something like that, that's in there that my humerus is spiraling around counterclockwise or something like that, whatever it is. I mean, is it the fact maybe a therapeutic benefit if something that you say or do and along those lines does something more to get your client connected with you in a way?

Cal Cates:

Well, I mean, I think what winds up happening is the worst game of telephone ever. So, I'm driving my son back over to his grandma's last night. And he told me all about zombies and werewolves and it was a torrential rainstorm. And he was talking to me about how zombies fall apart and rain like this. And I'm like, "Listen, I'm not a zombie expert. But if zombies fell apart in the rain, the zombie movies would be nothing."

Cal Cates:

And then, he started throwing in some lore about werewolves. And I'm like, "Listen, I know some things about werewolves, and what you're saying is not true." But had he been speaking with someone who was not so in the know, I could be going out today to happy hour talking to people about don't worry about zombies, we just need one good rainstorm. And so, everybody lets down their guard.

Cal Cates:

So, right, that's a ridiculous example. But it isn't because like we were talking about last weekend at yoga, the yoga instructor talks about when you do a twist, you're wringing out your liver. No, you're not. Your liver is not twisting like a towel at the beach and toxins are oozing into your interstitial spaces. That's not what's happening.

Cal Cates:

But because these are the terms we use, this is really what people think is happening in their bodies. And I don't know that that's terribly useful. Or at least, if we say, imagine this is happening, maybe there's something to that.

Til Luchau:

Because this may be these are all metaphors anyway. If we presented and work with it that way, maybe we're in a bit more integrity in terms of our authority, but sometimes useful metaphors and sometimes our trust in the metaphor can be therapeutically useful as well. If we're being clear that it's a metaphor, and who knows.

Cal Cates:

I mean, I think our textbooks, I mean, the more time I spend doing webinars and courses with Gil Headley, the more I want to just burn every anatomy textbook. Because I think this is another place where we're supported in the idea of like, this goes here. And so, when I say to someone, "Oh, I'm on your, whatever," you're in the vague vicinity of this. If your body has this or whatever, they're all these questions about what's really going on under the skin.

Cal Cates:

And I think it's just another way that we try to make ourselves smart and help our clients feel safe because we know stuff. But we don't really know a lot of the stuff we say we know.

Til Luchau:

Okay. And so, how about you, if I could ask, what got you interested in this? Especially around the breakability, death and dying thing, what got you into that?

Cal Cates:

Yeah. I mean, my story is mostly retrospective because I don't really have like, "Oh, this thing happened and then I ..." I think being gay and then being trans and being the only female on the male soccer team in South Carolina High School, and all these experiences of difference and kind of perceived isolation, and I'm looking around me and not seeing any good mirrors, really set me on a path in my probably early adolescence of like, "Huh, what is this that we're doing here? What is the point of even life in massage school?"

Cal Cates:

I mean, I don't even know why I went to massage school. Anyone who knows me knows that. My story is that one day, I just wound up in a massage school orientation. And I was like, "Oh, well, I could do this." And then I started when I got to massage school, I was like, "Oh, this is why I'm on the planet. I don't know where this is going to lead. But really, there's something to this." And during massage school, I was working with my grandfather at the moment that he died. And I had no training or experience for that. That had not been normalized in my family.

Cal Cates:

And certainly, being present and calm at the moment of someone's death is not a western thing. But that is how I felt. I was like, "Wow, I really love this person/ I'm really sad that they just died. And this doesn't feel like an emergency to me." And I felt like, "Okay, this is what I want to do."

Cal Cates:

And in retrospect, it was probably a really selfish motivation because I felt really alive and connected to something inexplicable in that moment, and I wanted more of that. I wanted to be in a place where sort of the veils were down and the layers of protection were not available, even if for just 30 seconds as I watched him take his last breath and then be dead. It was like, "Wow." There's so many stories were telling that we don't even know we're telling that are holding up our relationships, our systems, our everything. I want to know more about that.

Cal Cates:

And so, I sort of threw myself into hospice massage and just being in places where people were forced by circumstance to take off their armor and to just be available for that and to learn from people who were like, "Yeah, so I spent my life being this person that wasn't really who I was. And now, here I am possibly dying, and it's too late to fix it."

Cal Cates:

And I think that's really essential to our job as caregivers. I mean, we want to help, but we want to help so we can stop feeling the suffering. I think if we don't go inside and really notice that so much of what we call caregiving is actually a desire to move ourselves out of a place of discomfort. And people get all bristly, and they go, "That's not true. I just love people." And I'm like, "That's cool. But your defensiveness is really instructive."

Cal Cates:

And so, I just recommend that you maybe consider that there might be some truth to it doesn't mean you're a bad person. It means you're actually a really normal person, and that we are wired to avoid discomfort. And really, our avoidance of discomfort allows racism, systemic homophobia, capitalism. I mean, all of these things that really build on each other and keep some people up and some people down is because we are just trained to not feel and to stay away from things that make us uncomfortable.

Whitney Lowe:

One of the things that comes to mind here, too, I've seen this so many times over the years, my background was in actually psychology before I got into massage, and I was in a graduate program studying counseling. There's a lot of aspects of massage where we are in a very close intimate relationship with somebody for an hour, one-on-one talking with them and doing things.

Whitney Lowe:

And a lot of people kind of get this motivation of like, I really want to help people and do some of the things that you're talking about to get them to change their perspective about the world, their relationship with dying, or their relationships with things outside their physical body world or something like that.

Whitney Lowe:

And it's always been a little bit scary for me because I recognize that many times through the very best intentions, people can do some pretty, I don't want to say damaging but problematic interactions with people because they don't understand sometimes the subtleties of how to come across with some of those kinds of things.

Whitney Lowe:

Have you seen that sort of thing happen? And we talked about the importance, so much of who you are and what you've done with your own personal development to be able to get to places but what kinds of things have you ever seen that kind of go sideways and be a problem?

Cal Cates:

Oh, I see that all the time. And I want to go back to your sort of hesitancy to use damaging because I think this is a really common thing that we do. It's damaging. We don't want to call it damaging because we didn't intend for it to be damaging, but our intent and our impact are not married the way we wish they were.

Cal Cates:

Just because I didn't mean to hurt you doesn't mean I didn't hurt you. And this is one of the many sort of layers of self-awareness that we need to bring to our experience as humans and certainly becoming better global citizens and understanding that we are harming all the time from a place of mindlessness, from a place of rote behaviors that we've just always engaged in.

Cal Cates:

And until we can slow down and be willing to say, the unintentional nature of this harm doesn't remove its impact. And I have to be willing to notice that the ways that I've talked with my clients or the ways that I've done whatever it might be that has perpetuated harm, now I'm aware of them.

Cal Cates:

And I think this is part of why people don't open their eyes fully. Because once you're aware of it, you have to do something about it. Or you know that you're knowingly not doing something about it, and that's a crappy feeling, too. So, if you just keep going, you don't have to be in that dilemma of, "Oh, now I know this, what do I do about it?"

Whitney Lowe:

Right. Yeah, that definitely makes sense.

Til Luchau:

That part of what's around your question too, Whitney, is a question of scope. Scope in terms of our role with people I mean so, if I want to do something besides fix it, does that mean I need to make it psychologically better, if not physically better in a way? Or does that take me into realms where they're traditionally outside of my defined scope as a therapist? How do you adjust that in your trainings, Cal?

Cal Cates:

Well, I think we really, we work with our students actually to get really good at open-ended questions. And we resist asking questions because we're afraid what we'll do with the answer. And sometimes people just need to talk. And sometimes it's really useful for people to have an open-ended question offered to them and be given the space to answer it themselves.

Cal Cates:

And that it's not actually our job to even say that makes sense or what are you going to do about that? When people hear themselves respond to a question, for instance, this isn't a massage thing, but a friend of mines mom is dying right now. And she texted me last night, and she said she just started morphine, which if you're in the end of life world, you know that that's sort of an indication that she's moving into sort of the active dying phase.

Cal Cates:

And instead of saying, "Oh, God, that's awful." I just said, "What do you think about that?" And then she just told me what she thought about it. And she said, "I don't want her to be uncomfortable. But I'm also sad because I know this is another step closer to her dying." And that's all. I don't have to say, "Oh, that must be awful." Or, "I wish I could do something." Just shut up. Just let people have their experience.

Whitney Lowe:

Yeah. Well, it poses a real challenge for us, I think. Because, you know what I mean, this is not a real dichotomy, but if you could make the dichotomy between what we do with the physical body and what we're doing with our sort of interactions there, we're kind of on this mindset, like we're going to do something-

Cal Cates:

Yeah, you got to do.

Whitney Lowe:

... to change you or fix you or whatever. And so, therefore, I got to respond to this.

Til Luchau:

Or at least you need to leave feeling better, even that is a setup in the bigger sense.

Cal Cates:

Yes.

Whitney Lowe:

Yeah.

Cal Cates:

Totally.

Whitney Lowe:

Right. Yeah. So, I got to feel like I have to make a suggestion or do something here. I'm going to just put this out there just as a curiosity. Because I mean, you hear this sort of stereotypical thing all the time, especially more from male therapists, because men want to fix things. They want to just do something.

Cal Cates:

Right.

Whitney Lowe:

Not listen, just listen. I mean, I don't know, maybe there's some also some truth in that, too. I know I can see myself fall into his patterns frequently.

Cal Cates:

Well, and I think that really caregivers want to fix, too. I mean, I think when we work with nurses, man, talk about some people who want to fix and who don't want to feel, for the most part. I mean, obviously, we can't say all nurses are like this. But I think when you move into that space, people who choose, it's well documented the people who choose to take care of other people have deep wounds themselves and typically haven't spent the time to become truly intimate with those wounds and what they have learned from an integrated and what needs to go from those wounds.

Cal Cates:

And so, they wind up being a wounding healer instead of a wounded healer. And these are people who really need to feel valuable, who need to feel like what they did mattered, and who have a hard time believing that spending an hour in meaningful connection with another person is, A, worth $90 or whatever you charge, but also enough, and that I think we do more harm by trying to do than by finding that space where we can be with this other person.

Whitney Lowe:

Yeah. Lovely.

Til Luchau:

You want to tell us about your June retreat?

Cal Cates:

Oh, my gosh, I'd love to tell you about it. So, it's called Opening to the Mystery. We've been teaching it, gosh, probably we, me and my alter ego, I don't know. I've been teaching it for about 11 years.

Cal Cates:

And it's always been a live retreat, of course. And we piloted a virtual version of it last year. And I really, I was very skeptical because it is very sort of ... It's based in connection and there's some silence there, some meditation, there are definitely sort of dyads and triads where we work together as members of the class and explore things. And it really honestly, it used to be a three-day weekend. So, it was three seven-hour days, exploring your mortality and being present to that. And turns out, that's a lot to do in three days.

Cal Cates:

And so, now we do it in six days, where in the evening for three and a half hours each day, we explore those same things, but it allows a lot more time for metabolism and integration. And people have said that they just really ... It's enough, three and a half hours, they're just almost full by the time we're done each day. And then they have time to integrate, and then they're ready when they come back the next day.

Til Luchau:

And where do I stay in DC when I come to this?

Cal Cates:

Well, when it's live again, you could stay at my house.

Til Luchau:

Oh, you mean it's online?

Cal Cates:

Yeah, it's online.

Til Luchau:

Yeah. We didn't [crosstalk 00:45:52] that yet. So, it's an online thing. Yeah.

Cal Cates:

No, it's it is virtual. Yeah. So, it's in late June. And it actually is 21 CEs. It's considered health care massage, but it's also 21 CEs for nurses, social workers, doctors, psychotherapists, a variety of other health care disciplines.

Cal Cates:

And it's basically, it's three days, or six now, six half days of getting out of your own way, and really engaging in what is called memento mori, remembering that you will die, that it seems counterintuitive, but engaging with our mortality and the impermanence of everything around us, in fact, invites more joy into your life and lets you really do kind of a spiritual decluttering of like, wow, what relationships aren't good for me? What dynamics am I engaged in that are actually sucking my life energy?

Cal Cates:

And to be able to start asking yourself every day, if I died today, if I died tomorrow, would I be glad that I spent today doing what I'm doing? And to really, it's not about massage at all. It's not even about health care. It's really about what does it mean to be an authentic human engaged in a moment to moment way? And how can I start noticing how often I'm not doing that? And to do it with some other people in a really intimate space, who also want to just experience more joy and be more themselves than they feel like they've been.

Til Luchau:

Lovely. So, you're immersing in the being aspect?

Cal Cates:

Definitely. Yeah. And it's way more fun than people would think. I mean, everybody comes out of that class, like, "Wow, I thought this was really going to be a downer." But it's a lot. It's heavy. It's deep. But it's just fun because you go, "Oh, my gosh, these are some crazy stories I've been telling. That just don't serve me. And I could just stop."

Til Luchau:

And it's Opening to the Mystery. What's the mystery part?

Cal Cates:

All this stuff we've been talking about. I mean, we don't know as much as we think we do. And we really don't know what's going to happen when we die. We don't know how much longer we're going to live. We don't know what our potential is.

Cal Cates:

And not our business potential or income potential, but our human soul potential to really be the person that we arrived on this earth as before we learned all this cultural stuff that taught us to feel ashamed and small and quiet and acceptable.

Whitney Lowe:

Sounds great. I'm glad we can give you a place to speak about it and a chance to hear about it.

Cal Cates:

Yeah, thank you very much. Well, I assume you guys will put the link in the show notes.

Whitney Lowe:

Absolutely.

Til Luchau:

I am actually going to try out a sponsor blurb for you here in a minute.

Cal Cates:

Awesome.

Til Luchau:

Yeah. Before I do that, Whitney, anything else you want to ask or say?

Whitney Lowe:

No, this is such a wonderful conversation, so many places to go with it.

Cal Cates:

Definitely.

Whitney Lowe:

So, yeah, I would just encourage everybody to really look at some of these things that are so very important for us in growth and in personal development that have a big impact on how you relate with the work that you're doing.

Whitney Lowe:

And these are the things that are much harder to quantify. They learn a magical technique or modality or things like that, but they make so much difference not only in the treatment room with people, but they make a lot of difference in your life, too, I think.

Cal Cates:

Absolutely.

Til Luchau:

That's right. That's the being dimension. Opening to the Mystery is a unique online retreat, designed for those who want more access to their wisdom and to cultivate deeper, more authentic relationships, both professionally and personally. Led by Cal Cates, our guest today.

Til Luchau:

Participants will snuggle up to their own mortality. But the course is not about death. It's about living and how to invite more joy, more clarity, and more simplicity into your life and heart no matter what your job.

Til Luchau:

The next retreat will be June 21st through to 26th, 2021 and is approved for 21 CE credits for massage therapists and other health care professionals. Use the coupon code, thinking, at your checkout for 10% off on the retreat at healwell.org.

Whitney Lowe:

And we thank all of our sponsors for the show here. We thank the sponsors, and of course, our listeners, thank you so much for joining us here today. You can stop by our sites for show notes, transcripts and extras. You can find that stuff over on my site at the academyofclinicalmassage.com. And Til, where can they find that with you?

Til Luchau:

My site is advanced-strings.com, where they're our show notes, et cetera. Cal, we mentioned healwell.org. Are there any other links or references you want to insert at this point?

Cal Cates:

Well, online.healwell.org is where you can find all of our online education. And a lot of that is those soft skills that we don't think about communication ethics, anti-racism, stuff like that. And you can come check us out at our private online interdisciplinary community at community.healwell.org.

Til Luchau:

Great. There's questions or things you want to hear Whitney or myself talk about on the podcast, email us at info@thethinkingpractitioner.com or look for us on social media. Mine is just under my name Til Luchau. How about yours, Whitney?

Whitney Lowe:

And you can find me under my name also on social and you can follow us on Spotify, rate us on Apple podcasts or wherever else you happen to be listening.

Whitney Lowe:

And of course, if you're unable to find us in any of those locations, you can grab an A track tape of the Venezuelan tuba ensemble to the cover up Jimmy Page's guitar solo from Stairway to Heaven and find us over there.

Til Luchau:

Yes. Wow. Kindred souls.

Whitney Lowe:

Indeed.

Cal Cates:

That's awesome.

Til Luchau:

Thanks, Whitney. Thanks, Cal.

Cal Cates:

Thank you, guys.

Whitney Lowe:

Sounds good.

Cal Cates:

It's always a pleasure.

Whitney Lowe:

We look forward to chatting soon.

Cal Cates:

Excellent.

Whitney Lowe:

Okay. See you.