Deconstruction of the Runaway "MFR" Thread

[nari]

Well uttered, Nick!

I have been looking at several unusual CAM sites out of curiosity; and today our dear local paper used up EIGHT pages promoting all sorts of weird stuff.
Particularly, promotion of cosmetic surgery for anyone with door prizes, 'free' meal, and treatment of skin blemishes by Photorejuvenation Therapy (Intense Pulsed Light), which delivers thermal energy to deep tissues.
Another one is thermography, full body imaging to 'tell you where your pain is'.
Yet another one advocating weekly classes in pilates matwork, so 'your postural muscles (pelvic floor, TA) will always be strong'....

What is behind this? As with Barnes.....$$$$$$$$$

Feldenkrais was an exceptional inclusion.

Nari

[Barrett Dorko]

I'm taking it easy on another Saturday following another trip. There are times when I wonder how much longer I can do this without growing, well, the list is long; unwell, indifferent, stale, confused, robotic, esoteric, unfunny, unresponsive, apathetic and a few others that I'd rather not think about. I want to stress that I'm not worried about ever becoming messianic.

Nick, a post like yours truly helps me get back out there despite the sniping from those in our profession who think that popularity, financial success, supposed "miracle" cures and a belief in some future discovery by the scientific community they deride as uncaring and heartless protects them from sensible and responsible practice.

[Tim]

Here to Learn

I made my first comment about a week ago. I was hoping no one was thinking I did a "hit and run". Because of my heavy background in MFR and CST (mainly training with Barnes), and then recently taking Barrett's course, Barrett asked if I would give my comments regarding the two "approaches".
I didn't feel comfortable giving an opinion a week ago, and I am still not thoroughly comfortable at this time, as I haven't had considerable experience yet with SC. I have had two weeks to apply my understanding of it, and have seen, in my opinion, a greater degree of ideomotor movement in my patients, however, I need a lot more time and experience to get to the "compelling" level of my impression of SC. Before I dared brave this second comment in this forum, I wanted to be more informed, thus I have spent the last week doing a considerable amount of reading, including reading and rereading Barrett's Course Workbook, and pulling out my old files on MFR, CST, and some of Barrett's writings that I have collected over the years.
(I find it interesting that I did not know Barrett was teaching seminars until about two months ago. If I had known, I would have gone years ago. I thought he just wrote!).

Maybe that is a good place for me to start. Barnes is well-advertised and that is one of the reasons he is well-known. In my opinion, a reason Barnes' MFR theory and treatment are accepted by so many is because he has been the one providing hands-on demonstrations throughout the country continuously for more than 25 years to thousands of therapists. John Upledger is another example. Barrett does little demonstration. If I had not had a lot of background in MFR and CST, I think I would have left Barrett's course not knowing what to do with the information. I have a lot of questions, and I need a lot more guidance that my style of learning requires.
I would like to observe Barrett treat people. That is how I learn. Therapists can go to Barnes' workplace in Pennsylvania and observe him work and ask questions. I learn by seeing and doing, as I suspect a majority of individuals do.

I have questioned the theory behind MFR for years. Having the grounded-in- science information that Barrett presented was absolutely exciting to me. It gave me a much better understanding of why my patients respond the way they do to the light touch of MFR. I had never heard of ideomotor movement and theory. I came away understanding that I have to be even lighter and without any agenda whatsoever in the direction a patient moves. My results are already better. I am convinced that knowing why a manual therapy method works aids in its effectiveness.

I can relate very well to Christopher Squires. I have had many of his same questions, and I still have many. I am on this blog to learn from the rest of you. It is really the only reason I am here. I have a lot of questions. A lot of the comments I read on this blog are rather abrupt. Yet I will stick-around because I am impressed by what so many of you have to offer. Like Chrisopher wrote: " I really don't care who is egotistical, rude, cultish, or who makes more money. I want to do what works." I will add that I also want to know why what works works. When we know why, then we have a point to progress from. Science builds upon science, knowledge upon knowledge, and technology upon technology --- which is my answer to Christopher's question: "The effect in the treatment room is going to be the same, no?" (regarding whether we are using MFR or SC).

I spent much of this past week trying to figure-out what was the real object of this forum, and not until I read Diane's recent answer to Christopher did I really understand. Is it really as simple as "It is the lack of actual science that is the issue here."? I would like Barrett to address this. Since I haven't really seen an expert use SC on a real patient, I really don't know if what I have done in the past is SC, or SC/MFR, or if they are both really the same except for your understanding of how it works, or what? Does MFR work for that same reason SC works? I think this is part of how Christopher feels. I don't want flippant remarks. I want an attempt for my questioning to be respected and understood, and then a polite way of addressing it.

Barrett asked if there is a good reason not to attend his course:
1. At his seminar, Barrett compared himself to "House", the MD on the television program. I have to admit, that is a fairly good comparison. If you are turned-off by bluntness, construed by some as rudeness, and you don't like Dr House for those reasons, maybe you shouldn't attend. If you can look beyond that, and want to get some real logic and understanding and cutting-edge science behind neuroscience, and a glimpse of how to begin using it to positively benefit your patients, then, by all means, attend.
2. The brochure that Cross Country Education sends to registrants indicates that "As this program is lab-based, participants should wear casual , loose-fitting clothing." There is a small amount of hands-on, but if you are planning on getting much experience in using Simple Contact at the seminar, you will be disappointed.

My understanding of what Barrett said at the end of the seminar was that he could not teach us any more - just take the information and practice the simple contact with our patients. That is simply not enough, especially for someone who comes to the course with little foundation in neuroscience.

Having said all that, from the background that I have had, and my personal need to have a scientific basis for whatever therapy I do, I am grateful beyond measure for what I have learned from Barrett.

I have loads of questions. I still have a respect for MFR and SC. I think Barrett said that he had not had an MFR course. That concerns me, because I don't how he can make an informed comparison between SC and MFR. I can't really make an informed comparison either. I don't know what the possibilities are with SC. I won't ever know if I'm at a level comparable to what Barrett does and achieves, because I will never see him use it under real treatment conditions. I won't hear how he verbally communicates under real patient conditions. I won't know how he handles a variety of difficult patients. I won't know anyone who knows. I won't know how to compare myself to anyone else who uses SC. I don't know if he has a preference for starting SC in the standing position, sitting position or supine position, or if it really matters. I started a new patient two days ago in a sitting position. He was one of the most "stoved-up" patients I had ever had. He had been in severe neck and upper body pain for 5 years since an MVA. He could hardly move his neck at all. His left shoulder was a full inch forward of the rt, and his left scapula was 1 1/2" higher than the right. After about 5 minutes of my hands gently touching various parts of the head and neck and shoulders and upper back, no movement of significance was happening. I could detect a little at times, and perhaps with enough time, some more substantial ideomotion would have occurred because of the depth of his problem. But I was thinking, if I go any longer with him not feeling anything happening, he is going to think I'm really weird and he's outa here. So I had him lie on the plinth supine, and I let my MFR training take-over, which was -- when the head or neck are not responding, be sure to release the thoracic outlet first. So I did MFR of the thoracic outlet, and keeping him in the supine position, was then able to get some ideomotion of the neck. I don't know if that was a good thing to do, or the best thing to do, or what I should have done in Barrett's opinion. Perhaps, in this forum, or by direct email or telephone with Barrett, I can get my dozens of questions answered.

Sorry about the length of my comments. Later. :zip:

[Barrett Dorko]

Tim,

You know I appreciate how much it took for you to post this. I'm no stranger to fear and how it can immobilize us.

What I see here in you is a desperate need to be told how to practice. This does not mean that you aren't a good therapist or a thoughtful and caring person. I don't think it implies anything about your intelligence either.

That being said, there are moments in every course when I address this issue among the participants. Given the time Cross Country allows I offer two short periods of actual hands on experience with Simple Contact and ideomotion. For most, this is more than enough. I say this because many sit down and talk to each other before I begin to lecture again. I say that "they have the rest of their lives" to get better at this in their own way. I think this is where you and I have a problem. It doesn't seem as if you need more instruction in the concept of ideomotion but rather that you need to be continually guided by someone you consider an expert in the application of technique.

In addition - and this is important - you seem to forgotten or ignored the importance of what I call the characteristics of correction. These provide you with all you need to know about where to put your hands or position your patients. As I make clear at the course, I can't tell you what to do. Your patient tells you that and the way you hear them and progress is up to you. It's your practice and no one elses. People who need to be told what to say to their patients might be said to need "coddling" and are exactly what those who teach "progressions" of a method are looking for. Those who teach in order to be admired, revered, honored, venerated and worshiped also want that sort of student. Sound like anyone you know?

I play a part when I teach. I have chosen a manner that gets the job done in six short hours because I respect the time and money that therapists have invested. If this means I have to be blunt at times I am so. If therapists - who are adult professionals after all - need more then they will be disappointed, but they will learn nonetheless and the course objectives will be achieved. I evoke the image of Gregory House for a reason; he gets the job done. Isn't that the very justification MFR adherents use to justify their crazy theories and inappropriate examination of their patient's history? I'd suggest you read "Mr. Dorko's Neighborhood" archived in "The News from Cuyahoga Falls."

There's this as well: you persistently seem to think that my work is about its relation to MFR - about which is better in the clinic. This is your own idea. This thread is about sense versus nonsense, not Simple Contact versus MFR.

Again, I appreciate your writing. You've earned the coveted "Cuyahoga Falls Ohio" cap. Just tell me where to send it.

[Jon Newman]

The times in which we live contribute to shaping our values. In the 1950's, David Riesman's book The Lonely Crowd identified a tectonic shift in the nature of individual motivation. Riesman observed that people of the current generaton were becoming increasingly "other-directed." That is, they were acting in repsonse to the expectations of others, doing things because of what other people thought as opposed to being "inner-directed" and doing things simply because they were the right things to do. The change was something philosopher Soren Kierkegaard had predicted a century before: loss of the individual at the expense of mass man.

The above is from The Rapture of Maturity: A Legacy of Lifelong Learning by Charles Hayes. I've been captivated by that paragraph ever since I've read it. I don't have a good idea as to whether we are becoming increasingly other directed but something clicked when he identified this ubiquitous (and I think recursive) problem.

He puts some of this concept in motion later in the book with the following

I'm quite certain that, had I not begun my lifelong effort at self-education, I would have become a frustrated and anxious individual by now, very likely convinced that any reason there might be for my not achieving more in life was someone else's fault.

Today millions of Americans have such an outlook and what's so disappointing is that I know how they feel. After more than two decades of voracious reading, writing and reflecting, however, I'm convinced that curiosity can overpower indifference. I also know that reaching a level of interest about any subject powerful enough to become a self-sustaining form of motivation can be a hard thing to do. Still, I think for most people it's not a question of their having too little time but of how they choose to spend what time they do have. Intellectual maturity is a function of deliberate learning, not of age. True adulthood is not possible without it.

Lastly,

Growth comes with learning how to embrace life with an intellectual awareness equal to the task of deriving wisdom from experience, and continuing the pursuit, even when the going gets tough and the understanding elusive. To do this we have to learn to care more than just what others think. We have to learn to discern value for ourselves. Real self-help does not come from someone else's list of things we should do or believe.

And then I am reminded of a quote I learned from Barrett in a post made in the not too distant past. It was a line from a poem,

When the woodsman enters the forest
All the trees murmer:
"The handle of the ax is one of us"

[Diane]

Tim,
Glad you're back.

What you say, I can relate to. I remember being disappointed that I didn't get taught how to use my hands thoroughly in PT school. Manual therapy was really what I wanted. I was much the way you are; my learning style needed.. um.. coddling. (I think it was because I was so earnest and didn't want to make mistakes, learning to use my hands. Furthermore, when you think about all the touch taboos there are in the world, we all feel we need some kind of support around overcoming them, I think..)

Anyway, I went to dozens of workshops to learn other peoples' methods. I picked a different "teacher" who was a DO (first name not John...) otherwise we could be twins. I mostly looked to him for instruction, but I also went and learned from a variety of other teachers. It took years for me to work out that there were some big contradictions inherent in the teaching, or at least in the lack of coherent concepts that could organize all the information in a way that made sense. Meanwhile I was a successful hands-on practitioner, got "good results" etc.

It wasn't until I took David Butler's workshops that finally things started to make sense. I was in my late forties by then (..talk about a late bloomer).

The whole manual therapy world needs serious upgrading, especially in the department of "soft tissue." There are a plethora of diverse groups who practice this, each group has its own flavor, and their adherence to science exists along a spectrum of little to nothing at all. All of them including Barnes deludes people into skipping over the nervous system as the unifying factor in the encounter, and moving straight into handling "tissue." (Barrett doesn't do that, if you noticed. Barrett insists that you consider the nervous system.)

What are the factors that have contributed to this? Here's a little list, incomplete and in no particular order:
1. A historical lack of concern on the part of society.
2. Hands-on has always been seen as woo-woo anyway.
3. Those of us who are born to use our hands to treat people with, have to go learn from systems loaded with bad memes, we get infected, we get taken out by those memes, nothing progresses.
4. A tendency on the part of people who do this work to be coddly people, who self-coddle as much as we coddle others or enjoy being coddled ourselves, and don't like "tones" in writing or thinking that "feel off" i.e., non-placeboic. We each have to grow past that trap, any way we can.
5. An accomanying notion that because our hands know what they are doing it's less important somehow for our minds to be congruent with what our hands "know." We are satisfied with very low-level explanations. The thing is, we keep our patients as ignorant as we keep ourselves if we stop there, and we certainly don't do the overall perception of what we do, any favors. We continue to be seen as everything from slightly daffy to fraudulent.
6. Cartesian thinking on everyone's part.

What would progress look like? The technical side is fine for the most part, it has stayed alive, mostly all by itself all these years. The real issue is with the overall concepts, which are archaic and quaint at best, and absolutely misleading and antiscientific at worst, and quite thoroughly self-serving overall.

The point is, gaining visibility and respect in the world of health care. This cannot be achieved without a crisp, coherent, clear, concise overall point of view that is up to date with what all the other fields of research into the human organism, "know."

I use the word "know" in the scientific sense, that all the confounding factors have been excluded and any hypotheses that have withstood all efforts to knock them down, through logic and through experimentation, that have stayed standing, have therefore earned the right to be called "knowledge." The bathwater must go completely and the baby must be allowed to dry off and grow up.

That is where we need to go, upstream. We can't get there in a leaky "Barnes"acle-covered boat loaded with stinking garbage and no paddles, no sail, towing behind us a bunch of fishing nets loaded with rotting memeplexes, that we look out fondly upon as our "legacy" or "history"(!), and a tendency to look past placebo and the obvious other effects on the nervous system our work helps produce. That is the visual equivalent of what we have as our conceptual underpinnings, that's ALL we have right now, unfortunately. Harsh, I know, but if we want to move this line of work forward (and I love this work, I want to see it move forward, improve as a worthy, honorable field of endeavor for humanity)... it has got to clean up, get rid of the crap and nonsense, faulty reasoning, lack of science and antiscientific attitudes.

Each of us has a boat. It's our life. Inside the boat we have our livlihood. It's safe. To move the work forward, we have to move our life, ourself, further. Try to get the boat moving. First we need to cut off the nets because they only pull us back. We have to tip any rubbish/ballast over the side. Reading a few skeptic websites can help people do that. Maybe diving over with a knife in our teeth and doing some Barn(es)-acle scraping would be good. Make sure Oschmann isn't hanging on under there while you're at it. Plugging the leaks, obviously. Building a new sail is next. It should catch the breeze of current science. We will only be able to do our own science if we study wind and learn to manouver our craft in it/with it. It will be a while more before we have that piece together, but meanwhile there's a lot we can do, including having a site like this that debunks the garbage and is hostile to it. Hopefully we can infect others a bit or a lot with this attitude.

A big inertial factor is the fact that manual therapy has evolved as a guru based system, and is kept alive as such, by those who want to make big bucks, and by those who want to support them to make big bucks because there isn't anywhere else to learn this stuff yet, because it isn't scientifically acceptable yet, because it has evolved as a guru based system, and people like Oshman try to prove ludicrous things and call it science and pull the wool down further over the eyes, so that the gurus can continue to flourish... OK, I better stop before I punch someone. :angry:

Anyway, I hope you stick around, your mind seems sharp. :thumbs_up
Together we can. Some day.

[Barrett Dorko]

Diane,

I think it was when I got to "rotting memeplexes" that I started to actually laugh out loud. Boy, and they call me blunt! A classic post and I agree with it entirely. A little while ago I got to thinking about our (that is to say all but the Barnesians here) tendency in our boats to regularly "course correct," as any competent sailor would do, especially on rough seas. I had not considered the netloads of rot and "Barnes'icles" (which is more accurately spelled "Barnes'acles") people like Walt and Dave and Pia have to deal with. Thanks for pointing that out. Maybe it will make me a little kinder and more patient.

Nah, probably not.

I have beside me Dennett's new book Breaking The Spell. You must read this.

Jon,

You've got it just right. We aren't superior in any way really, we are simply passionate about learning more, changing as that which we learn dictates and remembering how much like our colleagues we could become unless we remain vigilant.

What we've chosen to do, given the response it will surely bring from our colleagues - and we all know about paying that price - appears to some as a movement from the secure world of customary practice, the sort of practice we explain with comforting memes (all untrue) and bill for effortlessly; the kind of practice that makes the boss smile. But Helen Keller said it best:

"Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing."

[Diane]

Barrett, I've corrected the spelling.. thanks for the tip.

Depending on how bad or thick the Barnes-acle growth is, an underwater version of Occam's chainsaw might be useful.

I definitely will get the Dennett book. Love the Helen Keller quote. Will steal it now and redo my signature with it.

[Christopher Squires]

There seems to be a common theme throughout the anti-Barnes thought that is clearly confusing issues of morality (a philosophical field of analysis) with any mode of thought that is departed from a current scientific view (I'll let the multitude of researchers/theorists argue what that is). I believe this is confusing two separate issues. In other words, being pseudoscientific does not necessitate an immoral livelihood. You guys are starting to sound like missionaries. That means you're in danger of becoming fundamentalist thinkers. I think Diane mentioned that she felt it appropriate to be "hostile" toward the "garbage". My, my, Diane...hostile indeed. I wonder what emotional impetus is really at the helm here. Hostility is pretty low on the list of possible strategies in terms of effectiveness. Just my opinion.

"We will only be able to do our own science if we study wind and learn to manouver our craft in it/with it."

This reminds me of a question/answer session I once attended with famous fighter pilot/ace Chuck Yeager. Someone asked him, "How do airplanes fly?" He looked at them with a blank expression for about 30 seconds before he replied, "I don't know. The scientists say it's Bernoulli's Principle, whatever that means. They say it has to do with a pressure differential above and below the wings. All I know is, when I pull back on the stick, the plane goes up. When I push it, it goes down. Yes...next question..." This, of course, rang a bell with me and I've never forgotten it. Know the science, it can't hurt, but more important is basic observable cause and effect. People were sailing ships across entire oceans long before science existed. Whatever enormous scaffolding you decide to accept and base your sensible view on is going to be outmoded later. I know you know this already, no need to tell me. But this is a relevant fact. It means, essentially, there is no ultimate truth, because all knowledge/meaning is relative (in Buddhism, "ultimate truth" is said to be empty of inherent meaning, necessarily). Arts are of equal value with sciences.

Mr. Dorko was slightly critical of Tim, stating that, "What I see here in you is a desperate need to be told how to practice." I see some hypocrisy in this, since most of you have communicated a need for someone else's sensible scientific research to provide you with a rudder (more sailing analogies ;-).
I'm not trying to be difficult and give you guys a hard time, but I think your view is dangerously constricted. Again, just my opinion as viewed through the printed word (much left to be desired with this medium).

Be careful with Occam's razor. That thing's sharp...you might cut yourself. Cheers.

-Chris

[Diane]

Chris,

Be careful with Occam's razor. That thing's sharp...you might cut yourself. Cheers.

At least we know how to pick it up and we know what it's for.

About your comment about how all things are relative, equal or something, check out this blog.

The professional science writer has a daunting task. His or her audience will consist of all ranges in education, from elementary school kids just getting their first taste of the wonder of the natural world, to retired professors. It's not an easy job, and maybe that's why so few succeed in making a living at it. Sadly, now it's even harder, thanks to a cavalier attitude towards science fostered by certain elements in the political establishment:

Why is it that politicians who say they want to strengthen science teaching standards can sound so post-modern about science? --Carl Zimmer

Don't you think that in general, uninformed/misinformed people with money who are willing to buy more misinformation/disinformation because they don't know any better, are easier to control, manage, and live off of? Should we agree to being used? Or should we break the cycle, learn to think, get off the "wheel" of ignorance, slow it and stop it instead of turning it faster?

[Christopher Squires]

Diane,

The pendulum that exists between science and magic had swung hard to the scientific side. Now it's swinging back. Why? Arrogance and emotional sterility for starters. And then there are science's idiot children...they've done a great deal of damage. It's still raging out of control. Because immoral people scooped up science and twisted it (by way of it's arcane-ness, it is easy to confound people) to make billions upon billions of dollars. You guys want to complain about Barnes. Good grief...Barnes is a little teeny bug compared to the pharma industry. They, nice representatives of science gone horribly wrong, have and still are raping the world on a momentary basis. How about the energy (oil, electricity, etc.) industry? How about the "defense" industry? Science is a pawn in this world, some perspective needs to be maintained. I am not anti-science. I was reading books about neurotransmitters when I was 18. The filter I try to send everything through is, how does it help people and the world? That's it. It can be "wrong" but good. It can "right" and very bad. It's all about how it's being used. No polar issue is ever clear on either side, and the more extreme the viewpoint, the more one-sided it becomes, necessarily. While we're all cleaning up our thinking, we should try to bear in mind exactly what it is we are trying to accomplish.

-Chris

[Jon Newman]

Chris,

I'm glad you state that you are not anti-science but your posts do seem to come across that way. It's difficult for me to follow your posts as you bring an enormous amount of material to cover. It seems that your thoughts hinge on your conceptualization of what "science" is. Do you have a main point or two to make or are you asking us a question? I can't tell.

Thanks for any clarification you may offer.

[Barrett Dorko]

Science should only progress our understanding when it helps others? Your moralizing aside, you’ve already admitted that you aren’t a historian and thus didn’t know anything about the existence or significance of The Enlightenment. (This, by the way, is no excuse whatsoever though it certainly explains a good deal about what you say and, I assume, you believe to be true.) Saying that, it’s no wonder that you think that all scientific knowledge “is relative” – it isn’t of course, it’s provisional, and never has pretended to be anything other than that. You have confused it with religion. Perhaps it’s your ignorance of The Enlightenment that does that to you. I’d suggest you Google a little. Then consider reading.

Saying that sailors crossed the sea “before science existed” is actually kind of funny. Are you suggesting that they didn’t use any sort of navigation? Without that they might certainly have sailed across but they wouldn’t have known where or when they might land. In Ohio we call this “luck” and when out on Lake Erie we use science – even if only to return to Toledo.

Saying that I’ve been taught how to practice because I’ve looked carefully at research reveals yet another division in our thinking and the way we define words. I define practice as the way you actually employ what you’ve learned. It is an individual thing driven by all the unique things that surround you. I don’t tell others how to do that and I don’t want to be told how to do it either.

So shoot me.

[Christopher Squires]

Mr. Dorko,

That is kind of funny, but I think you know what I meant. If you really think it will help anything, I will read about "the enlightenment". Scientific knowledge is both provisional and relative. It is relative, as is all knowledge. To think otherwise is just silly, in my opinion. I'm sure you're not interested in debating this and we can just agree to disagree.

What is my point? Just to try and bring some balance to this lopsided representation. What exactly is hoped to be accomplished by constantly deriding those you disagree with? I see this group painting a picture where those that believe in something different from you are somehow automatically immoral. You've now expanded beyond Barnes and want an inclusive anti-science establishment to wage war upon. It seems like there is good bit of emotion behind some of your feelings, and it begins to appear more of a personal issue than something useful or sensible. It also lacks humility, which makes it appear arrogant. I am not trying to be insulting, I am merely describing how it appears from my side of the screen.

-Chris

[Diane]

Screen or shield?
Lopsided? Yes, maybe so.. 10 or so people against 50,000 and more.
And you dare to scold me for seeming a bit hostile?