Manual Magic

[Barrett Dorko]

There are some lines and images from The Illusionist that struck me as appropriate to mention here.

In the movie’s prologue there’s a scene depicting Eisenheim as a young boy attempting to hide from some hostile men. He soon finds that he simply can’t do this with mere force of will and never tries to do this again. In fact, he later admits that he has spent much of his life “looking for a real mystery,” but he’s never found one. To me, this sounds like something a number of therapists have done over the years. Of course, a few stopped looking once they imagined that a real mystery had been found and they stayed there. This includes everybody doing “energetic” work.

The narrator also speaks of what he calls “the forces of the universe – life and death, space and time, fate and chance.” Of course, none of these are universal forces at all, they just sound like they are. Using language in this way makes the magician seem very wise, especially when the general public doesn’t know what the 4 forces actually are. As is said of Eisenheim when he is a young boy; “People began to believe that he had some kind of special power, or that he was, at least, a bit different.” Funny thing, John Barnes writes autobiographically of his own life in this way though I was simply described as “a well-adjusted child.”

Eisenheim is described as someone who’s “broken free” and whose illusions “approach the realm of art.”

Now, to me, that’s magic. Can we make manual care appear this way without pretending that it’s a super power?

[Randy Dixon]

Barrett,

Do you do magic in the classes you teach? You should. It would leave a lasting impression about how our senses can fool us and many of the other themes that your class revolves around.

[Barrett Dorko]

Randy,

I agree that it would, but I found long ago that the performance of the simplest effect had a very negative effect upon me personally. Though I thought I eventually would, I was never able to overcome the profound fear and "flop sweat" magical performance would produce and I simply had to abandon it. I presume that this has its origins in a sort of deception I am uncomfortable with (I prefer other kinds) and the possibility of failure. Funny thing, juggling and playing the harminica don't have this effect and I've been known to do these when I feel it will help.

You bring up a good point though, and it's addressed in the movie. Eisenheim's rival is the crown prince, an intelligent but profoundly arrogant man who thinks he cannot be fooled. Having been humiliated by Eisenheim's use of a hidden magnet (something the magicians exploited until the general public learned about them), the prince is chastized by his fiance. He responds, "He tries to trick you - I try to enlighten you - Which is the more noble pursuit?"

I'm with the prince on this one. Too bad he's a sadistic control freak.

Optical illusions are common knowledge except when it comes to the visual inspection most therapists do though they exist on the patient's surface as well. There's also the issue of the usefullness of this information even if it is reliable. I tell my students that with one exception (hip posture) they'd be better off not looking.

[Barrett Dorko]

So, if therapists want to appear magical, and I think they do, the question becomes this: What do we need to understand about the magician’s knowledge and skill that will make us appear magical?

1) Magicians don’t mistake their skills for super powers. What they claim is up to them and this is where ethical concerns play a role. Many would say that their entire disclaimer regarding special powers is contained in the words “magic SHOW.”

2) Though they typically remain silent regarding the science that forms the foundation of their effects, they are capable of explaining all of this at an appropriate time.

3) How they go about presenting their knowledge and skill is an individual thing and will vary depending upon the context of the situation. Seen from a therapist's perspective this includes, of course, the nature of the patient.

Finally, there is the moment of revealing. By this I mean the orchestration of the trick’s unfolding; its completion. Customarily this is enhanced with elements of surprise and further mystery.

This is where I think the practice of magic and that of Simple Contact differ profoundly and fundamentally. I touch others and they soon begin to move in ways they find effortless and surprising, warming and relaxing. I know that this appears magical, and I know as well that this result and this moment are the end result of study and experience on my part. I know where the movement comes from and what it represents. I know that my attitude is reflected in my hands’ activity at the outermost layer of the patient.

Here’s where I break from the magical community. I do this by explaining everything I can immediately. Random and unexpected movement may be present and observable in the patient, but there is no mystery, and I never encourage another to treat the phenomenon of self-correction as if it were.

[Jon Newman]

I just learned of this article and thought I'd post it here.

Great thread Barrett.

[Diane]

My favorite bit of Jon's article:

Reality is the most potent check on runaway magical thoughts, and in the vast majority of people it prevents the beliefs from becoming anything more than comforting — and disposable — private rituals. When something important is at stake, a test or a performance or a relationship, people don’t simply perform their private rituals: they prepare. And if their rituals start getting in the way, they adapt quickly.

My bold.

[EricM]

A patient commented to me during the middle of a session that they felt as though lots of little demons were being exorcised from his body. I had explained what was happening and why a few days earlier of course, and the comment was offered in a joking manner, but it made me think of this thread and how at that moment I had the option of playing up the whole exorcism angle and if I had, whether the outcome would be any different? If therapists want the magic and the mystery, do patients too?

Eric

[Diane]

I don't think so. I think when patients talk that way, they are describing their own interoception in their own way, that's all. I think we can nod along, taking it for the metaphor it is, and let them express it as part of their own "narrative therapy".. but when they ask a question they should get a straight answer. The therapist needs to be the stand-in "parent" in a therapeutic relationship - I think that entails a responsibility to not confuse patients with more fantasy, perceptual or otherwise. They need information, not a "pandering".. remember their brain chemistry is changing along with their motor output. Someone has to stay sober to "drive home".. - points of info in this case. If they want fantasy they can go to the Reiki person, right?

[Barrett Dorko]

Great additions to the thread here.

I can’t think of the name of the thread I began some time ago but it contained a passage from one of Michael Shermer’s books. An anthropologist in the South Pacific found that when fishermen journeyed far from shore their rituals and superstitions grew in relation to the distance from land. As they returned to shore their rituals and irrational beliefs diminished. In short, it’s the uncertainty that generates magical thinking, not its effectiveness. Shermer points out how you see this in baseball in the form of players heading toward the field or the batter’s box.

In my experience therapists begin to act a little strangely and tend to accept irrational explanations when dealing with neurologic problems but not when they can make the case for mesodermal dysfunction. Neurologic problems are, in effect, far from shore. And, the fact is, movement solutions for neurologic problems look a bit like “magic” and the therapist in their presence like a magician. This puts the ortho people in a bit of a bind when they try to stay with the biomechanical rational they hold so dear.

To me, that last paragraph explains a lot about the quandary many trying to treat an abnormal dynamic find themselves in. No wonder they are drawn to the “magical” sorts of care sold out there. I don’t think they’ve quite thought this through.

[Barrett Dorko]

Thanks to Jon here is the link to the previous thread I mentioned.

[Barrett Dorko]

Let’s go back to the issue of fecundity. Cory’s link to the newspaper article was perfectly appropriate because it demonstrates a problem with any successful meme any therapist might propose – financial disaster for those who have come to depend upon our prolonged and (possibly) incompetent care to generate all kinds of money related specifically to repeated visits for chronic pain.

This is not rocket science, and I defy anybody to explain to me why any manager would welcome a real reduction in visits simply because it helps patients get better and stay better more rapidly.

In the case of my method for the abnormal neurodynamic there’s also this: a distinct reduction in time spent doing all sorts of testing. I’ve written about this in The End of Evaluation? and discussed in depth in the Five Questions thread.

If I'm right, my meme spawns decreased attendance to therapy and an elimination of many dearly held notions of evaluation, thus it is very unlikely to endure or be passed along with any real fidelity.

Therapists want magic but when you give it to them they can’t use it.

Ironic, huh?

[nari]

Neurological problems are definitely far from shore in comparison with mesodermal issues. This is why there is a plethora of orthopaedic-mesodermally inclined PTs.
It doesn't seem to matter much whether we think about the free system or private; but I dare to say that in the free public system the drive is to keep seeing patients for as short a time as possible. Not so much in the private...:thumbs_do

Of course, no-one has managers who are keeping an eye on pursestrings; what an individual therapist chooses to do with a patient and how long they choose to do it for is entirely up to him/her. Privately, the patient can call it quits if they can't afford any more sessions; the PT calls it quits if no changes are occuring. Or they should do so.
A meme that means patients get better faster and stay better much longer is probably everyone's theoretical mission. Unfortunately the means to this outcome lies away from the mainstream mesodermal focus. And that is dangerous territory for some.....or so it seems.
Therapists want magic - but they are scared of being labelled offshoreists. (A neologism, but I like it)

Nari

[Barrett Dorko]

I like this "off shore" analogy more and more as we write of it. The solid ground of the island most therapists would prefer to remain upon is akin to the “concrete” nature of mesodermal thinking and dysfunction. It is a place where predictable reactions to time, position and metabolic economy are seen and where imaging has a reliable and valid place. On that island patients hurt where and when they’re supposed to.

But most of this world is water, and if we refuse to learn how to navigate it we will never venture far into it without undue fear and superstition. Figuring out the way of the ocean reliably took some time but it was well done centuries ago by people who had little to go on but their own observational skills, experience and intuition. Those with special knowledge often kept it to themselves in order to maintain their position of power and I’m certain that this advanced technology appeared “magical” to an ordinary seaman. (see the Arthur C. Clarke quote at the top of this thread)

I’m reminded of an essay I wrote a few years ago after seeing the movie Cast Away. To me, this is the story of a man in physical pain who finds himself out to sea and alone. He rescues himself with creative acts, and there’s a good deal of magical behavior involved.

Years ago I wrote this in a journal I keep in a corner of my office: The moment I want to nurture lies between the question and the creation. The question is: What do you want to do? And the patient’s response is a creative act.

I meet the patient at sea and make no effort to tow them toward shore. Instead, I float along with them as their strategy for a return toward dry land emerges. I think that this is a job for their intuition and instinct, and wonderful literature supports that theory.

Unfortunately, no one reads the literature. No wonder this meme remains so unsuccessful and appears so mysterious.

Today, I'm not certain how to overcome this.

[Barrett Dorko]

Impulse buy

This morning I thought a bit more about the nature of my work and teaching as it has evolved over the past 35 years. I want to use the “stress ball” analogy I’ve mentioned in the past, most recently here.

Aside from its useless nature, a stress ball is most commonly an impulse buy. The marketers stack them by the checkout counter, shape them pleasingly, color them brightly and price them cheaply. They give the buyer free access to play with them and experience in a tactile and visual way their seemingly magical ability to both lose and regain their original shape. This isn’t some sort of moldable and passive clay in your hand; it seems to have a life of its own. We buy it for all of these reasons, take it home and then never play with it again. It wouldn’t be uncommon for many to hide this impulse buy from others once we realize how wasteful it was.

For the vast majority of therapists my lectures and method have all the same qualities or seem to gain them rapidly once they are placed beside the realities of modern practice, institutionalized documentation and financial expediency.

At least, as far as I can tell.

[Diane]

I've been thinking about this thread, even though I haven't been adding to it. Learning something new, even if it's "easy", adds to allostatic load on the students. Perhaps especially if there's a suggestion that everything they've been doing is wrong or muddled. (I'm not saying it's not, I'm just saying that it may add to the overall allostatic load if that is pointed out directly.) There will be unlearning to do as well, a lot probably.
Do you think therefore that part of a solution to the overall problem might be an issue of framing the information differently?