Simple Contact Brochure

[Barrett Dorko]

I appreciate the concern about "geriatric" and I've wrestled with this myself.

My travels taught me that this is what many therapists identify as the problem i.e. people are getting old and this is what hurts.

Unless a course addresses this issue they won't attend. I know better, of course, and will make clear that this conflation of aging and pain might disappear with education about pain, but first I have to draw therapists together for the workshop.

[Jason Silvernail]

I think the connection is great - more traditionally taught manual care is often not tolerated well by the frail and a gentler approach that you can use for a wider population with a larger number of comorbidities is a great idea.

[John W]

I like the geriatric tag as well. This is a group that is considered to be more prone to peripheral "pain generators" by many PTs. It's also a group that wrestles with many of the affective and sometimes cognitive aspects of the neuromatrix, so it provides an opportunity to discuss these contributions as being potentially as important if not more important than nociception in persistent pain.

Maybe you can bring a few x-rays of some bone on bone knees or hips in a patient you're treating with neck pain to help get this message across.

[Diane]

The timing is perfect to include the geriatric tag. The bulk of the population (boomers) are now on the brink of senior-icity.

[Barrett Dorko]

Often I have the impression that if a few of my patients were younger I couldn't treat them as effectively or, at least, with such ease. If that's the case, then the comorbidities that accompany aging can be said to help at times. It's an interesting thing to look at it, and I'd have never come to this conclusion in my old job.

These days I'm not terribly younger than the people I often treat, and there's no reason to believe that what has happened to them won't happen to me. No one in my current venue planned on being there one day.

[gerry]

I've wondered about this Barrett. What comorbidities do you think make it easier for you to treat this population? I'm not surprised you have the success you do as you mentioned in the other thread. I am considering doing some work in geriatrics, and would love to begin this practice utilizing the techniques I read about here.

I'm ready to sign up for this course!

[Barrett Dorko]

Gerry,

Thanks for the response. perhaps Alabama is in my future.

From this Wikipedia entry:

Comorbidity is either:

* The presence of one or more disorders (or diseases) in addition to a primary disease or disorder; or
* The effect of such additional disorders or diseases.

I am focusing on the effects of multiple diagnoses, and I'm convinced that these include patience, comfort with relative stillness and rest, introspection, interoception and a relative (I said relative, not complete) indifference to mirrors.

Are there others that you might suggest?

[John W]

...a relative (I said relative, not complete) indifference to mirrors.

I'd like to hear you speak more on this, Barrett. I recently had a very well-to-do, 70-something female patient who had undergone several plastic procedures to her butt, boobs abdomen and face. She had LBP. She didn't do well in PT, and I'm convinced that her vanity played a strong role in this, but I'm not really sure how.

[Barrett Dorko]

A few years ago I put on my glasses one morning and abandoned the contact lenses I'd worn daily since I was 16.

In my book, there's an essay titled "The lady in the lace gloves." You might already have guessed that it was about what I saw in my waiting room one cold November day and how my heart sank at the impending failure. I need authenticity, not ornamentation. I need improvisation, not artifice.

I think there's a difference between vanity and a real effort to look our best for good reason. I also think that this is a line often hard to detect until you've crossed it.

[gerry]

One of the qualities I thought of, when thinging of my elderly aquaintences, was less of a concern about what others think of them. I realize this varies from person to person. But overall, I get the sense from many that the accumulation of years allows them to freely express themselves. Seems to me, they have "earned" that right.

I also wondered about the beginnings of dementia, and if that might actually be helpful in not trying to analyze what is going on in detail. Perhaps a gentle touch goes further if it is simply appreciated and not scrutinized till it loses all meaning. Perhaps it also helps in decreasing the worry and concern about what others think. Just wondering.

[Mary C]

I get the sense from many that the accumulation of years allows them to freely express themselves. Seems to me, they have "earned" that right.

These are the patients I cherish.

I see too many that never did learn this. So I call them 'control freaks' and tell them to focus on the tree outside the window. If they're going to work that hard all the time, they should be doing something profitable.

Mary

[nari]

One of the qualities I thought of, when thinging of my elderly aquaintences, was less of a concern about what others think of them

.
Gerry, I think you are spot on. I had noticed that characteristic with patients and non-patients, but didn't connect any dots. This is a window of opportunity, but it would be very interesting to see how dementia patients fare under the same window.

Nari

[Barrett Dorko]

It's gratifying to see such support for the program. I'd like to see this marketed with the ease with which the older patient can change in mind.

I've not yet heard from the sponsor but would like to send them here in case anyone else expresses interest in attending.

[aplikator]

Dear Barrett,
I`ve re-read Simple Contact: The Great Conversation and a whole lot of other posts discussing SC. I think I`m starting to get a grip on it. SC seems so easy – but at the same time it seems to require a lot of knowledge and understanding in the field of neuroscience and human behavior.
I now see SC as much more than “just” ideomotion – or enhancing ideomotion in our patients to relieve stress on / from the nervous system.

Again, out of curiosity I wonder.
1. Who or what inspired you to evolve SC and enhance ideomotion? What made you evolve this consept?

The closest hand-on approach I can think of is the functional and indirect techniques applied by a lot of osteopaths (but sadly with an old-fashioned and outdated theoretical framework)

2. Why do you place your hands on lateral bony points?
This is also emphasized in a lot of energy-based osteopathic treatment techniques.

[Barrett Dorko]

The notion that I put my hands on "lateral bony points" comes from someone observing me. I have no sense of this and think they are wrong. The cellular mechanics of touch encourage doing it at bony prominences but this is not a firm rule by any means.

I learned all of the other techniques and applied them early in my career. I discovered Spitz's text in a review in Skeptical Inquirer. My patients taught me what to do, and what to stop doing. The theory is always evolving and it comes from all the reading I and many others do.

I got a message from Summit Professional Education yesterday informing me that my proposal for a workshop on aging and pain will be shelved. No other sponsors have expressed any interest whatsoever.