simple contact and the close talker

[BB]

I thought of a new metaphor that may be helpful in enhancing our patients' understanding of ideomotion and subsequent use of simple contact to elicit it. Let me know what you think.

Does anyone remember the Seinfeld close talker (http://www.youtube.com/watch?v=eBO3I97SzJU) episode in which Elaine's boyfriend gets extremely close to talk to people? Hilarious. I think most of us have encountered such a person and likely know the feeling that you get when speaking with one. Either you 1) move back to restore your personal space (http://www.youtube.com/watch?v=gsio-1FT4I8), or you 2) stand your ground and bear it, most likely uncomfortably awaiting the conversation to end.

The close talker's attack on our personal space motivates movement to restore the comfortable space. This is a lot like pain. It motivates us to move. If we don't allow the movement to occur, the muscular activity we are fighting against is evident in the case of the close talker, isometrically awaiting it's chance for expression. It doesn't subside until we 1) move away 2) the close talker moves away, or 3) we convince ourselves to be comfortable with the closeness (maybe you are a close talker!). Simple contact is a way to help people become aware of this urge to move and allows for its expression. We live in a culture where people feel they must continue to stand toe to toe with the close talker in a conversation that never ends, and simple contact awakens us to other choices and the thoughtful clinician gives the OK to step away.

[Jason Silvernail]

I like it. This has the advantage of helping people understand that the supression of instinctive response has cultural roots, and that is a very important concept.
Good stuff, Cory...

[nari]

Cory,

I like that analogy too. I have never watched Seinfeld but I know exactly what you mean by a 'close talker'; those folk who have to stand front on and say their many pieces to one's face.
I guess it works both ways - some PTs may stand too close to their patients, inhibiting them and creating both a tension and a need to 'obey'.

I found it useful to stand beside them during SC, or even behind, so my presence did not intrude on their thoughts. I also avoided eye contact.

Nari

[Barrett Dorko]

Cory,

It's nice to see what I call "TTT" (teaching through television) used so effectively by others. This close talking analogy is brilliant.

Consider the "low talking" episode (the one also containing the "puffy shirt") and what it implies about our need to understand in opposition to our need to maintain a certain distance.

[BB]

I've been finding that this analogy is useful in helping to bring understanding to some of the characteristics of correction. Especially, effortlessness. It takes effort to resist the urge to get away from the close talker. Getting away from them is effortless and a relief.

Also, when Chris came down for Diane's class we had a nice conversation about the characteristic of softening. Since then I've been able to better elaborate on this characteristic as it emerges which seems to help the patient continue to gain more softness. Also, Barrett's essay on the forest as a metaphor for stiffness, from his book Shallow Dive, is very helpful in this regard.

Warmth doesn't seem to require too much in the way of description it seems.

So, I'm in search of a way to better tell the story of the last characteristic of correction: spontaneity. I still get some confused looks when I speak of this.


creativity vs. productivity (http://www.barrettdorko.com/articles/creative_movement_for_pain_relie.htm), and

intention and desire (http://www.barrettdorko.com/articles/surrender.htm)
Fit here I believe.

Also, this essay on being Lost (http://www.barrettdorko.com/articles/lost.htm) should be helpful.

I'm going to attempt to stay with the close talker analogy as I find keeping a consistent topic to use as illustration helps the patient.

When confronted with the close talker, the desire to be polite may often overtake the intention to regain comfort (see the above link). We've decided our social appearance to be of primary concern over our comfort. In order to accomplish this we are producing behavior, we forcefully stay still.

If, the social requirements were able to be ignored and you could grow quiet as mentioned in the lost essay, an improved ability to see your intentions to move would result. In this case it would likely be to step away. Spontaneity is simply following your intentions instead of your desires.

What do you think?

[Barrett Dorko]

Cory,

Wonderful stuff. Especially those references to my own writing (ha,ha).

I would agree that the concept of spontaneity is one that might produce a struggle for some, therapist and patient alike. I ask my classes, “Ever surprise yourself with your own words?” and the reaction is mixed. A few will nod immediately while others seem to remember doing this with a certain anxiety. Others stare blankly. Actually, I get a lot of that last one while I teach and ask questions, but that’s a whole other thread.

I go on to say that we’re supposed to surprise ourselves with our own behavior regularly if in fact that behavior is authentic. This is the opposite of playing poker constantly – and you know what I think of that.

These days I play a long series of pieces performed by Art Tatum (http://www.somasimple.com/forums/showthread.php?t=3329) on my iTunes list before class. Otherwise, I never really attend to jazz very often, though I appreciate what it takes to perform in this way. Tatum’s artistry has yet to be equaled and was characterized by an astounding ability to shift seamlessly from one rhythm to another, one key to the next, all mixed in with musical ornaments that flowed from his brain and into his hands effortlessly. I don’t know for sure, but I’m pretty sure that Art couldn’t have told you what he was about to play next – he just let it out.

Perhaps the background of jazz helps me speak as I do without any distinct effort and often, to me, a surprising amount of insight. When it’s going well I feel as if I am witnessing this lecture much in the same way my students are.

Musical jazz performance is similar, I’m sure, as is elite athletic performance, and many aspire to this. But there is a problem. As often as people admire this sort of thing, relatively few actually follow it closely. In fact, I once heard of a sign posted by Lisa Simpson (http://en.wikipedia.org/wiki/Lisa_Simpson) regarding the popularity of this art form: 139 Americans can’t be wrong.

[christophb]

Whew... I thought my conversation with you inspired the "close talker" analogy.

Jonathan Haidt in his book, The Happiness Hypothesis, uses the description of a rider and elephant to describe the conscious/unconscious mind respectively. I've been trying to work something out with surprise in relation to this, but it is still imperfect. So far it something like the rider controlling/training the elephant to some extent, but if rider and elephant are put in danger the elephant will try to escape and it's sometimes better, and the only option, to let it do what it needs instinctively. And how it moves to safety should be observed by the rider as spontaneous. It's safer to do this if in a wide open space (accepting treatment room) vs. a crowded city market (job interview??). I don't know, still working on it. Maybe surprise comes from realizing you are being carried by an "elephant".

On Jazz... I heard on NPR a while back an interview with Sonny Rollins (http://www.youtube.com/watch?v=S46dhVcYWpY&mode=related&search=)the famed tenor sax player. He was talking about all the hundreds of hours put into practicing the tiny details of a piece before a show. But when on stage, he just let it all go and just played. The practice before hand was essential, but perhaps more important was knowing how to get out of the details of the piece and control of the instrument and just play. As a tenor "saxomaphone (http://www.youtube.com/watch?v=mdHrwGPXMH4&mode=related&search=)” player myself (although very rusty these days) I appreciate how hard this is... and how rewarding. Like studying a language intensely so you can better express yourself and tell a story with the music. And having seen him live in Chicago in the mid 90's, man can he tell a great story.

[EricM]

Barrett, do you have a favorite Tatum album?

Cory, I like the growth of this metaphor, and Chris, I swear I will release my inner elephant to do as it wishes. Have you used the elephant metaphor as you practice push hands? I sense it could also be useful there somehow.

[Barrett Dorko]

Eric,

I really like 20th Century Piano Genius (http://www.amazon.com/20th-Century-Piano-Genius-Tatum/dp/B00000473S/ref=pd_bbs_sr_3/103-4023012-9733411?ie=UTF8&s=music&qid=1184378165&sr=1-3). Entirely solo, live performances. The very beginning of "Willow Weep for Me" is amazing, to me anyway. He's able to pick out the entire core of that song in about five notes.

I liken it to the initial manual contact that results immediately in the characteristics of correction - and the patient gets it.

[Randy Dixon]

Since this thread mentioned both Tai Chi push hands and NPR it reminded me of an interview I heard on NPR not too long ago with the author of this book:
http://www.amazon.com/Art-Learning-Journey-Pursuit-Excellence/dp/0743277457

It was a good interview and the book has great reviews, so somebody order it and tell us if it was good.

[christophb]

I think it was brought up on a thread here a while back (Ian??) I bought and read the book... Josh Waitzkin is a machine, I would not want to do push hands with him (Ok, I’d like to try at least once). For me it was more inspirational than informative, but a good read nonetheless.

Chris

[nari]

Cory and Barrett

I find this thread very interesting in its implications.

An admission here: if I am faced with a close talker who is speaking into my face, I do not hesitate to back off. I don't even think about it - it is spontaneous and instant. I don't back off far, probably a few inches.

Does this imply personal space violation or spontaneity or both?

Nari

[Barrett Dorko]

"Close talking" requires a movement of one's face toward another's and without question this sort of uninvited intimacy is disconcerting at best. No wonder our movement away.

By contrast, Simple Contact engages closeness with a therapist's hands. It was always my experience that patients were eager for such a thing once they gained a sense of the therapist through all of the verbal and non-verbal cues offered during the interview. Of course I mean that they came to trust this therapist, not fear them.

When done well (and this takes very little skill) this sort of handling reveals simultaneously to the patient and therapist something I referred to years ago as "the passive voice" (http://www.barrettdorko.com/articles/passive.htm) when I spoke of what I'd learned in college about handling while I was an attendant for a man with quadriplegia for three years. I gave him a bed bath every day, not realizing at the time how well this was preparing me for my career in manual care.

[Diane]

Sure like that little essay. Takes me back to hospital days. Just because the sensations no longer get all the way to the human cortex doesn't mean that the fish brain (i.e. spinal cord) isn't alive and well and trying to escape at the slightest provocation. Learning to handle whatever is innervated by the fish brain only, certainly does teach pacing and patience in handling, how to take the right amount of time to do the job well, and avoid overprovoking that life that still exists, not just in SCI limbs but in everyones' limbs.

About the metaphor, I agree it's a good one. I get so uncomfortable with "in your face" people I couldn't even write a post about it until now. I wonder: perhaps the phrase "taken aback" has roots in the fish brain/sensory motor/non-conscious/ reflexive act, and to delayed recognition by the socially engaged part of conscious awareness, that this action feels as though something else literally takes hold of one to pull one back. This is a paradoxical discomforting situation for troop-focused social primates like us, and good example of the default mechanism at work within the modular brain, where an evolutionarily older non-conscious part will commandeer motor control to enhance survival.

[christophb]

I wonder if close talking is partly threatening because invasion of personal space, and also because the closeness doesn't permit you to see the nonverbal communication of another. It's like looking at a painting really close up and not taking in the whole thing. Without this other source of info it might be more difficult to gather the intention of another or express it back. It’s pretty easy to lie with words, but harder to suppress it in the face. And isn't a large part of communication reciprocation of non-verbal’s? If I can't see theirs, how can I express mine appropriately until I've created space to "see"? Of course this all happens unconsciously. Just pondering...

[Barrett Dorko]

Chris,

Yes, I think you're exactly right. Moving in too close to see well makes the situation more threatening on several levels.

Of course, Don Corleone knew this and expressed it this way: Hold your friends close, and your enemies closer. The uninvited intimacy that the con man presses upon his intended victim also comes to mind.

To me, effective manual care always contained this apparent paradox - friendliness and distance at once. In other words, to my patients I was nothing more than a friendly stranger and certainly not a friend. This, I feel, always enhanced the reflexive effect of my touch.

[BB]

Chris,

That is very interesting. I wonder if the personal space, and the differences in its size from person to person, depends upon that particular persons manner of taking in non-verbals. For example, one particular close talker that I know well is very facial oriented. Her facial mannerisms are quite distinct which makes me think her mirror neuron system likely uses this information in others to create recognition for her. If her main source of non-verbal info is strictly facial, she will not feel threatened by missing out on all of the other bodily info and therefore she is comfortable talking close....very close. I personally have a fairly large personal space. In the midst of a group I often end up backed into a corner to get sufficiently away from everybody. I also rarely remember a lot of facial features of someone new that I meet and habitually am not a real strong "look you in the eye" type of person upon first meeting someone. I may depend largely on bodily non-verbals and need more space to take them in.

So, I guess I'm saying the size of our personal space may be dictated by the manner in which we take in non-verbals, and ,as you said, not having access to our non-verbals would be threatening and uncomfortable.

[BB]

Nari,

I would think it demonstrates spontaneously resolving a violation of your personal space.

[christophb]

Cory, my personal space is quite large also. The ironic thing is my passion for martial arts, in particular tai chi, calls for people moving in on my personal space often in threatening ways. The trade off though is developing use of touch and tactile cues to gather another source of information. There is a whole aspect of martial arts that involves closing the gap or change in flow between combat ranges. See distancing (http://en.wikipedia.org/wiki/Distancing) and trapping (http://en.wikipedia.org/wiki/Trapping_%28Martial_Arts%29).

[EricM]

Has anyone read David Morris' The Sense of Space (http://www.sunypress.edu/details.asp?id=60983) yet? It's a book I've been waiting to get to for a while and this thread reminded me of it.

[nari]

Cory, that makes a lot of sense.

Many PTs might naturally violate patients' personal space even if they (the patients) expect this to happen anyway. Perhaps this spontaneously hands the patient over under the PT's control with a sort of submission we like to call "compliance".
After all, isn't that the aim of physical therapy - compliance? ;).....and isn't moving in too close an effort on the PT's part to 'see' the component at fault better and 'fix it'?

If one sees the 'whites of their eyes' then we're too close to see what we need to see.

Nari