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As our profession pushes toward patient-centered care, one thing is becoming clear — the old clinician-as-the-expert model isn't serving our patients the way we think it is.

In this episode, Jamie sits down with Walt Fritz — a physical therapist with nearly 40 years of experience and someone who famously walked away from a prominent role in the myofascial release world to publicly question the narratives he'd built his career on.

They talk about shared decision-making, informed consent, power sharing in the therapeutic relationship, and why the "soft skills" might actually be the most important skills we have.

In this episode:

• Why the clinician-as-the-expert model is failing our patients
• How the language we use (like "releasing fascia") affects informed consent
• What shared decision-making actually looks like in a treatment room
• The concept of *metatherapy* — and why how you apply a technique matters more than the technique itself
• How to give patients a range of treatment choices including home care, frequency, and movement
• Why the "micromanaging patient" is actually your greatest asset
• Carl Rogers' 1957 paper and what psychotherapy figured out 70 years ago that manual therapy is still catching up to
• Why Walt calls these "human skills," not soft skills

Whether you're deep into manual therapy or just starting to question some of the narratives you were taught — this conversation is going to make you think differently about the person on your table.

Safety video Walt Referenced can be found by clicking HERE

References:

Helou, L. (2017). Crafting the dialogue: Meta-therapy in transgender voice and communication training. Perspectives of the ASHA Special Interest Groups, 2(10), 83-91.

Cerritelli, F., Chiacchiaretta, P., Gambi, F., & Ferretti, A. (2017). Effect of continuous touch on brain functional connectivity is modified by the operator’s tactile attention. Frontiers in Human Neuroscience, 11, 368.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of consulting psychology, 21(2), 95.

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We've been told a lot of things by our regulatory bodies about what we should and shouldn't do in our treatment rooms. But there's one area where I think we've been steered in the wrong direction — and that's mental health conversations.

Of all the musculoskeletal professions out there, our patients open up to us the most. They're on our tables for an hour, relaxed, vulnerable, and trusting. And yet we've been consistently told to shut those conversations down and hand them a referral card.

This episode is about why that needs to change.

⚠️ *Content warning: this episode discusses self-harm and suicide. Please honour where you're at before listening.*

In this episode:

• Why massage therapists are uniquely positioned to hold space for mental health conversations
• Jamie's personal story of losing 12 people to suicide — and what every one of them had in common
• Why suicide isn't what most people think it is — and why that reframe matters
• Why it's better to say something than nothing — every time
• The ALGEE framework from Mental Health First Aid and how it applies directly to your treatment room
• What the research actually says about asking someone directly if they're thinking about self-harm
• Two real-life stories about asking the hard question — and what happened next

This is the conversation our profession has been avoiding. It's time we stopped.

🎓 Want to feel genuinely equipped for these conversations?
Jamie teaches both Psychological First Aid and Mental Health First Aid. Sign up on the waitlist: https://go.themtdc.com/mhfa-waitlist

🆘 In crisis or know someone who is?
Call or text 988 (Canada & US) — someone will answer.
Here is a link to find a helpline anywhere in the world https://findahelpline.com/

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We didn't learn this in school — but we probably should have.

In this episode, Jamie sits down with friend and fellow RMT Mike Reoch to talk about something most massage therapists are never taught: how to actually build a sustainable practice.

Mike has been a massage therapist for 18 years, worked in seven clinics across five cities, and now runs a thriving clinic in Kamloops with his wife — and he has a lot to say about what actually makes a practice work long-term.

In this episode we cover:

• Why BC isn't actually saturated with RMTs — and what the numbers really say
• How to stand out when every therapist's bio sounds exactly the same
• Finding your ideal patient avatar and why niching down actually grows your practice
• The danger of building your practice on one referral source — and how to diversify
• Why "sales" doesn't have to feel gross — and what good sales actually looks like
• Mike's new course, *The Honest Practice Blueprint*, and why he built it for newer RMTs

Whether you're just starting out or feeling stuck in your current practice, this conversation is full of practical, honest advice that nobody taught us in school.

🎙️ Enjoying the podcast?
Subscribe so you never miss an episode — and if this conversation helped you, leaving a review goes a long way in helping other massage therapists find this show.

If the New Generation Massage Therapist Podcast has been part of your growth as a therapist, consider supporting the show. For as little as $3/month you help keep this content free and available for massage therapists everywhere who are ready to level up

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We've spent three episodes talking about your patients' nervous systems. This one is about yours.

If you're showing up for complex, trauma-affected patients with skill and sensitivity — you're absorbing something in the process. That's not a weakness. That's the cost of caring. And it puts you directly at risk for compassion fatigue.

In this final episode of our four-part series on trauma and the nervous system, we turn the lens around and talk about what this work actually costs us as therapists — and more importantly, what we can do about it.

In this episode we cover:

• The two distinct components of compassion fatigue — secondary traumatic stress and burnout — and why understanding the difference matters
• The Job Demands-Resources Model and how it explains why so many therapists feel depleted
• How your own HPA axis responds to chronic stress in the same way your patients' does
• The three core psychological needs that research shows protect against burnout: autonomy, competence, and relatedness
• Why protecting yourself isn't selfish — it's clinical

The work you do matters. And it requires a version of you that has something left to give.

🎓 Ready to build everything from this series into a real clinical framework?
Fundamentals of Therapeutic Movement for Trauma-Competent Therapists is now open — everything we've covered across these four episodes, plus the practical tools to put it into action in your treatment room.
👉 [https://go.themtdc.com/ftm]

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"Your patients don’t respond to a technique. They respond to safety."

Why do some patients instantly brace when you touch them, while others fail to relax no matter how gentle your manual pressures are? In this episode, Jamie Johnston cuts through the academic fluff surrounding "trauma-informed care" to deliver a highly practical, clinical protocol for the treatment room.

When a patient has a history of trauma or persistent neurological pain, your treatment table isn't just a physical space—it can be a sensory minefield. Jamie introduces a concrete framework designed to transition your practice from protocol-based treatment to neurocentric, psychologically sensitive care. Learn how simple structural alterations, language adjustments, and patient autonomy can completely down-regulate a sympathetic nervous system stuck in "survival mode."

Inside this episode, we break down:

• The 5 Pillars of Trauma-Informed Care: Safety, Trustworthiness, Choice, Collaboration, and Empowerment.
• The Myth of Assumed Consent: Why the standard "intake signature" fails your complex patients and how to implement explicit, ongoing dialogue instead.
• Flipping the Script on Authority: Shifting your clinical dynamic from doing a treatment to a body to facilitating recovery with a human.
• The Clinical Emergency Plan: Exact communication steps and grounding cues to use when a patient experiences disassociation or a flashback on your table.
• Small Choices, Massive Wins: How giving clients control over simple variables (like which limb to treat first) restores the biological autonomy that trauma steals away.

Go Deeper: Evolve your clinical approach with Jamie’s targeted mini-course, From Fear to Functional. Turn these neurobiological concepts into real-world treatment protocols, master graded exposure frameworks, and learn how to manage complex pain cases with total confidence. Available now for just $37 at the link below!

👉 Enroll in From Fear to Functional ($37): [Click Here]

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"It's not a mechanical problem. It's a biological debt."

Why do some patients plateau despite perfect manual technique? In this episode, Jamie Johnston dives into the structural and neurological changes that trauma leaves in the body—long after the distressing event has passed.

We move past the philosophy of trauma-informed care and get into the hard science: how childhood trauma alters gene expression (Epigenetics), why adulthood stress creates a "physiological overdraft" (Allostatic Load), and why your geriatric patients lack the "biological bounce-back" they once had. This isn't just about being "nice" to your patients; it’s about understanding the specific biological mechanisms that drive persistent pain.

Inside this episode, we discuss:

• Epigenetics & The NR3C1 Gene: How childhood trauma can "switch off" the body’s ability to build cortisol receptors, leaving the stress response running indefinitely.
• The Allostatic Load Bank Account: Why complex adult patients are often living in a state of "overdraft" where every minor injury tips the system into widespread pain.
• The Geriatric Nervous System: Why aging naturally raises baseline cortisol and damages the hippocampus, making calm clinical environments a biological necessity.
• Red Flags for Referral: Recognizing when a child or adult needs psychological support beyond the manual therapy scope.
• The Power of Presence: Practical ways to restore the sense of control that trauma takes away through choice, routine, and predictability.

Go Deeper: This episode is a preview of the frameworks found in Jamie’s focused mini-course, "From Fear to Functional." Designed specifically for manual therapists, this course helps you turn these neurobiological insights into concrete clinical decisions.

Access the course for just $37 via this sign up LINK

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"It's not an attitude problem. It's a nervous system response."

Have you ever had a patient who seems "jumpy," constantly guarded, or simply fails to respond to treatment despite your best manual techniques? In this episode, Jamie Johnston breaks down why these "complex" cases often have nothing to do with physical tissue issues and everything to do with a nervous system stuck in protection mode.

We explore the anatomy of the survival brain—the Brain Stem, the Limbic System, and the Prefrontal Cortex—and discuss how trauma "logs" sensory details like smells, sounds, and temperatures, turning your treatment room into a potential trigger. Understanding this neuroscience is the first step in moving from a "fixer" to an ally who builds genuine safety for their patients.

Inside this episode, we discuss:

• The "Smoke Alarm" Effect: How the amygdala misinterprets safe environments as dangerous long after the traumatic event has passed.
• Brain Hierarchy: Why the "Thinking Brain" (Prefrontal Cortex) goes offline during a threat response, making logical reasoning impossible for your patient.
• The Chemical Cascade: How chronically elevated cortisol and adrenaline physically damage sleep, memory, and immune function.
• Beyond the "Big" Events: Why an emotionally unavailable parent or a "minor" car accident can trigger the same neurological protection as combat.
• Recalibrating the Approach: Why "tissue work" isn't enough when the nervous system hasn't received the message that the threat is gone.

Special Training Announcement: If this episode resonates with you, keep an eye out for Jamie’s upcoming mini-course, "From Fear to Functional." It is designed specifically for massage therapists who want a practical framework for working with persistent pain patients. Subscribe to the show to be the first to know when it drops!

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"If you move, your disc will bulge." "Your pelvis is out of alignment."

As massage therapists, we often use language intended to help, but we might actually be planting seeds of fear. This fear of movement, or kinesophobia, is one of the biggest drivers of long-term disability. If you find yourself constantly adding new manual modalities to your toolkit because your persistent pain patients aren't getting better, it’s time to challenge the idea that another technique is the answer.

In this episode, Jamie Johnston explores the shift from passive treatment to active, lasting outcomes through Graded Exposure. Learn how to move beyond "tissue manipulation" and start teaching your patients to trust their bodies again.

Inside this episode, we discuss:

• The Modality Trap: Why unconsciously reinforcing that change only happens through your hands can sabotage patient recovery.
• The Root of Kinesophobia: How the healthcare profession—including massage therapy—has historically created a fear of movement.
• Threat vs. Damage: Understanding the nervous system's role in interpreting movement and how to change that interpretation.
• The Graded Exposure Framework: A practical, step-by-step guide to helping patients perform feared activities without pain.
• Promoting Self-Efficacy: Why our ultimate goal is a patient who doesn't need us anymore.

This Week’s Challenge: Identify one "seed of fear" you might be accidentally planting during your patient education. Try replacing it with a safety signal this week and notice the difference in your patient's confidence.

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