Hands-In, Hands-Off, Hands-On... Vote!

[bernard]

My choice because =>

immediate results
long lasting relief.

[Diane]

I have run into the same problem here as I did on RE.. can't vote for more than one thing! It's been less than a week since Bowen, but already I'm spending about half my time with patients on the floor teaching them somatics, the other half of the time doing manual treatment.. ( I'm good at manual treatment and it helps me understand someone's tissue issues more clearly, so I do that first espec. with new people... so I won't be throwing out all these accesses to peoples' nervous systems any time soon!)

I'm hands-on AND hands-in. (Bi-manual!)
Cheers,
Diane

[bernard]

Diane,

Polls make problems since you're allowed to a single reply.
I know that imperfection and I'll try to find some better thing?

By the way, Hands-In = Hands-On+ Hands-Off. So You're more a Hands-In therapist?

[BB]

I voted for hands-in. I was going to vote for hands off simply because education was its associated word. I would consider most of what I do education, although it is mostly not them sitting and listening to me talk. Most of the time it is educating them during a movement or with the hands and words together.
Cory

[nari]

I voted for Other - because I chickened out on selecting only 1 option....
Sorry Bernard!

I was about to select the Hands-Off option; Cory implied that option suggests just a sit and talk session, which I agree does not happen very often at all! Hands-Off implies to me: education, direction of movement patterns, strategies for normalising movements and correction of misunderstandings.
A class in a room, doing movements under a trainer or fitness instructor, is largely a Hands-Off to me....but I also get "in" there on occasions; it depends so much on the patient.


My Other option would be hands-off (70%) and hands-on/in? (30%).


Nari

[Servaas]

Hi Bernard,

I like your questionnaire, but cannot fully support your wording. I understand what you mean but to refer to somatic education as 'hands-in' is very strange for me.

The idea is that the process of treatment is experienced from a first person perspective. That is what needs to be embodied in the definition. When I read about 'hands-in', it instantly refers to the hands of the therapist.

Somatics is a dance, a unity between the educator and the client.

Is it possible to change it to 'somatic education' ?

What do you think ?

Servaas Mes
www.somatichealthcenter.com

[bernard]

Mon ami Servaas,

The concepts of Hands-In refers to the topic =>
http://www.somasimple.com/forums3/viewtopic.php?t=89

In my view, Hands-In reflects your vision of this dance?
The hands/mind of therapist induce the internal changes in the patient?

[Green Hornet]

Bernard,
I have hesitated to vote on this post for an unknown reason. Now I can sense why.

I was impressed with the hands-in concept, when you brought it up in one of the previous forums.
But, it (hands-in) still seems to see an internal change in the client from a third person (from our end). From a first person perspective, the change should be little to do with our "hands." It is hard for us to give up our credit, but let's give all the credits to our client. That might be the true first person perspective.

Please disagree. I could be wrong.

[Green Hornet]

Bernard,
I still love your "in" concept, but not "hands."

[bernard]

Takao,

I'm totally imperfect and I need your experience => make a proposal? :idea:

We keep the In and add...?

[emad]

Hi Takao & Bernard;

What about ;

Brain In concept

Neuromatrix In concept

Matrix In concept

Awarness In concept

Thinking In concept

concsiousness In concept

Attention In concept



cheers
emad

[Servaas]

Greetings,

When working with awareness from a first person perspective, there is no focus on hands or feet or backs or necks.

You are literally mobilizing awareness and creating more life force within the client as well as yourself as practitioner.

Of course it is only words, but we need to work towards definitions that can be used by all in the big wide world.

In awareness,

Servaas Mes
www.somatichealthcenter.com

[bernard]

Servaas,

I take it! 8)

[Diane]

Servaas, you said:When working with awareness from a first person perspective, there is no focus on hands or feet or backs or necks.

Well, my first person experience of somatics was that at first there was placement of awareness on back, breathing, abs, blades, neck etc., as individuals, and once the pieces worked in concert, then it was possible to lose the focus and experience one's body 'being' organic, moving as a whole through patters that seemed more intelligent, easy etc..

But uncovering organic movement seemed for me to involve using my awareness much as I would learning any sort of choreography, or singing, or playing music: Learning the notes and then allowing them to blend together into a continuous progression that leads into the next until the song is a complete expression. And eliminating, one by one, what Bernard referred to somewhere as "parasitic movements"... The song, at first, must contain no off key notes, or added warbles.. It needs to be what it is, the song of the body when the body is on its back, the song of the body when the body is on its side, the song of the body when the body is prone. It is necessary to learn the pure melody line, as cleanly as possible.

Once one is upright, then gravity kicks in and momentum kicks in and various other influences kick in, but that melody line can be played while upright and functioning. E.g.: Beverly, I noticed my arms swinging easily and symmetrically all by themselves as my trunk rotated freely as I strode down the street, my feet walking an almost perfectly straight line one in front of the other with no effort to do so from me...

And yes, Servaas, you have learned to play the body song to a place where now you are able to compose new music, by building blocks of "intelligent movement" into new forms. I think acrobats and breakdancers and other sorts of expressive movement athletes like iceskate dancers, can go there too: they practice soma joy. I think we all can strive to get to where you are. But first, we have to learn to play our instruments well enough; learn our notes, our phrasing, our breathing, our runs at whole bars, eliminating sour notes or muffled pitches.. we might be able to play a bit of music, even get through a whole song with a sense of joy, but there's a long way to go, at least for me.

Look forward to the next music lesson sometime, :)
Diane

[pablo]

Servaas,

You wrote:

"When working with awareness from a first person perspective, there is no focus on hands or feet or backs or necks.

You are literally mobilizing awareness and creating more life force within the client as well as yourself as practitioner.

Of course it is only words, but we need to work towards definitions that can be used by all in the big wide world."

You are correct. A good definition of what is meant by "creating more life force" and "mobilising awareness" are very sorely needed. Language may not be adequate to do this, but it's important to try. Without a good definition it makes it much easier for people who are sceptical of your way of thinking and treating to dismiss it as quackery. I personally don't know what you mean by "life force" for example. I would suggest using a different vocabulary, one that is less ambiguous. The word "force" already has a definition in science. It will make scientists cringe and turn away from what you have to say, regardless of its merit. It's a big problem for physiotherapy in general, the language we use does not always mean anything to others.

Pablo

[nari]

Mmm....

:?

I'm lost on this thread, sorry guys.

I really do not know what is being said, although I have tried to follow the language used. Perhaps my brain is off on another tangent; I shall disappear into some geology for a while (much easier to follow) and see how it pans out later.

Nari

[Green Hornet]

Nari,
Did you see the forum discussing the definitions of Somatics at http://www.somasimple.com/forums3/viewtopic.php?t=213 ?

Did you find it helpful?

Many physio lacks their first person experience and incorporate it into patient care. They go to seminars and learn how to see clients from a third person perspective and then they apply it in clinical setting.

I would recommend you to experience someday. Words can do much, but not all. We have to fill the gap. I did fill the gap (I might not have filled all the gap, but the experience was significant) between what I really know with my whole body and what I know in the head, when I attended Servaas' seminar in May.

I thought that Diane beautifully wrote.

Bernard,
How about "In-Action"?
Neurophysiology in action.
Change in action.
Transformation in action.
Potential in action.
Awareness in action.
etc

[bernard]

Welcome to Pablo, wellkown on NOI group.

It is a great pleasure that you joined the board to share your experience!

[Diane]

Nari and Pablo,
I agree with Takao and Bernard. The missing piece we have as practitioners is our knowlege integrated with our cerebellar output or our "action neuromodules." Especially of those pesky paraspinals that are so patient but get so rigid through a lifetime.

Takao, Servaas would probably come on here and say, so I'll beat him to it, that he already has a name for it and the name is "mobilizing awareness." Do you feel that name needs to be further deconstructed? Apparently you do Pablo and Nari, so I'll take a run at what I think it boils down to:

1. I think a clue is in the fact that embryologically the mesoderm that paraspinals are built from, diferentiates out earlier than that which builds the rest. Perhaps because epaxial mesoderm comes slightly earlier than hyaxial mesoderm (everything else in the voluntary body) it is wired differently with less "consciousness" built in from day one. We all know there are fewer sensory nerves in it than in other useable parts. It's as if this "workhorse," more vermiform part of the body came preloaded with built-in obsolescence (called "sensory motor amnesia.")

(How sad, really, for the paraspinals.:( . I suppose that we weren't supposed to live past the point when this could become a problem for us post reproductively. Genes don't care about individual lives. But the older we live, the more conscious work we have to do to stay 'integrated' especially physically/neurologically/functionally.)

2. The paraspinals are covered with the big sheet muscles (lats and traps, the upper traps with cranial nerve innervation). The only way to get to the
paraspinals with frontal lobe intention is to disinhibit them by gaining control of the breathing (diaphragm), and what is innervated closely to it; i.e.: TrA, traps.

3.The movement sequences deliberately start with wavelike movments, very slowly performed, and all conscious and in concert with breathing. It's important to not trigger any emotional resistance, as you can imagine, because this is all about getting past personal inhibition barriers to movement. So the work is designed to safeguard the practitioner (and therefore the patient) against inadvertant emotional barrier invasions.

4. Eventually the person on the floor or oneself, finds him/her/one-self USING paraspinals as if they suddenly have stopped being frozen and have come online. Then the "music" starts. Then "organic movement" including this older and less conscious part of the body can be performed.

5. The feelings come up but they are positive ones. The paraspinals can make the back do all sorts of wild and wonderful things. Too bad we use them like a coat rack most of the time and rarely learn to let them play. Rarely learn to use them "consciously." Rarely practice such movements instinctively. (Cultural norms interfere with us, other cultures less so probably.) This work is very remedial. You might find similar aware use of paraspinals done in belly dance or in 'continuum' dance. Letting the paraspinals lead the movement means that the back won't be pulling itself into two different directions all the time, resulting in zero motion, it flows in stable patterns instead with quite large range of motion.

6. Probably (I'll lay odds) most back pain is a result of the former and not the latter. Also I've noticed less appendicular pains and aches since learning care and feeding of my paraspinals through somatics. I've had more back "soreness", but no lack of function, and would put this soreness down to using body parts in a new way that have not moved in (probably) decades. The access to new range that feels good and strong, deeper breathing, and stronger less inhibited abs, more than makes up for any temporary soreness IMO.

7. I think the sense of wellbeing that ensues is based on the frontals pumping out opioids once they have learned to connect to this older nervous system/action neuromodule. The thrill of integration, of more hard drive opening up in the action neuromatrix.

I know personally know now how connecting to this part of my own body has made my movement more "intelligent"...I wonder if it can do the same for my mind?..hope there's a carryover effect!

Diane out.

[bernard]

Diane,

Awareness
From Wikipedia, the free encyclopedia.
In biological psychology, awareness describes an animal's perception and cognitive reaction to a condition or event. Awareness does not necessarily imply understanding.
Awareness is a relative concept. An animal may be partially aware, may be subconsciously aware or may be acutely aware of an event. Awareness may be focused on an internal state, such as a visceral feeling, or on external events by way of sensory perception. Awareness provides the raw material from which animals develop qualia, or subjective ideas about their experience.
Electro-chemical networks related to the chordate nervous system facilitate awareness. Researchers have debated what minimal components are necessary for animals to be aware of environmental stimulus, though all animals have some capacity for acute reactive behavior that implies a faculty for awareness.
Popular ideas about consciousness suggest the phenomenon describes a condition of being aware of one's awareness. Efforts to describe consciousness in neurological terms have focused on describing networks in the brain that develop awareness of the qualia developed by other networks.
Neural systems that regulate attention serve to attentuate awareness among complex animals whose central and peripheral nervous system provides more information than cognitive areas of the brain can assimilate. Within an attenuated system of awareness, a mind might be aware of much more than is being contemplated in a focused extended consciousness.

Mobilizing awareness is too esoteric (it's not pejorative). But many will be lost in such terms?

[Diane]

Hi Bernard,
Wow! Neural systems that regulate attention serve to attentuate awareness among complex animals whose central and peripheral nervous system provides more information than cognitive areas of the brain can assimilate. Within an attenuated system of awareness, a mind might be aware of much more than is being contemplated in a focused extended consciousness.

Our posts crossed paths. I went back in and worked on deconstructing the term "mobilizing awareness." Apologies to Servaas, who I know believes that phrase says it all.
Cheers,
Diane

[nari]

Takao -

In answer to your first question: Yes

To your second question: No.

I am at a loss to the "I" and "they" concept.
What happened to second person - the 'you'?

Are you saying that we take on some dimension of the person we are treating as though we are experiencing what they are experiencing?

That sounds rather odd - and not a wise move for the "I"????


Never mind - it does not worry me at all that it is too metaphysical for me to 'access'...

Nari

[Diane]

Hi Nari,
I see now how you are confused. "First person" awareness means that you learn it through your own body first, and after that, teaching it to or discussing it with (a third person), is simpler. Not too different from most physical procedures we do with patients, really... I don't think I've ever done anything with a patient that I hadn't already had done on me, or tried on my own body first.

What's slightly unusual with somatics is the profound degree to which we are (most of us) "unconscious" of our back muscles, and how fast they can become 'in the loop.'
Diane

[nari]

Diane

Thanks for the reply. You explain it simply. But I figure most physios are aware of what they teach. I can describe what a number of things feel like when I teach.....pelvic floor included.

I am not sure why this is a revelation....


nari

[Green Hornet]

Nari,
You must have a good group of physio's around you.

I have seen a surprisingly large number of physio's, who have no idea of what they are teaching to their patients because they have not experienced it. They just know it in their head.

[nari]

Hi all,

I'm going to take this line of thought a bit further...maybe off the track, but possible relevant.

Does one have to experience back pain of significant intensity for a long time to adequately 'teach' others about managing the sensation of pain?

Does one have to have borne children to be a good childbirth educator?

Does one have to have experienced severe shoulder dysfunction to adequately educate and treat hands-on/in to be effective?

I don't think so.
So how can we 'sense' another person's pain? How can we know what they are feeling, the impact on their lives?

Takao, what is it really that we must experience in order to teach?

I know precisely what Trans Ab/pelvic floor/diaphragm control feels like.
I can consciously decontract my trapezii in a second or two. (Though the EMG might disagree- yet I can feel an instant release)
I can walk along and barely use hip flexors, driving with the momentum or whatever of hip extensors. (As models on a catwalk tend to do)

Does this help me to teach my patients to do the same?
I know quite a lot of physios who could do the above tasks. I contend that it might help, but it remains quite difficult for a lot of patients to 'learn' what I know I am experiencing myself.

I am willing to admit that I am missing a crucial point. I am still at a loss to understand what that crucial point is.....

Nari :roll:

[emad]

Hi all :

Thus like anything in life ,any activity , any work , even walking .......

all when done on the subconsciuos level will be poor.
when done on the conscious level will be better , will try to realign, make more right ,correct itself .

i think the diffenece is very large/huge between the 2.

Nari :
you are right in the examples you mentioned , but the person who experience the pain/any problem will help more better in the situation more than the person who have not experienced , i think physios who experience back pain will deal better more with LBP patients.

those who experienced facial palsy will deal more , as they experienced the feel.
But
i have to say that thus may not be very long , to some time , with practice we gone out of the experience of feel.

cheers
emad

[Green Hornet]

Nari,
I would like to clarify my point.
We do NOT have to experience a severe back pain in order to teach.
We DO Have to experience what we teach to our patients with awareness.
That is my point.

[nari]

Takao

Thank you for your reply, but as we show patients how we want them to move (visual demo, as well as tactile and verbal) we are probably experiencing the sensation anyway.

Or are you saying as well, that some PTs will simply demonstrate something 'out of their head' without thinking any further about the quality of affect/impact on the patient/s?

I can understand that could be a problem....


Nari

[Adiemusfree]

Thinking, feeling, doing, being

[JasonE]

I'm definitely more of a "Hands-In" kinda guy. I love massage/bodywork, train clients in various exercises and stretches, and am constantly educating people to the best of my ability. If someone learns to work effectively with their own body, I may quickly become redundant for them - the ideal outcome!!


How about "In-Action"?
Neurophysiology in action.
Change in action.
Transformation in action.
Potential in action.
Awareness in action.
etc

Don't forget the hyphen! Then again, you might get a nifty catchphrase for your marketing:

Neurophysiology In-Action to correct neurophysiology inaction! (or some such ;) )

[Mary C]

Neurophysiology In-Action to correct neurophysiology inaction!

An apt description of Barrett's vocation. :D

[Barrett Dorko]

Mary,

You're right. I'm writing this while seated in the Cleveland airport waiting to depart for New Jersey and then on to Halifax - which is right near you, right?

I understand that I'll be speaking to a number of students in the Physio school up there. I'll be sure to emphasize neurophysiology in action, beginning with some pictures of Homer on Mercury (http://somasimple.com/forums/showthread.php?t=5352). Surely this is something to which they can relate.

I will also reduce the number of references I make to the golden age of television and the silent movies.

[Mary C]

Barrett, I take it the old laptop really did learn how to fly.:D

I really wish I could go to Halifax but have to save for a wedding in Texas Dec 13. Will you be anywhere near Fort Hood that week?

Don't forget, it was JasonE that coined the phrase.

[Barrett Dorko]

Writing now from Newark. On that day (December 13th) I'll be sweating it out in front of Paris' faculty at the University of St. Augustine.

I will be glad to give JasonE credit for the line and will be sure to encourage everybody there to come here. I want them to defend the mesodermal perspective so that we might have another opportunity to question it.

It has been said: In science if you don't work hard enough to prove yourself wrong your friends will gleefully take up the slack.

I want them to come here and find some friends.

[Mary C]

Instead of them "befriending" us?

[Jon Newman]

I'm currently working on the book Team of Rivals (http://www.amazon.com/Team-Rivals-Political-Abraham-Lincoln/dp/0743270754/ref=cm_srch_res_rpli_5). Great stuff.

[bobmfrptx]

Manual therapy......specifically MFR techniques.....
Why?
Today , when I thought I just finished my last patient I saw an older gentleman sitting in my waiting room......I asked him what can I do for you and he proceeded to tell me his story...He had just finished 11 weeks of PT at the local mill for his back pain, sciatica and foot drop....all of which he still had...he was obviously in discomfort, antalgic gait and slap slap slap of his right foot....He stated his MRI was normal and that he was 81....
I asked him what he did at therapy...he proceeded to tell me with demonstration that he did this {rode a bike}, then did this {UBE} then did this {side steps left and right}...then he got moist heat and did DKTC.......3 x a week for 11 weeks!!!!
He had ran into an old friend of his who told him to come see me. I took a brief med hx and told him to lie on the table...well he had a torsioned pelvis with leg length difference of 1 inch...a very tight and painful right piriformis and no active DF on the right...
I performed 3 MFR techniques lasting a whopping 15 minutes and then repeated the dorsiflexion testing, much to his (and my) surprise he now had grade 3 DF. He then stood up and asked what did you do? my back pain is gone ...he began to walk around the room, no slap slap slap and kept asking what did you do?, what did you do? I told him I relieved him of nervous system pressure and that I thought I could help him further... He said he would be back...immediate results, manual care.......
What really pisses me off is that the mill got paid boo-koo bucks to do nothing...evidence based nothing which did one thing waste his medicare dollars.......
Call the mechanism what you like, but it is all about the results!!!!!!!!

[Barrett Dorko]

Call the mechanism what you like, but it is all about the results!!!!!!!!

Gee, this sounds familiar.

Please, if anyone ever sees me posting like this do me a favor - shoot me.

Soma Simple isn't about "calling" the mechanism whatever pops into your head, it's about explaining and then defending that explanation with evidence of biologic plausibility. After over 30 years BarnesMFR has yet to do that.

[nari]

Bob,
The only thing I can agree with you is the alarming runaround this old fellow put up with in the previous Rx regime.
Otherwise, I agree with Barrett. If you don't know why and how something works biologically, results don't mean much.

Nari

[Mary C]

Nari, I have a hard time with this statement.

results don't mean much. Results mean a lot to therapists, and they can make a world of difference to patients.

Bob, I have had startling success with "lymph drainage" techniques on severely damaged finger joints. Most people would throw up their hands in despair when they saw them and look at the biologics to see if they would help. If they did not cost so dang much, I'm sure they would have tried them.

Keep looking for sound, physiologically based reasoning to explain your results. I found the paper on C fibres and the influence of stroking the skin on the reward centers in the brain. I find this a much more plausible explanation than lymph drainage. And that is what this forum is all about. How we explain our effectiveness.

This forum has had me drowning in neurophysiology since I joined. What I have learned has made me more effective. And that has helped me teach more effective home programs. My patients have no problem understanding what I want from them when I tell them to treat their skin like their cat (or a luxurious fur coat if they hate cats.)

Knowing why speeds up the process of increasing effectiveness. And that gets better results!

[Diane]

Mary, I think your entire post is a testament to Nari's entire statement, which was:
If you don't know why and how something works biologically, results don't mean much.
:)

[bobmfrptx]

Mary, I know the why's and neuro explanations and use them when approriate for the patient to grasp his/her home program. I let them know not to rile up the nervous system by stretching too hard because the connective tissues need time to process the commands they are receiving, I like the fur coat thing....Results mean everything to the patient!!! Knowing the mechanisms has not led me to be a more effective therapist or altered my manual techniques, it has answered some questions however and raised a few others. Shaclock gives mention to the fascial tunnel environment of the nerves in the first few pages of his book... using the skin as a handle to influence underlying fascial and neuro tissue works well for me....If the nervous system doesn't need a nudge here and there why doesn't it self correct without touch?
Barrett perhaps you can bring this topic up in your next course? Where is that again?
Being shot is not pretty either do not wish that on yourself..........

[Diane]

Congratulations Bob on having started to consider the nervous system at all.

[Mary C]

why doesn't it self correct without touch?

Because we won't let ourselves move appropriately?
...kinesiphobia?
...mistaken beliefs?
...confusion between hurt vs harm?

[Diane]

why doesn't it self correct without touch?
Because the brain (not the fascia) needs a bit of judicious contact (via skin synapses)?

[nari]

Mary,
Results certainly mean a lot to patients and therapists. But, in the bigger picture, if the therapist doesn't know why performing method A leads to outcome X but tells the patient about some untested and spurious rationale, it does nobody any favours in the direction of credibility and professionalism.

It is actually better, IMO, to simply tell the patient that it is unknown why method A works better than others. Even better to then find out the most sensible reason why, which is what you are doing. Connective tissueology and quantum energy simply does not fit into the current rationale. Maybe it will, some day but not now?

Nari

[bobmfrptx]

Congratulations Bob on having started to consider the nervous system at all.

Poor Diane,
Why do you believe I never did even though I told you repeatedly that I give the nervous system its due.....review my posts and then congratulate me for viewing the entire human primate for its awesome potential and intricate yet to be fully comprehended functions.
Mary,
The John Barnes Jiggle technique helps correct structural imbalances through innate movement...Just read about some movement awareness teachings on MFR CHAT being taught to kids....with the chant Jiggle like gelaton rearrange your skeleton.....
Have a great day
bob

[Jon Newman]

Bob,

When you state something like

Knowing the mechanisms has not led me to be a more effective therapist or altered my manual techniques, it has answered some questions however and raised a few others.I don't know whether you know the mechanisms or not because you never talk about them and you dismiss them as being important even if it is the central theme here at SS. JFB-MFR has been given its due and found to be lacking in its explanatory model. I expect you think as much but can't say so for political reasons. Rather you continue to promote his special brand of techniques as if His jiggling carries some special quality that other jiggling does not. The fact that I think you repudiate his explanatory model but continue to promote his material is particularly annoying and promoting JFB seems to be the only thing you post about. I feel like you're knocking on our door to ask us if we've accepted JFB into our hearts.

Also, the fact that you promote (and associate yourself with) someone who launched a cease and desist letter threatening a law-suit against three of our moderators and two of our friends lowers our tolerance for your interactions here. Your presence will have a menacing flavor to it because people may remain hesitant of being critical to avoid possible legal action.

If all you're going to do is evangelize, I'd personally prefer if you did it elsewhere.

p.s. I should note that I'm as posting this without my moderator hat on. It's my personal opinion.

[Diane]

With and without my mod. hat on, I share the same opinion as Jon.

[bobmfrptx]

I answered the survey question and gave my reason for my answer.....no evanglism or anything....just stated I used 3 hands on techniques which I learned at MFR courses which were highly effective end of story.....
Jon.....I am aware of the mechanisms espoused to explain what happens beneath my hands.....all of them....the client beneath my hands isn't and the techniques still work.....I explain as needed to the level of the patient, In my 27 years of experience few really want to know the exact mechanism or care....hence educating the client was not the primary reason I chose on the survey list......
I will not send a letter to anyone..give your opinion freely.....and I guess I may have offended Barrett, my bad , didn't know about the cancellation of his sponsorship until after my comment.....I never got a brochure either and he was all over Pennsylvania...maybe he will be better off......sorry Barrett.

[Barrett Dorko]

For the public record, your apology is not accepted. I do not believe you didn't know and your meanness was simply exposed.

Too bad for you.

[Jon Newman]

Bob,

You've made it clear elsewhere at SS that you are proud to be associated with JFB MFR and not just generic MFR. Normally I don't think much of guilt by association politics. Trying to associate Obama with Ayers for example was pretty lame this last campaign cycle. On the other hand if Obama subscribed to the same politics and manner of expressing those beliefs then I think it would be a reasonable association to make. However, Obama renounced those negative aspects while not denying other aspects. He had to do the same for other guilt by association tactics used during the campaign (for example, with his minister.)

I appreciate that you will not send cease and desist letters as it is not your style but it is clearly the style of the person you proudly associate with. When you bring him with you it makes it less likely that people will criticize your JFB MFR advocacy which is good for you, I guess, if you don't want any sort of criticism. At least that's how I feel about it.

I don't know why you bring up what it is your patients do or don't want to know because it has nothing to do with the point that here at SS we do care and encourage people to explore it. Since you already know ALL the mechanisms please elaborate. It would be nice to know them. Unless, according to you there is no use in knowing them.

Finally, I think your claim that you aren't evangelizing for JFB MFR is pretty thin. I adovcate and evangelize for plenty of things and I can see it. What's the MFR in your name for? You can do it I suppose but I'm not a fan.

[John W]

In my 27 years of experience few really want to know the exact mechanism or care

Here, bob, you are exposed.

The hubris of this statement reminds me of Canute commanding the waves. Your profound lack of understanding of pain neuromatrix theory is so exquisitely exemplified by your supposition that patients don't care or know about how their pain works. In fact, though they may not be able to express it, articulate it or consciously appreciate it, understanding their pain is all patients care about because that is the only way it will be resolved.

Our job is to teach- manually, verbally, kinesthetically- those in pain how to find and then express this understanding.

bob, you've been wrong for nearly three decades, and so has your mentor.

[bobmfrptx]

Here, bob, you are exposed.

The hubris of this statement reminds me of Canute commanding the waves. Your profound lack of understanding of pain neuromatrix theory is so exquisitely exemplified by your supposition that patients don't care or know about how their pain works. In fact, though they may not be able to express it, articulate it or consciously appreciate it, understanding their pain is all patients care about because that is the only way it will be resolved.

Our job is to teach- manually, verbally, kinesthetically- those in pain how to find and then express this understanding.

bob, you've been wrong for nearly three decades, and so has your mentor.


My patients walk out without their pain..results that is what they care about. I teach them HEP which they perform to keep the pain away....it has involved elongation stretches long before they were being promoted by the neuro population.....breathing and holding for long periods of time if necessary......so John explain to me agian how I have been wrong if understanding {i believe resolution }pain is all the patients care about and they leave without it!!!!!!!!

Barrett your belief system is your belief system...so be it.
you guys enjoy your club

[Jon Newman]

Bob,

Actually we're a discussion board, not a club, but I get what you're saying. Certain discussion boards have different areas of emphasis. MFR chat may be more your speed given your current attitude and areas of interest.

I'm in agreement with John W. and think you are mistaken that patients don't care about understanding their pain. I'm sure there are those that don't but my general experience is that those that care the least do the worst. Regardless of who is correct, the question of whether patients care to understand their pain or not seems to be a testable hypothesis.

But lets suppose I'm wrong. Patients really just want to be fixed and not be burdened by actually understanding--like me when I drop my car off at the mechanic's shop. Is this a desirable state of affairs? Should patients be encouraged to understand? I think they should be encouraged. Where do you stand?

[Barrett Dorko]

For those of you who are undoubtedly wondering why bob doesn’t “get” this I have an explanation: He’s been abducted by aliens. Now, I don’t mean this literally, and I don’t mean to imply that I actually think that such a thing is possible, but I know for a fact that many, many people report that this has happened to them and once they believe it, they never relinquish that belief nor will they recant. It’s over for them, but they remain human beings, they are “normal” in every other way and we must at the very least respect that. bob's human, and we would do well to remind ourselves of this.

I know about such things because I’ve read and often include in my lectures two books: Captured by Aliens ( http://www.amazon.com/Captured-Aliens-Search-Truth-Universe/dp/0806524960/ref=sr_1_1?ie=UTF8&s=books&qid=1226928367&sr=1-1) by Joel Achenbach and Susan Clancy’s Abducted: How People Come to Believe They Were Kidnapped by Aliens ( http://www.amazon.com/Abducted-People-Believe-Kidnapped-Aliens/dp/0674018796). I’ve written about them in a thread here ( http://somasimple.com/forums/showthread.php?t=3885).

There’s a lot in that thread to digest but I’d recommend giving it a shot. As I re-read it this morning I was especially struck by this quote from Clancy:

The abductees taught me that people go through life trying on belief systems for size. Some of these belief systems speak to powerful emotional needs that have little to do with science – the need to feel less alone in the world, the desire to have special powers or abilities, the longing to know that there is something out there, something more important than you that’s watching over you. Belief in alien abduction is not just bad science. It’s not just another way to explain misfortune and a way to avoid taking responsibility for personal problems. For many people, belief in alien abduction gratifies spiritual hungers. It reassures them about their place in the universe and their own significance.

I doubt that bob is ever going to see that a rational explanation for the effect of manual contact and movement on pain should, as a natural consequence, also contain a repudiation of that which is both unsupported and irrational. Such a thing would force him to release his grip on a theory of care that seems to have abducted him long ago. This theory is fused directly to The One who continues to sell it, and despite his recent threat of legal action against those who question it because they think it’s wrong, bob remains silent on that matter. To me, that says more than he might prefer. From the movie A Man for All Seasons comes the line: The dictum of the law is Quin tace con conseri, meaning Silence gives consent. Isn't it ironic that the potential victims of the law suit have been silenced?

No, bob can’t really talk theory or offer all his explanations without violating physical law. Instead his says, “Patients don’t care about that stuff.” To me, this is absurd, and for a few more years than he crows about I can tell you that it’s been my experience that they do care, and that explaining their recovery is an integral part of the recovery itself.

In Clancy’s quote above she evokes the “spiritual” and anybody familiar with bob’s background in manual care can see that this is its common thread. By extension, those of us who evoke rational, scientific thought are accused of lacking in this regard. What are we to do?

Our best tactic, I guess, is to simply stay on track. bob’s on the Mothership and we can’t help him, but I see no reason to allow him to insist we join him or criticize us for not joining the crew.

After all, we know who the pilot is.

[John W]

bob, if you're still there (which something tells me you are), then I'll answer your question.

When I talk about "understanding" in the context of neuromatrix theory, which is the best explanatory model of persistent pain currently available, I'm referring to the multidimensional, mal-adaptive response on cognitive, affective, neuroimmune and sociological levels. Patients must "understand" this in order for their pain to resolve.

They don't need to understand or know how to treat it from the clinician perspective- that's supposed to be our job. However, the understanding that I have gained from studying the neuromatrix approach and the nature of the "brain that changes itself," has led me to the conclusion that the interaction between patient and therapist is transactional. It is the interaction of two nervous systems speaking, sensing, modulating that provides the "results" that you speak of. We must teach patients to make sense of the disorder that is occurring within their nervous system for them to restore an adaptive response to their pain output.

Yet, you and your fellow MFRers continue with the archaic dualistic explanation that emphasizes the clinician "doing" something to the patient's fascia. The begrudging credit you give to the nervous system is evidenced in your ongoing promotion of an explanation for pain that I'm not even sure you accept. It's hard to tell as you continually talk about how you've read Moseley, Melzack and Shacklock, but you never discuss the concepts they propose in any depth.

"Annoying" is a good term for this on a superficial level. On a more profound level, it's duplicitous.

[Bas]

A quick question to bob. Why are you here on SS? What is it that makes visiting here valuable to you?
If it is the discussions, well, you should have clued in that "it works" is a concept that is not well-received. If it is the neuroscience articles, well, you need to start either reading them (again) and decide that: a) MFR's explanations are bogus, b) you need to leave because you think this is BS here, or c) continue, because you want to keep spreading the gospel according to Barnes, while paying lipservice to the science.....

[Barrett Dorko]

Bas,

Maybe I can answer that question for bob. I'm sure he won't mind.

My mole on the MFR listserv tells me that he carried on about this patient there as well. In response he's received many strokes from his fellow abductees. Today one wrote:

How about if everyone took the time to jot down 2-3 stories sharing the wonderful results they have personally or with their clients.

We could put them together and title the book-

JFB-MFR Results based therapy!

I have noticed that the use of exclamation marks is common in their posts and I'm actually surprised that there was only one included here.

Anyway, you're right, bob wants it both ways and, apparently, thinks he's achieved that. To me, his credibility just continues to plummet, and that after it started at ground level.

Maybe he'd feel even safer if there were a legal threat to criticism in place.

Oh wait, that's already happened.

[John W]

If it is the neuroscience articles, well, you need to start either reading them (again) and decide that: a) MFR's explanations are bogus, b) you need to leave because you think this is BS here, or c) continue, because you want to keep spreading the gospel according to Barnes, while paying lipservice to the science.....

Let's start another poll: I vote for c).:vomit:

[Diane]

I doubt that bob is ever going to see that a rational explanation for the effect of manual contact and movement on pain should, as a natural consequence, also contain a repudiation of that which is both unsupported and irrational.
That's the crux. If bob is ever going to become a professional.
And what is a "professional"?
Someone who carries (and has learned to use) an Occam's razor with two edges, one for clearing a path in front and the other for clearing a path through his own brain.To improve a profession.

Link to Distinguishing Science from Pseudoscience (http://www.somasimple.com/forums/showthread.php?p=62481#post62481). Check out section called Harm to the Public from Pseudoscience. (http://www.somasimple.com/forums/showthread.php?t=6408)

[Jon Newman]

In Clancy’s quote above she evokes the “spiritual” and anybody familiar with bob’s background in manual care can see that this is its common thread. By extension, those of us who evoke rational, scientific thought are accused of lacking in this regard. What are we to do?Barrett, this is a very good question. Those of us who evoke rational, scientific thought are not lacking in this regard although I concede that there may be a minority who are lacking. Maybe a thread on what is required in order to be considered spiritual would generate some discussion although I suspect it would end up as an argument about word meanings.

Bob, do we have your position correct? If so we could start a new thread exploring your argument that understanding pain is pointless for both the clinician and the patient.

Knowing the mechanisms has not led me to be a more effective therapist or altered my manual techniques In my 27 years of experience few really want to know the exact mechanism or careI'm asking because you qualified the second statement by using "exact". To me this suggests that you do think it is important but patients don't need to know about such things as trpv1, val-val phenotypes, etc. I guess I continue to be confused where you stand. No one here is likely to argue that results are unimportant. Rather we're asking you to consider taking a broader view of what should be considered when assessing "results."

[John W]

1. Deception of the public. Most people generally would rather have correct information than false data upon which to base their beliefs and decisions. People should not prosper by spreading false information, whether they intend to mislead or not.--Beyerstein (my bold added)
Every time a patient's belief in some biomechanical failing on their part is reinforced, by a PT, we are committing a pseudoscientific harm.--Diane

I'd more specifically qualify "most people" in Beyerstein's statement to include virtually all rationally thinking people.

And this is where the "results are what matters" argument falls flat on its face. So, bob, you've stumbled upon a quite simple and intuitive practice of modulating an individual's pain through manual contact. What about the harm this fumbling about creates to society and our profession at large? All in the name of "results" for a single individual or even long series of individuals. You, by yourself, bob, along with all the other MFRers (and I'll even add my clueless Mesoderm Academy graduates as well) couldn't see and treat enough patients in pain to undo the harm you're creating by perpetuating the myth of the fascia.

You're refusal to see the "bigger picture," as our health care system teeters on the brink of imploding under all of its reductionist memes, compels me to conclude that, like so many others within the realm of the fascia fantasy and the Mesoderm Academy, it's all about you.

[BB]

As per my usual, I'll punt to the science based medicine blog:

When impressive science fails to impress patients (http://www.sciencebasedmedicine.org/?p=75)

[bobmfrptx]

.

Bob, do we have your position correct? If so we could start a new thread exploring your argument that understanding pain is pointless for both the clinician and the patient.


Understanding pain is not pointless for the clinician I do not see where I said that????
It has not altered my hands on techniques at all......some patients love to hear the whole pain diatribe....others say don't care as long as I get better.....

the thing that bothers me is that you bash my techniques for the rational you think and suppose I am putting out there, but only one, Nari , has said anything about the "professionally Clinically superior" {thats how they advertise their practice} abused this poor mans medicare money and he left witht the same symptoms he had when he started therapy!!!!!!!!! (extra!!!!just for Barrett)

My immbedded chip is glowing, must phone home.........

[Bas]

Let me repeat this once more: no-one here is "bashing your techniques" or your outcomes. No-one.
If there is any "bashing" it is your apparent cavalier approach to the essential role that patient education plays, and your stubborn adherence to anything Barnesian in the face of all the evidences provided on this site.

"some patients love to hear the whole pain diatribe....others say don't care as long as I get better....."

This presents such a clear picture of your priorities. It goes like this: "As long as I am succesful in the eyes of the patient, it does not matter".

Methinks your embedded chip was calling you back to the hive....

[Barrett Dorko]

The part of your technique criticized here would be the mountain of what the MFR tribe calls "dialoguing" that obviously promotes endless and possibly harmful speculation on "the cause" of the current pain from this life or some other. You never talk about that but I don't hear you repudiating it either. This is what I meant when I said you wanted it both ways.

Assuming you do all of this, and your silence on the matter forces me to speculate, what would your explanation for the patient introduced to the idea of ancient trauma sound like?

Don't wait around for us to speak critically of the practice your patient described. We've been doing that for years and I see no reason to waste any more time on it.

[Jon Newman]

Understanding pain is not pointless for the clinician I do not see where I said that????

You stated this

Knowing the mechanisms has not led me to be a more effective therapist or altered my manual techniques

I consider it pointless if knowing the mechanisms hasn't led you to be more effective nor altered your manual techniques and your patients don't want to know about them.

the thing that bothers me is that you bash my techniques for the rational you think and suppose I am putting out there...

Who is bashing your techniques? You no longer provide a rationale and the one you used to subscribe to has been addressed, or bashed, as you phrase it.

We did ask that you refrain from associating with JFB MFR while here because it feels like baiting and I don't want to say something during the passion of discussion for which someone might sue me. If you want to discuss the greatness of jiggling or other techniques then discuss why it is so great. You could discuss the mechanisms which you claim to know (even if they won't change anyone's effectiveness or manual technique) or cite some sort of outcome study.

[nari]

I'm not sure about the "professionally Clinically superior" implication - where did that come from?
Hundreds of patients get poor quality management, whether it be hairdressing, massage, performance training, MFR, physical therapy, medicos.....the fact that you achieved good results with one is all very good, but it doesn't mean MFR is superior to traditional physical therapy. The whole business of improving a patient's health is complex, and we all achieve lousy and excellent results along the way. That's OK, we continually learn.

Most people appreciate and absorb accurate information on pain processes. This is obvious, clinically, and Beyerstein says likewise, as do many other writers. A few don't, and they may be the passive folk who don't care about self-efficacy with regard to their health.

Nari

[Diane]

Quoted by Barrett as having originated in the MFR list: How about if everyone took the time to jot down 2-3 stories sharing the wonderful results they have personally or with their clients.

We could put them together and title the book-

JFB-MFR Results based therapy!

bob (from post 38): Call the mechanism what you like, but it is all about the results!!!!!!!!

I think we could hypothesize, for the literature, a previously unnamed HPSG social reflex, which we could term the "Rooster Reflex", i.e., the tendency to:

1. crow loudly and continuously and not know how to:
a) explain the crowing itself or
b) be able to downregulate it successfully, or
c) even see any point in doing so;

2. crow hard to get across anecdotal information.

[John W]

...the thing that bothers me is that you bash my techniques for the rational you think and suppose I am putting out there, but only one, Nari , has said anything about the "professionally Clinically superior" {thats how they advertise their practice} abused this poor mans medicare money and he left witht the same symptoms he had when he started therapy!!!!!!!!!--bob

For my part, I referred in this thread to the "Mesoderm Academy," which would be the other side of the reductionist coin that gleefully charged the maximum allowable to this man's Medicare benefit. Shame on them. (BTW, there's a "Search" feature at this blog where you will likely find dozens of critical discussions of traditional, modality-driven, connective tissue-based physical therapy approaches. Surely you know where the bloggers here stand on that?)

Tu quoque, tu quoque, tu quoque....(one for each decade of silence that Barrett refers to, bobmfrpt.)

[bobmfrptx]

I'm not sure about the "professionally Clinically superior" implication - where did that come from?

Nari
THIS IS HOW THE MILL ADVERTISES THAT THEY ARE CLINICALLY SUPERIOR THERAPY..........
i HAVE NO DOUBT THAT THEIR CLINIC IS NICER THAN MINE....MAYBE THATS WHAT THEY MEAN......i JUST HAVE TWO PLAIN ROOMS........
COCK A DOODLE DOOOOOOOO AS BILLY SQUIER PLAYS SLOWLY STROKE ME......lol

EDIT SPELLING

[Diane]

I vote we use the mute function.

[Barrett Dorko]

Yes Diane. That last post was nothing less than demented.

[nari]

I agree to muting. Provocative and irrelevant prose.

Nari