Reflexology: The Definitive Practitioner's Manual: Recommended by the International Therapy Examination Council for Students and Practitoners

• Shoulder or neck line – this divides off the phalanges, and the head-related and neck muscle areas.

• Diaphragm line – this includes the distal point of the metatarsals and metacarpals, covering the upper part of the body: the chest, lung and breast, also heart and upper back muscles. (See plates 1 (#litres_trial_promo) and 3 (#litres_trial_promo).)

• Waist line – the waist line is measured on the foot from the fifth metatarsal tuberosity (the protuberance at the proximal base) on the lateral aspect. On the hand it is measured from just below the fifth metacarpal on the ulnar side (seeplate 4 (#litres_trial_promo)). This is found when the fist is clenched to form a transverse crease. The area between the waist line and the diaphragm line covers the middle section of the body: the liver, gall bladder, kidney, adrenals, stomach, pancreas, spleen and solar plexus.

• Heel line – the waist line down to the heel line covers the intestinal areas, also the bladder, pelvic and buttock areas. It is found in line with the medial malleolus encircling the heel to the lateral malleolus. On the hand, it is taken from the trapezium bone and the proximal point of the first metacarpal where the muscles bulge at the base of the thumb (thenar eminence), to the middle of the hypothenar eminence on the ulnar side.

• Ligament line (on the foot) – this is a guide line. First work either side of it; at the end of the treatment session you should be able to work on it.

As an example for diagnosis, you can examine the fifth metatarsal notch to assess the waist line. If there is a greater proportion of the foot in front of this imaginary line it denotes that the person is long waisted, but short in the leg; if the reverse is true, this denotes that the person has very long legs. If the medial malleoli at the lower end of the tibia are not level it indicates a low lumbar problem.

Questioning (#ulink_23934bca-ffec-5b05-bafe-1c946ff9504e)

This aspect of diagnosis, whether using a Western or an Eastern system, can be summed up by an old Chinese quotation called the ‘ten askings’:

• One, ask chill or fever

• Two, ask perspiration

• Three, ask head or trunk

• Four, ask stool or urine

• Five, ask food intake

• Six, ask respiratory

• Seven, ask deafness or thirst

• Eight, ask past history

• Nine, ask energy

• Ten, ask causes (nowadays we would look at behaviour patterns and lifestyle).

This ancient Chinese system is still used today even in the West. In reflexology we must ask questions, not necessarily to find the nature of the disorder, but to ascertain which organ or part of the body may be in a disturbed state. When palpating on the feet, hands or ears we can also diagnose imbalances by tender spots; however, painful reactions can be caused by all sorts of variables.

During questioning the reflexologist should note carefully what the patient is complaining of. Specific questions may include the following:

• Onset – is the disease or disorder acute or chronic?

• Is there an overactive or deficient organ?

• Are there tender spots on the feet, hands or ears? These can be a signal of a functional problem that is not yet evident.

• Is the person suffering from overtiredness?

• Is there an inherited tendency?

• Are there any foot complaints?

• Have there been any injuries or accidents to consider?

• Where is the site of pain? Does it radiate up or down?

• What is the nature of the pain? Is it sharp or dull? Is it constant or intermittent? Is the pain bearable?

• Is it a slight problem (this means that the patient can still attend to their daily tasks with a little discomfort)? Is it severe (meaning that the patient cannot carry out the normal daily tasks)?

Listening (#ulink_2aa756c0-4099-53c8-afc9-280387447e6c)

One of the keys to effective therapy work is the skill of active listening. Active listening could be said to consist of:

• Looking at the person who is talking, and sitting quietly with them

• Responding naturally with gestures and expressions

• Doing nothing else but listening to their particular problem

• Reflecting back the essence of what you just heard so that you can explore any inconsistencies (as a means of helping the client to understand their own problems)

• Asking only a few questions.

For reflective listening skills, the practitioner must develop the ability to concentrate on each individual’s problems during consultation, and to give as much space and attention to each and every patient as required. Try and listen and do not be judgemental or too critical of patients’ problems. Take note of their tone of voice and watch their body language; it often tells you more than their speech. Awareness and perception play an important role and patients must be allowed to go at their own pace, as the healing process can be slower than you may have allowed for. Never rush a person through their experiences as this will only force the process. Part of the therapeutic encounter is to develop a mutual trust of each other; as well as becoming a teacher and a guide, it is useful to remember that we can learn from our patients. The holistic healing process is aimed at treating the whole person, the mind as well as the body. Make sure in particular that you are ready to deal with their emotions, as during a reflexology treatment emotional release is often likely to happen. This can take many forms: agitation, anger, anxiety, distress, laughter, often slightly uncontrolled, and tears. All of these are the result of an emotional overload. This release is very important and plays a part in the curative process.

Listening is the key to communication; there is a real art in being a good listener. Some people do not listen. Not listening is much more common in our society than listening. Think about your own experiences. When was the last time someone gave you their complete attention while you were talking? The following situations are indications of not listening:

• Interrupting someone while they are talking

• Taking over a conversation that someone has started

• ‘Switching off while someone is talking, or fidgeting and looking at your watch

• Changing the subject, or responding with an inappropriate answer.

These should be avoided during the questioning process.

The case history (#ulink_8e2ca878-0672-52c4-bbc4-d86c5f94e44c)

The information gained from observation, questioning and specific diagnostic techniques (such as palpation) should be exactly recorded for future reference. This is usually done by keeping a case history. A case history consists of many things that might be related to the patient’s disorder. It allows for a methodical evaluation.

It should record the following at the first consultation or treatment session:

• Date of commencement

• Date of birth

• Name and address