Bowen Technique

The Bowen technique, also called Bowen therapy, is a branded kind of massage therapy that came from Down Under in the 1950s. It exemplifies many of the flimsiest ideas in manual therapy, and is one of the oldest . While it can be practiced in a modern way, progressive practitioners with some respect for science are extremely unlikely to bother. It is a relic of the golden era of massage techniques named after guru-like “masters” of hands-on therapy — when a lot more people still believed that “magic hands” was almost literally true, as if the best massage therapists were like Mr. Miyagi.

Named for its founder, Tom Bowen, it involves gentle, rolling motions over muscles, tendons, and fascia with the practitioner’s thumbs and fingers. This technique is punctuated by frequent pauses, where the therapist steps back and allows the client to “process” the treatment. Sessions are typically performed with the client lying comfortably on a massage table, fully clothed or covered by a sheet.

The idea behind Bowen therapy is that these soft-touch manipulations send signals to the nervous system that promote healing, ease pain, and restore balance. Proponents claim that it can help almost any ailment, from musculoskeletal pain to digestive issues and psychiatric disorders. The approach is unique for its lightness; it’s neither a deep-tissue massage nor an aggressive adjustment. Bowen therapists describe it as "resetting" the body, tapping into an innate healing ability supposedly lying dormant in all of us.

It’s marketed as a treatment for just about anything that ails you, with adherents boasting dramatic recoveries from chronic pain, migraines, and even fibromyalgia. Sessions usually last about 45 minutes to an hour, and while some clients report feeling better immediately, others are — quelle surprise — advised to undergo multiple sessions to achieve full benefit.

The skeptical perspective on Bowen technique

Bowen technique is a classic example of the pretentious theme of facilitating healing in manual therapy especially, and alternative medicine more generally. Tom Bowen called it a “gift from God,” showing the usual humility of “modality emperors” who fancy themselves to be “healers.” (Bowen also fancied himself an osteopath, but the Austrialian osteopaths disagreed and wouldn’t grant him a license.)

Despite the appealing notion of being gently nudged back into wellness, the scientific basis and plausibility for Bowen is flimsy at best. While anecdotal accounts of miraculous recoveries abound (as they do for literally every snake oil, even the obviously dangerous ones), the plausibility for that is extremely low. Controlled clinical trials are few and far between, and those that do exist all suffer from poor methodology.

The theory behind Bowen therapy’s efficacy is also murky, if not incoherent, and Bowen therapists rationalize their methods with essentially any and every trope of alternative medicine, adopting new ones willy nilly as they emerge. For instance, many have gotten “Vagus fever,” using it to recton?To retcon something is to change the story. It’s a portmanteau of “retroactive continuity,” a storied term. Mirriam-Webster: “the act, practice, or result of changing an existing fictional narrative by introducing new information in a later work that recontextualizes previously established events, characters, etc.” This story-changing business is extremely common in alternative medicine: when you never had a particularly clear explanation in the first place, it’s easy to switch to (or add) a fancier-sounding explanation later. Older methods are generally encrusted with multiple layers of these explanations. their explanation for what they do. Many Bowen therapists have also enthusiastically embraced the ridiculous fetishization of “fascia,” because it seems science-y to them.

But the idea of “resetting” the body’s healing mechanisms is not grounded in any clear physiological principles. There’s no scientific evidence that light massage and touch can significantly influence the nervous system in the profound ways claimed. The pauses in treatment, heralded as a time for the body to “integrate” the experience — where the magic happens — could just as easily be explained as moments for the client to simply relax — a benefit that can be achieved through any number of relaxation techniques, from simple deep breathing exercises to napping.

Moreover, the Bowen technique’s claims to treat a laundry list of conditions — ranging from back pain to mental health issues — are glaringly too good to be true. Broadly effective therapies tend to have a clear biological mechanism and are usually better supported by evidence.

Gentleness is good

It’s worth noting that many intense forms of manual therapy claim essentially the same biological effects and benefits as Bowen therapy — but they try to achieve it painfully. All other things being equal, I’d much rather spend my time and money on a gentle therapy experience than a brutal one. Like craniosacral therapy, it may be nonsense, but at least it’s gentle, peaceful nonsense.

The Bowen technique’s appeal and entire benefit are more about its gentle nature than its effectiveness. Feeling pampered and cared for can be powerfully comforting, and that is inherently valuable — but it’s also no different from what any other kind of massage can and does routinely deliver. Like most other alternative therapies, what’s good about it isn’t unique, and what’s unique about it isn’t good!

Massage is lovely in many ways, but Bowen therapy is an obsolete snake oily variant no one should pay for.

Massage mythology

Bowen therapy is barely distinguishable from “gentle massage,” and so of course it indulges in most of the major myths about massage.

The major myths about massage therapy are:

• Massage increases circulation. Probably not… and definitely not as much as a little exercise.
• “Tightness” matters. The three most common words in massage therapy — “you’re really tight” — are pointless.
• Massage detoxifies. It’s actually the opposite, if anything.
• Massage patients need to drink extra water to “flush” the toxins liberated by massage.
• Massage treats soreness after exercise. Studies have shown only slight effects.
• Massage reduces inflammation. An extremely popular belief based mainly on a single seriously flawed study.
• Fascia matters. The biggest fad in the history of the industry.
• The psoas muscle is a big deal. The most overhyped single muscle.
• Massage stimulates endorphins (natural opioid) and reduces cortisol (stress hormone). They do not.
• “Trigger points” are evidence-based. Actually, the science is seriously half-baked.
• Massage therapists have spooky palpation skills. No, it’s just ordinary expertise… and misleading.

The complete list of dubious ideas in massage therapy is much larger. See my general massage science article. Or you can listen to me talk about it for an hour (interview).

And massage is still awesome! It’s important to understand the myths, but there’s more to massage. Are you an ethical, progressive, science-loving massage therapist? Is all this debunking causing a crisis of faith in your profession? This one’s for you: Reassurance for Massage Therapists: How ethical, progressive, science-respecting massage therapists can thrive in a profession badly polluted with nonsense.