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Waves of Hope

As you fly overhead, Sri Lanka’s coast is a tropical paradise of lush green palms and aquamarine waters. From below, the scene transforms into a chaotic thriller as buses zoom in and out of lanes, jolt out of ditches and barely miss pedestrians.

More than two years since the tsunami swept through, signs of its wrath still haunt the fishermen who lost their boats and wives who lost their homes. Even more frightening is the civil war that continues to rage between the Sinhalese Buddhist government and the terrorist Tigers of Tamil Eelam (LTTE). The infamous Tamil Tigers have been fighting for an independent homeland since the 1970s.

Things seem calm in the south, but gunfire echoes in northern Jaffna and eastern Batticaloa, where suicide bombings had their origins. The glimmer of hope for reconciliation after the tsunami didn’t last long, as the race for aid money only widened the country’s ethnic divide. In a country of fewer than 20 million people, the civil war has killed about 63,000, displaced one million and held back the island’s economic growth. About 22 percent of the population live below the poverty line. Sri Lankans love their island paradise, but this is a land of uncertainty.

It was the sheer force of the tsunami - the largest natural disaster in world history - that first drew Michael Lear to this island paradise in 2005.

“Those waves were like a slap in the face from their mother, their sole provider,” says Lear, a senior Trager® practitioner and ashtanga yoga instructor. This Pennsylvania native escaped the tsunami by mere miles, and grieved its destruction alongside strangers in a tiny café in Goa, India. With more than 220,000 lives lost and millions more completely devastated, Lear’s focus turned immediately to Bodyworkers Without Borders - a concept he developed years back in hopes of sharing the Trager Approach with the developing world. Then, he had a lucid dream about a big white building by the sea.

More Than a Dream

Two months later, Lear found himself standing on the veranda of that very building on Sri Lanka’s southeast coast, staring at the ocean yards away. It was unmistakable: Navajeevana (which means “new life”) Rehabilitation Hospital was the building that appeared so vividly in his dream. A private hospital unlike any other in Sri Lanka, it aims to serve those most isolated along the coast.

In 2007, Lear was able to return to Navajeevana for his third time to share Milton Trager’s innovative approach to movement re-education, thanks to support from the U.S. Trager Association and the Real Medicine Foundation. His six-week stay would include dozens of Trager sessions with Navajeevana patients, many bumpy trips in miniature took-took cabs to villages served by Real Medicine clinics, and hours of training sessions for therapists in Trager’s approach to movement and selfcare.

On his first day back in Tangalle, Sri Lanka, Lear meets with Navajeevana’s new physiotherapy manager A.T. “Arun” Arunkumar, who reports that 50 percent of the 2,500 patients they serve are experiencing painful conditions, which may include post traumatic stress issues, chronic pain or spasticity. Another 40 percent are children faced with congenital neuromuscular disorders such as cerebral palsy. Lear knows this kind of neuromuscular tension—intensified by shock and fear—is the kind of condition Trager addresses most effectively.

The Trager Approach uses a two-part system:

  • Table work done by a certified Trager practitioner using weighing of the limbs, gentle rocking motions, wave-like shimmers of the tissues and gravity-assisted swings
  • Mentally directed movements that patients can do at home to access their body’s own fluidity called Mentastics® or “mental gymnastics.” These movements suggest to the mind feelings of lightness, freedom, openness and pleasure.

What most distinguishes the Trager Approach from other bodywork? A focus on the mind. Most other methods direct their attention to one of the body’s tissues; but Trager said that tensions, restrictions and rigidities are not physical patterns, but mental ones.

Navajeevana’s founder, Kumarini “Kumi” Wickramasuriya, is impressed by the way Trager movement education complements physical therapy. “You see, that feeling is there—that lovely feeling to help another person,” she says.

Anna Marie Bowers, administrative director of the U.S. Trager Association, agrees. “I think this is the perfect way to introduce Trager to another culture,” she says. “Trager offers a way for therapists to address fear, pain and restrictive physical patterns not addressed in their prescribed protocol. The body’s natural reaction to trauma and stress is to shut down, withdraw or contract.

Our body needs this important fight or flight mechanism when responding to danger, but over time, when the stress is still there, that’s when you have a problem.”

Adults at Play: Mental Gymnastics

Teaching Trager halfway across the world comes easily to Lear, using body language to fill in the gaps where talking seems overrated. The therapists laugh when he slouches in his chair like a couch potato with a TV remote, to show why it’s better to keep the body moving. To get them into their comfort zone, he demonstrates “Mentastics.”

“Most importantly, I want you to have fun. I want to reawaken our ability to be playful and spontaneous,” he says, as he begins moving.

The group of therapists follow him, shifting from foot to foot at first to feel more grounded. Lear asks them to write their name using their nose, then jokes they should “write a note to a friend” using their shoulders. The mood lightens. Soon, the group breaks into a dance, laughing out loud. They’re entering the state of awareness called “hook-up” by Trager practitioners around the world. Trager describes hook-up as a meditative state, like the way you become connected with your environment when walking by the ocean.

“Ask yourself: ‘What is half the effort?’ says Lear as he dances along with the therapists. “Now, what’s half of that? Even where there’s tension, find a place that is soft. You’ll be able to learn how to give these techniques to your clients.”

Occupational therapist Gahmani nods and smiles broadly, indicating there is no language barrier here. Using less effort is a concept he sometimes forgets; life for the therapists at Navajeevana is just as hectic as in a Western rehab hospital, with fewer conveniences.

“They are so dedicated though,” says Arun. “They don’t get paid all that much. They go from one patient right to the next and don’t ever complain. They love their work.” As the need for rehabilitation grows, Sri Lanka has seen a shortage of therapists, which can make the workdays stressful for Gahmani.

“In demanding environments such as these in remote areas,” says Lear, “having the ability to stay relaxed, comfortable and focused is essential to administering the best possible care.”

In training sessions, Lear uses familiar Buddhist philosophy to remind the therapists that caring for their own body comes first: “As the Buddha said, be selfish so that you can give freely. You can’t take anyone else somewhere you aren’t feeling yourself.”

Anchoring the Experience: Tablework

It’s apparent Lear has internalized this self-care philosophy. Not only does he practice Mentastics, but he also devotes hours each day to an intense ashtanga yoga practice and time for meditation.

After a short break in the training, with water buffalo grazing outside the hospital door, Lear begins to show Navajeevana therapists how they might use Trager to enhance physical therapy. He gives each of them a Trager tablework session to anchor the experience. Occupational therapist Gahmani is first in line. The movements look so enjoyable because instead of working against the body’s basic reflexes, it stimulates its normal range of movement.

First, Lear gently paws Gahmani’s shoulders like a cat. Then he cradles his head and weighs it until it gets heavier. He’s watching to see what kind of “stories” Gahmani’s body might have to tell. After releasing Gahmani’s head, he steps back and takes a break, to shake out his hands and relax his own body. Then Lear creates a hook with his hand, wrapping it close to Gahmani’s ear, rocking and letting his head roll naturally side to side. Both men’s bodies begin to share the same rhythm. When he takes Gahmani’s leg by the ankle and wiggles it, the wave ripples through the whole body like sending waves through a rope.

Those ripples help him to see what’s happening in Gahmani’s hips and lower back, says Lear. Senior Trager instructor Deane Juhan likens the technique to using a broom to get something out of the corner from a distance. It’s these fundamental principles of inquiry, weighing, rocking and elongating that form the basis for this language of touch.

As the session ends, the rocking slows gradually. Then Lear anchors the experience in Gahmani’s mind by saying, “Just as you can recall a stressful situation, you can recall this feeling of fluidity and softness.”

“When you said ‘this feeling is yours and you can have it any time you want,’ that is very important,” says Gahmani. “Sometimes stressful situations may not allow me to get relaxed. But by using my mind, I can go back to that beautiful place.”

Creating a Safe Environment

Even though Sriyawathie Wanigabadu lives in this beautiful place, life isn’t so easy for her. Her arm was pinned down by debris during the tsunami and she almost drowned. When she first meets Lear in the Real Medicine Clinic at Yayawatta Village, her elbow is swollen and she winces with pain. Though it’s a bit unusual for Sri Lankan women to receive bodywork from a man, Wanigabadu is reassured that someone else will be there and that she will be fully clothed.

Lear uses the movement of his own feet on the ground to transmit motion to her body, rocking back and forth, back and forth. The repetition gets the nervous system to quiet down, says Lear. “If it gets boring, that’s good!” He works with no expectations. Muscle holding patterns present themselves, and he senses that Wanigabadu’s pain and swelling are related to post-traumatic stress. From conversation, it’s clear that Wanigabadu is still suffering psychologically. “I am not afraid of the sea, but I don’t ever want to see it again,” she says.

Days later, Lear works with Wanigabadu’s 16-year-old son, Amil, who has developed a reputation as a hyperactive and troubled child. “He’s known to pick a fight when he doesn’t get his way,” says his mother. As Lear talks with him, Amil nervously picks at the many cuts on his legs from a recent bicycle accident.

“I gave Amil a session to give him the feeling of what is peaceful, relaxed and easy. Sometimes this is all you need,” says Lear. “For traumatic injury, you have to create a safe environment in order for the body to let go.”

The next time Lear sees Wanigabadu, her arm has improved by about 80 percent, she reports no pain and seems very relaxed. Amil walks with a new sense of confidence and vitality. Working with more than one family member makes a big difference, says Lear, as each person begins to support the other in finding a more peaceful, easy approach to life’s inevitable stresses.

“Trager affords patients the opportunity to feel good in a safe environment while experiencing the same type of movement they may have felt when they shut down,” says Bowers. “It helps replace patterns of restriction with those of open, free movement.”

More Smile

The Wanigabadu family has just begun learning about the Trager Approach, but for other Sri Lankans, Trager is a trusted friend. Mr. Nathyanandam is one patient who showed signs of vast improvement since Lear’s last training in 2006. He saw Arun at a rehabilitation hospital in Jaffna for hemiplegia, extensive spasms in his right arm and leg. With Trager tablework sessions and Mentastics movements at home, based on patient feedback, Arun says Nathyanadam has improved the function of his hand by 50 percent and his gait by 30 percent. But the best part according to Arun—his smile.

“He used to come to physio [therapy] once in a week, but after I started giving him Trager along with regular physio, the spasm is relieving nicely,” says Arun. “With Trager, I can put more ‘smile’ on the patients’ faces. We also can make them more confident mentally and physically.”

The pleasing quality of Trager movement—the part that brings “more smile”—should not be minimized, according to Juhan. On the contrary, three reasons make it essential:

  • Pain inevitably engages reflex muscular defensiveness, producing amplified, not reduced contractions and holding patterns.
  • Pleasing is a potent biofeedback element, leading to deeper relaxation, softening of tissue and increased ranges of motion.
  • Trauma and pathology have created pain and fear, to the extent that patients can no longer imagine any part of their body as a source of pleasure, comfort or strength

Unfortunately, Arun can no longer visit Nathyanandam because of the conflict between the Tamil rebels and army forces. There was a curfew set in the Jaffna area, which means he is barred from leaving his house. For Nathyanandam and others like him, the need for Trager is only increasing.

Sharing the Peace of Trager

Compared with the stresses faced by Sri Lankans - the fear of another tsunami, the threat of Tamil Tiger bombings and the toil of working on tiny fishing boats for weeks at a time—Lear’s own stresses lose their intensity. Mother and son Sriyawathie and Amil Wanigabadu arrive on his last day to say goodbye, along with many other patients. They embrace Lear wholeheartedly, like a member of their own family.

Lear’s ambivalence is palpable as he boards the van to the Columbo airport. When he looks back, the smiles are filled with optimism. Each time he returns to this tightknit community he is drawn closer to its people. Though he can’t stop the tears, he is consoled because he has shared a large piece of himself—and the peace of Trager.

That’s what Milton Trager originally had in mind - world peace - one body at a time.

Real Medicine

As senior Trager® practitioner Michael Lear began his work at Navajeevana Rehabilitation Hospital in 2005, American pediatrician Martina Fuchs was setting up a children’s clinic yards away on the southern Sri Lankan beach. Not until the two returned to the United States did they trace their common cause.

Fuchs was so moved by her trip, that she made a promise to the Sri Lankan children that she would return. She got to work at home in Los Angeles forming a nonprofit organization called The Real Medicine Foundation—based on her belief that “real” medicine is focused on the whole person—by providing physical, emotional, economic and social support. Then she heard about Lear’s Bodyworkers Without Borders effort. She called immediately. Today, Lear and acupuncturist Beth Cole have formed Team Whole Health—a branch of Real Medicine that aims to enhance traditional care with holistic healing modalities.

“Optimal healing is found in the synergistic effects of Western allopathic medicine and Eastern methodology,” says Cole, a Floridian who is now practicing acupuncture in Africa.

Because Real Medicine is a small organization with less bureaucracy, its efforts yield targeted results. Their “friends helping friends” philosophy has helped them provide humanitarian support more quickly to people in disaster, postwar, and povertystricken areas. Through partnership with Real Medicine, Lear was able to obtain funding to continue his work in Sri Lanka, and he hopes extend his reach to other areas such as Africa and Pakistan.

Certified Practitioners of the Trager Approach have successfully completed the certification program provided by Trager International, and have maintained continuing education, and other requirements of Trager International. To learn more about Milton Trager and the Trager Approach, or to look for classes in your area, visit www.trager.com/index.html.

If you’d like to learn more about Bodyworkers Without Borders, Real Medicine Foundation and Team Whole Health, sign up for an e-newsletter, or go to www.realmedicinefoundation.org. You can also contact Lear at 484-542-0249.

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