Reflexology – A Reflective Review
Those of you who are familiar with my previous blog articles will know that, until now, I have focused primarily on my personal attempts to try and make sense of and unravel the mechanisms and theories involved in reflexology – the “science” of reflexology. In this article however, I would like to turn my attentions towards some rather more contentious aspects of reflexology – in effect I wish to wave the flag for the other side of the reflexology equation, the art of reflexology, and hopefully encourage an injection of common sense.
Over recent weeks several encounters have caused me to question where reflexology, as a therapy, is actually heading. After a prolonged period of “radio silence” having made a conscious decision to step back from the debates on social media, I have decided to share my growing concerns on the current status of reflexology, knowing full well that in doing so I am likely to upset more than a few of my colleagues.
Firstly I have become aware that the managers of a very prestigious health spa have some concerns about including reflexology in their list of available treatments because of the clinical focus that reflexology is now associated with and the growing list of conditions that should be “treated with caution”, the ethos of the spa being one of inclusion, encouraging wellbeing, not treating conditions. Then a client told me about a magazine article she had read, recommending that pregnant women should avoid pedicures because of the dangers of miscarriage. I have to assume that this has evolved from the misinformation that circulates regarding the potential of reflexology to cause miscarriage. This was followed by meeting an experienced therapist who revealed that she never treated anyone who was pregnant because of what she had been taught at college. Finally a very sad case, where a palliative care patient told me that she used to enjoy regular reflexology but, once diagnosed with cancer, her therapist had told her she could no longer treat her because reflexology could make her condition worse. This lady was more than a little confused to be offered reflexology in a hospice setting, and yes she is now aware that she had been misinformed and again benefits from and is delighted to receive regular reflexology treatment.
I would suggest that it is time to consider how, as a profession, reflexology is viewed amongst both practicing reflexologists and the world in general, are we providing an honest and realistic representation of reflexology? With an apparent growing division within the profession, we appear to be facing an identity crisis – holistic therapists or diagnostic and prescriptive pseudo clinicians?
To quote a kinsman of mine – Robert Burns;
“O wad some power the giftie gie us to see oursels as ithers see us!”
(English translation; “Oh would some power the gift give us, to see ourselves as others see us”)
In other words perhaps it’s time to remove the rose tinted glasses and take a realistic look at the “the science and art of reflexology” from a different perspective.
Whatever has become of reflexology, that simple holistic therapy that I trained in 16 years ago? Back in the “good old days” we were taught basic anatomy and physiology, we learned the routines, feet and hands, there were 2 contraindications and we were advised to avoid working on new clients within their first trimester of pregnancy – not because we could cause miscarriage but simply to avoid accusations of having caused a loss of pregnancy during the time period where miscarriages are most likely to naturally occur. It worked; we felt confident to venture out into the world to start practicing and got great results.
Nowadays we see a range of educational options for reflexology, short weekend courses for those with an interest in reflexology, various schools and colleges offering professional courses with a bewildering range of levels numbering 2 through to 8 – and I have to ask is the reflexologist holding a level 8 qualification really going to be a better therapist than the person with a level 3? – very debateable. Added to which each school has their own technique, foot maps, routines, do’s and don’ts, many of which contradict each other; not to mention the vast range of post qualification courses. Then there are courses encouraging parents to use reflexology for their babies and children, targeting common childhood complaints, all are providing an excellent window into the world of reflexology and a wonderful way to promote reflexology to the public but this also has the potential to encourage the public to see reflexology as being designed to treat specific conditions. Then there is the need to address the all important question as to where do we cross the line from amateur to professional regardless of whether a fee is being charged as here in the UK anyone can set up as a reflexologist, there is no statutory regulation as regards training. We have various professional organisations representing reflexologists, all competing with each other for members, setting their own membership standards, code of ethics etc.….in short, it’s a mess. If the reflexologists are confused then what hope is there for the average person on the street to separate the good from the bad, fact from fiction?
Taking an overview of reflexology on a global scale as we see it practiced today reveals a very complicated and confusing picture – lots of jargon, medical terminology, conflicting advice, misinformation, mythology and numerous variations on a theme. Are we looking at true progress and development or an industry that is slowly succumbing to commercial pressures in an increasingly crowded market place, using the power of language to persuade each other and the general public that we can “cure all ills,” using technical medical jargon to create a “professional” image, authoritative colleagues instilling doubts in the minds of their fellow practitioners thereby effectively creating a need for and implying that we require “specialist training” before working with various client groups in order to avoid causing harm – our very own “project fear”.
There are so many different reflexology techniques now being used perhaps we should be questioning exactly what do all these different reflexology techniques actually achieve, what is the common denominator? Is there a genuine difference between the outcomes for these various techniques? Do we actually need all the “bells & whistles” that have become so entrenched in reflexology thinking over the last decade? Yes the human body is complex but there is only one skeletal system, nervous system, circulatory system etc and there is a finite number of ways that human to human touch can interact with these systems, and touch is the only apparent means of physical influence.
Increasingly, over the past few years, I have found myself feeling disconnected and more than a little frustrated and uncomfortable with the direction that many in our profession seem determined to drive us. Reflexologists have, it would seem, become somewhat expert at “navel gazing”, focusing inwards, arguing about charts, which course offers the better training, the minutiae of potential neural pathways, to treat or not to treat, devising a growing list of specialist training courses for specific ailments and client groups etc. We have perhaps become overly concerned about the opinions of the medical profession and the quest for scientific proof, driven by those leading our profession to be seen as a legitimate adjunct to health care. Whilst there is no doubting that science is important we do need to keep things in perspective – science has a very long way to go before it can provide us with all the answers, there is however also a very real need to keep an eye on the bigger picture – the “human” aspect of reflexology and the public and professional persona. Yes I would agree that research is an important component in pushing the boundaries of understanding in reflexology but this appears to now be happening at the expense of the holistic approach and, dare I say it, basic common sense. I originally began training in complementary therapies because I had become so disillusioned with the nursing profession; patients had become lists of symptoms, tick boxes, with little or no time allocated for care and compassion of the individual, the person behind the symptoms being forgotten in the rush to identify and cure their ailment. Now it would appear that the push to be regarded as “valid” within the medical world sees reflexology emulating very similar mistakes with an increasing focus on symptoms and disease and which reflexes have to be worked or avoided. I am concerned about the mixed messages emanating from our professional bodies and it is highly possible that if we continue on our current course, circling in ever decreasing circles, then reflexology as we know and love it will cease to exist. As a profession I do fear that we have lost focus on the original ethos of reflexology which, it has always been my understanding, is to offer a truly holistic approach that does not seek to diagnose or cure specific ailments but supports the whole person – mind, body and spirit, promoting health and wellbeing.
Ultimately it was this sense of confusion and dissatisfaction with the theories, focus and direction that reflexology appeared to be heading in that made me press the “pause button” several years ago, and effectively start from scratch to develop my own approach to working on the feet – from this Zu Qigong, foot energy work (ZQG) came about.
So let me offer an overview of where I currently see reflexology and take a brief look at some of the basic concepts:
This distribution of energy exchange, dependent on the reflexology technique applied, can ideally be represented by the classical Yin Yang symbol. If the reflexology focus is on applied pressure i.e. thumb walking, then the majority of the energy exchange betweenpractitioner and client will take the form of mechanical energy whilst inevitably there will be some “bio-energy” transfer through the simple touch connection.
However if the practitioner is focused on providing a light touch or energy based technique then the majority of the energy transfer will take the form of “bio-energy” with only a small transfer of mechanical energy. The intention of the therapist being the key to understanding this concept, and hopefully we can all agree that intention is vitally important in any touch therapy.
From this we can therefore conclude that there are actually 2 distinct approaches to reflexology – classical and energy based. With the wide variety of reflexology techniques now in use around the world we can view the different techniques as existing within a sliding scale of energy delivery ranging from mechanical through to light touch “bio-energy”.
It is important to remember that although reflexology may be regarded as providing a holistic healing touch, the therapist does not heal. The therapist can support the healing process but it is the client’s body that does the healing.
This is a problem I personally refer to as “Bob the Builder syndrome” based on the children’s cartoon character who’s motto is “I can fix it” something that many therapists seem to be overly concerned with; the “I can fix your disease, ailment, problem” approach! In reality no you can’t, as therapists we can only offer support. The “fix-it” mind set has, it would appear, come about as a result of the current trend to focus on clinical diagnosis and “treating” specific conditions / ailments and client groups. This is an all too evident departure from the original holistic ethos of reflexology.
The human body has a natural ability and intelligence to heal itself, attaining its own unique functioning “balance”. Yes these natural mechanisms can become overwhelmed due to stress, environmental factors, trauma etc. and require some external assistance. Positive touch can provide a supportive input of energy to aid the healing process, the therapist therefore only acts as a catalyst. Similarly the physician offers assistance through medication – chemical energy, the surgeon may remove irreparably damaged or diseased tissue enabling the body to begin its repair work, the psychologist encourages a change in thought patterns, plaster casts and sutures provide a physical support. All are designed to assist the body’s inherent healing process.
Logically we can conclude that the primary effect of any touch therapy, not just reflexology, is to transfer energy, the exact mechanism in then moving this energy throughout the body remains inconclusive. In reflexology there are numerous theoretical models currently in use but as yet nothing scientifically proven, and it is important to keep things in perspective as it would be easy to assume that we already have scientific proof judging by the tone of many forum discussions and articles currently circulating. The use of clinical and scientific language effectively creates an illusion of concrete evidence.
From a personal perspective, the connective tissue – collagenous network – I would suggest provides the primary point of energy entry, with all physiological structures including the nervous system, being embedded within this network. I have covered this topic at some length in my previous blog articles and therefore do not intend to discuss my theories in any depth here, but it is important to acknowledge that there are likely to be several mechanisms involved in reflexology. One of the biggest hurdles to be overcome in reflexology is the very distinct focus on neural pathways, this perhaps stems primarily from the name given to our therapeutic approach. By talking about “reflexes” there is an automatic assumption that we are only affecting the neural communication network, hopefully as the scientists are now beginning to explore the relevance of connective tissue, the reflexology world will begin to widen their thinking, there is much more to physiological communication than just the neural network .
If we consider the mechanical aspects of applied pressure i.e. push, pull, twist and press; then we know that this will result in changes in the tensioning of the collagenous tissue, which can then be transmitted across the network. Alterations in tension of this tissue will consequently result in a neurological response. As reflexologists we are aware that the neural pathways in the feet are primarily involved in proprioception and motor function and will therefore respond accordingly to applied pressure. Collagenous tissue does appear to exhibit an interesting response to a specific type of pressure – the “on-off” press and release action of thumb walking for example, can result in what could be interpreted as a release of tension, an “unwinding” effect on the collagen fibres, relaxing tissues and alleviating pressure on nerve endings and therefore reducing the pain response. Various therapeutic techniques are now emerging that utilise this principle and it will be interesting to see how this approach to touch therapy develops over the coming years and any associated research resulting from this.
I firmly believe that there is much more to reflexology than simply the mechanics of applied pressure, if it were that simple, then merely walking across varied surfaces and weight bearing would be sufficient to correct any imbalances within the body and clearly that is very definitely not the case. Similarly if we look at hand reflexology our hands are constantly exposed to various mechanical pressures during every day activities and yet imbalances continue to exist in the body. From a personal perspective my current focus is on the subtle, yet powerful, “bio-energy” exchange that occurs through touch and the implications of this in the efficacy of reflexology. We know that touch has been shown to be important in maintaining our physical and mental wellbeing. A newborn infant for example will fail to thrive if deprived of the loving touch of a parent or carer and will exhibit growth and learning impairment. A simple touch, holding the hand of another person, can instil a feeling of peace and calm in a difficult or stressful situation, gentle touch applied to a painful area of the body can reduce the level of perceived pain, all are techniques used on a day to day basis.
For now, unfortunately, we have to accept that this energy exchange lies beyond current scientific understanding but this does not mean that it should be ignored or discounted. Ancient cultures have acknowledged and used this concept of energy exchange for thousands of years with great success; globally the “laying on of hands” has been regarded as a powerful healing concept across the millennia.
So how would I define this bio-energy? In simplistic terms if we consider that we are constantly exposed to energy from our natural environment in the form of electromagnetic radiation from the sun and magnetic forces emanating from the molten iron core of our planet, then logically the human body or mass is likely to have evolved a capacity to transform and use this energy in order to maintain effective function, in much the same way as plants use light to convert water and carbon dioxide to produce glucose via the process of photosynthesis. Indeed we know that the human body uses specific wavelengths of light to produce vitamin D, and although vitamin D can be sourced from certain foods the most effective source is that produced from sunlight. The effect of light on the pineal gland is used to set and maintain our circadian rhythm, with alterations in day length during travel across time zones resulting in jet lag.
I would assume that the use of electromagnetic radiation and magnetic forces is what the ancient cultures refer to as Universal energy i.e. coming from the heavens and the earth. This energy is therefore flowing through us, being transformed during its passage through the body… “altered” then “discharged”, it is this altered and discharged energy flow that we are able to exchange through touch. It is possible to speculate that this altered energy is more readily accessible by the human body and can therefore be utilised quickly to aid the healing process? Yes this theory is open to debate but given that touch undoubtedly has a significant impact on human wellbeing it should not be dismissed as nonsense.
What I find particularly interesting is the growing acceptance of energy medicine within allopathic practice. We readily accept the use of radiotherapy in the treatment of cancer, ultrasound to treat kidney stones – lithotripsy, ultraviolet treatment for skin conditions, infrared therapy to speed up healing, ultrasound to minimise scar tissue, lasers to perform specific surgical procedures and yet the concept of energy transfer through touch and its potential ability to improve wellbeing is dismissed by the medical profession as simply placebo or “quackery.”
In 2013 the cell biology unit at Glasgow University published results showing that mesenchymal stem cells could be induced to turn into bone cells by exposing them to short bursts of specific vibration – a process they term “Nanokicking.” Does this give us a small but significant clue as to one way in which the body may use natural electromagnetic radiation?
“We still do not know one thousandth of one percent of what nature has revealed to us” Albert Einstein
The “science of reflexology” debate is undoubtedly going to continue for many years to come so for now we need to apply some common sense, there are other factors that definitely need addressing. It is time to clean up our act and present a united and credible front, a more coherent public image. There is a very real need for honesty and transparency in reflexology, it is time to ask some important questions – even although the answers may not be what we want to hear.
The benefits of Reflexology?
None of us are in any doubt as to the many and varied benefits of reflexology both at the physical and psychological level. However the benefits experienced by our clients are by no means exclusive to reflexology, all touch therapies will produce a range of physical and psychological benefits as will various exercise disciplines.
The key to understanding this is in recognising the 3 principal effects of these interventions; a sense of relaxation, de-stressing physically and psychologically, and keeping the energy system of the body flowing. If we look at this list of the benefits of Qigong it is clear to see the similarities to those we identify with reflexology. Again a similar list can be made for the benefits of yoga and even regularly walking your dog in the fresh air will produce many of these effects.
For those of you who are unfamiliar with the practice of Qigong, it is an ancient Chinese healing art involving meditation, controlled breathing, and gentle movement exercises. Nowadays described as moving meditation, the roots of this ancient practice date back over 4000 years and predate acupuncture etc. The principal aim of Qigong is to improve and enhance the flow of energy or Qi into and throughout the body.
The movement of energy around the body in order to maintain health and wellbeing is the underlying concept being accessed in Qigong and many, if not all of the benefits that reflexology produces may well be attributed to the movement of energy.
The main benefits of reflexology or any touch therapy can therefore be identified as being an opportunity to take time out to relax in a peaceful, safe and comfortable space whilst allowing the therapist to provide an exchange of energy designed to encourage the body to restore and maintain balanced function.
The question then has to be how does reflexology differ from any other touch therapy? For the answer to this firstly we need to look at where on the body we apply touch; the communication system of the collagen network – the connective tissue – and its potential to transmit, transform and store energy being for me the obvious starting point.
If we view the connective tissue as providing a continuous network running throughout the body and forming multiple layers of communication then it is possible to see the significance of working on the extremities – feet, hands and head. These areas represent the furthest points in the system and as the network is believed to be continuous then we have to assume that connections allow the system to loop round travelling back towards the vital organs contained within the torso and the control centre of the brain; this therefore would theoretically give us access to the various layers of the system. If working on the torso and limbs we can only access the pathways on the surface. Yes firm pressure will reach the deeper layers but the energy transfer will not be as specific.
This picture of “Connie” my “connective tissue doll” will hopefully enable you to see that the feet or hands can give us comparativelyeasy access to the different layers. Working at the furthest points of the network gives us the opportunity to apply touch and thereby influence the individual layers with relative precision.
Interestingly if we extrapolate this theory then we can see the potential benefits of auricular reflexology. The ears being composed of cartilage and therefore part of the collagenous network, working on the ears could give direct access into the skull cavity via the auditory canal and by definition access to the energy network surrounding the brain?
How much influence can the therapist actually have on energy flow?
This question raises numerous concerns for me about the claims of various reflexology techniques and highlights some of the mythology that has become so embedded in reflexology theory.
If we accept that bio-energy exchange is a primary effect of reflexology then can we honestly claim that once the exchange has occurred we have any influence over the energy’s passage through the network or where in the body the energy will be used? This would be like saying that we can influence how the energy from food is utilised by the body once it has been swallowed. Would it even be ethical to do so if it were possible, given that we tell our clients that we do not diagnose or treat specific ailments – although many therapists have a tendency to stray somewhat from this holistic ethos.
In developing Zu Qigong (ZQG) I have been totally convinced that ultimately it is the client’s body that makes the decision as to if and where change is required – not the practitioner. ZQG uses a simple algorithm designed to deliver energy across the whole energy delivery system using the access provided by the feet and lower legs. The routine remains largely the same for all clients with only slight changes made where the practitioner feels there is a “sluggish pathway” – i.e. a few additional gentle passes to encourage a better flow. However if change does not occur after these additional passes then the practitioner moves on with the sequence rather than forcing their will in deciding what is right or wrong for the client, this allows the client’s body to make any changes as it deems appropriate. Sounds mad?….well clients repeatedly report that they are amazed at how different their experience is at each treatment, no two treatments produce the same effect for individual clients.
Similarly this concept raises the question of whether the therapist can genuinely sedate or stimulate a “reflex”. There are many reflexology techniques that incorporate this theory but on closer inspection we have various versions; clockwise to stimulate, anti-clockwise to sedate, some apply this from the client’s perspective, others use the practitioner’s perspective, some techniques apply a difference in direction between the left foot and the right foot…all very confusing and probably irrelevant. If we accept that we are transferring bio-energy then yes working with the flow pattern of the network may produce a more efficient transfer and working against the flow may result in a less efficient transfer, but ultimately once into the system the client’s body will make the alteration to energy flow as it deems necessary.
However this mental focus could be of some significance when we look at the power of intention. As therapists we accept that the intention of the therapist to “help” contributes significantly to the efficacy of the treatment technique, but unfortunately this is an aspect of touch therapy that we cannot scientifically measure, for now we simply have to trust and accept that this is the case. This power of intention theory may well explain why therapists who have attended training in “specialist” reflexology techniques will claim that they now see much better outcomes for their clients.
In Qigong theory mental focus and relaxed breathing lie at the root of being able to move and emit Qi (bio-energy). We therefore need to consider the possibility that if a reflexologist has been taught that they can cause harm by touching a specific point on the feet or that they require specialist training before working with specific client groups, then their ability to transfer energy or Qi will be hindered. Attending the “necessary” training then alters the mindset and confidence of the practitioner and their ability to transfer energy will also be affected – a self fulfilling prophecy perhaps. The placebo effect is not limited to the client but affects the therapist too, if as a therapist you feel confident about the technique you are using then you will feel relaxed and have good focus thereby transmitting Qi more effectively.
Similarly focusing excessively on one specific reflex in an attempt to “fix” an area of concern has the potential to overload that area of the network, causing additional imbalance – forcing the body to make rapid adjustments. Yes this may ultimately bring about a correction but it could also explain the phenomenon we refer to as a “healing reaction.”
Classical V’s Energy based reflexology?
This question comes down to the preference of the individual practitioner and their client base – each to their own as they say. Hopefully I have presented a case worthy of consideration as regards using an energy based approach to reflexology. All techniques work but I personally have opted to leave behind the physiology and disease based thinking of reflexology, I find this approach increasingly muddled, very restrictive, and has a tendency to stray from the holistic ethos that first attracted me to reflexology.
As outlined earlier in this article, reflexology can be divided into 2 separate categories – the techniques that use mechanical energy and those that use a bio-energy approach. It would perhaps be fair to state that there is a case for using one reflexology approach over the other depending on the client’s state of health. I perceive the mechanical or thumb walking approach as being more beneficial in working with clients who are experiencing muscular-skeletal or “hardware” type problems, the thumb walking pressure helping to induce a release of stored tension from the collagen fibres in the network, whilst clients suffering from an internal imbalance in their physiology or “software” problems, will respond better to gentle energy based techniques. The majority of clients who walk through my treatment room door are coping with stress and its related problems and therefore respond well to my gentle energy based technique. If a client is looking for assistance with a muscle or joint problem then I much prefer to work directly on the physical problem area as opposed to the reflected, again applying an energy based technique to relieve tension followed by ZQG to help the body restore an overall balance. All therapists have their own unique approach and will draw on their accumulated experiences and skills, ultimately the client will seek out the therapist best suited to their needs.
From the very first day of my original reflexology training working on the feet “felt right” – and I’m sure the majority of reflexologists will identify with this feeling. Although having trained in many other therapies I have always felt drawn to work on the feet, perhaps tapping in to some ancient knowledge passed down through the generations. However, I have felt increasingly at odds with the evolving reflexology world, uncomfortable with the growing use of clinical language designed I am sure to impress potential clients and boost the public image of reflexology, not to mention the continually growing list of cautions, do’s and don’ts much of which appear illogical – hence the development of my own approach to working on the feet.
It is incredibly liberating to break free from the “rules” of reflexology and work without the anxieties regarding which reflex to focus on, which to avoid, trying to predict patterns of disease, worrying about pressure and causing pain. Using the Zu Qigong approach I have the freedom to enjoy working with each individual client, offering a gentle energy exchange across the entire energy network using the access available on the feet and lower legs, allowing the client to be in control of change. No diagnosing, no sedating, no stimulating, simply working with the physical and reflected energy delivery or meridian system, encouraging the natural flow of Qi using a sequence of light touch movements. Yes I do still adhere to the code of ethics and the contraindications of reflexology – DVT and acute infection, and indeed also include psychotic and bi-polar illness in my contraindications due to the deep effect that ZQG appears to have at the emotional level. I have chosen to blend the anatomical reflection maps of reflexology with the principles of Qigong, to produce a therapeutic approach that works for me as a practitioner and for a wide range of clients; simple, gentle and effective. So yes I do question how much of the increasingly complex approach to mainstream reflexology is actually necessary or indeed any more effective than a good standard treatment routine delivered by a confident therapist.
First and foremost I am a holistic therapist not a clinical therapist, choosing to use simple touch based therapies, and more than happy to leave clinical diagnosis and the treatment of disease to the clinicians who are trained to do so. I am not turning my back on reflexology but instead have taken a very definite sideways step. I have reached a point in my career where I have become tired of all the hype and spin that exists in reflexology practice today, and ask that we stop trying to emulate the medical profession, lose all the unnecessary clinical jargon and be proud of what we do, reflexology is an amazing therapy regardless of which approach you use and does not need to pretend to be anything more. In its simplest form reflexology is a powerful gift so let’s promote this therapy without all the window dressing, stop over thinking things, apply some good old fashioned common sense and get back to honest basics.
“ Any intelligent fool can make things bigger, more complex……..It takes a touch of genius – and a lot of courage to move in the opposite direction”
E. F. Schumacher.