Ep 369 – Getting Comfortable with Mystery with Ruth Werner and Til Luchau

A woman holding her hand to her mouth coughing.

Ruth Werner, host of the podcast I Have a Client Who . . . and a columnist for Massage & Bodywork magazine, has been dealing with a chronic cough for decades. She is now working with fellow M&B columnist Til Luchau to determine what can be done. In this episode of The ABMP Podcast, Ruth and Til discuss the process of dealing with this mysterious chronic cough and how massage may be able to help.

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Author Bio: 

Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably with her Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at booksofdiscovery.com. More information about her is available at ruthwerner.com.   

Til Luchau is the author of Advanced Myofascial Techniques (Handspring Publishing), a Certified Advanced Rolfer, and a member of the AdvancedTrainings.com faculty, which offers online learning and in-person seminars throughout the US and abroad. He and Whitney Lowe cohost the ABMP-sponsored Thinking Practitioner podcast. He invites questions or comments via info@advanced-trainings.com and Advanced-Trainings’ Facebook page.


Darren Buford is senior director of communications and editor-in-chief for ABMP. He is editor of Massage & Bodywork magazine and has worked for ABMP for 22 years, and been involved in journalism at the association, trade, and consumer levels for 24 years. He has served as board member and president of the Western Publishing Association, as well as board member for Association Media & Publishing. Contact him at editor@abmp.com.

Kristin Coverly, LMT is a massage therapist, educator, and the director of professional education at ABMP. She loves creating continuing education courses, events, and resources to support massage therapists and bodyworkers as they enhance their lives and practices. Contact her at ce@abmp.com.



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Full Transcript: 

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0:00:50.4 Darien Buford: I'm Darien Buford. 


0:00:51.4 Kristin Coverly: I'm Kristin Coverly. 


0:00:52.6 Til Luchau: I am Til Luchau. 


0:00:53.9 Ruth Werner: And I'm Ruth Werner. 


0:00:55.0 DB: And Welcome to the ABMP Podcast, a podcast where we speak with the massage and body work profession. Our guests today, as you just heard, are Ruth Werner and Til Luchau. Ruth is a former massage therapist, a writer, and an NCBTMB approved continuing education provider. She wrote a massage therapist Guide to Pathology now in its 7th edition, which is used in massage schools worldwide. Ruth is available at ruthwerner.com. Ruth is also the host of the podcast, I have a client who, which runs every other Friday on this very ABMP Podcast network. And if that wasn't enough, Ruth is a columnist and frequent feature writer for Massage and Body Work Magazine. Til is the author of Advanced Myofascial Techniques, a certified advanced Rolfer and a member of advanced-trainings.com faculty, which offers online training and in-person seminars throughout the United States and abroad. Learn more at advanced-trainings.com. Til is also the co-host of the ABMP sponsored podcast at Thinking practitioner. And if that wasn't enough, Til is a columnist for Massage and Body Work Magazine. Hello, Ruth, Til, and Kristen. 


0:01:54.3 KC: And I'm gonna jump in before and add that they're both CE providers for the ABMP Education Center. 


0:02:00.5 DB: Nice. 


0:02:00.9 RW: Yes we are. It's so... 


0:02:01.0 TL: Great to be here with you. 


0:02:02.0 RW: It is really fun to be all in the same room at the same time. 


0:02:05.3 KC: It is. And podcast listeners, we are gonna take advantage of this unique opportunity to have both Til and Ruth with us in person and we're gonna talk about something that they're working on together. Our topic for our pod today is getting comfortable with mystery. So we're gonna start the conversation by asking Til and Ruth what brings you together in person to our studios today. 


0:02:29.0 RW: I'll take that on. So many people know that I live with a chronic cough and have done for decades and last spring I was co-hosting the Back Jam, an ABMP sponsored event with Diane Murkowski and Til was one of the presenters. And he presented a segment on working with the ribcage and during which he talked about having a friend come visit and be the model for this segment. And that he had a chronic cough that he felt was, had some improvement because of this work. And that made me, completely take advantage of my friendship with Til to say, hey, Til, how would it be if I came to visit you and you maybe tried to see if we could get a handle on my chronic cough? And he was a very good spot. And after he figured out that I actually, yeah, I meant it. 


0:03:19.4 TL: Yeah. I was like, sure, why not? And then you like, meant it. I'm like, okay, [laughter] 


0:03:25.6 RW: And so here we are, we're taking advantage of, I am completely taking advantage of the opportunity to stay with my friend and see all of my friends in the area, but also to get some body work to deal with this condition that I have lived with probably since around '96 or '97. 


0:03:48.1 KC: Yeah, we'll definitely talk about the body work and the techniques, but first Ruth, I know a lot of people listening are probably asking, do you know the cause of your chronic cough?  


0:03:56.3 RW: Well, yes and no. I mean, I know some contributing factors. So at that time, from the late '90s and up until 2010, I lived in a suburb of Salt Lake City. So I was at 5000 feet of altitude. We were trapped in some very poor air quality. There's oil refineries and gravel pits and temperature inversions. And also during this time I was working at a school, I was lecturing probably 12 hours a week. I was singing in a church choir and I was traveling 10, 15 weekends a year to do, eight or 12 hours of lecture over a weekend. And between all of those things, I developed a cough. And in many ways, to me it seemed that the cough took over from my regular seasonal allergies. 


0:04:47.9 RW: I used to have just really awful seasonal allergies with coughing, with sneezing and runny eyes and itching and all that stuff. And it was so odd that one year it just seemed to stop. I didn't have my seasonal allergies anymore, but that's when my cough developed. And I don't know what the point-to-point correlation is. I just noticed that that was a change that happened, but then my cough just didn't get better and it didn't get better and it didn't get better. And if I ever get any little respiratory thing, it gets blown way, way up. I have, so in terms of causes, probably it was a combination of a number of different things. But even after having been away from that environment now for 13 years, I continue to have a cough and it would be really lovely someday to not have a cough, but I'm not 100% sure that that is ever gonna happen. 


0:05:36.5 DB: So, Ruth Listeners probably wanna know, you did move from the Utah area to... 


0:05:42.4 RW: To the Oregon coast with the best, cleanest, freshest air on the planet. 


0:05:47.6 DB: And that didn't change anything. 


0:05:48.7 RW: It did not change anything. I was hopeful because I noticed when I lived in Utah, when I could travel to sea level, that it, to me, the way I described it, it was like breathing balm. It felt so good to bring in some air that wasn't hot and dry. But living in Oregon has not made a substantial change. 


0:06:10.1 KC: And over the years you've seen different types of practitioners and received different types of treatments from acupuncture to chiropractic, etcetera. Tell us a little bit about that. 


0:06:19.3 RW: Yeah, so, the first thing that I as a pathology educator wanted to do was rule out worst case scenarios. And so I spent time in the conventional medical community going through lots of tests. They tested my thyroid, I had thyroid nodules. That was really exciting and a few other things. And after all those tests, you get the call that probably lots of our listeners have had, which is to say, "Congratulations Mrs. Warner, there's nothing wrong with you." And I kind of respond by going, "Oh, that's awesome. Thank you so much." And, it's better that I don't have tuberculosis or congestive heart failure or any number of other worst case scenarios, that's fine. But it didn't leave me with a lot of options. One year, I had some colleagues through the school where I was teaching, so I spent a summer going every week to an interdisciplinary clinic where I would get acupuncture and, craniosacral work and chiropractic. 


0:07:15.6 RW: And I think there was another intervention. And there was a naturopath there as well. And it felt to me like over the course of that summer, we maybe, made some progress. And then it was over and we didn't, weren't, very careful about writing down who did what when, and the benefits subsided. And, here I am again. And since that time I've continued to go through pretty extensive testing and went through a lot of work at OHSU, Oregon Health Sciences University. They put a scope down to watch my larynx and my swallowing. And they were a little bit appalled when they asked me to speak. And they, basically, they said, count to 10, 'cause they wanted to watch the thing on the TV screen. 


0:08:00.5 RW: And I went, one, two. They're used to people going as fast as they can because it's not pleasant to have a garden hose shoved down the back of your throat. But I was just into, I was fascinated to see what they saw. And they saw I have a tiny, tiny little bit of excursion with a hiatal hernia. I don't have reflux and I don't have anything else that they could identify. So they basically sent me away saying, yeah, it's... The best we can give you, is some kind of motor neuropathy. And here work with this speech pathologist, which I did with some success. And still have a cough. 


0:08:35.6 KC: And that leads us to today where you're here to work with Til. So Til, talk to us, what's your thought process when a client like Ruth comes with a chronic condition that may not have a identifiable cause?  


0:08:48.3 TL: Those are the most interesting ones to me, because there's always multidimensional factors going on in every symptom. And the times that nothing seems to help or we can't figure out how to stop the symptoms that we want to get rid of are the biggest opportunities really for shifting the way we see things, the way we work, and getting really adaptable as a practitioner or really finding a way to work with our clients as opposed to working on them. If there was a magic muscle I could just massage and stop Ruth's cough, that would be wonderful. But it is not known. 


0:09:23.4 RW: That's not how it works. 


0:09:24.8 TL: Yeah. It's not known to me. 


0:09:26.2 KC: Darn it. 




0:09:27.3 TL: So, if you're still listening now after hearing that [laughter], then I wanna try to talk about what I hope does help. And it starts with, and it's wonderful doing it with you, Ruth, because we are friends and colleagues and you're an educated practitioner yourself, you're in the field. So I get to narrate almost to myself. I get to think out loud with you. And that's kind of the approach I take with my clients maybe in a different way. But really I'm looking first and foremost to become co-investigators in this question of this mystery that we're presented with, a symptom that you haven't been able to find relief from. 


0:10:05.2 RW: And we're going on this little adventure. 


0:10:07.9 TL: Yeah, that's right. Really that's, what that's doing is it's laying out or maybe it's recalibrating the expectations because people want not to cough. They want the shoulder not to hurt, they want the migraine to go away. That's why they come to us. And we as practitioners wanna help them with that. And it's amazing how often we can, we just do our work and that symptom is gone and yet, and then sometimes... 


0:10:30.2 RW: And then sometimes there's people like me, and one of the things I have learned, and you just alluded to it, is the crossover. First of all, chronic cough is not rare. It's really common. And doctors hate it because it just doesn't respond to the easy fixes. And there's so much overlap in the life experience of living with chronic cough as compared to something like living with chronic pain in the sense that it's invisible. It doesn't have a specific cause, doesn't have a specific way to fix it. And it impacts virtually every part of my decision making through the day. Now I'm not trying to suggest that people who live with really severe chronic pain, don't have it bad. And I feel like I'm, have come to a certain level of peace with living with a chronic cough, figured out appropriate accommodations that work for me. But it is, there are similarities to, for lack of a better word, to being stuck with this challenge. And it certainly has given me a different understanding of what living with chronic illness is. 


0:11:38.5 TL: There's a lot to say about that. There's, having had chronic symptoms myself that no one could help me with, and those being really influential in my thinking, in my work and in my approach, there's a lot we could say about that, including the sense of aloneness or hopelessness or not being believed or being minimised. All those things that can come with. Yeah. There's nothing wrong with you. We're happy to tell you that. 


0:12:01.6 RW: Yeah. We have a limited bandwidth. And so my goal, and then the goal that I suggest for people who live with chronic illness is to understand, it's there, it's part of your, of what's on your plate. What we'd like to do is help it be a relatively small part of what's on your plate, and that your plate is filled up with lots of other things that you love. But that's, and that's not my, I did, that's not my imagery. I didn't make that up. Someone else made that up. But it works for me. And I feel like in general, I'm pretty good at that. And there are times when it just really, really makes me angry that I'm living with this stupid thing. 


0:12:38.7 KC: So Til, talk to us about your process. I know Ruth was first introduced to this idea from a class you were teaching about working with the ribcage. So I'm guessing, is that where you're gonna start with Ruth and then you'll explore and keep trying and do different things or? Tell us a little bit about your treatment planning process?  


0:12:57.4 TL: We are a practical culture, body workers, massage therapists. We wanna know what to do. We wanna know what structure to target, how to do it, how many times to do it. And if we knew that there wouldn't be chronic symptoms. And so a lot of it is, like my, I do have a process. And the process starts with, again, a relationship, starting this co-investigator relationship in a way that we can discover together what makes a difference. And for me, the difference can go either way. 'Cause if I can provoke a cough that is really useful information, and similar with a lot of symptoms, if like a headache, if I can find a place that increases the headache, I am talking through the headache, through the mechanical factors within the headache. And in theory, if I can make it worse, maybe we can find a way to make it better too. At least we know it's malleable, it's changeable. And sometimes that by itself gives people a lot of hope. Like you can out, there's actually something I can do that changes this intransigent chronic symptom, whether it's a headache, a cough, or even pain. 


0:14:01.3 RW: And that feels to me, especially true when you're talking about central nervous system involvement. Because this is essentially at this point, a type of central sensitisation. And, it is easy to leap to the conclusion, oh, well, swear word. That's my central nervous system. That's never gonna change. 


0:14:20.2 TL: You're talking about like the cough centers in the brain that trigger the physical response of coughing. They're part of the central nervous system. 


0:14:28.4 RW: Exactly so. And so... And we, historically, we don't look at that as being very malleable or very adaptive once a pattern has become established. 


0:14:40.0 TL: How do I massage that too?  


0:14:40.7 RW: Right. But as we see with the way people are now thinking about manual therapy and chronic pain, what, maybe we're not getting rid of it. Maybe we're just turning down the volume and then the central nervous system can maybe step in and reset some trigger settings. 


0:14:57.8 TL: Yeah. Okay. So getting the rapport, getting this co-investigator relationship, trying things together, seeing if we can provoke or relieve it in service of learning about it, but also maybe changing the, here's the big one, the disturbance that causes, or the reactivity that happens. If we think about pain for a second, pain is complex. It's many things, but on one level it's a sensation, on another level it's an emotional reaction. All kinds of things rolled in together. And teasing those apart can be really, really useful. 


0:15:30.8 RW: And so I wanna explore that. You and I kind of started this a little bit earlier. And I'd love for you to take that word disturbance and unpack that a little bit, because that can mean different things to different hearers. 


0:15:42.3 TL: Absolutely. I think of myself... Is almost a working hypothesis, but let me give it to you. I think of myself as someone who works with disturbances of symptoms. The symptom is the proximal experience, let's say. It is what we target. We want to try to change it so that I'm not disturbed. But the reason people come to me is 'cause they're disturbed. Not everybody with a chronic cough comes to me. It's the people that are disturbed by the chronic cough. 


0:16:06.6 RW: It's the bothersomeness. 


0:16:08.3 TL: It's the Bothersomeness of it. It's what I don't want to be. 


0:16:11.2 RW: Well I'll raise my hand to that 'cause I'm... 


0:16:13.2 TL: Yeah. And why should you?  


0:16:14.6 RW: Highly bothered by it at this point. I'm tired of having to put a happy smile and make the mitigations that I make every single day. 


0:16:23.8 TL: Which is where it gets complex because there's so much, the A word, which I almost never say with clients is acceptance. There's so much to say, "Okay, so if we can't get rid of it, let's just work with accepting it". And that sounds like defeat for so many people who are really bothered by what they have going on. 


0:16:39.5 RW: Yeah. And I, and that's where I live, I live in... 


0:16:41.4 TL: Yeah. You're already working with that. You're already playing. 


0:16:45.1 RW: Yeah. And I can do it. And I've managed to build a career as a speaker against all odds. But what would it be like if I didn't have a cough? [laughter] And I'll tell you one of the things that I saw that was a little hurtful to me. It was on Facebook and it was in a conversation where people were talking about me. And then I happened to stumble across it and someone said, "Yeah, I went to a class with her and she was coughing the whole time, and she never covered her mouth. And what is this chick doing teaching pathology?" And it felt so awful. And I completely understand it, and I always introduce every class saying, "Hi, I'm Ruth. I live with a chronic cough. I'm not sick." But I can, it's one of those things that become, it makes me feel very, very self-conscious about, especially in any kind of face-to-face setting. 


0:17:39.2 DB: Ruth, when you cough, does it release and the whole process slowly begins again?  


0:17:44.2 RW: I don't know for sure that this answers your question. When I cough, it feels like I'm scratching an itch. And so if you're aware, we were talking at lunch today about people having great big mosquito bite welts. And you can decide, I'm not going to scratch that, but it takes all of your focus to not scratch that for a really long time until your nervous system has something else to pay attention to. And that's a lot what this is like. So there's a relief in the sense of, I scratch that itch and I know that's not the last time that's gonna happen. [laughter] 


0:18:21.9 KC: Let's take a short break to hear a word from our sponsors. 


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0:19:08.0 KC: Let's get back to our conversation. I wanna come back to something you said earlier, Til. You mentioned teasing apart the physical and emotional experience. Can you talk a little bit more about that?  


0:19:19.1 TL: Sure. And that might be just the same strategically, it might just be as simple as having someone describe what happens when they cough and really slowing it down to that present moment, body-based experience, which is huge in and of itself. We're not used to living there, and it takes a while for some of our clients to even know what we're talking about. But if we can find ways to get people interested in their actual sensations, like, oh, it actually, we were playing with yesterday. It starts as a tickle or some kind of sensation deep in here, and I can't touch it, but it's in there somewhere, that by myself is an important first step as we have now defined it, described it as a sensation, and it's not a cough yet. It's not even just, maybe not even disturbing yet. It's just a sensation. The basic kinda mindfulness idea that just paying attention to something, is a lot in itself and that then everything else can kind of build around that. 


0:20:12.0 RW: But the paying attention to it can make it self-fulfilling. 


0:20:15.6 TL: Make it self-fulfilling, mean lead to a cough?  


0:20:17.5 RW: Mm-hmm. 


0:20:18.3 TL: Okay. The other thing I want to do is, move the goalpost a little bit. If it's a long-term chronic symptom, one of the early things we need to do is recalibrate expectations around that and change what's gonna be a satisfying outcome. We come up together with even the idea to investigate and let's see what happens. And there might be a place in there like, okay, so what would be satisfying or what would make this worth it? If we weren't able to find the magic cough muscle and massage it, what would make this time valuable to you? So when a cough become, you're talking about the cough is self-fulfilling, I think, and I say... I said this to you. This is awesome. I want this to be a time [laughter] when you can cough as much as you want. In fact, the more you cough, the more we can trigger it. The more we can self fulfill it in this context, the more helpful it's. 


0:21:08.8 RW: And I acknowledge that eliminating the cough is not a realistic goalpost. It would be awesome. 


0:21:13.0 TL: Yeah. 


0:21:13.8 RW: A, To cough less, and B, To have more tools to have a little bit more power over how much it impacts my life. 


0:21:22.4 TL: A little more power. Have some tools, have a little more power, and you're a sophisticated client. Everybody kind of knows that. I mean, on some level people get it. They're like, oh, you haven't been able to get rid of this. Maybe there's something useful here besides just getting rid of it. People are open to that on some level and on another level, if it hurts, we just want it not to hurt. It's that simple and that's really human and really understandable. So it's holding... For me as a practitioner, it's holding this paradoxical possibilities and goals as we investigate together. 


0:21:54.1 KC: Yeah. And we talked about getting comfortable with the mystery and that's for both the practitioner and the client. So we are talking about setting realistic goals and changing the goalpost for the client's expectations. But talk to us, Til, about how a practitioner who only wants to help and do the best they can for their client, can get comfortable with the idea that you may not be able to find that cough muscle and solve the problem. 


0:22:16.9 TL: The practitioner only wants to help, you're in big trouble. Or we gotta, what we have to, really have to do is redefine again what that, move that goalpost, what does it mean to help? Because honestly, there's a lot we can do to help, anything, anytime, anywhere. And that's what I am loving about listening to your pathology podcast over the years, is that I see that nuance emerging more and more that you really do bring in, well, this, we're not doctors, we're not medical people. We're not actually about trying to... 


0:22:47.8 RW: Fix this. 


0:22:49.4 TL: Fix this or cure this, or whatever it is. And yet there's a possibility here for us practitioners to really do some good, really support people, really relieve things, really help in many, many ways. 


0:23:00.8 RW: What's your strategy? What are you doing with your hands?  


0:23:03.1 TL: What exactly are we gonna do with our hands? We started yesterday, actually we started a couple months ago when you came by a class I was teaching and we got half an hour, whatever it was, just to experiment a little bit. And we did that with you soup on, I think. You were lying on the table after a class. Said, I'm just feeling and you were asking questions, what happens here? What happens there? And we didn't catch a fish, meaning we didn't provoke a cough. And... 


0:23:27.9 RW: And I was surprised because I fully expected you were working very specifically in my anterior throat. Which is where I reported. That's where it feels tied up to me and nothing happened. 


0:23:39.8 TL: But nothing happened. We didn't find a spot that made you cough, which I did... I'm not surprised about because the thing that coughs is our throat. But there's a whole lot more involved. And like the story I told in the back jam, it was my friend who's in Denver seeking a thorough eval for a long-term chronic cough for him staying at my place, helping me with some filming and just put him on the table for a demo and working on his ribs. He goes, whoa, that's my cough in there. I can feel that. And so he made a somatic or felt connection of how this thing in someplace we didn't expect at the side of his ribcage was actually very connected to his impulse to cough. Though I didn't necessarily expect to find something in your throat, even though it was your throat that coughs it would be connected. 


0:24:25.9 TL: But we still had to rule that out. Yesterday, we worked as a upright position, which is a lot more relevant to coughing and speaking and breathing and, those kinds of things. Then lying down on a classic massage position. And we... I was again, experimenting to see if we could find a place that would either provoke or relieve the ongoing urge to cough. And the focus was what, for my hands, was what moves and what doesn't. And we started with some outer structures of your shoulders, your ribcage, the upper ribs, layers of skin and superficial fascia around your throat, neck, back. And then we moved into some deeper, scaling movement with you gently turning your head. 


0:25:12.8 TL: And I was feeling mobility differences left and right. So that was curious to me. But then I was coaching you through some gentle head rotation while I would coax those, Myofascial compartments otherwise known as muscles, to glide evenly left and right. There was a difference. And it seemed to be getting, my interpretation was I was getting good feedback from you verbally, non-verbally, that seemed to feel interesting or good enough to continue. And we played with that. And as we were going through this, I noticed that you were not coughing. We had you exploring with the origin of the cough describing to me where you felt it start. We were experimenting with movement, where you were feeling the possibility for movement. And we learned a few things about this. What would you call it? An electric. 


0:26:05.6 RW: I felt I had identified a portion of my neck that felt like a band of static. And then after the neck work that you did, it felt, what was the word we used? I think I said it felt scrubbed, it felt fresh and still does. 


0:26:20.1 TL: Yeah. We identified some of the sensations that arose with the beginning of the disturbance. We shifted that to a different sensation and even a different image or different metaphor there. And we called it a day. 


0:26:34.6 RW: Well, and then, shortly before we wrapped up, I got started again. I inhaled the wrong flick of saliva or something. I don't know what it was, but it was a really hard one. It was like made up for all that lost time. And I swear to God it was not on purpose, but it was a much more severe, long lasting, it was a fit. It was a, yeah. And I'm, and I was so angry. I was so angry because I thought, I was almost there. [laughter] 


0:27:03.5 TL: I was almost enjoying not coughing. And then, yeah. 


0:27:08.0 RW: Yeah. And that's another aspect of the disturbance issue because it's not just living with a cough. It's being really mad about it. [laughter] 


0:27:14.9 TL: And again, because I'm talking about you here, I can narrate what was going on for me there. I wouldn't necessarily say this to my client, but my role that moment was to normalize that and to help give you other options to thinking like, oh, now I blew it. And the metaphor I offered was, okay, so you get a massage, you're driving home, someone cuts you off in traffic and you get tense again. Have you totally wasted all the value from the massage? Probably not. Maybe if in this case... 


0:27:42.7 RW: Yes, but I had some pushback to that. [laughter] 


0:27:45.2 TL: We had some little discussion about that. Yeah. 


0:27:48.4 RW: Yeah. Because having a bad driver is an external event. And as someone who has had that experience with some frequency, right? You get a lovely massage and you, and something happens on your way home and it rattles you. And then you have to sort of consciously decide to go back into equilibrium. But for me, the cough, rightly or wrongly, or, what's the word I want, usefully or not usefully, my cough is part of me. It's internal to me. And you said, well, okay, so stop your digestion. That's part of you. Can you do that? And [chuckle] obviously not, but I can... 


0:28:29.4 TL: We got into a fun mental, yes. 


0:28:32.2 RW: Yeah. But I can take steps and consciousness have make, take conscious actions to influence my digestion. And probably still digest things. Anyway, it was a little frustrating. 


0:28:48.1 TL: And you're saying maybe that you don't feel that in terms of, in relationship to your cough?  


0:28:54.5 RW: Not enough. I take a lot of steps and I manage my cough pretty well, which is why I can have the work, you know, do the work that I do. But there are times when I would give a lot to not have a cough. 


0:29:08.1 TL: For me as a practitioner, it's an interesting moment because it's so easy also to fall into being the ambassador for hope. To being the one who's gonna hold that point of view and reassure you and find reassuring metaphors maybe that you've found ways to debate a little bit. But then we could get into a debate. Is it gonna be hope or is it gonna be helplessness, [laughter], which instantly we've almost solidified our roles. I've taken the hope position, you're stuck with defending the other side. 


0:29:33.8 RW: And then how much am I holding onto this, just because it's part of my personality now, right? And I don't wanna be that person. But I do wanna be realistic. 


0:29:43.3 TL: There you go. 


0:29:43.8 RW: It is, again, this takes me back to the conversation we had about Fibromyalgia years ago. Not years, months and months ago. Last year sometime you and I and Angie did a podcast on Fibro and talked a lot about what it is to live with chronic pain and have that chronic pain become so much a part of your identity, that that is another obstacle to letting it go. And I wonder how much of this is true of me. 


0:30:08.5 DB: Beautiful. Does anybody have anything else before we bring the podcast to close that you wanna say?  


0:30:14.8 TL: Can I have another session or two we're gonna do before you go. And I'm gonna... This briefly, I'm gonna broaden the lens. We're gonna, I think we'll find out, but I think we're gonna investigate more places in your body, more positions. 


0:30:28.3 RW: I can't wait. 


0:30:29.1 TL: That sounds all right to you. 


0:30:30.0 DB: Yeah. Listeners, I hope you loved this as much as I did. This has been fantastic to actually work through the process of body work sessions and to think intensely, fairly intensely from the perspective... Hearing the client out and hearing Til's approach to how they will be working together. So I want to thank our guests today so much Til Luchau and Ruth Werner. To find out more information about both of them, visit ruthwerner.com and advanced-trainings.com. Thanks Til, Ruth and Kristen. 


0:31:02.8 RW: Thanks everybody. 


0:31:03.6 TL: Thank you for having us. 


0:31:05.1 KC: And thank you both for being with us and for that really open and honest conversation. Your willingness to share so much of your story will really help listeners in both their roles as a practitioner and client. I know that for sure. 


0:31:26.0 S1: Members are loving ABMP 5-Minute Muscles and ABMP Pocket Pathology. Two quick reference web apps included with ABMP membership. ABMP 5-Minute Muscles delivers muscle specific palpation and technique videos, plus origins, insertions, and actions for the 83 muscles most commonly addressed by body workers. ABMP Pocket Pathology created in conjunction with Ruth Warner puts key information for nearly 200 common pathologies at your fingertips and provides the knowledge you need to help you make informed treatment decisions. Start learning today. ABMP members Log in at abmp.com and look for the links in the featured benefits section of your member homepage. Not a member, learn about these exciting member benefits at abmp.com/more.


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