Repackaging Simple Contact

[Jon Newman]

The hook that got me was the nonconscious. I'm unsure if it was an emotional or intellectual hook. For sure an emotional hook for me was the lament over the loss of expressive touch in favor of procedural touch.

[Diane]

Jon, now you've got me all hooked into your post. Exactly.

[Luke Rickards]

I don't think I'll be much help. It was the intellectual hook that got me all emotional about Simple Contact. To quote Barrett from MORE THOUGHTS ON SIMPLE CONTACT - "For me, Simple Contact made more sense than any other manual technique.":teeth:

How about Simple Contact - Reflective manual care and movement therapy for pain. ?

[Randy Dixon]

I have to wonder if the questioning about repackaging Simple Contact isn't primarily rhetorical, a means to start a conversation.

I think Cheryl made a good point about the best way to approach people to change their mind. I've watched on RE as ginger, with no evidence to back him up, has created a good deal of curiousity and even acceptance of his ideas about referred pain. I also watched Diane get a practitioner of CST to question the basis of what she is doing. I think we need to look at why those approaches created good will and an openness to new ideas, while many of the "debates" here lead to antagonism and rejection of new thoughts.

I also think that Barrett is asking the wrong crowd. It's like a preacher asking the choir, who are yelling "Hallelujah!", what is wrong with my sermon? The people who have that answer are the ones walking out the door or in this case who have attended the course, and haven't accepted what was taught or don't use it. People like Raulan, who attended the course, but still question it. These people need to be listened to, not judged, dismissed or lectured to. I assume there is a formal feedback form at the course, does it ask, what could I do to make it clearer, more understandable, more practical, better? What are the answers?

Good sellers, and I define good sellers as those which are not always the most successful but which do often make the sale and can be proud of what they do, do one thing more than anything else. Listen. They try to understand the customer's wants and needs and then they figure out a way to meet those needs. They don't assume the wants and needs and try to sell them on those. Personally, I can't think of a quicker way for a person to lose my business than to try to sell me on things they think I want rather than what I do want. Ok, insulting me or implying that I'm stupid for considering buying a competitive product might be worse.

[Barrett Dorko]

I take issue with a number of assertions and assumptions in Randy’s post.

“New ideas” have not been “rejected” here. A few people have offered their theory and then during the course of its examination it was found sorely lacking in construct validity. This isn’t “rejection.” It’s the fundamental experience of scientific debate. Those who don’t recognize that or don’t understand that those who seek to destroy your theories (fairly) are being your friends shouldn’t be representing themselves as trained professionals in healthcare provision. Without exception, the moderators here are skeptics. This insures both open mindedness and careful scrutiny. For many these combined qualities are too difficult to maintain and require too much courage to express. We do it anyway.

I get your point about asking the unhappy students what they’d prefer in the way of an educational experience and if I were much younger I’d take such advice to heart. But I discovered long ago that what most therapists want –protocols of care, specific sequences of handling and coercion, completely predictable responses to various pressures, an absence of ambiguity and complexity with testing and consequent diagnosis, magical powers – don’t have anything to do with the clinical reality of most painful problems. I simply won’t teach them things I know to be untrue. Others are glad to do that, and I know the students love them for it and report that their educational goals have been met. Too bad their patients don’t need or often want what they’ve learned to do.

In short, my presumption is that the patient’s “wants and needs” trumps the therapist’s. This certainly explains a lot. It’s been my experience that selling my ideas and methods to the patient is easy.

Ginger’s effect on RE is a consequence of his persistence, not the reasonable nature of his argument. This tells me more about his audience than it does his, uh, theory. Diane uses accepted and logical inferences from research to make her case. Again, when people reject those because their current worldview cannot tolerate change I know more about them than I do Diane’s ideas.

The disparity between my view of a therapist’s role in cases involving an abnormal neurodynamic and the view of those who show up at my courses seems to grow larger as the years pass. If you were to follow me around you’d find that for the most part I deal with therapists overwhelmed by their jobs, and, I notice, by their lives. They are hiding, blowviating about their imagined successful outcomes, bitching ineffectively about a wide variety of work issues and hanging on by a thread. These things I cannot fix. But I am absolutely convinced that a commitment to self-learning, formal and informal instruction and, above all, communication with others in a place like this would help. All of that is primary and it’s a big part of what I sell. Too bad that they want something else; as I’ve said, they want an easily employed manual pressure that relieves pain. To my knowledge, the human body doesn't work that way, no matter how much therapists wish it did.

While teaching, I say more than once something that thrills some and disheartens others: “Your patients will never be helped by your skills nearly so much as they will be by the depth of your knowledge.” In response I get both nods and frightened stares. Above all, I get complete silence.

No one refutes this, but for many it is not what they want to hear – or buy.

[Jon Newman]

Randy suggests, "I also think that Barrett is asking the wrong crowd."

This is available to the world. Just because others don't participate doesn't mean they aren't being asked.

[Jon Newman]

This is something that might help with repackaging. Honestly, I think it's already in there (like Ragu) but perhaps it could be emphasized.

The more they understand, the less they need to memorize

[Cheryl Conard Haight]

To be clear-- I am not saying I know the best way to change people's minds. I have been only mildly successful with a few colleagues, and these only the ones I work closely with who have a chance to ask me "why?" questions a lot.

As far as feedback forms in Barrett's courses...I've been to his course a couple of times and there IS a feedback form. I'd bet the vast majority who disagree, or just don't get it, do not take the time, and more importantly, do not want to work that hard, to fill it out in any thoughtful way.

"Your patients will never be helped by your skills nearly so much as they will by the depth of your knowledge." This implies the need to increase our knowlege--read, think, question. How many of us were taught this in PT school? I remember being asked to memorize a great deal, but very rarely to reason things out or question. We were passive learners. Tell me the "answer," show me the "right" technique and I'll work hard to be able to reproduce it and "fix" my patients.
I think it's ironic that Simple Contact is so much less work physically and mentally in one way, and yet requires a much greater depth of knowledge and critical thinking. Not to mention awareness and trust. And it's not airy/fairy magical or reductionistically mechanical; it makes sense (that was my "hook" also.)
Overwhelmed by their jobs and their lives and still looking for that magical one right answer to fix everything. Not the way our bodies work and not the way life works.
Here's a W.H. Auden quote from Joko Beck's NOTHING SPECIAL:
We would rather be ruined than changed,
We would rather die in our dread
Than climb the cross of the moment
And let our illusions die.
She goes on to ask, "What pushes us to abandon this melodrama, to sit through the confusion? At bottom, it comes down to the unease we have with the way we are living our lives." I would add-- the unease with our profession and the way it is practiced.
Still no answer to how to best "spread the word."

[EricM]

If most of us here were attracted by the emotional and/or intellectual hooks suggested by Jon and Luke, and I think that we are, is it also safe to say that those hooks were baited in such a way as to attract a unique type of fish? A whole fishing metaphor is coming to me now...use your imagination.
Barrett's assertion that the "emotion that underlies our profession’s longing for skillful handling has short-circuited (the) message," like fish who simply pass up a certain sort of bait. He goes on to say "the manual care part, which I feel is essential for the patient’s initial awareness, must be sold as something that fulfills the therapist’s emotional need, to say nothing of the patient’s." "Ironically, I’ve come close to this for years but continue to bump up against barriers that have grown in our clinics for years."

It seems to me there is a balance between intrinsic and extrinsic factors at play here. A fisherman can only appeal to a fishes intrinsic needs, he has no control over the extrinsic factors such as weather, and water temperature.
If this hook is going to attract more fish, it will have to be baited with something different than what brought each of us here, thus the original purpose of this thread. As far as I can tell we are all unique fish. Unlike a fisherman, with a great deal of effort, I think we can exert some effect over the extrinsic factors as well. We are not only going to have to find the correct bait, but create the correct conditions for a feeding frenzy to occur.

Eric

[Diane]

I was thinking about this as I woke up this morning, and knew I'd likely end up back on here with the ideas that arose.

1. Human primates don't do well when they feel shamed, as a group or as individuals. Shame is often an unconscious projection, doesn't belong, shouldn't even be there, but the more unconscious it is the more pernicious it can be. It's the hardest part of the shadow to own and integrate. People really don't like being reminded they have things to feel ashamed of.

Human primates do much better when they feel reassured and encouraged, as a group or as individuals. Reassurance and encouragement is not flattery. It is an appeal to the best that others harbour within themselves. Patients or students.

Everyone has things to feel ashamed of and everyone has things that are their best things. The "shame" things immobilize minds, and the "best" things mobilize minds. It behooves a teacher of anything to speak to the bit that will motivate/move/mobilize the "best" bits and not stimulate the shame bits, whether inadvertantly or by design. Sometimes it's hard to know where to place the authenticity line in this, to reassure and encourage but not flatter, and not denounce or shame unduly when we see the mess we'd like to set right.

2. Human primates of any age do very well, better than expected even, when a series of steps are provided to get them from where they are at /from where an instructor perceives they are at, to where they ought to be /to where the instructor thinks they ought to be.

3. It's the instructor's job to offer just the first step. Explain it, "sell" it, I suppose, answer questions about it, explain it again, encourage curiosity to be expressed about it.. explain it again.. Randy's definition of soft sell. Act like there is all the time in the world to just hang out and talk. Meanwhile this marvelous invisible thing called "rapport" is building bridges between minds. It is thin but tough, like spider silk.

4. The "thing" that is being sold is not a car, fridge or stove. The "product" here is an intellectually derived set of thoughts/thinking/behaviors. Because it's invisible, not a concrete item, it will defintely NOT be as obvious to the students/"buyers" as would be a physical car.

5. As intellectually derived products go, the ones without the built-in warm fuzzies are a harder sell than the ones with, i.e., "science-based" ideas are a tougher sell than "spiritual" ideas.

6. There is no way to make up for the fact that we are selling a fuzziless product without concete reality other than;

• to be accessible,
• reassure people that they a) definitely have the capacity to do this, b) that they are smart enough to learn to think for themselves, learn to revamp their professional minds,
• provide them with a series of steps that trail off into the future, but highly elaborate the first step so they can grok it fully (which includes emotionally).

7. All social changes start with a frustrated instigator who believes all is lost and that he or she is getting nowhere. It is usually true (for themselves) in their own lifetime, but growth of an idea is achieved over several lifetimes and through many lives. So.. it becomes a gift in the end, even though the giving is hard and thankless.

[Cheryl Conard Haight]

Diane,
Thanks and WOW! Your post reminds me to treat the people I'm trying to sell to in much the same way, and with the same respect, as I treat my patients.
Cheryl

[Barrett Dorko]

Diane’s said quite well what I’ve come to understand over the years, though this isn’t a situation I’ve handled perfectly. That’s obvious.

Early in the day I ask these questions:

Is there a correlation between pain and strength?

Is there a correlation between pain and posture?

Is there a correlation between strength and posture?

Is there a correlation between appearance and pain?

According to me and the literature I carry with me, the answer to each question is “no,” though each may take some explaining. By the time this is done, I can usually sense a shift in a few present. Some have had their suspicions confirmed while others see their basic philosophy/theory of care undermined, to say the least.

For that second group a choice must be made; defend, attack, learn or shut down. If they choose to feel guilt for their lack of reading or interest in neuroscience I suppose that’s understandable. Shame, however, is typically defined as the sense that there is something fundamentally wrong with the person feeling it, whereas guilt is the sense that we’ve done something wrong.

As well as I am able, I make it clear that the skill necessary to do what I do (and what I demonstrate is pretty much all that needs to be done) is something every member of the class already possesses. Seeing that, shame, as defined above, would surely dissipate. Guilt will disappear with study. At least, that’s my message.

[nari]

I came into the picture because I had an intrinsic interest in the brain and its tributaries, ever since graduating. I was also dissatisfied with a) the system and b) the sort of thinking involved in being a diverse, but muscle/joint based PT. I figured it was me, a square peg in the round hole of physiotherapy. It probably was, to a certain extent.
So I was looking for a change, to both the system and the focus on mesoderm. A fish inclined to take any bait, with the proviso that my sense of professionalism prevented my taking juicy baits, offering extraordinary claims to success, such as CST, et al.

Perhaps the second group that Barrett identified in his latest post are happy with the system and with themselves as providers of care. Or, if they are not, they don't know it; it can be an insidious discontent. Perhaps, like tourists on a bus tour of the Europe of physical therapy, they simply need to "tick off" yet another CE requirement - yes, this is an interesting city but others felt more like home, vaguely familiar and therefore safe. Not all travellers read up intently before going to a completely different place - or follow up on its differences for months afterwards. They simply are not interested enough in deepening their experience.

Nari

[Diane]

Still on the topic of shame and guilt, I think it's likely that most of your students are either too young or too busy thinking about external stuff to have given much thought to them"selves".. likely they haven't yet learned to distinguish the two terms, own what is theirs and lay to rest that which isn't. So, when dealing with unsophisticated thinkers, I still think one must not tread too heavily or expect too much too soon. They could easily go spinning off into feeling immobilized rather than charged.

And, as Nari has pointed out there may be illusions of either grandeur or self-complacency to dismantle (carefully), which it sounds like you already do.

I just have to add this, from Ian. It's about perceptions and human foibles, and traps therein, so clearly and cogently written that I think it could add to the discussion.
Mind Stuff.

[Randy Dixon]

I take issue with a number of assertions and assumptions in Randy’s post.

“New ideas” have not been “rejected” here. A few people have offered their theory and then during the course of its examination it was found sorely lacking in construct validity. This isn’t “rejection.” It’s the fundamental experience of scientific debate. -Barrett

You don't think your ideas are new to many people you present them to? Or you don't think those ideas are rejected? WhY assume that I meant this only occured one way? As to the rest, I understand your points but they aren't really relevant to the question you posed: how should I repackage my course so it will be better understood and accepted? This is why I questioned whether the question was rhetorical or if you really wanted other's opinions. If you have already decided what therapists want, and that you won't or can't give it to them, why bother asking the question?

"Randy suggests, "I also think that Barrett is asking the wrong crowd."

This is available to the world. Just because others don't participate doesn't mean they aren't being asked."-Jon

Do you really think posting on this forum, which consists almost exclusively of those who share similar thinking on the views of therapy, is really the same as asking those you know to have differing viewpoints? That it is the same as asking the wider therapy world?

I agree with Eric and I like Diane's analysis. A funny thing is that I find myself agreeing more with Diane after she once admitted that on the matter of ectoderm/mesoderm and related issues that she has a bias a mile wide. I make allowances for that now and can better see the thoughtful approach that sometimes that bias masks.