For those who have had surgical interventions for endometriosis, appendectomies, or another type of abdominal surgery, or who simply have had a car accident or injury that they’ve never fully recovered from: today’s conversation is for you. We’ve talked about many root causes of SIBO in past episodes of this podcast, but today we are going to do a bodily deep dive into some of the structural issues that could be holding your body back from digesting properly.
Even if you don’t have SIBO but seem to be one of those people whose health problems all stem from the gut, types of bodywork like visceral manipulation and structural integration could be the piece of the puzzle that’s missing in your long-term healing. To talk about these modalities and why they are so powerful is Dr. Jason Wysocki, a Naturopathic Physician and owner of 8 Hearts Health & Wellness in Portland, OR.
Dr Wysocki has been involved in researching various natural interventions in the treatment of digestive disorders, depression, and anxiety—including bodywork techniques like structural integration.
A quick taste of what we’ll cover:
- What can cause structural issues that lead to SIBO
- The difference between an adhesion and scar tissue
- Ways you can mitigate the negative internal effects of surgery (endometriosis gals, take note!)
- How fascia function in the body and create our internal mask
- Whether certain types of core exercises and ab work can cause more constraint on your intestines
- Visceral manipulation and how it differs from other types of massage and bodywork
- The 10 stages of structural integration, who it’s right for, and how to find a practitioner
- Why emotions can linger in the body and cause actual structural issues
- How bodywork can improve microbiome imbalances like SIBO or simply help “gut people” who hold emotions in their abdomen heal for good
Resources, Mentions and Notes:
- Dr. Wysocki’s website
- Dr. Wysocki’s interview with Rebecca Coomes Part 1 and Part 2
- IASI board certified practitioners
- ROLF Institute
- Clear Passage abdominal therapy
- The Wellness Project book, Back It Up chapter
- Join the SIBO Made Simple Facebook Community Page
- Subscribe to receive a free download of the episode transcript
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VISCERAL MANIPULATION AND STRUCTURAL INTEGRATION FOR SIBO TREATMENT
PHOEBE: Thank you so much Dr. Jason Wysocki for coming on the show today. I’m really excited to pick your brain about all things structural when it comes to SIBO.
JASON: Thank you, Phoebe. It’s a pleasure to be here. I’m joining from a rare sunny day in Portland. I know you’re on the East Coast.
PHOEBE: Yes, I’m very jealous. It’s 3 o’clock and almost dark here. Okay, so on some past episodes, we’ve gotten into some of the root causes of SIBO, but the one that we haven’t really talked about in depth is the physical structural issues. I would love to start there with you today, and just so we can get the basics covered, get everyone on the same page, I would love it if you could just tell us top line what some of these structural issues are and why they can lead to SIBO.
JASON: Of course, so that is a vast topic. The area that I specifically really work in is chronic SIBO, multiple practitioners, multiple failed treatments, and then it’s something that we look at. I love that we’re starting there because that’s at least a minor mission of mine at this point is to bring the structural aspect earlier into the diagnosing, earlier into the treatment so that many people are not suffering for years, and then realizing, oh, my goodness, this was in my hip. First, let me just start by saying that, from my view, a lot of structure in the body relies on this thing called fascia, and fascia is this ubiquitous term that talks about this connecting organism through the body. It’s not muscle. It’s not bone. It’s not classified in any of those ways. It is its own classification. It interweaves with bones, muscles, obviously contains nerves, blood vessels, and these sorts of things.
The best way I could describe it and it’s very hard, and maybe we’ll have to do this a couple times trying to explain what I would even see fascia is. The best way I could explain it is, if you cook, there’s this little fibrous, mucousy clear thing when you try and debone a chicken or any sort of animal, and that’s the fascia. It’s the in between, and many times this can get adhered. What I mean by adhered is it’s just not moving correctly. Some people feel this as muscular dysfunction. Some people feel this as bone dysfunction. Some people feel this as this part of me is not moving like it used to.
In the classical definition of adhesions and looking for SIBO, we of course think abdominal adhesions. What could they be from? They could be from endometriosis, surgery, all the above. A previous injury, a car accident, these things can cause adhesions in the abdominal area, and that fascia can therefore wrap around the intestines and not allow them to work correctly. There could be adhesions at the ileocecal valve. There could be adhesions all through the intestines, and that specifically in terms of SIBO is what we’re looking for.
PHOEBE: I had on my note sheet what is an adhesion? What is fascia? You’ve already answered some of our basic questions. Back to an adhesion, is it basically just scar tissue, internal scar tissue?
JASON: It can be, and here’s the misconception is, when there is just scar tissue, that is not necessarily an adhesion. It definitely is adhesions of sorts in the big picture. Again, we’re trying to think of whole body movement, definitely intestinal movement with regard to SIBO and gastro health. The adhesion needs to be not allowing movement for it to be an adhesion in terms of my definition. People can have scars at certain parts of their body, and they very well may be adhesions. In terms of do we need to address them, that would be whether it is causing some lack of movement, at least in the way that I view it.
PHOEBE: Are there certain types of surgeries that can more likely lead to an adhesion as you would define it? How do you mitigate that risk if, let’s say, you have endometriosis, or you’re getting your appendix out? Is there anything that someone can do to make sure that their scar tissue doesn’t become an adhesion?
JASON: That’s a really good question. There’s so many preventative ways, meaning either supplemental or exercises. Really, it’s you always have to do the cost benefit analysis with a really good surgeon in the sense of, hey, this needs to come out, meaning if an appendix is acute, you’re going to have that surgery, and it is what it is. That should be accepted in the sense that sometimes the best of science. We need to this right now, and then we can deal with the ramifications down the road. That’s just at least my perspective.
I want to say that sometimes these surgeries are needed, and they shouldn’t be feared. It’s just something to take into consideration that after that surgery someone should probably be thinking of getting some type of visceral work, structural integration. Something of that nature to make sure that those surgeries, those adhesions, the scar tissue is being worked through, is healing. I mean, there’s so many different fields of medicine that can help, some that even coming to mind right no. Acupuncture, cupping, these sorts of things, those are also things that work on this plane. It’s not just the lens that I’m trained in and I look through, but there’s so many ways to look at that and prevent that, either supplementally or with different practitioners.
PHOEBE: How does acupuncture help with fascia and scar tissue? Obviously, it’s moving blood through certain areas, but does that actually help the healing process in a way to prevent that kind of rigidity that might arise?
JASON: Absolutely, so an adhesion is lack of movement. At its core, if we really wanted to – it’s much more complex than that, but to make it simple, it’s lack of movement. Something is not moving the way it will. How I explain it to my patients is picture Saran wrap. It’s such a wonderful product. Think of when you try and move it and play with it, and it gets stuck to each other. Then you can’t get it apart. That’s like fascia.
We’re talking about acupuncture right now. Acupuncture is dealing on the level of chi and energy flow, and if you look at acupuncture and think about it, one of their organ systems may actually be the fascial system. They might have named an “organ system” the fascial system. It can address it, and anything that brings the body’s intention and movement and energy to a particular area has the potential to work through an adhesion. The unique part of structural integration is it’s fashioned to add a very direct anchoring for someone to move through that area. Many times structural integration is one of the latter things that you would want to do to move through an adhesion whereas acupuncture, exercise, movement, supplements would be, like you were saying, preventing this from happening, trying to move through this area where if a greater level of intervention is needed it would be more the structural integration visceral work.
PHOEBE: I’m so glad you brought up these two SIBO buzz words. I had never heard of visceral manipulation or structural integration before I started researching SIBO, and I’ve done a lot of digging in the vast world of holistic health. I want to get to each of them specifically in a minute, but because I assume you need a practitioner for both these things and acupuncture as well, I just wanted to hone in on any strategies that people can start with, any sort of at-home bodywork, even if it’s yoga moves, or Pilates, or self-massage. Are there any strategies that people can try at home?
JASON: Absolutely, so movement is life. Movement is key. Definitely starting there and having the goal to just move through an area can sometimes be enough. It’s not always. Making sure someone is stretching. Yoga, qigong, tai chi, Pilates, these sorts of things are very effective at creating movement and are certainly a part of a good treatment plan. We’re just speaking about an intervention for adhesions, but when someone is trying to truly become well and address life, these things have to be a part of it. It can’t be independent. It’s not like, oh, there’s just this one path is what someone needs to move down.
Definitely, any of the movement exercises or tactics are not going to hurt. They’re going to help. They may bring out, oh my, I was doing this in qigong today, or I was doing this in yoga today, and I’m just feeling my hip isn’t moving. Can we address that today? Many of my patients that are long-term patients, we have that discussion sometimes at the beginning of one or our sessions in the sense of, oh, I was doing this in yoga, and I really feel my thoracic area, my mid-back is moving so much better after last time. Now I feel my pelvis or my right hip isn’t moving as well, and we really focus on that today. It’s kind of a – I hate to say chicken or egg, or one way or the other. I think it’s just an all the above, and they all just interplay.
PHOEBE: This might be a silly question. You said that no types of movement can really harm, but I always wonder. I really turn to Pilates a lot after writing my book, The Wellness Project, because I had a whole host of back issues and just really needed to strengthen my core. Sometimes when I go to Pilates class these days and come back, my mid-section, my abs are just so sore. I think about structural issues in that area and wonder if sometimes creating more muscle or constraints is affecting my intestines at all.
JASON: This is a really good question, Phoebe, and thank you so much for bringing it up. It is not silly at all, and thank you for clarifying that. I should definitely clarify that. The very focused gentle movement can never harm. I would say a decent portion of my structural integration practice are very, very in shape people that really work out and work hard. Sometimes they need to take a break from some of those things as we’re working through certain areas. Again, it’s hard to be so specific on a big scale, but everyone’s situation will be different. Yes, there probably are certain exercises, specifically abdominal exercises, crunches, these sort of things that could actually make things worse.
What I was trying to refer to is gentle movement, meaning walking, bilateral cross crawl, tai chi, qigong, these sorts of things, gentle yoga, more the yin side of yoga, the regenerative yoga that really aren’t striving to necessarily build something quickly, or build muscle, or these sorts of things. It’s just moving and it’s gentle. Thank you for allowing me to make that clarification.
PHOEBE: Yeah, and I think it’s something, especially on my side of the globe in New York City, that people I think need to hear. We’re definitely a culture of people who like to go hard and “push ourselves to our limits” in terms of the way the boutique exercise culture works around here, so I’m glad that we both clarified that as well. Switching gears down to the specifics, let’s talk about visceral manipulation. Could you tell us what it is and what sort of practitioner does it?
JASON: Another big question. Visceral manipulation would be viewed differently by the type of practitioner that’s doing it. Simply stated, visceral manipulation is moving the viscera or the internal cavities of the body, whether that be organs. Some of them deal with fascia. Some of them are moving certain pieces. It’s literally the inside. Simply stated, it’s moving the insides, the omentum, which is this fat layer that covers the intestines, the stomach, the liver, the gall bladder, the organs, and it is quite visceral, meaning abdominal focused mainly in the thoracic, which is that center section of the body. Think about all those vital organs, all that area.
Simply, it’s just someone that’s trained to go into that area normally, hopefully, very gently and move what is stuck. For instance, a visceral manipulation that I use probably on, I’m probably being conservative, 95% of my patients, so a lot of them would be a hiatal hernia syndrome. I want to stress the syndrome because there are things where there is a hiatal hernia, which is a place in the diaphragm where the stomach can – where it meets the esophagus, and the stomach can come above the diaphragm. This could cause things like shortness of breath, lack of digestion, even heart palpations at times. It’s a very amazing functional gastroenterology that really, really not many people speak about. This is a visceral manipulation, meaning we are moving the stomach very gently down to where it’s supposed to be, and restoring that function causes a lot of positive effect.
Specifically, from what you’re asking in the context of this podcast, visceral manipulation would be more in the level of abdominal adhesions, meaning someone has had a laparoscopic surgery for an appendectomy, meaning they’re removing their appendix, or they’re needing a section of their intestines to be unraveled or moved or endometriosis to remove those adhesions that have grown. That scar tissue that develops around that or the adhesions that develop around that sometimes need to be moved and need to be moved through for proper function to be restored. Visceral manipulation is one of the ways to do that, and the specific practitioners that can do that are normally PTs, physical therapists. Naturopaths do it a lot, definitely hands-on practitioners, and you would definitely want them to be well-trained specifically in that area.
PHOEBE: They’re, basically, just using their hands in a targeted massage technique?
JASON: In a broad sense, yes. Visceral manipulation would be more on the massage side of things without a doubt and definitely using their hands. Most times, tools are not used in visceral manipulation.
PHOEBE: Is there a certain certification? How does someone find a PT who could use visceral manipulation to help them with their intestinal issues or SIBO?
JASON: There isn’t a specific certification, but there’s a lot of continuing education, meaning someone gets their basic license, and then they focus on the areas that they want to focus on. That would simply be just asking either the office that the practitioner is in or the practitioner themselves, researching them online. If they focus on this, they’re going to say it. It’s going to be somewhere on their website, somewhere in their advertising, marketing. Their front desk or help should be able to say this is something that this practitioner specializes in. Specifically, S-I-B-O patients, SIBO patients that are chronic, they would want someone that has seen this a couple times.
PHOEBE: I know we talked a little bit before we hopped on the line about who would be the right candidate for some of these techniques. Of course, it’s also individual and has to do with the whole case history, but I’m curious if you could give us some broad strokes with people besides just those with endometriosis and some of those surgical interventions who might want to explore this.
JASON: Definitely, so when I think about this – and I view SIBO treatment as a four-pronged approach. I know that that could be the topic of another podcast, but I’ll go through it really quickly because it relates to this. Right in the beginning, I really like to spend time with any patient on diagnosis, on really trying to figure out what is the cause of this? Are there any obstacles to cure? What is the cause? Almost spending time putting someone’s history on a whiteboard and saying as best we can, oh, this is what this looks like.
It could be months. It could be years. It could be decades. Just seeing, okay, this happened here. This happened here. These symptoms arose here. These symptoms arose there. This is what this looks like, and then very, very carefully selecting either tests or interventions to figure out what we’re specifically targeting.
Since we’re talking about the structural side, the heart of that diagnosis procedure, meaning that first step, would be speaking about have you had a motor vehicle accident anytime in your life? Have you fallen? Have you had any injuries? Have you broken any bones? Have you had any surgeries? I know we focused on that probably a little too hard in the beginning because there’s all these other things that could influence this, and specifically, do you just have a part of your body that doesn’t work the way you would like it to work?
I’m thinking of several patients right now that just shared with me sometimes, oh, I can’t go up a ladder appropriately, or I can’t move my hip the way I used to, or I can’t bend the way I used to. Lo and behold, there was adhesions or lack of movement in certain parts of their body that once we removed them not only did their digestive function improve, but they were able to go up a ladder. They were able to reach things. They were able to do their job in a better way. It’s part of that big picture look to get smaller. As part of that big picture look, looking into just certain things of I try and do this in yoga, for instance, and I can’t move this part of my body. That’s a huge flag for me to say we need to investigate this a little more, or I have never been the same since that motor vehicle accident when I was 15, or I never was the same since anything. I mean, fill in the blanks, or my leg never felt the same after this certain event. Those are specific things that I would just say it’s mining gold for my practice.
PHOEBE: It’s usually a physical trauma. There wouldn’t ever be a case of an adhesion that arose for no particular reason.
JASON: Thank you for bringing that up. Sometimes we get so focused on the body and these sorts of things, but I spent ten years as a counselor before becoming a physician. There are many times that it is not just physical. The body remembers, and this fascial organ, for lack of a better term, is intertwined with everything. It’s not just physical pain. It could be emotional pain. It could be spiritual pain. There could be a part of the body that just is not moving because that was the part that was abused or hurt.
Again, fill in the blank in the sense of anything that does damage to normal function can be remembered by this part of the body. Dealing with that takes a little bit more complexity than simply just moving one’s arm. Sometimes that could be the easiest thing, or moving one’s abdomen, or viscerally moving one’s organ. Sometimes that’s all it needs. There are times that it is. Thank goodness. Other times, it requires a multilayered approach of, oh, I didn’t realize my abdomen was so constricted because I felt so bad from those years in school, and that’s when I started not feeling well. There’s so many different cases that we can talk about, but thank you so much for bringing it up. Without a doubt, emotional, spiritual abuse, anything like that can cause adhesions of sort in the body.
PHOEBE: Yeah, that was something that I went through personally. There is a whole alignment, back pain chapter/monthly focus in my last project and book. I definitely found as I was working a bodyworker that, as I talked through some of the things I was feeling, specifically anger, she was rally feeling it in my body, and the only way for it to release was for me to verbally get it out on some level. I’m curious. I mean, do you try and have a bit of talk therapy in your sessions? Do you refer people out to therapists to work through the issue, obviously, in a more prolonged fashion and deeper fashion emotionally? What is your path forward for those people who may have emotional baggage tangled up in their physical form?
JASON: Very, very complex question. I would say all the above. I’ve had cases of all the above. To talk about structural integration, here’s the beauty of structural integration and why I as a physician decided after all my all counseling training, after all my medical training, after all these things, to go back and learn this discipline. The beauty of this at times is that just addressing this adhesion in sometimes a very physical way. If anyone’s listened to the previous podcasts, each session has a very, very unique physical area that we’re working on, and addressing that area sometimes requires no words. Sometimes I would have my hand on someone’s lateral leg. They’re moving through it, and it may be painful. It may be uncomfortable, may be just fine.
All of a sudden, emotion wells up, and sometimes they know what it is. Sometimes they do not. As soon as that adhesion releases, they take a deep breath, and sometimes it’s released. Other times, that begins a journey where that is brought up, and it does come to mind. Then we do talk through that if we’re at that place or if I am that practitioner, and other times, it comes to be an obstacle to cure where this is something that we’re going to need to address this, as well as the overgrowth in your small intestine, as well as the adhesions in your hip. This stuck emotion or stuck hurt also needs to be addressed, and yes, I will refer out at that point to either a therapist, or counselor, or spiritual leader, all the above. We like to form these algorithms in medicine, and then sometimes they’re really useful for guiding us in certain areas. Then there’s real life, and then you have to take each individual and individual story into consideration, and form a plan for that.
PHOEBE: Yeah, I mean, some of this might sound woo-woo to people, but I can personally attest. It really is. There’s no separating the physical body from the emotional experience. I had a friend who saw the same bodyworker as I did. She would call me sometimes after her session and just be blabbing away, and then go so sorry. I just came from Rob, and so I’m feeling very open. It just dislodges a lot of things when you work on someone physically.
Back to square one with structural integration, tell us what it is. Tell us about the whole process, what it involves, and yeah, what you’re seeking to solve, essentially.
JASON: Structural integration is a form of medicine developed by Ida Rolf. She was a PhD in Biochemistry, and she studied with physicians at a time that women were not very prevalent in the medical society. She was a phenomenal woman, and I always like to point that out that the heritage of this comes from such this beautiful, wise, wonderful woman that really surpassed so many things and broke so many barriers. She designed this structure of medicine, which has evolved over time, and we’ll talk how but this structure of medicine which she called Rolfing after herself that was based to organize someone in gravity. She called it processing, and how she processed someone was very much with rulers and mirrors and angles. There was nothing woo-woo about it. See, that’s the funny thing. We all get on all these other things, and then, at the core of it, it is literally, no, your neck will be at this angle, and it will move in this way. There is very, very structural aspects to this. That’s how she came up with – over the 40 years of her practice and her PhD degree, she came up with this and learning from multiple physicians ten sessions.
The ten sessions, it’s probably good to go through them. The first one focuses on the shoulders and the hips with relation to breath and respiration, so that’s where things start. It starts right with breath. It starts right with two very, very affected areas in our society. All of us work at desks. We hunch over. I call it American disease. You bend forward. Your shoulders get tight. This sort of thing is where it all begins.
Session two goes down in the lower legs and feet, so you immediately right at session two are working on the foundation of someone’s structure. Session three comes up the outer seam. Almost like a pant leg. If you’re going to use an iron, it’s that outer seam of the legs, and that goes up the side of the body and into the armpits. These three sessions are called the external body, or the external fascia, or superficial fascia, for better terms, and this addresses that jumpsuit, if you will. Almost like unpinning all of these areas superficially and externally.
Speaking on that woo-woo side, this also is someone’s external mask. This is the protection that someone’s body has put up that can be moved through, so this is the other thing. This is how the work has evolved, and this is why it draws so many different people. I have a unique perspective because I’m a physician that specializes in the GI tract in men’s health and mental and emotional. It just drew me into this. Because working through all of it, I bring those specialties into this, and that’s why knowing your practitioner, trusting your practitioner, they’re going to modify all of these things that we’re talking about for their specific giftset.
Getting back to the nuts and bolts of structural integration, these three sessions are where you build things off of. I would refer back to my previous podcast on structural integration and SIBO because I mention that these three sessions are sometimes where someone stays. There are many times that with some people I just do session one, two, and three over and over again. That’s not common. That’s not the way that we set out to do it. We set out to move through the ten sessions, but many times we just need to meet people where they are. That’s just the process.
PHOEBE: Why can’t certain people break out or graduate beyond those specific areas? Is it something in their daily life, like the hunching over the computer? The mask, the seam, maybe that has to do with some emotional issue that hasn’t been processed or dealt with. Do you find that there are any themes for people who can’t move through the full ten sessions?
JASON: It’s in all the above. Like I said, it is not common in that sense. The whole goal and my whole goal as a practitioner is to meet people where they are but also encourage them onward. There’s not many people that I have not been able to help through the ten sessions. Let me just say that we’re talking about a very, very small minority, but it’s very important to say because it’s not failure. It’s not graduating. This is not about finishing. This is about the journey, and it’s about moving through where you are. It’s moving through where you need the most help and the most facilitation of your wellness. It’s not necessarily, oh, you’re like this other person, or you’re like this, or you’re like that.
To be honest, even if I’m doing session one, two, and three over and over and over again, the other sessions energies are there. We like to talk about things linear, like a line, and just something that is set. With this sort of work and especially with the human body, it’s a little bit less like a line and more like a swiggle.
PHOEBE: Ten sessions does sound quite linear.
PHOEBE: Suspectly linear. Now I see, okay, that it depends. Is all Rolfing essentially structural integration, or does someone have to look for a Rolfer who specializes in structural integration? What’s the differentiation?
JASON: This is a political thing, and I don’t like getting involved in that. I will just say the truth so it comes forward. The Rolf Institute in Colorado has the trademark on Rolfing. That’s the only institution that people can call – the Rolf Institute and the Rolf Guild, these are the only institutes that you can call yourself a Rolfer. There are so many other wonderful schools that are board certified that work with Rolfing or the principles of Ida Rolf, and they have to call it structural integration.
The reason that I love calling it structural integration is because we’re mixing together the wisdom of so many different disciplines into the structural integration that we do. That, yes, it is based on the wisdom of Ida Rolf and the ten sessions of Rolfing, but there’s so much else. That’s what’s hard to say. I actually wouldn’t go that far in my previous podcast to say what we do is somewhat even different than this, but it is. That’s just the truth. Finding a practitioner that you trust, that you really, really resonate with them and their bio and you feel that they have the professionalism and specialty to specifically address what you need addressed really can help.
PHOEBE: How does someone find someone who practices structural integration in the genre that you’ve been trained in? Do you have a specific school that you’d like to recommend that people can look for practitioners who are certified there?
JASON: It’s very hard to say. This is a new field. Actually, it’s an old field. There’s a new resurgence in it, and it’s very hard to speak to specific specifications. There is a board. It’s called the IASI, the International Association of Structural Integrators. That would be one place to start. There is the Rolf Institute. They do a lot of research where they’re graduating really good graduates that are certified in Rolfing.
It really doesn’t necessarily come down to – the qualifications should allow you to check that box off, but sometimes the more important box is the connection and really feeling like this person understands where you are in your health journey. Can they help you, and have they seen people that have gone through very similar things to you? That can be so much more important. Definitely, I agree with you; you have to get through the qualification side just to make sure that you’re with an established practitioner.
PHOEBE: Amazing, well, I’ll link to those resources in the show notes. In terms of SIBO specifically, what do the ten sessions usually alleviate that helps, I guess, remedy some of the issues that may cause it to be chronic?
JASON: Thank you for bringing me back to that. We didn’t even finish what the ten sessions were. This is how the sessions go. Then when you get to session four, you are actually starting to go into the internal core. Just like session three was the outer seam, session four is the inner seam. Why you reminded me on this is now we’re talking about where the “SIBO specific” sessions are, if we can say that. I mean, it’s all relative, but at session four, you start going into the inner seam. Then session five begins in the pelvic floor and the anterior abdomen. Really, five and then six, which is the upper abdomen and then the back, this is where you’re really starting to deal with what is specific to someone trying to move through SIBO.
PHOEBE: What would your argument be for someone, maybe they have limited resources or budget, who would say, oh, well, I just want to skip straight to sessions four through six? That’s what’s going to help me. What’s your argument for really trusting in the process?
JASON: Ooh, this is a tough one, and this appeals to my very pragmatic side, even though I sound quite woo-woo in this podcast. I’m a pragmatic guy. I do what works. That’s why I’m a naturopath. That’s why I find these very, very specific things that truly help people. At the end of the day, I don’t want people wasting their time or resources. I want to do things that work. I want to do things that help, and my only horse in the race is the patient in front of my and not myself, not my strategies, them. They need to feel better.
Here’s the place where I would say and my argument would say sometimes I have patients come in – because they fly from all over the country, and I have an hour and a half. There is no way in heck that I’m going to be able to do ten sessions.
PHOEBE: How long does a session normally take?
JASON: A session is a – for me, a session can range anywhere from about 50 minutes, and we schedule them for about an hour with an hour and 10 – a 10 minute buffer. It can go anywhere from 50 minutes to an hour and 15 minutes, and that’s a typical structural integration session. I keep them separate from my medical practice where I do do some visceral manipulation and some adjustments. I keep it separate from my medical practice because we want to focus on different things. Now, that’s not to say I don’t do some structural integration or the greatest hits in my practice. I do keep them very separate to keep the focuses separate as well in the sense of, if we’re going down this path, let’s truly walk down this path while we’re doing the best of this medical path, this mind-body path too.
I guess I make myself multiple practitioners in that sense, but getting back to your question, sometimes the only way to keep something sticking in the body, the only way to have an adjustment stay is to make sure that it’s moving through the whole body. The wisdom of the sessions is made to align someone in gravity, to make them a better earth dweller. The whole process is what allows that, oh, my goodness, I just need session five. I have an anterior abdominal adhesion. I know I had an appendectomy, and it hasn’t been right since then. It’s making my ileocecal valve go wonky. That’s a medical term. Let’s just do session five. Sometimes I can just do the ileocecal valve adjustment, and someone will get relief.
My argument would be and I guess I’m ruined this way just from what I’ve done is there may be something down that leg. If we’re talking about the lower right side of the body where their ileocecal valve is and that’s near the appendix, there might be something right at the right knee that is causing some of that adhesion that we just removed a piece of it. That could give relief, and there is nothing wrong with that. There’s no judgment, but that adhesion down the leg or that adhesion up the chest may not allow that to stick as long as it should. The reason being is the whole body isn’t integrated, and that’s the wisdom of the sessions. That’s the reason we go through this whole rigmarole. Let me be honest. As a physician doing this level of body work, it’s work, and it’s a choice. It’s definitely something that I fully, 100% believe in, and that’s why I do it, and that’s the reason.
PHOEBE: You say it’s work for you just because of the physicality of it. When I think of Rolfing, I think of the most deep tissue massage I’ve ever had. The one time or the few sessions that I was Rolfed, I was not presented with this ten session option. I had a Dalmatian formation of bruises all over my back. Is that the name of the game, just so people really know what they’re getting themselves into?
JASON: No, the Rolfing, again, this is also political, and I’ll just be careful. The Rolfing of the 70s and the 80s came out of the human potential movement of psychology, and that movement did want to go to the extremes. It did want this it’s got to hurt to really move. No, that is not what the structural integration I’m talking about. There is times where there might be a little mark that just forms. That will go away. There are times that things are quite painful, but normally, I mean, it’s literally I will anchor something. Someone will move it, and it will be uncomfortable for 30 seconds, maybe a minute. Then it’s fine. That’s what we’re talking about.
I mean, this is the God’s honest truth. Every practitioner practices differently. No matter what their qualifications are, no matter what their field of medicine is, there are practitioners that really love what they do. They’re really good at certain things. If that’s what’s going on with you, that’s who you want to see. Sometimes that’s hard to find. That’s a journey.
Truly, feel free to ask questions. Say, hey, what are we doing here? What is this about? What’s the big picture? Where are we going? What happens if this happens? I mean, I love those questions. I love talking about that stuff, at least with my patients. I know they care then. I know they’re not just coming on a table and being like, hey, fix me.
Here’s the other truth. I can’t fix anyone. It’s about moving through yourself. You asked what might make someone stuck. It’s just they’re not ready to move through that, and there is no judgement. That’s just where they are, and my job is to get them the best place they can be where they are.
PHOEBE: I love that. I do want to get to seven through ten. Why don’t you run through those before I ask my next follow up question?
JASON: Absolutely, so I love this. Session five and six is really dealing with abdominal area, the pelvic floor, which truly, I mean, there’s a reason it’s in the middle of the sessions. You asked, hey, can we just skip there? I think every structural integrationist, I think every Rolfer, I think every patient is like, hey, can we just skip there? We need to use the discipline of the feet are connected to the knees, and the knees are connected to the hip. The hips are connected to that whole abdominal area. Enough of that, though.
Five and six, we have now moved our way up into the head. Session seven is a wonderful session. It is the neck. It is the skull bones. It is inside the mouth. It is inside the sinuses. It is an amazing session. This is where a lot of people get scared. They’re just like wait a second, in my mouth, really? Yes, really, this is where we move the skull bones or the patient or client moves the skull bones and can truly start moving through their central core.
Four, five, six and seven are recognized as the core sessions. If we were going to make this simple and make it like geometry, the outer core is like an outer envelope, picture two cylinders. The outer cylinder we deal with in sessions one, two, and three. Sessions four, five, six, and seven, we’re dealing with that inner cylinder. These cylinders have to be integrated. They have to work together. Four, five, six and seven is working on the inner cylinder.
Before we lose eight, nine and ten, let me just go quickly into it. Eight, nine, and ten are the integration of all of this. Just like we were talking about the outer cylinder, the inner cylinder, the external or superficial and the core, eight, nine, and ten. Eight is the lower body going into the upper. Nine is the upper body, and then ten is just integrating both of those together. Those are integration sessions that can bring together all the different work.
From each of those sessions, you can see it’s like, wow, that can take more than an hour, and sometimes it does. Those sessions are on specific areas that can move things through, and these are bringing it all together with the ultimate effect of having someone able to move anything through their core. Whether that be something physical, whether that be something emotional, whether that be something spiritual, move that through their core, and be a better earth dweller in gravity.
PHOEBE: Does this stick permanently if you do make it through all the sessions? Do people relapse at certain places? I think, again, the argument that someone might have about investing in this sort of work is, well, gosh, it’s a lot of work. Am I going to actually be better after it, or am I going to have to do it all over again one day?
JASON: This is a complex question, and here’s my semi-complex but simple answer. When I tell my patients and I say to them, listen, I’m not hard selling you this, go listen to the podcasts. Go do some research. Think about if this is the path you want to go down, and they ask me this exact question. I say to them here’s what I can guarantee you. Things will change in the ten sessions, and those changes are permanent. Who knows what that actually will be in its entirety?
Again, I also remember that you asked me what I’m looking to address, and let’s get back to that. For right now, I’m saying things will change. Some people, I do ten sessions. They’re done. They were constipated. They’re not constipated anymore. Their right hip wasn’t moving. They’re now able to move up ladders. They’re doing tai chi, yoga, whatever they want to do. That’s that.
Some people want to address a certain area again. They’re like you know what? We got through ten. Session five, I remember you touching this area, and I remember this from when I was 16. I didn’t tell you. We didn’t address it. I just thought about it, and I feel great, but I want to go back and address that. Sometimes that’s the way it goes.
Other times, how I normally do it is I do ten sessions. Then I say, listen, you need to take at least six to eight weeks to let this integrate. Let’s just do a check in, and see how that’s going. Possibly at that point, someone’s just like this is better. This is better. This is better. This is better, but I want to do this.
Then I say, okay, well, it looks like we should probably just do eight, nine, and ten again because it sounds like the integration is what you still need some help with. Other cases, they’re like that was the most amazing experience of my life. Can I do another ten? I’ll say, okay, you must be one of those people. Why would you put yourself through that torture again? It’s not torture. I’m kidding.
Why would you want to do that again? Then we talk about it, and they say, well, this is what I accomplished with ten. Can I do more? I’ll say do you want to do more? They say yes, so I say, of course, I’m there with you. Let’s journey through another ten with the expectation of different results. Not that we’re going after the same thing.
The reason I’m going through all these different things is everyone is different, and everyone is going to have a different case. I hope that that helps. I’m sorry I’m being so nebulous. I hate doing that, but it’s just I’m stuck here. This is where I just have to be truthful. I say to every one of my patients I’m a straight shooter. Many of them love that, and I will always just say what is going on and what the truth is.
PHOEBE: No, I love it. I didn’t even know we were going to have a controversial conversation around the Rolf Institute and whatnot. Back to the things that this addresses, for people who don’t necessarily have SIBO specifically but maybe falling into the camp of “gut people” who just seem to always have their issues residing in that region, are there any other benefits that this alone can help with? Can it help rebalance your microbiome just by getting things flowing properly?
JASON: That’s a hard question. Again, that’s another one of my specialties is working with the microbiome, and of course, I’m doing everything I possibly can from both supplements, nutrition, all the above to try and optimize someone’s microbiome. From my standpoint, I wouldn’t be a true scientist if I said, oh, look at this person. I brought them through the ten sessions, and their microbiome is now optimized while I also did all these other treatments with them. This is why sometimes I look at things holistically. I try and be the best scientist I can and limit the variables, and that’s why I’m saying you have to go back to that big picture and realize what you’re diagnosing and what you want to treat.
Is it SIBO? Is it dysbiosis? Is it yeast? Is it any of those sorts of things, or is it just I just hold my emotion in my gut? There’s a lot of people that that is what they do. I did it as a kid. I actually went through all sorts of tests that were all normal. I even saw the Dr. Atkins in New York as a kid to try and just do this, and it just was I’m one of those people that hold my emotion in my gut. There isn’t anything else that we’re going to find “diseased.” It’s just that.
PHOEBE: Does structural integration help you?
JASON: That’s the only reason, Phoebe, that I am sitting where I am, speaking to you right now about this very specific thing is because it helped me. I get the work regularly. I’ve been through the ten sessions now twice and get some touch-up work. My acupuncturist that works at 8 Hearts works on me from that angle. This is the truth. You have to have a team. You have to take care of yourself, and you just have to find what works for you. What is your journey?
My definition of health is not restriction. It’s freedom so freedom and adaptability. That’s what we need to work towards, and that’s why I love structural integration. At its core, that’s what it’s trying to do. It’s trying to make your body more free from lack of adhesions and more adaptable to whatever may come its way, whether that be a future injury, whether that might be – if that’s physical, mental, emotional, or spiritual, more adaptable to future injury. Again, at my core, being a naturopath and loving being a naturopath, I practiced preventative medicine. At its core, this is both corrective and preventative medicine at its finest.
We’re not just talking about the gut. There’s some athletes, there’s some bodyworkers, there’s some doctors that want structural integration, and I work on them so that they’re optimized. It’s not just about fixing this one thing. Quite honestly, no one has that power except you.
PHOEBE: No one has just one thing, also.
JASON: No one has just one thing, exactly. It’s just one of those things. This is really one of those paradigms that does it fit for everyone? I think everyone could benefit from it, but you don’t do things on someone that is not ready or wanting to accomplish something. I think most people could benefit from structural integration, which is a little bit different than the specialized visceral manipulation or adhesion work.
For instance, Clear Passage, I’m not sure if you’ve done a podcast on that. We recommend people to go to Clear Passage when they have very, very, very set abdominal adhesions. Larry and Belinda Wurn are geniuses. They’ve done so much work. They have amazing research out there. They work just on the abdomen for 20 to 40 hours as part of their program. It’s very expensive. It’s very specialized, and in some people, that’s exactly what’s needed.
That’s not what we’re talking about with structural integration. We’re talking more about a more universal, more primary care, more entry level adhesion work that can actually integrate the body. What I would say is sometimes, when someone gets that much intensive abdominal work, then they needed to be integrated because this one system has been hit so hard.
PHOEBE: Yeah, that makes a lot of sense to me, and now I need to sign up because you’ve convinced me. I’m a believer and could certainly, I’m sure, benefit from this work. While we wrap up, is there anything else you want our listeners to know about alignment, or bodywork, or any part of the physical process of SIBO healing?
JASON: Absolutely, SIBO healing, all healing needs to be a part of a whole picture, and for each person, that looks different. Do they need a team of practitioners? Some people do. Some people don’t. Some people just need one, two – maybe just one practitioner that really can keep their whole body, whole picture in focus, and that’s where this fits in. Remember, this has to be part of that overall picture, of that overall path of using the best treatments for each thing.
As you wisely shared, Phoebe, someone doesn’t normally just have one thing going on. You can treat one thing at a time, and sometimes that’s best to unwrap that top layer of an onion, so to say. That’s how wellness and that journey goes is it’s layers of an onion that you’re just continually working on and accepting what layer you’re at, and that’s what I just would share at this point. That this can be such a powerful tool in the right hands for the right purpose, and that’s what I would encourage listeners to just mull over is where they are on this overall picture, what kind of help they need. Again, like I said, this is normally part of me helping people on multiple planes, be that nutrition, bet that supplements, be that pharmaceuticals. Naturopaths in Oregon have full prescription pad.
It’s just what someone needs at the time. Making sure we’re treating what we’re supposed to be treating. With a condition like SIBO which has ramifications with the thyroid and blood sugar and all of these other things, this can be a piece of that, but let’s be very careful and clear that it is a piece, not the entirety.
PHOEBE: Such powerful and important advice. I also appreciate all of the cooking analogies you’ve presented over the course of our conversation. I know those will really resonate with our listeners here. Thank you so much again for taking the time, and I will, of course, link to all the resources you mentioned and tell people where they can find you. You may be getting some new patients flying in from out of town, just guessing. Have a wonderful day and thanks again.
JASON: Thank you, Phoebe. It’s a pleasure. At the core of this, we’re just trying to help people and get that message out to people that just need some hope and to know that there might be something else out there. Please, as you said, you’re going to link to our website, 8 Hearts. Please use us a resource. We’re always available. Our front desk is available to answer questions on what this might mean for a particular person and what that looks like, and please, just investigate our website and look up things.
Disclaimer: The information Dr. Jason Wysocki shares is not meant to and does not provide medical advice, professional diagnosis, opinion, or treatment. The information discussed is for educational purposes only and is not a substitute for medical or professional care.