When it comes to breast massage as a therapeutic, professional modality, there are two questions which come to mind. Are we on the brink of understanding? Or are we putting our heads in the sand? These are dichotomous questions � each having a real place in the discussion of breast massage as a therapeutic means toward breast health.

Breast massage is not an entirely new concept. Europeans practice breast wellness without modesty; even our Canadian neighbors have incorporated breast massage into their health care system. Yet, the practice of therapeutic touch administered to healthy breasts in this country holds tremendous stigma and is practiced by only a relative handful of trained therapists.

Why the difference amongst cultures? Why does one society accept the breast as an important piece of total health, while another only addresses the health of a woman�s breasts as she readies to have one surgically removed? We could certainly lay blame at the feet of many. We have to ask honestly, can we touch the breast without our act being sexual? In reality, we can hardly even talk about it.

When it comes to their breast health, most women have very little to say. They are more willing to talk about their unfaithful husbands or failing careers than they are their breasts. Ask Hannah Hanlon. A breast massage educator and longtime advocate of women�s health, Hanlon was surprised to find the female client was not willing to talk about this aspect of her anatomy. And why not? �There exists the public breast,� says Hanlon. The public breast belongs to Hollywood, our partners, our babies, etc. A woman�s breasts belong to everyone but herself, Hanlon theorizes, so is it any wonder she �disconnects� with them?

Massage, Hanlon says, can both reconnect a woman with her breasts and bring about a greater sense of health. The problem is getting people to listen.

When Hanlon first made her leap in theory between the Vodder lymphatic work she was studying and the potential connections it might have to women�s breast health, she was excited to share the information. �I ran out into the world thinking people would be excited about it.� She posted a discussion about breast massage on a wellness-related Web site. No one responded.

�I found there was a great hesitancy on the public�s part. I couldn�t understand why people weren�t getting it.� In the same vein, Hanlon said while some colleagues appreciated what she was doing, many others were concerned with the information she was putting out. �You could tell there was hesitancy. It was a real head-scratcher for me.� That was four years ago, and, while Hanlon may still feel some of the challenges she did then, she hasn�t slowed down her efforts to help care for women. �This was a natural place for me to go.�

Hanlon�s goal then and now is to empower women to take care of their own breasts. �But the silence is deafening out there.� It�s that silence that is spurring Hanlon into action. �With what women don�t know about their breasts and breast cancer, we�re operating on a lot of fear. Knowledge,� she says, �is power.�

�BYOB�

Massage therapists are not the only ones uncertain how to deal with breast health. Katie Armitage, executive director at Associated Bodywork & Massage Professionals (ABMP), says it�s difficult to weigh the benefits of breast massage against the potential liabilities. �In the past, leaders in the profession discouraged massaging the breast, because of public perception,� she said. �Partly that was because of the continuing battle to change public perception of massage from �massage parlor� images to a legitimate health care service received from a well-trained professional. In addition, a massage client is in a potentially vulnerable place with massage, and so many people are uncomfortable with their bodies anyway, that the discussion of breast massage might actually turn them away from trying the service. Another caution, unfortunately, comes with cross-gender breast massage. I would strongly discourage cross-gender massage for our members, because of the potential boundary problems.� Armitage rightly pointed out that boundary issues are tough enough already without the added fuel of breast massage and all the issues it brings to the surface � from draping on down to client comfort. �ABMP still discourages its members from providing breast massage to clients except in states or local jurisdictions which have specific rules and permission safeguards governing that treatment, and for members who have specific training for this work.�

Hanlon understands the need for caution when it comes to male therapists performing breast massage, but she also sees that 50% of her inquiries for training come from men who want to give their clients the best work possible. �Their clients are requesting it,� Hanlon says. Even though Hanlon�s first breast massage classes were women only, today she offers male therapists a �BYOB� opportunity. That is, to participate in the class, they must bring their own female client to work on � �bring your own boobs.� She said it�s calmed the uneasiness of female therapists undergoing the same training, helping them not feel pressured to exchange work with the men, but still benefiting from the mens� in-class perspectives.

Regardless of gender, Hanlon stresses the need for proper training. �I do believe in the proper context and proper standards. If you just try and do it because it seems like a good thing, you could get in trouble.� All the experts agree on one thing � the client must be given the right to refuse breast massage at any juncture, for any reason. With boundaries so critical in this line of work, therapists must check in consistently and frequently. In addition to proper training, those interested in practicing breast massage need to check the regulations in their city, county or state.

Vodder lymphatic work Even though research in the area of breast massage is extremely limited, those teaching it and practicing it believe in its benefits. �It�s an easy connection for me, but I�m not a physician,� says Hanlon. �When you think about the monthly filling and emptying of our breasts, what eventually happens is that debris is left behind, and it�s that debris which creates most of the benign breast disorders we have.� It makes sense, she explains, that if the breast is drained really well, it will detoxify the breasts, helping to remove carcinogenic properties. �Now, there may be a whole piece of the physiological picture I don�t understand, but everything I read and learn makes that correlation. I haven�t found a thing yet that says this doesn�t make sense.�

With all the potential, why hasn�t there been more research surrounding breast massage relative to the incidence of breast pathologies? �What I find is that people are so busy trying to mitigate cancer and increase technology around detecting cancer, they�re not even thinking in terms of prevention. And even though they still talk about early detection, massage is not part of their language.�

So, will the stigma surrounding breast massage ever diminish, or will it continue to penetrate our mindset? �It�s going to take the handful of educators out there working really hard and training brave practitioners to break the stigma � one step at a time.� Hanlon says the support of the profession as a whole would help get people thinking about massage for breast health. Doctors, physical therapists, even estheticians can work with the breast without intense scrutiny. �I think it�s time for our profession to truly step up to the plate and ask, why are we not trustworthy?� Hanlon believes with professional standards, a clients bill of rights, the medical indication and the physiological rationale, there is no reason breast massage shouldn�t become a household phrase.

Still, even though breast massage is an �underground� type of therapy, its presence is growing. �A few years ago my class had four people,� said Hanlon. �This time it was 11.� Small steps, but forward steps nonetheless. �We just have to keep pushing and nudging and loving it along.�

For more information about Hannah Hanlon and her work, call 206/227-8247 or e-mail her at tmkoru@aol.com.