Somatics, Feldenkreis... Please define!

[Green Hornet]

It would be nice to get some questions to find out the level of understanding. So, some of us who have expereinced somatics and master somatic practitioners like Servaas can explain out better.

I would start out to lay out some of key words to explain the concept of Somatics. Tell me how much you understand each key concept.

Soma
Pandiculation
Pathological patterns of movement
Organic patterns of movement
Awareness
Sensory motor amnesia/Somatic amnesia
Reflexes of stress
Acture
Sensory motor feedback loop
Agonist-Antagonist/Reciprcal relationship
Motion-Emotion-Energy

[bernard]

Hello Takao,

My actual understanding =>

Soma = Human Being
Pandiculation = global reharmonisation/functionning?
Pathological patterns of movement = the same but merely = pertubed movement.
Awareness = focusing, attention.
Senrory motor amnesia = global/local functional imbalance.
Reflexes of stress= idem but ignored by traditional medecine = zoom out
Acture?
Sensory motor feedback loop= idem

Agonist-Antagonist/Reciprocal relationship = the core of problems!!!!!

[emad]

Hi takao & Bernard :

like bernard some of the concepts , i do not know .

Acture?
Sensory motor feedback loop?

Pandiculation? please example ?

cheers
emad

[Diane]

I understand where you are coming from Takao, Bernard, Emad, and I too see the need to translate these terms into Physiotherapy-ese, so that others can get what they are about, so the ideas they represent can be visible and understood. To me the words are less important that the valuable concepts they represent. I am prepared to try to translate these words into Physio-ese or maybe Physiolese... others may want to redefine, refine, add nuances, or disagree completely:

Soma 1. A live (human or animal) organism as opposed to a dead one; 2. A live (human or animal) with full (potential or actual) access to all his/her/its physical, mental, emotional and creative faculties; 3. (Human) organism possessing willingness to learn to feel their body better/ feel better in a body; 4. A live (human or animal) body with conscious (human or animal) awareness (potentially or actually) integrated throughout.

Pandiculation 1. Full conscious contraction/shortening/telescoping of a muscle or muscle group, followed immediately by full conscious lengthening/detelescoping of same muscle or muscle group, generally still with some tensioning, performed slowly and luxuriously in concert with a full inhale and full exhale; can be done with help from another, as a form of hands-on, or not. The pandiculation of agonist is followed by pandiculating antagonist.

Pathological patterns of movement 1. Movement patterns that have gradually or suddenly become habituated, automatic, non-organic, splinted, self-defeating, uncomfortable or painful; do not express full movement potential, do not provide the organism with full or even adequate range of motion; 2. Movement patterns that exist cut off from conscious will and intent.

Organic patterns of movement 1. Movement patterns that are innate to the sequential motor unfoldment of human function in infants; 2. 'Garden of Eden' in a sensory motor context.

Awareness 1. That nervous system faculty by means of which attention can be directed.

Sensory motor amnesia/Somatic amnesia 1. Condition that underlies pathological movement patterns; 2. The forgotten ability to sense and move as organically intended.

Reflexes of stress 1. Predictable yet preventable (and reducible) patterns of movement entropy in living creatures.

Acture 1. Posture that moves through space and time; 2. Dynamic posture as opposed to static posture or pose

Sensory motor feedback loop 1. Pathway established by conscious awareness of movement between intention and effectors of motion i.e.: between cortex, and muscular and cerebellar expressions of motor function.

Agonist-Antagonist/Reciprocal relationship (Seriously, who doesn't already know about this? This already is Physiolese.)

Motion-Emotion-Energy 1. Three concepts that pertain to both fueling of movement patterns, or barriers to movement patterns.

It's a start,
Diane

[emad]

Hi Diane :

excellent defining /describation.


cheers
emad

[Green Hornet]

Excellent job, Diane. Nobody else can do better than that.

Pandiculation: I would add (it gets more technical vs. defining)--- The padiculation of agonist is followed by pandiculating antagonist.

Sensory Motor Amnesia: The forgotten ability to sense and move as organically intended.

Now Servaas finally joined us and his wed site is always a great source for learning Somatic concepts. www.somatichealthcenter.com.

I think that great definitions by Diane are a great start. Now we have a job to put all the key concepts together and put them into action.

Please always ask what you don't know. So we can try to help.

[Diane]

Takao,
I added your thoughts/improvements into my post with the definitions.
What do you think should happen next? Are you going to write an article?
Cheers,
Diane

[nari]

Bernard -

Diane and Takao (and of course Servaas) have lots of ideas, new ways of thinking. Ideas tend to lead to discovery, and discovery to validation.
It might take years.

We know that Lorimer Moseley et al, have validation for their hypotheses.
Research on what they are presenting has been going on world-wide for over ten years.
How accepting is the medical world? Extremely slow, but it is happening. Sports physicians are starting to work with the diversity of neurodynamics, orthos are not, neurologists are not.
Many physios are not, some are. Yet there is proof.....it takes a VERY long time for what David (and Barrett?) calls a paradigm shift.

We know that a lot of RCTs, etc are inaccurate and based on dodgy data.

So do we take a middle road anyway? :?:


Nari

[emad]

Hi Bernard ;

you are right we can use our clinics to prove , but we need trials , which can be used as evidence -based practice to convince other physios to use hands in .


cheers
emad

[rolf]

Hi all!
Some like the mother and some like the daughter!
Some like to use elecrotherapy some like somatics.
Some like to treat hands on somle like hands of!

In the long run i dont think it matters what we use as long as we as practioners and our patients belives in it.
The main issue isa THERAPEUTIC ALLIANCE,defind by Horvath et al(1993) as:
1.The clients perception of the relevance and potency of the intervention offered.
2.The cients agreement with the therapist on reasonable and important expectations oft he therapy in the short and medium term.
3.A cognitive and affective component influenced by the clients ability to forge a personal bond with the therapist and the therapists ability to present him7herself as caring,sensitive and sympathetic,helping figure.

"The degree of sucses of the theraputic relationship depends not just on the degree of technical skill posesed by the clinician,but also on the extent to
which he or she is able to develop an alliance a collaborative releationship as the basis of treatment.The essential point is that a possitive relationship needs to be established in order to maximaise the intervention."Mitch Noon from Topical Issue in Pain 4,editor Louis Gifford.
This book is MUST .
I have just read the first part"Placebo and nocebo"andwill from this moment not never say that on treatmentis supirior to than another.
BY the book its in the champion league!
:wink: :wink: :wink:
RIN

[nari]

Rin

I did read some (not all, became distracted and never got back to it) of Gifford's text.
The placebo/nocibo concept is fascinating. Apparently there has now been a defined pathway for placebo, using patients with irritable bowel syndrome. Two groups, one with placebo and one with standard medication. The outcome showed the anterior cingulate happily lighting up equally with both groups, and relieving pain. It was a particular section of the AC, from memory the (R) ventrolateral part, that was crucial in pain modulation. Will try to dig out the paper.

I think you are right in your post. What really matters is how a PT goes about treating someone, not what is chosen. Rapport, charisma, positive attitude, excellent listening skills; all those aspects are invaluable. I still hear from patients, who have had previous physiotherapy for their chronic LBP, that the pain went away for six months with five treatments of hot pack and ultrasound...

Sometimes the foibles of human nature can challenge the effects of scientific endeavour and application. That's what I think at times, when it seems like life is getting too complicated with this method and that method.

Nari

[bernard]

Somasimplers,

The placebo role in Modern Medicine is known but denied in studies???.
Somatics, Feldenkreis make really a rejuvenation of Soma/human beings.

The normal modern studies may fail because they search about 'cold' results but refuse to judge the healer?

But these technique/medicines are considered as pseudoscientific, and, in my view, they need a shift to the 'traditional way of thinking' .

The good new is that the traditional one give all the material to a global acceptance of "Natural" behaviors of caring.

[nari]

Bernard,

I have a copy of a study which proves the placebo effect beyond debate, even to the extent of identifying the modulating area of the brain. (anterior cingulate - no surprise)

At work I will try to send the article.


Nari

[bernard]

Nari,

All is placebo if we consider an internal reaction about every type of care!

Placebo is a In reaction but different that the In one implied by a physical activity with awareness, in my view?

[nari]

Bernard,

Please explain the difference between a placebo effect with and without awareness -

Are you saying that awareness of movement produces a much stronger placebo?
How is this known?

Nari

[rolf]

Hi all!
This is starting to be an interesting discussion.
If awareness through movment is supirior to other treatments, ,but this strill hasent been proven yet,and you as a therapeut has positve attitudes,caring for the patient,showing empathy etc,a therapeutic alliance,
WOOW,perhaps this will be the ultimate pt.treatment.
Just dreaming,its lot of ways to Rom.Sometimes somatics is the best,but not always,it depends more on the therapeut ,than the tecknic in my point of view.
:wink: :wink: :wink:
RIN

[Green Hornet]

Rin,
It is not like one is superior to the others. But, somatics seems to lift the other skills to a higher level and to put all the pieces together.
By improving the level of awareness, all the other skills improve,
because you can sense yourself and your patients better and they can sense themselves and you better, then action and outcome are phenomenal.

[bernard]

Hello Somasimplers,

Fine discussion.

Let us put away some myths first;
1/ Is Somatics able to care everybody? No, but Somatics could improve and ameliorate almost everybody.
2/ if placebo is a side effect directly linked to any effective/ineffective treatment (itself) how is it possible to measure efficiency? Placebo is a subjective effect of the treatment on/in the patient!
3/placebo can be enhanced/reduced by the PT attitude and belief.
4/ placebo role does not require automatically awareness.

There is in fact almost three kind of placebo => the patient one, yours and the action of yours on patient?

The magic with awareness and some motion is that is really more effective than other therapies I knew by the past. I may say that is not more necessary to search hard joint manipulations; you can realize them, yourself, because you get a more complete control (I do not like the term) over the body.

But the magic is not really extraordinary.

1/ attention, focusing, awareness is a conscious but limited faculty.
2/ motion is one of the major task in human brain. It requires many brain processes to be correctly achieved.
3/ motion is the quite only process that is engaged in a constant loop.
4/ pain and merely chronic pain is often an anticipated engagement (before real movement).

5/ Awareness focused on realizing a slow movement, discards easily, the anticipated but wrong muscular activation that causes pain. All those terms are equally significant!!!!!

[bernard]

Nari,

I must add that many times, patients are totally true unbelievers to be cared in few minutes. Our action will be greater but our placebo role too. We have a real impact that must be minimized in my view.
We helped them to realize a self-caring with their resources. We were, for a moment, a guide but only for a moment!

[BB]

Wow,
I am gone for a few days and come back to an explosion of ideas! Very interesting to read through!

My thoughts after reading through some of the new posts=
It seems that a lot of the principles described by Diane from the somatics course are already defined in the traditional medical community.....smooth lengthening of the lat=eccentric control, sensory motor amnesia= motor control or rythm or several other descriptions. If we want to define things in a way that is usable for an as yet unexposed medical community, maybe using the existing language would be helpful. I mean no disrespect, but it seems that the various folks who come up with new things all like to invent their own language to describe it. That makes for a lot of languages out there to understand, and often they could be using the same language to describe thier particular angle.

The idea of 1st person experience I think is a good way to describe and to expand on the idea of "active" which we have talked about extensively on this forum. A pt. said to me the other day "isn't it great the way I figured this out." My first impression was to be turned off by the egotism, but I later thought...it would be nice if more of my patients said this to me. I think that is the first person experience for the patient.

Cory

[nari]

Cory

Well said!!

Nari

[bernard]

Nari and Cory,

Active is a good start but imprecise?

[BB]

Hi Bernard,
Please expand.

Cory

[bernard]

Cory,

We use the term active if the patient do a voluntary muscular activity. In my view, this concept is far from the awareness one.

Active does not necessarily involves attention/focusing?

Perhaps active and attentive?

[nari]

Bernard

If I ask someone to raise the (R) arm to reach an object, and the shoulder is painful, they may or may not be successful because of the anticipation and fear of pain factor. That is an active movement, no assitance of any kind except for the request, or the shoulder may be so dysfunctional as to be impossible to 'move'.

But if I ask that person to take the object down from a shelf, and to concentrate on the hand making the movement, it is likely to be quite successful - ie the pain will be much reduced.

I would call that a fairly precise, controlled active movement?
Or, might it be called something else because the patient is 'cheating' by achieving a task through the hand focus?

Nari