by John Murphy, ADVANCE for Physical
Auto accidents can cause trauma. Repetitive movement may
to repetitive stress injuries. Can emotion cause chronic physical pain?
PT's who use the Rosen method find that the gentle hands-on bodywork
combined with a certain kind of talking during the treatment session
can enhance physical therapy treatments and alleviate chronic pain and
dysfunction in the body.
Marion Rosen, PT, who developed the method, explained that Rosen method
practitioners employ hands on techniques to relax chronically tense
muscles in order to access the emotional background of pain that is
often at the root of chronic pain.
The emotional causes of physical pain, she explained, are typically
ignored in physical therapy. "Physically we do not try to take away the
pain (with Rosen method bodywork) but we try to relax people enough so
that through the relaxation, feelings can appear that cause the pain,"
said Rosen, who has a private practice in Berkeley, CA.
The Rosen method maintains that people have emotional attitudes about
themselves that occur during childhood, that cause a person to tense or
hold certain muscles. People are usually unaware of the tensions unless
they cause pain or discomfort. While talking with the person in a
particular manner, practitioners feel for muscle tension and watch the
natural breath as they work.
In a typical Rosen session, explained Teri Katz, PT, a person might say
that he has a pain in his back. "I might say, 'When did it start?' He
says he had an accident three years ago. As a Rosen method body work
practitioner, I would then ask what was happening in his life three
years ago. Very often, there is a connection between what was happening
in his life and the auto accident. As a person starts to relax, the
Normally, muscles contract, then relax, and the relaxation is reflected
in the breath. Rosen method practitioners look for muscles that don't
relax with the breath, and begin to talk to the person about
associations that could be linked with the muscle tension.
"Some sessions are very quiet, and in some sessions there's a lot of
talking. We feel that the talking deepens the work. When people can
verbalize things that they have never been able to verbalize before,
there's a shift that happens in the body that allows people to let go,
The Rosen method is not psychotherapy for solving mental problems,
cautioned Katz. "It's not oriented that way at all. It's much more
about whatever the experience is that someone has embodied."
For instance, parents might have told a child to stop crying, that it's
not OK to cry. "In order to stop crying, you have to tighten muscles in
your neck," Katz explained. The unexpressed emotions can cause tension
in those muscles throughout the person's life. "As the neck muscles
relax, these feelings surface and the person may express them."
Rosen explained that such muscle tension often originates while a
person is growing up, especially from the loss of a parent, fear when
going to a new school, the birth of a sibling, moving away, in addition
to a whole world of difficulties in relationships.
The population that a Rosen method practitioner sees varies with the
background of that practitioner, noted Katz. As a PT, she may use the
Rosen method with people who have complaints including disk problems,
post-polio syndrome, Parkinson's disease, AIDS and whiplash.
She also sees people with general everyday aches and pains or people
who are using it for personal growth who find the treatment both
relaxing and emotionally beneficial.
Before deciding to use the Rosen method for physical therapy, Katz
first rules out mechanical, inflammatory, repetitive injury problems or
joint dysfunction problems that could be treated with traditional
physical therapy. She also talks to people about their lives as she
works with them.
Physical therapy is very goal oriented, she
A problem is identified, and techniques aimed at alleviating the
dysfunction underlying the problem are employed. "I'm constantly
evaluating and re-evaluating the effectiveness of my work. With the
Rosen method, I don't have a kind of (physical) goal, because it's more
about people getting in touch with who they really are and what it is
that holds them back from being who they are."
As a soft tissue technique, the Rosen method is reimbursable, said
Katz, who also has a private practice in Berkeley, as long as progress
can be documented over time.
The sessions usually run an hour. Clients lie on a massage table and
remove as much of their clothes as they feel comfortable, always
keeping on their underwear. Some clients remain clothed or gowned. Katz
explained that there is no set order to how she begins the hands-on
work. Frequently she begins with the person lying prone and does soft
issue work on the trunk, chest, abdomen, legs, diaphragm and neck.
As she works, Katz may talk to the person while paying attention to the
person's natural breathing. "People get better faster when they talk
about their lives," she said. "The aches and pains that never went away
with physical therapy - or that went away and came back later - go away
and don't come back with Rosen work." Why this effect occurs is still a
mystery to Rosen, yet this is the key to results in her method. She
shows new practitioners through experiential training, so they can see
Rosen, now 80 years old, has been a practicing PT in the United States
for half a century. In the 1970s, she and her method were "discovered"
by a few clients who went on to found the Rosen Institute in Berkeley,
CA, in 1983. Since then, Rosen has taught extensively in the United
States and Europe.
The Rosen method has positively influenced Rosen herself, she believes.
"You know when you are 80 and you can still work pretty much a full day
and you have no pain, it should have had something to do with it." She
still receives treatments from other practitioners to see how it feels.
"There's always something new that comes up even after all these years."
"The body likes to be well." she said, "and if you help the body get
well and it feels better, why then would the same problems recur? Any
person who has a chronic pain, there's something else behind it."
Constant pain that can't be treated through physical relaxation methods
may not respond to the Rosen method either. The Rosen method is highly
appropriate, however, when the person gets better through muscle
relaxation and talking.
While the Rosen method has applications to physical therapy, Rosen
herself sees it as more of a preventive technique. Still, the method is
also worthwhile for those who have serious pain and are far along in
their condition. "Like my best patient who was supposed to have hip
surgery and the pain went away with her in one treatment," said Rosen.
"That doesn't happen with everybody, but it can happen."
People are often surprised to learn what kinds of influences have
caused them to retain physical pain, related Katz. Sometimes the
revelation comes while the person is lying on the table, and other
times people uncover the cause outside of the practitioner's office.
"It's not like some experience jumps out at you from a black hole in
your life and all of a sudden your eyes are opened," Katz cautioned.
More often the experience is a subtle memory of an incident or a
pattern of experiences. Sometimes it's just the experience of being met
with gentle touch in a way that acknowledges their pain and suffering
that allows healing to occur. A reaction will not likely cause a
physical shock, but could provoke a teardrop or two, she
for Physical Therapists, February 27, 1995