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“There are so many ways we can touch the person with chronic pain to reduce their discomfort.”
Joseph Kleinkort, PT, MA, PhD President, Pain Management Special Interest Group – American Physical Therapy Association
I read the quote above yesterday, August 31, 2006, in the latest issue of Orthopaedic Physical Therapy Practice – The Magazine of the Orthopaedic Section, APTA. Over the years I’ve found that the very thing that’s been floating around at the front of my brain is attached to something I’m just about to read. Clearly, I am psychic.
Dr. Kleinkort’s remark showed up after I’d spent some time thinking about how the care I provide might be more effectively taught and explained. Perhaps I should begin by saying that I strongly disagree with him for several reasons. Touching in and of itself is unlikely to have a significant effect on another with chronic pain aside from its well-know psychological effect. This effect isn’t insignificant by any means but I fail to see how it could possibly endure once actual contact is lost. Any subsequent prolonged relief would be a function of the person’s brain. In any case, we are now dealing with phenomena that would require the expertise of the trained counselor in addition to the physical therapist.
Still, saying that we can touch another and “reduce their discomfort” is a remarkably seductive message. I’ve met thousands of therapists who long for this skill. In Jay Conrad Levinson’s Gurrellia Creativity – Make Your Message Irresistible With The Power Of Memes he notes that “(People make purchases) because some sort of emotion lies beneath them. It is difficult to sell anything to anybody unless you tap into an emotion they’re already experiencing.” When I see how much my students want to learn some secret way of handling that will mark them as sensitive, insightful, astoundingly skillful, “healing,” even "magical" I know how easy it would be to sell something promising all of that. Anybody who thinks that educated therapists don’t want this should follow me around for a while.
Despite the profession’s longing to provide a sort of manual care that resembles faith healing (and I think Kleinkort’s quote reflects that), it remains clear that the majority of the patients we can help with painful problems will find the origin of their pain to be some sort of mechanical deformation. It follows that only movement will help, not touch. And if that movement is to be truly analgesic and enduring it must be corrective in nature. So, if a movement therapy of some sort is required for enduring relief, what does manual therapy have to offer?
For many years I’ve drawn people to my workshops with the promise that they will be instructed in Simple Contact, defined as “A technique of communication, either verbal or manual, designed to make another aware of their already ongoing processes and encourage their expression. Simple Contact does not move others. When used manually, it just deforms the skin.” At every course someone will walk up to me and say, “Okay, when you do this Simple Touch…” I correct them and then they say, “Whatever,” as if their desire to touch others magically were more important than my explanation of my manual method’s effect, i.e. to make another aware of the movement they might do therapeutically. This is ideomotion, of course.
I feel today that my lack of concern for the emotion that underlies our profession’s longing for skillful handling has short-circuited my message. I have, in fact, violated several rules of marketing that Levinson makes clear in his book.
I need to address this and subsequent posts in this thread are already in my head, so stay tuned.
Any thoughts?
Joseph Kleinkort, PT, MA, PhD President, Pain Management Special Interest Group – American Physical Therapy Association
I read the quote above yesterday, August 31, 2006, in the latest issue of Orthopaedic Physical Therapy Practice – The Magazine of the Orthopaedic Section, APTA. Over the years I’ve found that the very thing that’s been floating around at the front of my brain is attached to something I’m just about to read. Clearly, I am psychic.
Dr. Kleinkort’s remark showed up after I’d spent some time thinking about how the care I provide might be more effectively taught and explained. Perhaps I should begin by saying that I strongly disagree with him for several reasons. Touching in and of itself is unlikely to have a significant effect on another with chronic pain aside from its well-know psychological effect. This effect isn’t insignificant by any means but I fail to see how it could possibly endure once actual contact is lost. Any subsequent prolonged relief would be a function of the person’s brain. In any case, we are now dealing with phenomena that would require the expertise of the trained counselor in addition to the physical therapist.
Still, saying that we can touch another and “reduce their discomfort” is a remarkably seductive message. I’ve met thousands of therapists who long for this skill. In Jay Conrad Levinson’s Gurrellia Creativity – Make Your Message Irresistible With The Power Of Memes he notes that “(People make purchases) because some sort of emotion lies beneath them. It is difficult to sell anything to anybody unless you tap into an emotion they’re already experiencing.” When I see how much my students want to learn some secret way of handling that will mark them as sensitive, insightful, astoundingly skillful, “healing,” even "magical" I know how easy it would be to sell something promising all of that. Anybody who thinks that educated therapists don’t want this should follow me around for a while.
Despite the profession’s longing to provide a sort of manual care that resembles faith healing (and I think Kleinkort’s quote reflects that), it remains clear that the majority of the patients we can help with painful problems will find the origin of their pain to be some sort of mechanical deformation. It follows that only movement will help, not touch. And if that movement is to be truly analgesic and enduring it must be corrective in nature. So, if a movement therapy of some sort is required for enduring relief, what does manual therapy have to offer?
For many years I’ve drawn people to my workshops with the promise that they will be instructed in Simple Contact, defined as “A technique of communication, either verbal or manual, designed to make another aware of their already ongoing processes and encourage their expression. Simple Contact does not move others. When used manually, it just deforms the skin.” At every course someone will walk up to me and say, “Okay, when you do this Simple Touch…” I correct them and then they say, “Whatever,” as if their desire to touch others magically were more important than my explanation of my manual method’s effect, i.e. to make another aware of the movement they might do therapeutically. This is ideomotion, of course.
I feel today that my lack of concern for the emotion that underlies our profession’s longing for skillful handling has short-circuited my message. I have, in fact, violated several rules of marketing that Levinson makes clear in his book.
I need to address this and subsequent posts in this thread are already in my head, so stay tuned.
Any thoughts?
. I think that conclusion (the alternatives allowing ample time) may be another problem for popularity of the concept.
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