Julian Baker

Fundamental to the Bowen Technique are the breaks and for me there is no Bowen without the breaks; they are the thing that makes the difference to the client, the therapis and the therapy. But why?

First and foremost the breaks provide an opportunity to make a decision. If I said to you, “Go and run around the block, sign up now for this timeshare, and tell me in 500 words how you feel about poverty in the UK”, then the pressure is on you to do several things at once – and the chances are that you might take short cuts, not do them properly, or make choices or decisions that might be different if you had more time to consider all the options. However if you had more time between each task, with a chance to think them over and to make decisions about how and in what order you would complete them, then it’s probable that outcomes would be more favourable. You would have a chance to see how each of the issues might relate to each other and how completing each might affect your overall view.

The breaks in Bowen provide exactly the same function. By inserting breaks I am allowing the brain a chance to shut out other noise and focus on what has just happened. “What was that? Was it a sliding move? Was it a massage move? Was it a pokey move? Did it hurt? Did it tickle? And most importantly, what is the appropriate response to it?” The breaks therefore provide the nervous system with the space and the opportunity to potentially make a decision about how to respond appropriately.

This thinking doesn’t just apply the Bowen ‘moves’ themselves, but about the environment where the treatment is taking place. If the therapist stays in the room after the move has been made, the client is conscious that they are not alone and a subconscious narrative around “Someone else is present in the room while I’m lying down,” comes in to play.

“What’s the therapist doing? Are they watching me? Are they breathing on me? Are they filming me? Are they judging me?” There is a whole raft of sensory information and warning signals that have to be considered when someone else is in the room and these may well affect the progression or direction of the treatment. A study in Israel in 1998 into quantum physics, showed that observation affects reality and revealed that “the greater the amount of “watching,” the greater the observer’s influence on what actually takes place.” (Science Daily, 2020)

As Bowen therapists, as therapists, what we really want is for our client to be able to be at ease in their surroundings and reduce internal chatter so that the body and brain can focus on what exactly is going on: this is what it seems the breaks do. By leaving the room we are creating the client’s own space for the internal dialogue to be able to happen uninterrupted. All of this depends on informed consent from the client, having had the breaks, as well as your intention to leave the room, fully explained in advance. If at any time however your client asks you to stay in the room, or if leaving the room is not possible for other reasons then this becomes a different scenario. In these circumstances you should stay in the room and where possible, create some degree of physical barrier between you and the client; a screen that you can step behind for instance. This still creates the physical and therefore psychological separation of therapist from the client that is the defining factor of the Bowen break.

An interesting but not fully formed study was carried out under the guidance of Professor Tim Watson. This study measured responses to pauses in manual therapy using changes in the constantly present bio-electric current running through all living objects. The current was measured as a constant over a period of time and it was noted that as a therapeutic move was being applied, the frequencies reduced. During the breaks in intervention however, the current increased, climbing significantly higher after each pause.

Whilst the study was never replicated or written up, or the methods fully explained, the preliminary results suggest that it is during pauses in therapeutic intervention that something is happening, in response to what has gone before. It seemed not so much that the break was affecting the current, but that something in the body was responding to the previous intervention(s) when it was not being continuously subjected to more input. In other words, time to think things over creates a change in response.

The pause seems also to have potential benefits beyond The Bowen Technique. Over the years, I have suggested to many other clinicians and manual therapists managing pain scenarios that breaks in whatever intervention they are using could be very beneficial. Where they have followed this simple idea, the changes to outcomes have improved significantly. Anecdotal.

The breaks are fundamental, and while we don’t fully understand them, the anecdotal evidence is strong enough to suggest that leaving the room at certain points during treatment has significant benefits.

Leaving the room gives an opportunity to write down what we have seen and what we have done and coming back gives us the opportunity to see what might have changed and to establish what we might do next. It’s always ill advised to create a plan at the start of a treatment.

As we move from being a student, (where we are taught to leave the breaks at specific times), we become more adept at using our skills, our knowledge, and assessments to know when and where the breaks might be needed and can apply huge flexibility in our approach. There may even be times when, as Tom Bowen did, walking back into the room you decide that the treatment is complete for this session. This approach resonates with me powerfully. If nothing needs to be done then nothing more should be done!

As well as breaks during the treatment, one of the key parts of a Bowen treatment is the break between the treatments. While we normally suggest five to ten days between sessions, sometimes a longer break is very useful. If you have someone who is not progressing, get them to reschedule their appointment and leave them for two or three weeks. The key here is listening to what the client (their body) is telling us. There are many occasions when I have ‘given up’ on someone, thinking that we were not getting anywhere, only to find out a few weeks later that their problem just ‘went away.’ Sometimes things just aren’t going to happen to our agenda!

We don’t put breaks in because that is what Tom Bowen did, we put them in because of the evidence we have that the breaks have a significant effect on the overall outcome of the treatment. Ignoring or dismissing the breaks is to fundamentally misunderstand The Bowen Technique and reduces the increased potential that the breaks provide for change.

In summary, breaks between groups of moves and between treatment sessions are fundamental to the defining principles of The Bowen Technique. A treatment using Bowen moves without breaks, makes that treatment something other than a Bowen treatment and should be defined as such, with the client being informed that what they are receiving is not Bowen.

The breaks are there for a reason and have a logical and plausible explanation, based around physiology and science. By all means change whatever you need to change to suit your own approaches and if you can get better results this way, I would encourage you to follow this path. If you do, please give everyone else the courtesy of not calling it Bowen.

Recently, I have heard a lot on the idea of the psoas being able to harbour trapped emotion. Forgive me if my view is a little tongue in cheek but if you’ve watched our webinars, you’ll already understand how I look at things a bit differently.

If muscles were people, then the psoas would be the head of the football team, rugby team or cheer squad. Vacuous and emotionally stunted, whilst looking great. Muscles in general have one thing to do which is contract and relax. They are brilliantly equipped with their own cells and motor units and each muscle is considered an individual organ. What they are not capable of is memory. Although the idea of cellular transference and cellular memory is a thing, muscles themselves are power houses and I don’t believe in any idea of ‘muscle memory.’

Instead, what is clear is that nerves that are myelinated, having laid down fatty schwann cells, will transfer information faster via a process of it jumping over spaces, nodes of Ranvier, created by the myelination of the nerve. This jumping is called saltatory conduction after the Italian saltatore – to jump. Myelination of nerves comes about as a result of learning something. The more you do something the better you get at it, not because the muscles have learned anything, but because the nerve endings that deliver the information from the brain have become finely tuned to the job required, be it playing a trumpet or juggling chainsaws.

The area around the psoas is a hugely loaded area from many respects and the psoas fits in within a chain of other structures to do a job. The central location of this area being around the solar plexus suggests that it would be a central point for emotional responses based around the autonomic nervous system. This is an area that will need to have rapid response in the case of sympathetic nervous system responses, with the pancreas being involved in triggering hormones to release energy and for the digestive system to restrict blood supply and so forth. The psoas just happens to be there.

However, I do feel strongly that as highly emotional beings we don’t primarily respond mentally to our emotional input but instead go to the physical as an initial response. We don’t think angry, we feel angry, we feel sad, we feel stressed and so forth. Our language expresses this perfectly. Our thought processes come along and we start to think our feelings. For most people this is the problem and one of my workshops called Emotional Stiffness, discusses the idea of us being physical and emotional beings before being mental and thinking beings. What does ‘angry’ look like?

It’s not hard for us to look at someone else and say that they look angry, sad or stressed. As well as their behaviour there are physical signals being given that alert us to the emotional and, by extension, mental state of an individual. We use these senses all the time with ourselves and with others without being conscious as to what our physical form is doing to reflect or represent our emotional state. We have trained ourselves into these physical states since early childhood. We know what angry feels like in our body and we know what to do with our body when this feeling arises. As well as the physiological changes that we know about and can measure in the sympathetic nervous system such as heart rate, breathing, blood flow and so forth, we will have learned to adopt a physical position. It’s a go to that will happen every time the emotion, whatever it might be, is triggered. Learned behaviour is a training as sure as weightlifting or yoga is a training and we will lay down connective tissues around our muscles that will support this and allow us to adopt that position when we feel the input that directs the feeling.

If we have spent many years being angry, depressed and so forth, we will also have trained our physical form into an instantly familiar pattern that will reflect our emotional state. In time the physical state becomes inseparable from the emotional state and one potentially drives the other. The cycle is indivisible unless it is recognised. We might spend a lot of time with our therapist, recognising our patterns, understanding our behaviour, recognising our triggers and dealing with our behaviours, but if our physical behavioural patterns are strongly embedded, then just by moving into a certain position could have the potential to move us into the familiar emotional state that we are trying to step away from.

My aim in my workshops is to help people to start to recognise where in their bodies they experience emotional triggers and what happens to their body as a response. It’s a combination of movement and mindfulness that encourages people to assimilate recognise and where possible allow and welcome their feelings as manifesting in a physical form and then to avoid moving into a mental space that then just spirals downwards.

The bottom line is that it’s physiologically implausible to suggest that one muscle or even a collection of muscles for that matter, can ‘store’ memories. What they can do is respond to and easily move into a position that is familiar. Focussing on one muscle or structure is never either useful or correct and the idea of individual muscle function is a contradiction in terms. I believe that building integrated understanding of how we affect and influence our function from a physical, emotional, social and mental perspective and create imbalances in health and ill health, allows us to make much smaller and more manageable steps towards addressing dysfunction or imbalance.

What IS this thing called Fascia? I’ve often looked at my relationship and association with the world of fascia and questioned where it’s going and whether it’s the right direction. The move towards a website called Functional Anatomy is me trying to shift slightly the emphasis on fascia and to show that I have more of a view than some might think. But it’s worth trying to explain how I got here in the first place.

I’ve spent the last few years straddling two very different worlds. Running dissection classes in medical schools and rubbing shoulders with traditional anatomical approaches, academic imperatives and learning to keep my views to myself. It didn’t work as I’m still a pariah in these circles, at least in the UK. In this world, fascia is a poorly described connective tissue that is not given much consideration in terms of anatomy, diagnosis function or explanation. The information is there, but not much is made of it and it’s not a part of anatomy that has much of a presence.

The fascination that people for fascia is often derided and laughed at and when in the company of anatomists and those involved in classical anatomy, it’s not an oft talked about subject. “Fascia kittens for everybody!” as one senior Doctor chairing a UK anatomy association happily sneered about the world of fascia.

On the other side of the aisle, I still have a strong interest in the world of complementary medicine. I am principal instructor of a hands on therapy school, have written two books about it, hundreds of articles and lectured all over the world on it. It has been my life for over thirty years and most of the people I would call friends are in this sector in some way shape or form.

In this arena, fascia takes on almost god like properties and is imbued with all kinds of improbable qualities and abilities. People claim everything from it being responsible for it being the cause of mental illness to every pain you’ve ever had being as a result of injury, dysfunction, dehydration or something to it.

Therapies for it and approaches to it abound. The claim to stretch it, hydrate it, release it, move it grow it, or do something to it and with it come tools, books, videos and courses, all with fascia or myofascia on it or near it.

There are international and regional conferences on fascia, Facebook groups, research studies and people that have made their entire living and reputation on this inert connective tissue. Theories become beliefs and beliefs become fact and what once was a great idea and theory, now becomes something factual, even when the evidence doesn’t support it. Don’t get me started on evidence.

Somewhere in the middle of this is some truth and both worlds are guilty of taking extreme stances that are never likely to to reflect a middle ground.

Where to begin?

We have to start by saying that there isn’t a single thing that you can call fascia and what fascia is or isn’t, depends on who you’re talking to. There’s also no real consensus in science or even in the world of fascia itself, so we start from a tricky place. For the moment let’s call fascia, ‘A collagen based, body wide connective tissue that has variable properties.’ It’s pretty neutral, most people will agree, and we can go from there. All fascia is connective tissue, but not all connective tissue is fascia.

Fascia is therefore for me, the connective tissue that joins up the dots. It is in effect, the missing link between the branches of medicine and the disconnected bits of anatomy that litter our anatomical understanding. I once sat on a plane back from the USA and sat next to a heart transplant coming surgeon. I asked him how many of his patients complained of back pain post transplant. “All of them,” was his reply and he admitted to being puzzled by why this was the case. 45 minutes later and some pictures from the laptop and things were a lot clearer. There were connections that he had literally never considered, or more importantly had never seen or been taught as an undergraduate.

It probably won’t have made any difference to his surgery, but this simple bit of information certainly made him a better surgeon. Able to dispense advice and explain why people experienced what they did, enabling them to understand it was normal and that they could get help for it, although probably not from him. His capacity to see the person as a whole and how they presented as part of what he did allowed others to have more confidence in what advice and approaches he took.

I felt that my straddling of these worlds, understanding what his training had been and how he learned anatomy, enabled me to reach out to him and present him, not with an alternative view, but an extended view. He wasn’t wrong or blinkered, he had just not seen some of what there was to see.

All the structures I showed him and all the explanations I gave him were all what is in the body. The bio chemistry surrounding cellular activity in scarring and its effects on connective tissues were simple and basic science, but explained the body wide effects of scarring in a way he hadn’t considered before.

In speaking to therapists ‘on the other side,’ I use the same approach to demonstrate the myriad of connective tissue structures, what they consist of, how they get laid down and what we can (and cannot) do as manual therapists. I explain some of the scientific and physiological realities that have got mixed up in myth: there are no lines in the body, fascia is mainly non cellular and so on.

The straddling of the line isn’t fence sitting by the way and I know full well where I would choose to be if I were forced to make such a choice. I firmly believe that the wisdom, education, science, methodology and understanding of the body is something that both sides of the argument have more in common with than you might at first think. The polarisation of the views is what creates the problem for the populace who are caught in the middle struggling to get the best and safest help they can.

My role is to try and bring the worlds together and tease out this wisdom for the good of those who need our passion and knowledge. Wish me luck!