Barrett Dorko
19-03-2006, 09:17 PM
It’s been a quiet week in Cuyahoga Falls…
What is needed is a view of life that includes the dark.
Thomas Moore
The PT in Florida who said “What are you fishing for?” when I asked her about her background didn’t know it at the time, but she was giving me the hook for this week’s column.
In Florida the weather was beautiful and the venues perfectly adequate. I felt healthy and strong, my voice fully recovered from some recent trouble and my hair, such as it is, was behaving wonderfully. Recently I’ve put together a little more material about our use and understanding of movement for painful problems that I carefully wove into what I normally say. As I rehearsed it sounded seamless and I was pretty sure that the class would imagine I’d known this for a long time. This is an illusion, I know, but I think it’s a harmless one.
For all of this, I had a terrible week teaching. Just awful.
In Fierce Conversations Susan Scott begins by pointing out that in order to progress with our understanding of any issue we have to be willing to “interrogate reality,” and that this must be done first. Within the first ten minutes of every workshop I say that “our patients with pain secondary to mechanical deformation need a movement that is so enduringly and unfailingly helpful that it can be characterized as corrective.” And then I interrogate reality with this question: “Have we found this movement?”
I think that this is an important moment. I approach it with care and let my voice reveal how I actually feel about the answer – and the answer is “no.” I say this because of the numerous studies indicating that chronic pain is epidemic in our country, but far more significant is the very large percentage of therapists in my classes suffering from the same problem, and they have long since abandoned care, especially their own therapeutic approaches. They know that what I’m saying is true, and while a couple will nod in complete compliance most remain perfectly still. Some display an uneasiness that I suppose should be expected now that I’ve pointed out that there’s an elephant in the room. A few grow angry.
I imagine myself on a tightrope, and I know that a false step can be disastrous. I try to stay on by not saying anything I know to be, well, false. From this point on I have to speak only of those things about the brain and the body that are true – as far as I know. If avoidable, I don’t express opinions and keep referring to the deep model science has revealed. Of course, this makes some in the class angrier still. They typically remain silent but their seething cannot be hidden completely.
As I write this it occurs to me that some students, if they chose, now follow me onto the tightrope that rational practice requires we navigate each day. Falling to either side results in the use of senseless methods or robotic protocols unrelated to the actual problem. It’s my job is to lead them between these and I shouldn’t wonder at their lack of comfort.
Most expect a workshop like any other; a personable and charming instructor full of compliments for anyone in a “caring profession” and open to every question to say nothing of an expectation that their personal opinions will be honored as if they were always worthy of careful consideration. I don’t think you’re going to find me in there anywhere. Instead, I quickly build the case for therapy as a discipline driven by scientific advance. I don’t think it’s an art, and I think the “art” of therapy, such as it is, is not really different from the “art” of effective communication. This begins by interrogating the reality of today’s practice, and, as Susan Scott points out, this begins only after we have “mastered the courage” to do so.
The class is now compelled to make their next step with more care than they ordinarily do. They learn that I think that “belief” in any method of care is inappropriate and that only understanding will do. This understanding is a consequence of study and careful consideration – both of which are typically lacking in therapy departments driven primarily by billing concerns and the constraints of time. For a few this attitude toward their work is refreshing and welcomed. They step forward, following me along that tightrope. You might say I hand them a “balancing pole” with the literature I bring along. It’s composed of insights from Wall, Breig, Butler, Shacklock, Libet, Sagan and others, and for the first time most in the class realize that there’s some help out there. Of course, they have to actually pick up the books. I also point out that they have to turn on the computer. No matter how gently I put this, for some, this part of my presentation just fuels their anger.
As I said, I didn’t feel as though many followed me out onto the tight rope this past week. An OT after class on Friday told me that she was “a lay person and not a scientist because I can’t remember all of this stuff.” She also said, “I think the acupuncture points just lead to a nerve that goes directly to the problem and that’s why they work. One day they’ll discover that’s true.” Then there was the PT who walked into class with Kevin Trudeau’s book Natural Cures They Don’t Want You To Know About. “There are a lot of good ideas in there,” she said. Yet another therapist told me after class that I “sounded a lot like L. Ron Hubbard” (the inventor of Scientology and, apparently, the leader of her personal church) and meant it as a compliment though I certainly didn’t take it as one. Sometimes (not always) in the face of this sort of thing I am silent but I can’t hide my feelings entirely. They leak out of my face. Of course, anything less is unhealthy, which is the point of my work, mainly.
But my favorite example of my failure this week to lure a colleague out onto that tightrope was the woman I quoted at the beginning of this column. It was obvious to me that she knew a great deal about manual care and that many of the issues I addressed weren’t mysterious or new to her. Despite this, she was silent and perfectly still in response to every question and determined to let me struggle ahead as her classmates (who knew very little) couldn’t relate to any of the names or subjects I introduced. I was dying up there but she wasn’t going to support a single thing I said. In an effort to engage her, connect with her, to bond with her just enough to help us both get through the day, I asked very gently how she had come to know so much about the subject.
Her answer displayed a deep distrust of my motives and any opinion I might have, wherever that might have come from. I indicated I needed her help and she just looked at me. I knew then the day would be a long one.
It was.
What is needed is a view of life that includes the dark.
Thomas Moore
The PT in Florida who said “What are you fishing for?” when I asked her about her background didn’t know it at the time, but she was giving me the hook for this week’s column.
In Florida the weather was beautiful and the venues perfectly adequate. I felt healthy and strong, my voice fully recovered from some recent trouble and my hair, such as it is, was behaving wonderfully. Recently I’ve put together a little more material about our use and understanding of movement for painful problems that I carefully wove into what I normally say. As I rehearsed it sounded seamless and I was pretty sure that the class would imagine I’d known this for a long time. This is an illusion, I know, but I think it’s a harmless one.
For all of this, I had a terrible week teaching. Just awful.
In Fierce Conversations Susan Scott begins by pointing out that in order to progress with our understanding of any issue we have to be willing to “interrogate reality,” and that this must be done first. Within the first ten minutes of every workshop I say that “our patients with pain secondary to mechanical deformation need a movement that is so enduringly and unfailingly helpful that it can be characterized as corrective.” And then I interrogate reality with this question: “Have we found this movement?”
I think that this is an important moment. I approach it with care and let my voice reveal how I actually feel about the answer – and the answer is “no.” I say this because of the numerous studies indicating that chronic pain is epidemic in our country, but far more significant is the very large percentage of therapists in my classes suffering from the same problem, and they have long since abandoned care, especially their own therapeutic approaches. They know that what I’m saying is true, and while a couple will nod in complete compliance most remain perfectly still. Some display an uneasiness that I suppose should be expected now that I’ve pointed out that there’s an elephant in the room. A few grow angry.
I imagine myself on a tightrope, and I know that a false step can be disastrous. I try to stay on by not saying anything I know to be, well, false. From this point on I have to speak only of those things about the brain and the body that are true – as far as I know. If avoidable, I don’t express opinions and keep referring to the deep model science has revealed. Of course, this makes some in the class angrier still. They typically remain silent but their seething cannot be hidden completely.
As I write this it occurs to me that some students, if they chose, now follow me onto the tightrope that rational practice requires we navigate each day. Falling to either side results in the use of senseless methods or robotic protocols unrelated to the actual problem. It’s my job is to lead them between these and I shouldn’t wonder at their lack of comfort.
Most expect a workshop like any other; a personable and charming instructor full of compliments for anyone in a “caring profession” and open to every question to say nothing of an expectation that their personal opinions will be honored as if they were always worthy of careful consideration. I don’t think you’re going to find me in there anywhere. Instead, I quickly build the case for therapy as a discipline driven by scientific advance. I don’t think it’s an art, and I think the “art” of therapy, such as it is, is not really different from the “art” of effective communication. This begins by interrogating the reality of today’s practice, and, as Susan Scott points out, this begins only after we have “mastered the courage” to do so.
The class is now compelled to make their next step with more care than they ordinarily do. They learn that I think that “belief” in any method of care is inappropriate and that only understanding will do. This understanding is a consequence of study and careful consideration – both of which are typically lacking in therapy departments driven primarily by billing concerns and the constraints of time. For a few this attitude toward their work is refreshing and welcomed. They step forward, following me along that tightrope. You might say I hand them a “balancing pole” with the literature I bring along. It’s composed of insights from Wall, Breig, Butler, Shacklock, Libet, Sagan and others, and for the first time most in the class realize that there’s some help out there. Of course, they have to actually pick up the books. I also point out that they have to turn on the computer. No matter how gently I put this, for some, this part of my presentation just fuels their anger.
As I said, I didn’t feel as though many followed me out onto the tight rope this past week. An OT after class on Friday told me that she was “a lay person and not a scientist because I can’t remember all of this stuff.” She also said, “I think the acupuncture points just lead to a nerve that goes directly to the problem and that’s why they work. One day they’ll discover that’s true.” Then there was the PT who walked into class with Kevin Trudeau’s book Natural Cures They Don’t Want You To Know About. “There are a lot of good ideas in there,” she said. Yet another therapist told me after class that I “sounded a lot like L. Ron Hubbard” (the inventor of Scientology and, apparently, the leader of her personal church) and meant it as a compliment though I certainly didn’t take it as one. Sometimes (not always) in the face of this sort of thing I am silent but I can’t hide my feelings entirely. They leak out of my face. Of course, anything less is unhealthy, which is the point of my work, mainly.
But my favorite example of my failure this week to lure a colleague out onto that tightrope was the woman I quoted at the beginning of this column. It was obvious to me that she knew a great deal about manual care and that many of the issues I addressed weren’t mysterious or new to her. Despite this, she was silent and perfectly still in response to every question and determined to let me struggle ahead as her classmates (who knew very little) couldn’t relate to any of the names or subjects I introduced. I was dying up there but she wasn’t going to support a single thing I said. In an effort to engage her, connect with her, to bond with her just enough to help us both get through the day, I asked very gently how she had come to know so much about the subject.
Her answer displayed a deep distrust of my motives and any opinion I might have, wherever that might have come from. I indicated I needed her help and she just looked at me. I knew then the day would be a long one.
It was.