Manual Magic

[Barrett Dorko]

Nari,

I see what you're saying, but I have to wonder how it is that these same people have never heard of solving a mystery. Haven't they ever heard of Sherlock Holmes?

Perhaps I need to say, "I know this appears mysterious, and until I lead you completly to its solving it will remain so. After that, it's up to you whether or not you still consider it a mystery."

Again, the primary quote - Any sufficiently advanced technology is indistinguishable from magic - is perfectly appropriate to this issue. Clearly, many therapists don't possess the "sufficient technology" (modern neuroscience) to make Simple Contact and ideomotion something other than mysterious.

Typically, they never try to acquire it.

[nari]

Barrett,

Solving a clinical mystery is something somebody else does for you. Isn't that the meme in courses? I think with books, TV etc it is different, though I'm not sure how. It's perhaps a leap of faith from entertainment to work-related stuff....but that's another theme.

Definitely true that most therapists do not have the knowledge/understanding to take the perceived mystery out of ideomotive concepts. The academic knowledge may well be there, but the link has not evolved.

Nari

[gerry]

Barrett, Our family just rented The Illusionist last weekend. I enjoy woodworking, but do not do enough to be any good at it. Watching those who are skilled in woodworking and the spatial skills of cabinet making is somewhat magical to me. Seeing the end work of cabinets that open in unusual ways and use hardware to makes the most of space that is not typically used is wonderful. It does appear magical. But it makes me look behind the doors, or under the space to see how it works. Even then, as I gain some understanding of the "secret", and the "trick" disappears, the magic remains in the appreciation and wonder of the working of the system.

By the way, I really like your quote about the secret, trick and magic. I think would be good on your brochure.

I work a lot with wheelchairs, and it is amazing how technology is used to solve difficulties in new and unique ways. Sometimes it takes quite a bit of exporation and learning to figure out how something is done. While it explains the mystery of how a chair works, it is still magical to see it work.

[Barrett Dorko]

The Pledge

Gerry,

Perfect.

I’m simultaneously reading The Prestige as I watch the movie a few minutes at a time. Turning from one to the next as I travel, I have time during those long moments of airline-imposed reflection to think about how these two ways of learning are intertwined, each doing things that the other cannot.

In the movie, Michael Cain’s voice is first heard explaining that there are three parts to every magic trick. The first is The Pledge.

In the book it is written of in this fashion: There almost invariably comes a moment during the exercise of my profession when the illusionist will seem to pause. He will step forward to the footlights, and in the full glare of their light will face the audience directly. He will say, or if his act is silent, he will seem to say, “Look at my hands. There is nothing concealed within them.” He will then hold up his hands for the audience to see, raising his palms to expose them, splaying his fingers so as to prove nothing is gripped secretly between them…it is established that his hands are, indeed, as empty as it is possible to be.

Do you ever do this in some fashion before you touch your patient?

[Barrett Dorko]

More on The Pledge

I anticipated a reply but since one hasn’t been forthcoming I thought I’d add to my comments about The Pledge.

The way I see it, this refers in the clinic to those few moments just prior to handling. Aside from the obvious emptiness of your hands, a great deal more may be implied by your manner. Nonverbally it should be clear that you don’t hurt your patients, that your handling will not threaten them or proceed in a meaningless or random fashion. Above all, your hands will reflect your compassion and knowledge.

If you can manage all of that (or some reasonable approximation of it), you’re ready to move into the next phase of your magical presentation; what the movie refers to as The Turn.

[BB]

Hi Barrett,
I got to watch The Prestige last night. Great flick.

In some tricks the object of the magic was the magician himself, in others it involved something else, like a bird in a cage.

When the pledge involved the bird and the cage the audience comes up to examine them.

I wonder if an analogy would be that time in which the patient is able to tell their story, ask some questions, and see how we respond. A chance to examine us to look for trickery and deception.

[Barrett Dorko]

Cory,

I think that the emphasis here on a mutual examination – not only therapist of patient but patient of therapist – is important when we speak of magical practice. A mesodermal focus fairly eliminates such a thing.

When I reviewed Butler’s The Sensitive Nervous System in 2000 I made sure to quote this line, feeling it came from a clinician with an understanding of the body similar to mine: “The fact that most clinicians think that they are going to sample the nervous system may be restrictive. In fact the nervous system is going to sample you the clinician, and your performance.”

Now I know why I chose that insight specifically. It speaks both to The Pact of Acquiescent Sorcery and The Pledge.

You may recall that in the movie The Pledge also includes the magician showing the audience “something ordinary.” What do you suppose that thing might be in the clinic?

[BB]

Their own body as a precursor? A movement prior to the initiation of magic?

[nari]

Whether by verbal or tactile stimuli, the patients' nervous systems will assess us before we do. What we see, hear or find may be the result of that first assessment; so what we discover could be an anomaly. This is particularly true of chronic pain presentation; their nervous systems have been through all sorts of encounters, good and bad, before we see them.
If every PT appreciated that he/she is being assessed both consciously and nonconsciously, it could change their clinical approach no end.

Diving into ROM manouevres and strength testing is not what the patient's system orders on its initial assessment.

Maybe that is one magical part of clinical encounters; we can alter that initial assessment of us.


Nari

[Barrett Dorko]

The Patient's Pledge

Nari,

Good point. But what if the eval form insists that you do? (Just kidding, I think)

Looking at The Pledge from the perspective of the patient has been rolling around in my head today. Cory suggests, “Their own body as a precursor? A movement prior to the initiation of magic?” And I presume that when he says “their” that he is referring to the therapist’s body. That’s what I asked about, after all. But when I read his reply something turned my attention to the patient’s body as a precursor, and that’s where it will stick until I write through it, I’m sure.

Is it useful to consider the magic that a patient might perform? If they have their own “tricks” to present in the clinic, and I’m sure they do, don’t they have a pledge of their own to work through before the therapist’s manual contact? And though The Pledge focuses on the ordinary nature and commonplace appearance of things, we should remember that it might very well be full of deception and artifice. Remember, what things appear to be and what they actually are doesn’t always match in magic. They aren’t suppose to, and they don’t call it a magic act for nothing.

Have you ever had a patient rather deceive you with movement prior to care? Have they done this clumsily? With remarkable skill?

Maybe all of this magic stuff is even more complicated than I thought it would be. Maybe it’s even more useful than I suspected.

Time will tell, and there’s nothing like a long, thoughtful thread on Soma Simple for sorting all of this out.

Let’s stick with it, and work out the patient’s pledge before we move on to the next element of magical presentation; The Turn.

[BB]

Hi Barrett,

I did actually mean the patient. My thought was that if we are the magician, and the something ordinary corresponds the object that is about to be the target of the magic, then the patient would be the object.

The state of the object pre-magic is what I was getting at. However, I would also think that the magic has begun as soon as we peak our head through the lobby door and say hello. But the same is true for the magician as soon as he emerges onto stage.

Have you ever had a patient rather deceive you with movement prior to care? Have they done this clumsily? With remarkable skill?

Yes. I've also been decieved by their stated motivations. Clumsily and with remarkable skill.

[Diane]

There really are two "objects" to deal with, the patient on the one hand and the patient's nervous system itself on the other.

[Jon Newman]

The pledge is a diversion though it may be truthful.

[nari]

Yes to the question:

Have you ever had a patient rather deceive you with movement prior to care? Have they done this clumsily? With remarkable skill?

This can be conceived now as "fraud" by an unaware observer - cannot flex forward on command, but bends over to move something like a handbag out of the way, quite skillfully. Or clumsily, but not expressing increased pain.

Nari

[BB]

Jon,

The pledge is a diversion though it may be truthful.

Maybe then, the pledge is not the movement pre-magic, but is instead a change made to that movement under the pre-tenses of "examination."

For example, it hurts to raise the arm. A manual force is applied allowing pain-free motion. Now we've got the person's attention. "Hey. They just changed my pain in a way that hasn't happened for a while." Assuming we don't drop the cards out of our sleeve, we should have a captive audience after that point.