McWilliams: I would to ask you a few questions about how you work with clients who are in pain, especially in chronic pain. I?m going to cover a couple of areas: from an historical perspective ? the things you got from Dr. Rolf; from a clinical perspective, what you?ve picked up from your own experience; and any of the other strong influences on your work, such as Dr. Philip Greenman. Where would you like to start?

Jim Asher: I?ll start with Dr. Rolf, since I studied with her first. Dr. Rolf was really good at working with painful problems, but she did not believe in chasing pain. Her whole idea was to make space in the body by systematically working with fascia, balancing around the joints, and getting clients ?on their Line?; that?s the whole idea of the Ten Series. You simply can?t make space in the entire body in one session. It would be nice, but you can?t do it. Clients would love it, but there?s too much fascia to lengthen. She was good at working with pain. She would work on one or two places and open you up and balance things to the point where you didn?t feel pain. ?Prepare the way, get it in balance, and get out,? she would say. She would not necessarily work where the pain was. Sometimes she did and sometimes she didn?t, but she would find those connections that gave you enough space so that you didn?t feel pain when you got up and walked.
In 1971 she lent me The Cranial Bowl [by Dr. Sutherland] and that?s how I got started. I went to some early craniaosacral classes and in 1983 a spinal mechanics and Muscle Energy Technique (MET) [class] with Dr. Richard MacDonald. This led me to take an in-depth program by Dr. Greenman, author of Principles of Manual Medicine. He had done extensive research on low-back pain. Dr. Greenman believed that resolving pain takes more then one treatment. He had a systematic way of teaching over five classes, plus later advanced ones, and all of the classes built on the previous ones. Studying with Greenman I realized that he had an almost identical vision with Dr. Rolf. If you took his blueprint and Ida?s blueprint they were almost the same. No contradictions. There were some differences, but they both believed in getting space around the joints. In Greenman?s classes you got lectures with a lot of detail and were working at tables with good supervision. The supervisors were all sharp, mostly MDs, PTs, or DOs.
When I rolled my car I injured my back and was in a lot of pain. I went to this very good Rolfer and had gotten some relief. I also went to a very fine osteopath, Dr. Harold Magoun Jr., and had gotten some more relief in the lumbars, but then the pain came back because my sacrum was still out. When I was in the third class with Dr. Greenman, he put me on the bench and did some work and he got to my core problem. The Rolfer and Magoun had got everything but this one thing. Greenman was able to get this one thing. It?s not to take away from these other people. They were doing great things for me.
From these experiences I got more interested in pain. I liked studying with the osteopaths because they had the big picture. They worked with all the joints, and had a sense of how they all connected. They also understood fascia but they didn?t have the time to work with it. So I decided to try to put these two things together. Now everybody has gifts. I never met anybody who didn?t have a gift. I?d have to say that my gift is overlap. I am good at overlapping. Takes me a while. I?m slow. I am not a fast thinker. I kept sliding things around and then I would see the overlap between these two fantastic systems of manipulation. Their blueprints fit each other. So that?s what I worked with. Dr. Greenman and Dr. Rolf used movement. Dr. Rolf believed in giving people balance in function. Greenman believed in specific exercise to support the problem area. He would say, ?Well, I can open that joint but if your gluteals aren?t working you?re just going to collapse again.? So he also believed in giving people certain exercises.

RMcW: Similar to what a PT might be doing now?

JA: Right. Greenman taught at Michigan State. They have a physical therapy department there and he had some influence with them. In his book he shows exercises that helped him. You know he had a really radical scoliosis ? in his second book he actually shows the scoliosis. The thing about Greenman was he was always on point and he expected you to be on point. In twenty-five days we covered every detail in his textbooks. All of his assistants were prepared to teach every detail of his books. He was always on time and he expected you to be on time. All of his assistants were always on time. You had to be ready to go. At any rate, I had pain and he worked on me on the bench and when I got up and walked, I had perfect mechanics! One of the things that?s different between Rolfers and most PTs is, I think, we feel our bodies more. We pay more attention in class to how things feel. PTs are bright people but in their classes they don?t care so much about how you feel, but whether you know this or that. So when I got up from the bench I could actually feel my sacrum moving perfectly. I was going on about my sacrum and how I could feel my ilia, and when I looked around, everyone was looking at me like I was a goofball [laughs].

RMcW: Because you could feel what was actually going on.

JA: Right. So then I realized that I had to tone it down a little bit in explaining my experience. But I was out of pain and I stayed out of pain, because he had gotten that last piece.

RMcW: Would you call that the primary restriction approach? Identifying the primary lesion or restriction?

JA: Well, it could be. That would be one way of doing it. Now you have to remember that I knew I was going to this class [with Greenman], so I went and had a Rolfing Structural Integration (SI) session and I received work from Dr. Magoun, who was a genius himself. So in a sense, I was all set up to get work in this class. Now Greenman had a syllabus to follow and in looking at that syllabus I thought, ?That?s my problem? ? I figured out I had a left posterior torsion. We were working on each other, and I had already had my lumbars cleared out. So in a way, when he worked on me, there wasn?t much left. My system was pretty clear. He had me on the bench and he moved me and he knew exactly where he was going. It was amazing! He made it look simple.

RMcW: So would you say it was just really excellent palpation?

JA: Yes, it was excellent palpation and he was really dialed in. He moved my body and had me move with him, like two good tango dancers working together. I was able to let go and let him move me. He was the lead, so to speak, and I was the follower. You know when you go to a chiropractor and sometimes you?re not able to relax? With him, I was totally able to relax. He combined guided movement and MET. He didn?t thrust on me, by the way. Well, he kind of did but gently, and I was moving the whole time while seated on the bench. I remember Dr. Rolf teaching us how to work on the bench, and she would see someone working and she would say, ?Stop right there!? Then she would put her elbow in somebody?s back. She had a big soft elbow. People don?t remember that. She had a very comfortable elbow, not a pointed one. She would stop at one place and she would say, ?Now breathe right here.? Or she would have the client drop his head slightly, find his sitz bones, or have you move your elbow, and with that, she would get the joint to open. Ida was constantly calling for movement. When she started teaching the movement work, people didn?t understand how she used it, how she called for movement that was supposed to open a joint. Ida was not good at explaining the movement she called for. She understood it, and she thought you could see it.

RMcW: Would you say that an important focus for working with pain is through movement work, or through identifying appropriate movement through, say, a shoulder joint or vertebra?

JA: Right. Pain is typically when we have a collapsed joint or something is pinched. And if you can get that joint, whether it?s a vertebra or a shoulder or a knee, to open up a little more in the right direction, typically the pain will disperse. With Rolfing SI we have the ability to build a body better, so that the pain won?t come back, because we can get the person more balanced.
If you buy into the total concept, we look at what is above and below and how it?s going to help. That was Ida?s gift ? to look at what was above and below and see how that was going to assist this area in staying open. Keeping space. Whereas other people think about keeping space but they don?t look above and below. Greenman would look above and below and say, ?Okay, now you have to go down to the sacrum.? He had the full vision. He liked [working with] fascia and he had had [a number of Rolfing SI sessions] by a couple of different people, but he preferred to focus on the joints and on the nervous system too. So, I?ve had parents bring in babies with torticollis and you have to get length and space in those cervicals to relieve the torticollis. In working with, say, a clubfoot, you have to get the bones to move, but you also have to get the fascia to move too.

RMcW: So, say you have a client come in who has limited funds and has neck pain. What do you do with that client?

JA: I tell him that [by doing just a couple of sessions] I can only fix this for while. He really is going to need a full Series. I think I sometimes fail clients by not telling them they need a full series at some point. Realistically, you can get them out of pain for a couple of months, but unless they have had a lot of work, it won?t last. So if the person has neck pain, I?ll give a shoulder-girdle session including the arms. Again, you have to work above and below. I do translation [of the joints]. Now I don?t do any thrusting, no high-velocity work. I do low (slow)-velocity work to get that joint to move in the three planes of movement. When you get that movement, and you create that space, he?ll be out of pain for quite a while.
And you have to work around the nerves. [Before he passed away,] Don Hazen had been teaching Rolfers how to work with the nerves. Jon Martine is really good at teaching this. So you have to include the nervous system, as well as the craniosacral system, in your view. If the client has neck pain, the brachial plexus may not be sliding. You have to get that brachial plexus to slide. And this is the brilliance of Ida?s First, Third, Fifth, and Seventh Hours ? how to open up the thoracic outlet: get space around the upper ribs, get the clavicles up off of the ribs, get the shoulder girdle repositioned, and get some freedom in it. You?ll be taking pressure off those nerves. And remember, we have eight cervical nerves and they all need to slide. Just moving the joints isn?t going to do it, although the person might feel good for a day or so. But if you can give a good upper session and make sure that plexus is sliding, you?re going to get that person out of pain. You have to be able to palpate the plexus and work around it and not injure it. That takes understanding your anatomy well. Some Rolfers want to learn tricks, but they don?t want to know their anatomy. Having a deeper understanding of fascial anatomy and nerve anatomy will help you get your work to be more effective. So to understand pain, you have to have this perception of the systems. Ida wanted us to learn all the systems, but she felt that the fascial system was the easiest way to get in there. From there, you could enter into these other systems more easily.

RMcW: So, the primary way to approach working with pain is to get good mobility in the fascial system, and from there working with joints and the other systems of the body. How do you know how not to overwork something? You can over-mobilize something. How do you address this?

JA: Again, you have to remember to work above and below and then you?ll have a session with a beginning, middle, and end. At the end, you?ll tie it all together. Now clients will want you to keep working on where the pain is, but you have to tell them that it is all tied in together and you are going to wrap everything up at the end. Ida?s sessions always had a beginning, a middle, and an end. She would set it up, go to the problem area, balance around it, then have you get up and move. And she would get people out of pain. Greenman and Magoun also worked this way. Magoun would work on you for twenty, twenty-five minutes, with the last five minutes being cranial work. That was when he would balance the nervous system so that you would hold the adjustments.

RMcW: I know that we were taught to work that way, to have that integrative element. So are you saying that in working with pain you should allow a little more time for integration?

JA: Right. Now the problem is that people with pain don?t understand this. Most of my practice is dealing with clients in pain, and I have to explain to them that we need to balance things. Then they?ll start to tell me about these other pains and want me to work on those areas. I have to tell them that we can work on only two or three pain areas at a time, not four or five. The osteopaths know this. Greenman said, specifically, to never think you can fix someone in one session. It may take three, four, five sessions ? you just never know. He thought it was foolhardy to tell someone you could get them out of pain in just one session.

RMcW: This makes me wonder about the attitudinal piece of not trying to do too much in one session, but rather to just try to bring the person to a higher level of order.

JA: Yes, you can bring them to a higher level. Sometimes, though, you do get lucky and it all comes together in some sort of magical way and the person is out of pain. The problem is that it won?t happen every time. You also have to get your clients to do some things on their own. I?m always suggesting yoga classes. I teach clients stretches that will help them. Some people do them and I can see that it helps, while others won?t do them.

RMcW: So another approach to working with pain is to empower the client to take more responsibility for his own situation.

JA: Right. I have about five clients right now who have spinal stenosis and are in a lot of pain. So with them I?ll do some Rolfing work, some joint work, some cranial work, but I?m also trying to help them find their own ?sweet spot.? If you can get a person [with stenosis] to move through his spine, to feel his spine, and then balance his curves, you can get him out of pain. To stay out of pain, he has to have overall tone. Most people with stenosis lack tone somewhere. They may not have good core tone even though they have been doing Pilates. Maybe they have a good Pilates teacher, but the Pilates teachers are not putting their hands on them like a Rolfer does. So I show them the place where they need tone. I tell them to keep going to their Pilates class, but here is the area I want them to get more tone.

RMcW: Core stabilization.

JA: Yes, core stabilization is exactly it. Now you don?t want them to over stabilize. They may have a strong iliacus, but be weak in the transversus [abdominis].

RMcW: So it is this hands-on feeling instead of just getting a conceptual idea from the Pilates teacher.

JA: Yes. These people need to keep going to their Pilates class and strengthening their core. We don?t do that in Rolfing [SI]. We don?t strengthen the body. We give them length, then they can go out and build strength. People get irritated when I tell them this. They don?t want to have to do anything themselves. They just want to come and see me. But I believe it is my duty to tell them that they need to strengthen this or that part of the their body, and then they will be able to stay out of pain.

RMcW: Excellent.

JA: This is the same as in the Rolf Movement® work: like teaching people how to use their core and walk through their hinges. A lot of clients think this is stupid. They?ll say that they went to a movement teacher and all he did was show them how to walk. Well, knowing how to walk properly can keep you out of pain.

RMcW: That?s a great statement.

JA: Learning how to walk is not a waste of time or money [laughs]. Some people don?t make that connection. Dr. Greenman believed in gait analysis. Now he might send them off to a PT, because he didn?t have the time.

RMcW: Is it fair to say that, for you, when focused on resolving pain it is important to use the lens of structure, while also working at improving client function as a long-term strategy for mitigating pain?

JA: Right. Even when working with people with neck pain, I look at how they are sitting and help them try to find their Line while sitting. I actually do more sitting analysis than standing analysis now. They are probably sitting at a computer all day, so I?m going to work on how they sit. That?s probably where their pain is coming from.

RMcW: Is there anything else you would like to add?

JA: Yeah, there is. In 1992 I went to the World Congress on Low Back and Pelvic Pain that was held just outside of San Diego. Dr. Greenman and Andry Vleeming presented. Vleeming later wrote a great book on back pain with studies on facet dysfunction, myofascial states, spondylolisthesis, that sort of thing. Greenman had one study published that showed different percentages of sacroiliac pain, iliolumbar pain, pubic pain. This was great for me, having all these studies done on pain. So I read all these studies and I got some great ideas on how to work with pain. Greenman had honed it down to very specific types of pain. I used to teach this class and I would give out his [Greenman?s] handouts on how to deal with these different conditions. A lot of people just didn?t want to learn the information and I told them, ?Look, you have to know this information because then you can be specific.? You can ?shotgun? it sometimes and get good results, but if you really know the information you?ll be successful more of the time. So, anyway, I started going to these conferences and I?ve been to most of them.

RMcW: Did you go to the recent one in Los Angeles?

JA: Yeah. It was really good for me. There were these women from Denmark and Norway who had done these brilliant studies on women with pelvic pain. So I was watching these presentations with Eric ?Freedom From Pain? Dalton, and we could see that most of the pain was right next to places that you could work on in a Fourth or Sixth Hour ? just on or just below the sacrotuberous ligament, for instance. By understanding your pelvic mechanics you can do some simple work around the pelvic floor and you can help with this very specific pelvic pain.

RMcW: Well, Jim, we are out of time ? any final thought?

JA: Yeah. I feel like we Rolfers have a lot to offer people, and the Rolf Institute® does a good job of getting out the basic principles. People still need to keep taking classes, though. I still take classes, usually one a year.

RMcW: Yes, and you teach classes as well.

JA: Well, I teach a five-day class every year in Italy and I also teach in Japan and the States. I find that I?m better at teaching the shorter classes now. As I?ve gotten older, I find that my social tenacity isn?t quite what it used to be [laughs].

RMcW: Keep us posted about any upcoming classes and thanks once again for the interview.

JA: Thank you, Rob.[:de]Robert McWilliams: I would to ask you a few questions about how you work with clients who are in pain, especially in chronic pain. I?m going to cover a couple of areas: from an historical perspective ? the things you got from Dr. Rolf; from a clinical perspective, what you?ve picked up from your own experience; and any of the other strong influences on your work, such as Dr. Philip Greenman. Where would you like to start?

Jim Asher: I?ll start with Dr. Rolf, since I studied with her first. Dr. Rolf was really good at working with painful problems, but she did not believe in chasing pain. Her whole idea was to make space in the body by systematically working with fascia, balancing around the joints, and getting clients ?on their Line?; that?s the whole idea of the Ten Series. You simply can?t make space in the entire body in one session. It would be nice, but you can?t do it. Clients would love it, but there?s too much fascia to lengthen. She was good at working with pain. She would work on one or two places and open you up and balance things to the point where you didn?t feel pain. ?Prepare the way, get it in balance, and get out,? she would say. She would not necessarily work where the pain was. Sometimes she did and sometimes she didn?t, but she would find those connections that gave you enough space so that you didn?t feel pain when you got up and walked.
In 1971 she lent me The Cranial Bowl [by Dr. Sutherland] and that?s how I got started. I went to some early craniaosacral classes and in 1983 a spinal mechanics and Muscle Energy Technique (MET) [class] with Dr. Richard MacDonald. This led me to take an in-depth program by Dr. Greenman, author of Principles of Manual Medicine. He had done extensive research on low-back pain. Dr. Greenman believed that resolving pain takes more then one treatment. He had a systematic way of teaching over five classes, plus later advanced ones, and all of the classes built on the previous ones. Studying with Greenman I realized that he had an almost identical vision with Dr. Rolf. If you took his blueprint and Ida?s blueprint they were almost the same. No contradictions. There were some differences, but they both believed in getting space around the joints. In Greenman?s classes you got lectures with a lot of detail and were working at tables with good supervision. The supervisors were all sharp, mostly MDs, PTs, or DOs.
When I rolled my car I injured my back and was in a lot of pain. I went to this very good Rolfer and had gotten some relief. I also went to a very fine osteopath, Dr. Harold Magoun Jr., and had gotten some more relief in the lumbars, but then the pain came back because my sacrum was still out. When I was in the third class with Dr. Greenman, he put me on the bench and did some work and he got to my core problem. The Rolfer and Magoun had got everything but this one thing. Greenman was able to get this one thing. It?s not to take away from these other people. They were doing great things for me.
From these experiences I got more interested in pain. I liked studying with the osteopaths because they had the big picture. They worked with all the joints, and had a sense of how they all connected. They also understood fascia but they didn?t have the time to work with it. So I decided to try to put these two things together. Now everybody has gifts. I never met anybody who didn?t have a gift. I?d have to say that my gift is overlap. I am good at overlapping. Takes me a while. I?m slow. I am not a fast thinker. I kept sliding things around and then I would see the overlap between these two fantastic systems of manipulation. Their blueprints fit each other. So that?s what I worked with. Dr. Greenman and Dr. Rolf used movement. Dr. Rolf believed in giving people balance in function. Greenman believed in specific exercise to support the problem area. He would say, ?Well, I can open that joint but if your gluteals aren?t working you?re just going to collapse again.? So he also believed in giving people certain exercises.

RMcW: Similar to what a PT might be doing now?

JA: Right. Greenman taught at Michigan State. They have a physical therapy department there and he had some influence with them. In his book he shows exercises that helped him. You know he had a really radical scoliosis ? in his second book he actually shows the scoliosis. The thing about Greenman was he was always on point and he expected you to be on point. In twenty-five days we covered every detail in his textbooks. All of his assistants were prepared to teach every detail of his books. He was always on time and he expected you to be on time. All of his assistants were always on time. You had to be ready to go. At any rate, I had pain and he worked on me on the bench and when I got up and walked, I had perfect mechanics! One of the things that?s different between Rolfers and most PTs is, I think, we feel our bodies more. We pay more attention in class to how things feel. PTs are bright people but in their classes they don?t care so much about how you feel, but whether you know this or that. So when I got up from the bench I could actually feel my sacrum moving perfectly. I was going on about my sacrum and how I could feel my ilia, and when I looked around, everyone was looking at me like I was a goofball [laughs].

RMcW: Because you could feel what was actually going on.

JA: Right. So then I realized that I had to tone it down a little bit in explaining my experience. But I was out of pain and I stayed out of pain, because he had gotten that last piece.

RMcW: Would you call that the primary restriction approach? Identifying the primary lesion or restriction?

JA: Well, it could be. That would be one way of doing it. Now you have to remember that I knew I was going to this class [with Greenman], so I went and had a Rolfing Structural Integration (SI) session and I received work from Dr. Magoun, who was a genius himself. So in a sense, I was all set up to get work in this class. Now Greenman had a syllabus to follow and in looking at that syllabus I thought, ?That?s my problem? ? I figured out I had a left posterior torsion. We were working on each other, and I had already had my lumbars cleared out. So in a way, when he worked on me, there wasn?t much left. My system was pretty clear. He had me on the bench and he moved me and he knew exactly where he was going. It was amazing! He made it look simple.

RMcW: So would you say it was just really excellent palpation?

JA: Yes, it was excellent palpation and he was really dialed in. He moved my body and had me move with him, like two good tango dancers working together. I was able to let go and let him move me. He was the lead, so to speak, and I was the follower. You know when you go to a chiropractor and sometimes you?re not able to relax? With him, I was totally able to relax. He combined guided movement and MET. He didn?t thrust on me, by the way. Well, he kind of did but gently, and I was moving the whole time while seated on the bench. I remember Dr. Rolf teaching us how to work on the bench, and she would see someone working and she would say, ?Stop right there!? Then she would put her elbow in somebody?s back. She had a big soft elbow. People don?t remember that. She had a very comfortable elbow, not a pointed one. She would stop at one place and she would say, ?Now breathe right here.? Or she would have the client drop his head slightly, find his sitz bones, or have you move your elbow, and with that, she would get the joint to open. Ida was constantly calling for movement. When she started teaching the movement work, people didn?t understand how she used it, how she called for movement that was supposed to open a joint. Ida was not good at explaining the movement she called for. She understood it, and she thought you could see it.

RMcW: Would you say that an important focus for working with pain is through movement work, or through identifying appropriate movement through, say, a shoulder joint or vertebra?

JA: Right. Pain is typically when we have a collapsed joint or something is pinched. And if you can get that joint, whether it?s a vertebra or a shoulder or a knee, to open up a little more in the right direction, typically the pain will disperse. With Rolfing SI we have the ability to build a body better, so that the pain won?t come back, because we can get the person more balanced.
If you buy into the total concept, we look at what is above and below and how it?s going to help. That was Ida?s gift ? to look at what was above and below and see how that was going to assist this area in staying open. Keeping space. Whereas other people think about keeping space but they don?t look above and below. Greenman would look above and below and say, ?Okay, now you have to go down to the sacrum.? He had the full vision. He liked [working with] fascia and he had had [a number of Rolfing SI sessions] by a couple of different people, but he preferred to focus on the joints and on the nervous system too. So, I?ve had parents bring in babies with torticollis and you have to get length and space in those cervicals to relieve the torticollis. In working with, say, a clubfoot, you have to get the bones to move, but you also have to get the fascia to move too.

RMcW: So, say you have a client come in who has limited funds and has neck pain. What do you do with that client?

JA: I tell him that [by doing just a couple of sessions] I can only fix this for while. He really is going to need a full Series. I think I sometimes fail clients by not telling them they need a full series at some point. Realistically, you can get them out of pain for a couple of months, but unless they have had a lot of work, it won?t last. So if the person has neck pain, I?ll give a shoulder-girdle session including the arms. Again, you have to work above and below. I do translation [of the joints]. Now I don?t do any thrusting, no high-velocity work. I do low (slow)-velocity work to get that joint to move in the three planes of movement. When you get that movement, and you create that space, he?ll be out of pain for quite a while.
And you have to work around the nerves. [Before he passed away,] Don Hazen had been teaching Rolfers how to work with the nerves. Jon Martine is really good at teaching this. So you have to include the nervous system, as well as the craniosacral system, in your view. If the client has neck pain, the brachial plexus may not be sliding. You have to get that brachial plexus to slide. And this is the brilliance of Ida?s First, Third, Fifth, and Seventh Hours ? how to open up the thoracic outlet: get space around the upper ribs, get the clavicles up off of the ribs, get the shoulder girdle repositioned, and get some freedom in it. You?ll be taking pressure off those nerves. And remember, we have eight cervical nerves and they all need to slide. Just moving the joints isn?t going to do it, although the person might feel good for a day or so. But if you can give a good upper session and make sure that plexus is sliding, you?re going to get that person out of pain. You have to be able to palpate the plexus and work around it and not injure it. That takes understanding your anatomy well. Some Rolfers want to learn tricks, but they don?t want to know their anatomy. Having a deeper understanding of fascial anatomy and nerve anatomy will help you get your work to be more effective. So to understand pain, you have to have this perception of the systems. Ida wanted us to learn all the systems, but she felt that the fascial system was the easiest way to get in there. From there, you could enter into these other systems more easily.

RMcW: So, the primary way to approach working with pain is to get good mobility in the fascial system, and from there working with joints and the other systems of the body. How do you know how not to overwork something? You can over-mobilize something. How do you address this?

JA: Again, you have to remember to work above and below and then you?ll have a session with a beginning, middle, and end. At the end, you?ll tie it all together. Now clients will want you to keep working on where the pain is, but you have to tell them that it is all tied in together and you are going to wrap everything up at the end. Ida?s sessions always had a beginning, a middle, and an end. She would set it up, go to the problem area, balance around it, then have you get up and move. And she would get people out of pain. Greenman and Magoun also worked this way. Magoun would work on you for twenty, twenty-five minutes, with the last five minutes being cranial work. That was when he would balance the nervous system so that you would hold the adjustments.

RMcW: I know that we were taught to work that way, to have that integrative element. So are you saying that in working with pain you should allow a little more time for integration?

JA: Right. Now the problem is that people with pain don?t understand this. Most of my practice is dealing with clients in pain, and I have to explain to them that we need to balance things. Then they?ll start to tell me about these other pains and want me to work on those areas. I have to tell them that we can work on only two or three pain areas at a time, not four or five. The osteopaths know this. Greenman said, specifically, to never think you can fix someone in one session. It may take three, four, five sessions ? you just never know. He thought it was foolhardy to tell someone you could get them out of pain in just one session.

RMcW: This makes me wonder about the attitudinal piece of not trying to do too much in one session, but rather to just try to bring the person to a higher level of order.

JA: Yes, you can bring them to a higher level. Sometimes, though, you do get lucky and it all comes together in some sort of magical way and the person is out of pain. The problem is that it won?t happen every time. You also have to get your clients to do some things on their own. I?m always suggesting yoga classes. I teach clients stretches that will help them. Some people do them and I can see that it helps, while others won?t do them.

RMcW: So another approach to working with pain is to empower the client to take more responsibility for his own situation.

JA: Right. I have about five clients right now who have spinal stenosis and are in a lot of pain. So with them I?ll do some Rolfing work, some joint work, some cranial work, but I?m also trying to help them find their own ?sweet spot.? If you can get a person [with stenosis] to move through his spine, to feel his spine, and then balance his curves, you can get him out of pain. To stay out of pain, he has to have overall tone. Most people with stenosis lack tone somewhere. They may not have good core tone even though they have been doing Pilates. Maybe they have a good Pilates teacher, but the Pilates teachers are not putting their hands on them like a Rolfer does. So I show them the place where they need tone. I tell them to keep going to their Pilates class, but here is the area I want them to get more tone.

RMcW: Core stabilization.

JA: Yes, core stabilization is exactly it. Now you don?t want them to over stabilize. They may have a strong iliacus, but be weak in the transversus [abdominis].

RMcW: So it is this hands-on feeling instead of just getting a conceptual idea from the Pilates teacher.

JA: Yes. These people need to keep going to their Pilates class and strengthening their core. We don?t do that in Rolfing [SI]. We don?t strengthen the body. We give them length, then they can go out and build strength. People get irritated when I tell them this. They don?t want to have to do anything themselves. They just want to come and see me. But I believe it is my duty to tell them that they need to strengthen this or that part of the their body, and then they will be able to stay out of pain.

RMcW: Excellent.

JA: This is the same as in the Rolf Movement® work: like teaching people how to use their core and walk through their hinges. A lot of clients think this is stupid. They?ll say that they went to a movement teacher and all he did was show them how to walk. Well, knowing how to walk properly can keep you out of pain.

RMcW: That?s a great statement.

JA: Learning how to walk is not a waste of time or money [laughs]. Some people don?t make that connection. Dr. Greenman believed in gait analysis. Now he might send them off to a PT, because he didn?t have the time.

RMcW: Is it fair to say that, for you, when focused on resolving pain it is important to use the lens of structure, while also working at improving client function as a long-term strategy for mitigating pain?

JA: Right. Even when working with people with neck pain, I look at how they are sitting and help them try to find their Line while sitting. I actually do more sitting analysis than standing analysis now. They are probably sitting at a computer all day, so I?m going to work on how they sit. That?s probably where their pain is coming from.

RMcW: Is there anything else you would like to add?

JA: Yeah, there is. In 1992 I went to the World Congress on Low Back and Pelvic Pain that was held just outside of San Diego. Dr. Greenman and Andry Vleeming presented. Vleeming later wrote a great book on back pain with studies on facet dysfunction, myofascial states, spondylolisthesis, that sort of thing. Greenman had one study published that showed different percentages of sacroiliac pain, iliolumbar pain, pubic pain. This was great for me, having all these studies done on pain. So I read all these studies and I got some great ideas on how to work with pain. Greenman had honed it down to very specific types of pain. I used to teach this class and I would give out his [Greenman?s] handouts on how to deal with these different conditions. A lot of people just didn?t want to learn the information and I told them, ?Look, you have to know this information because then you can be specific.? You can ?shotgun? it sometimes and get good results, but if you really know the information you?ll be successful more of the time. So, anyway, I started going to these conferences and I?ve been to most of them.

RMcW: Did you go to the recent one in Los Angeles?

JA: Yeah. It was really good for me. There were these women from Denmark and Norway who had done these brilliant studies on women with pelvic pain. So I was watching these presentations with Eric ?Freedom From Pain? Dalton, and we could see that most of the pain was right next to places that you could work on in a Fourth or Sixth Hour ? just on or just below the sacrotuberous ligament, for instance. By understanding your pelvic mechanics you can do some simple work around the pelvic floor and you can help with this very specific pelvic pain.

RMcW: Well, Jim, we are out of time ? any final thought?

JA: Yeah. I feel like we Rolfers have a lot to offer people, and the Rolf Institute® does a good job of getting out the basic principles. People still need to keep taking classes, though. I still take classes, usually one a year.

RMcW: Yes, and you teach classes as well.

JA: Well, I teach a five-day class every year in Italy and I also teach in Japan and the States. I find that I?m better at teaching the shorter classes now. As I?ve gotten older, I find that my social tenacity isn?t quite what it used to be [laughs].

RMcW: Keep us posted about any upcoming classes and thanks once again for the interview.

JA: Thank you, Rob.