One of the basic principles of Deep Tissue Sculpting states: "Natural, effortless movement between receptive and active energy within both the client and the practitioner is the goal of many forms of body therapy" (p. 31). For me, this principle underlies the work described in this new edition, edited and expanded by Osborne-Sheets, a longtime AMTA member and co-founder of the Institute of PsychoStructural, now known as the International Professional School of Bodywork, in San Diego. In order to engender an effortless receptive/active connection, the book describes how practitioners need to continue to refine their perception and palpation skills, focus their intentionality, and sharpen their understanding of the human body.

To these ends, Osborne-Sheets, as the book's subtitle suggests, offers a holistic vision for bodywork, balancing both artistic and technical aspects. The more technical include the following: reviews of considerations for bodywork modification, for example, lightening pressure when a client cannot give reliable feedback due to medications; discussions of muscular and connective tissue anatomy and physiology; effects of deep tissue sculpting; and perspectives on structural alignment. She describes the body as "a sculpture formed around the framework of the bones ... Skeletal elements provide relatively solid base for creating a unique expression of curve, texture, proportion, density, and movement that is the individual human body" (p. 33). She explains structural misalignments and imbalances, but not the interwoven processes of growth and deterioration between hard and soft tissue. Why do so many elders require hip or knee replacements? What causes the neck of the femur to "wear out?"

Osborne-Sheets begins to answer such questions in Chapter 4, "Body/Mind: The Role of Emotions in Chronic Tension and Pain" (p. 47). Herein, she cites some of the leading thinkers in somatic psychology, which she defines as "the integral interaction between the physical body, the emotions, and the soul" (p. 47). She emphasizes Candace Pert's research in psychoneuroimmunology (PNI), which has demonstrated "beyond any doubt that the human is itself an interconnected holistic entity" (p. 48). She also refers to the work of Peter Levine, that memories of traumatic experience left unresolved remain active in the nervous system, "creating residual traumatic symptoms" that can lead to chronic emotional stress, which in turn becomes chronic musculoskeletal stress (p. 50).

With deep tissue sculpting, clients often get in touch with the underlying emotional issues. Along with continuing education in massage and bodywork techniques, many therapists supplement their practices with training in emotional release methods. Osborne-Sheets is a student of the Arica Institute, an eclectic school of consciousness studies.

The second half of the book is dedicated to the methods of deep tissue sculpting: how "to listen and intuit holistically so that clear session intentions can evolve"; how to develop graceful, self-nurturing body mechanics; how to enter and exit from the client's body with exquisite sensitivity; how to create a profound connection with the client, to be receptive and active (p. 57). In her section on perceiving the client, she includes physical and energetic anatomy. Osborne-Sheets then presents clear explanations of the techniques of deep tissue sculpting- compression and compression-to-stroke-to elongate and stretch the muscle and fascia. Precise application of these techniques arises from the practitioner's focused intention.

Following explanations and illustrations of specific applications, the book offers "tableside technique guides" printed on cardstock with tiny photos and reminders for the procedures, intentions, vectors (i.e., medial, caudal and inferior), and hints and precautions. I especially appreciate the reminders of precautions! The book concludes with a chapter on integrating the techniques into your practice. An example is included of a recommended 10-session treatment plan modeled on Dr. Ida Rolf's 10-session guidelines. Lastly, there are three case studies showing the effects of this work with individual clients.

This is the second edition of the 1991 text. Over the intervening 10-plus years, major research has been conducted on the psychological and physiological effects of massage. This new edition of Deep Tissue Sculpting-a how-to manual for cultivating consciousness, self-care and client connection-is very much up-to-date in providing a richly textured and uncomplicated mind/body perspective. Osborne-Sheets continues to make an important contribution to the massage therapy profession.

MTJ Book Review Editor Lisa Mertz, director of the massage therapy program at Trocaire College in Buffalo, New York, can be reached at: lisamertz@mindspring.com.

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