Alien Abduction

[Barrett Dorko]

I’ve begun reading a book published in ’05 titled Abducted – How People Come To Believe They Were Kidnapped By Aliens by Susan A. Clancy.

As does occasionally happen, a single text can generate a large number of ideas in me, most related to therapy practice though the subject of the book itself doesn’t appear to be about therapy at all. This is one of those times.

As my course evolves and I sit a little outside my lectures (in my head, I mean), I get the sense that my most ambitious 10 minutes involves the distinction between mesodermal and ectodermal structures – how they begin, what they’re capable of responding to and what that implies. This is Diane’s original thinking, of course, and I begin with a little talk about her work and generosity.

If what I’m saying at this point is correct, I am absolutely calling into question literally every aspect of the theory and manual technique these therapists have used for painful problems their entire careers. On a certain level this is mind-boggling, unsettling, and even brutal. Given that, anyone would expect some objection if only out of a desperate attempt to defend their training, thinking and clinical life.

Instead, in about a hundred instances, I’ve gotten nothing. Nada. Zip. Silence. It’s eerie.

Clancy’s book is about how and why people - perfectly normal people by the way - come to believe that they have been abducted by aliens from outer space. And she’s not talking about just a few. Included here are the legions who believe them despite the complete absence of evidence. It makes me think of my many colleagues, hardworking, competent and committed though they may be, who remain firmly entrenched in the traditions of therapy that depend upon a “belief” in mesodermal function and dysfunction that couldn’t possibly be true or relevant to many, many complaints of pain.

I see a parallel here, and since I’m only on page twenty-something of this book, I thought I’d begin this thread as I read and see where it takes me (or us if others get the book). Perhaps it will lead to further understanding rather than further confrontation. Actually, with neuroscience on my side, I don’t think it’s a fair fight.

But there is this; a line from Clancy I want to put into my power point presentation:

When you pit the cold, remote virtues of scientific data against the immediacy of personal experience, science is bound to lose.

Those who we hope to teach and change have been abducted by an idea that has had its day. Though convenient and culturally acceptable it was never adequate or defendable once neuroscience challenged it. It does however have “personal experience” going for it. We may be doomed to failure. Understanding the how and why of that abduction is what I want to begin with here.

More soon.

[Barrett Dorko]

So, here’s the basic idea behind this thread: Therapists commonly treat patients with painful problems in the absence of frank injury as if the problem were the result of mesodermal dysfunction. This isn’t logical nor is it supported by the evidence. To me, they are fundamentally the same as someone who believes they’ve been abducted by aliens from outer space. I know I’ve said that abruptly but I’m working to make my point here and get on to how and why so many remain mired in this approach.

Michael Shermer, a big fan of Clancy’s book, says that in order to find out why people believe in weird things you have to ask them. Clancy asked her supposed alien abductees and I’ve asked many “mesodermalists” the same question. The answers to the question are remarkably similar.

Clancy found that many of the people who contacted her after she asked the question: “Have you been abducted by aliens?” professed to have no actual memory of the event. They felt odd was all, and they were searching for a cause. Similarly, many therapists who follow the protocols of examination and care dictated by tradition are totally dissatisfied with the logic behind them and the results they often see. “There has to be some reason for the pain to begin with,” they think. This search for causes led them to investigate something they actually knew very little about but could easily see (the mesoderm). They were taught that it was “the cause” and
Occam’s razor isn’t something they’re familiar with. Really.

Countless times I’ve asked therapists why they adhere to a biomechanical model that hasn’t demonstrated a relevance to their patient’s complaint or when “corrected” hasn’t proven helpful for their pain. They say, “Well, you’re right, but if that isn’t the cause, what is?”

Their search for the cause satisfied and unaware (and I mean completely clueless) of any other possibility prior to my course, they stayed where they were. The trouble really begins when they’re offered another explanation.

That’s the subject of the next post.

[Barrett Dorko]

A little secret of the research process is that rarely does anyone really “discover” something. A discovery in the classic sense is a little like a triple play in baseball, a chance event that has little to do with the way the game is normally played…The idea that new research proves old research is wrong is a popular fiction.

From Captured by Aliens by Joel Achenbach

The book cited above is one I always quote from while teaching. Published in ’99, this is a wonderful example of good information surrounded by entertaining and compelling prose. Its subject isn’t all that different than Clancy’s and I am surprised to see no obvious reference to it in her book.

Anyway, Achenbach approaches the abducted communities from a slightly different angle, writing a great deal about the legitimate scientific investigation regarding the possibility of extraterrestrial life and even the definition of “intelligence.” Unlike Clancy, he goes way back to the origins of philosophy as we understand it, pointing out that Plato rejected the idea of scientific tests while Aristotle “at least believed that scientific observation should trump a philosophical ideal.” It seems I’m far more Aristotelian than Platonic as a clinician – a pronouncement that I’m sure many of my patients found utterly fascinating.

In therapy the notion of an “ideal” body took hold many decades ago and still holds sway. Seventeen years ago I wrote an essay titled The Fatal Heuristic, had it published in a well-distributed national weekly and then held my breath, certain that there would be a firestorm of protest. I’m still waiting.

As Achenbach notes in the quote above, true discovery is rare and disproving the conclusions others have drawn from their previously done research is equally so. What strikes me as unusual about the revelations of the neurobiologic revolution is that they didn’t result from research conducted just beyond the grasp of our predecessors in the profession (those who connected pain and posture to muscular strength) nor did it disprove the conclusions drawn by previous research done by therapists into the nature and origins of commonly seen painful presentations. It turns out that they hadn’t done any research to refute nor had they drawn any conclusions they could effectively defend with a theoretical construct of human functioning. My classes find that this is simultaneously true and nearly unbelievable. Believe it.

No wonder my colleagues didn’t say anything; we are, in effect, living in separate solar systems and they’d prefer to believe that theirs is governed by natural laws I’m unfamiliar with. Of course, Newton demonstrated that this couldn’t happen, and I’m happy to take his word for that.

[Barrett Dorko]

Searching for the Cause

When you’re looking for the cause of an anomalous experience, your search is limited to the set of explanations you’ve actually heard of.

From Abducted

Try as I might, I cannot seem to make any headway when it comes to changing the minds of my students. Well, almost none. Clancy wrote an entire chapter about “the search for causes” and it reminded me of this quote from Frederick Nietzsche:

“To trace something unknown back to something known is alleviating, soothing, gratifying and moreover a feeling of power. Danger, disquiet, anxiety attend the unknown-the first instinct is to eliminate these distressing states. First principle: any explanation is better than none…The cause-creating drive is thus conditioned and excited by the feeling of fear…"

I’ve used this before, and I think it goes right to the root of our search for an answer to the question, “Why do I feel slightly out of step with the reality others seem to occupy without the same anxiety?”

Imagine a therapist new from school entering a department where the majority of the patients complain of pain for which there is no obvious pathological basis. They aren’t typically warned in school that this is common and their meager knowledge of painful processes provides them with no satisfying explanation. Desperate to do something, they attend a course that emphasizes the biomechanical model of dysfunction and/or acquire a mentor that agrees totally with this. As Nietzsche points out, this reduces their fear. So though the practice they pursue is difficult if not impossible to defend, trading away their fear seems reasonable enough. Nothing less than this can be expected – and it all begins with the search for a cause.


Maybe we should avoid that.

More soon.

[Barrett Dorko]

Fruit from fertilizer

Clancy uses a “plant analogy” to enhance her point about any belief system’s ability to grow and become entrenched.

The idea itself (in her case alien abduction and in our case a mesodermal and purely biomechanical belief in a connection between pain and posture, pain and strength, strength and posture) is the fruit of the plant. And, like any plant, it needs some fertilizer in order to bear this fruit. Depending upon the soil conditions some plants need more fertilizer than others.

See where I’m going with this?

[Barrett Dorko]

When there's no hope

Abduction beliefs are natural by-products of our attempts to explain the unusual things that can happen to us. Given that most of us want to understand our feelings, that very few of us think like scientists in our everyday life, and that alien abduction is a culturally available script, I often wonder why more people don’t think they’ve been abducted. Today, confessing to such a belief doesn’t make you “crazy” – it just puts you, in my opinion, a couple standard deviations from the norm.

Susan Clancy in Abducted

Elsewhere in the book Clancy makes it clear that once someone has the discovered the safety and solace to be found in this belief it is practically impossible to dissuade them. Other people simply don’t have access to the data leading to and reinforcing what they’ve come to feel is true. The key word here is “feel,” and science cannot begin to alter that significantly if this is what someone trusts above all else – their own feeling, that is. Good evidence to the contrary has no power in such a situation.

I was asked two days ago by a woman in a class in Traverse City Michigan: “Why if a therapist is offered perfectly reasonable explanations of the sort you’ve offered would they continue to practice in traditional ways (read mesodermal only) when confronted with a patient in pain?"

My answer: “They’ve been abducted by aliens.”

I’ll expand upon that here. If someone practices in a certain fashion driven by what they’ve come to believe I never make a dent in the way they do things. But if their practice is driven by understanding and altered as evidence presents itself I have a shot at getting them to change.

[Barrett Dorko]

The power of abduction

I want to explore a bit more here the word “abduction.”

One of my favorite threads here concerns the nature of abductive reasoning. It makes the case for this being the primary process through which we discover things. Simply put, you imagine a diagnosis that reliably contains various sigs and symptoms and then say, “If (name of diagnosis here) were the case, all that we’ve seen and sensed in the patient would begin to make sense.”

This is powerful and legitimate, but it also carries with it the danger inherent to any reasoning; incomplete observation and/or selective attention to certain aspects of reality.

Being told what the characteristics of life were following alien abduction by an "expert" on such things many people have reasonably concluded that this is a justifiable conclusion to draw about their own life. Who could blame them?

Of course, the problem doesn’t lie in the conclusion drawn but in the validity of the whole story itself. Any story if told in a certain way might be believed by many for a variety of reasons. The key word there is believed.

Similarly, our colleagues in the mesodermal world of training for painful problems know quite well the story that surrounds and leads them to conclude that various diagnoses like “muscle imbalance” or “fascial restriction” or impairments like “poor posture” or “weak multifidus” are supposed to result in, and thus they use these reasons or excuses (whatever you want to call them) to explain “the cause” for their patient’s complaint. And, again, it’s that search for “the cause” that leads toward so much trouble. Never mind that the cause they’ve found couldn’t possibly be true. That’s typically an issue they’d rather not discuss.

No wonder we can’t change them.

They’ve actually abducted themselves.

[Barrett Dorko]

More about Abduction

Abduction also refers to a certain movement in the body at various joints, of course.

Breig and others have demonstrated conclusively that the consequence of hip abduction markedly reduces neural tension (see the Five Questions thread for more on this) This means that in the presence of neural irritation it’s extremely important for people to keep their feet apart.

Without question, this single maneuver is decidedly counter-cultural – not that the peripheral nervous system cares about that in any way. Time and again I would work to get people to move and rest in this fashion only to find that initially they were quite conflicted between doing what obviously helped them immediately and what they felt socially uncomfortable doing. I rarely found however that this conflict wasn’t resolved rather rapidly in favor of habitual abduction. I’d get my patients there by demonstrating its effect, reasoning with them, and, if that didn’t work, I’d holler at them and threaten to not see them any longer if they didn’t do it. How another therapist does this is really their business, not mine. Good luck.

My colleagues who have been abducted by aliens (I assume you know what I mean by that now) cannot argue that what Breig says isn’t true or that this abduction of the hips as postural advice doesn’t make sense, but I watch them struggle with doing it themselves or encouraging it in the clinic. It doesn’t conform to the “ideal” image of posture they depend upon to make some sense out of their world. Once they’ve been abducted, abduction is something they avoid.

Ironic, huh?

[Barrett Dorko]

Aliens and my fellow Buckeye

What keeps going through my head when my brain returns to this topic is Clancy’s explanation for the endurance of this belief in alien abduction, whether it’s in the abductee or in those who belive the whole story plausible. She says, "All the subjects I interviewed followed the same trajectory: once they started to suspect they’d been abducted by aliens, there was no going back.”

I recently had a fella in my class about my own age and he introduced himself quite proudly as a graduate of The Ohio State University just two years after I left there in 1973. We spoke of the teachers we had in common and of our mutual feeling for Ohio State football, especially when it came to how much we’d beaten Michigan recently. We were kindred spirits - and I don’t often find these in my classes. But a couple of hours later I asked the class if they were familiar with dowsing for water. He said, “I can do that.” I knew I was in trouble, and, sure enough, no amount of persuasion or careful questioning on my part shook his bedrock belief in his skill, and it certainly had no effect on his feelings about what he had experienced while handling the dowsing rod.

Clancy again: Once the seed of belief (is) planted the abductee begins to search for confirmatory evidence. And once the search has begun the evidence almost always shows up. The confirmation bias – the tendency to seek or interpret evidence favorable to existing belief, and to ignore or reinterpret unfavorable evidence – is ubiquitous, even among scientists.

I underlined the word “belief” in that last quote for reasons that seem obvious to me but I find they aren’t always evident to others. When a search for a cause is coupled with a need to believe in something and when an answer is found that seems plausible to a person not necessarily drilled in the scientific method the “answer” is remarkably seductive and compelling. Scientists are not immune to this. In effect, they fall in love with an idea. After all, if we return to the plant analogy, this idea is their fruit. Who is anyone else to say that they should abandon it?

My fellow Buckeye didn’t seem to relinquish his belief in what he called “some kind of energy field” and was reasonably unwilling to reinterpret his experience. I joshed him a bit but didn’t push too hard.

I’m not sure I would have been as easy on a Michigan grad.

[Barrett Dorko]

Filling a need

I found this portion of the thread a little difficult to write, but worked to remember that that which emerges from my writing without thoughtfulness or doesn’t take any courage to hit the “send” button isn’t always worth all that much. Both were present here.

If I see those therapists who have accepted the mesodermal model of function, dysfunction and consequent pain as thinking and behaving irrationally (see what I mean about the courage it takes to say that?) I have to wonder not only how they got that way (consider the plant analogy) but why it is they stay that way in the face of perfectly good evidence to the contrary.

Here’s a quote from Clancy near to the end of her book:

The abductees taught me that people go through life trying on belief systems for size. Some of these belief systems speak to powerful emotional needs that have little to do with science – the need to feel less alone in the world, the desire to have special powers or abilities, the longing to know that there is something out there, something more important than you that’s watching over you. Belief in alien abduction is not just bad science. It’s not just another way to explain misfortune and a way to avoid taking responsibility for personal problems. For many people, belief in alien abduction gratifies spiritual hungers. It reassures them about their place in the universe and their own significance.

I begin my courses by pointing out that today we are surrounded by images of the body that have nothing to do with our personal reality. “The culture is a snob,” I say. “And it’s an increasingly large snob when it comes to the body.” (Read more about that concept in Alain de Botton’s Status Anxiety here) As I sit in the restaurant this morning watching people come and go I count exactly two out of about forty who appear to have the carriage and weight considered ideal, and I have my doubts about their strength and endurance. If they had it all, wouldn’t they literally be alien to the rest of us?

My point is this: Despite the very unlikely possibility that any of us will become what the mesodermal model dictates we should be, many therapists continue to push patients in that direction – even if they have long since abandoned any personal effort in that direction. Bizarre as this appears, it serves a purpose not entirely unlike that served by a belief in alien abduction. It makes us special in some way, set apart from the vast majority without our “secret” knowledge and acute perceptual abilities. It fulfills a need vaguely spiritual in nature, and, in my experience, that’s quite enough to keep many therapists believing.

I know that I mention this at my peril.

[Diane]

Barrett, I think that you flatter this habit PTs have for preferring a mesodermal mentality by calling it a spiritual need. I would call it "adherence to mores of the troop" (a primate proclivity), or to a "cult" (the human primate proclivity). This adherence is emotional/psychological/instinctive/survivalist, and is laid in long before synapses are developed that allow individuals to think for themselves.

It's a short word, cult, but can you see by adding "-ure" to it, it becomes something within which we are all embedded? All cult-ures are snobs, by the way. Those who enact or promote the ideals of the cult-ure most successfully become the human primate "alphas", then expect either obsequiousness from all subordinates or at least unfaltering respect/loyalty and tons of money for their "service" of providing continued brain-washing (e.g., televangelism, movie star looks, leadership of any sort, "training"...). Very rare are workshops like your own that deconstruct rather than add more clutter. (On the weekend I tried to teach that we provide treatment of processes through time, not structure. I don't know how far it sank in, but we'll see. It's a start.)

Some cult-ures do not suppress those synaptic connections that promote or reward individuality while others do to the max. I don't know what to think about that, but one thing I know is that humans need to be raised in one, or else their brains will not develop much cognition at all; the language centers (symbolic coding and decoding) will languish; the potential to converse fluently in one's cult-ural language will be extinguished if not fully developed by age 7, if I recall correctly. Everything else, all other belief systems, like the mesodermal belief system our subtroop of HPSGs prefers, is an unfortunate subset/pale imitation/consequence of the bigger point here; i.e., that we all require cult-tural indoctrination to survive as fully functional humans - within one. We are wired to be believers in something/anything.

So m-a-y-b-e, just maybe, we can "learn" to "believe" we can "un-learn" (de-program)/learn something else that is more factual.

I think the tragedy (small but still real) is that because of the big picture and this laid-down, reinforced, survivalist, emotionally rooted, non-conscious human default tendency, our brains are vulnerable to falling into the mental/cult potholes that are everywhere, in every walk of life, whether they are blatantly "spiritual" or simply convenient - adopt a belief system, try it on, see if it fits you and your pre-existing confirmation bias. Add to that the way our mesodermal indoctrination is presented with a lot of kinesthetically conducted ritual, and HPSG becomes so placeboic - to the practitioner- that it is practically inconceivable that the enactor of said pseudoscience will realize that the belief system is only that. Add to that the basic drive most HPSGs have, which is to please, and it's almost a given that the mesodermal myth will be maintained.

This forum functions as a cult pothole filler/repairer, in my opinion. If we can eventually get the ground of our own PT HPSG profession smooth again, no one will ever know there was ever a pot-hole cult there for people to fall into in the first place. I don't think this is entirely futile. Mighty oaks from little acorns grow, all that.

If and when this takes hold, the mesodermal myths won't be bounced back to the patients as part of their treatment/ won't be perpetuated as part of our own "mythology" - treatment construct. Let's keep pouring research $ in, because mesodermal cultists may eventually come to understand that the science they are doing, quite well some of it, shows up how faulty the constructs are in the first place. Meanwhile we can each start in our own head, filling in the potholes there. Composting all the superfluous and irrelevant ideas we may have acquired in our professional lives. Deliberate and persistent pruning. Long shot I know, but it's our only hope.

It feels "alien", perhaps, to ditch all this conditioning, but it can be done. When I pinch myself I still feel pretty human and not from any other planet; with fully informed choice between living the rest of my life as a human abductor or an abductee, abducting others away from a cult-based belief system rather than being abducted into one or another, I line up on the abductor side without hesitation.

[Barrett Dorko]

Clinging to the mothership - a reasonable choice

Diane,

Spiritual needs are very real things, and, used in a certain way, “spiritual” is the proper way to describe them. I don’t think that anyone would be “flattered” to hear that I think they’re present – this is simply a way of acknowledging the humanity that is our inheritance.

Unlike most of the regular contributors here, I don’t just currently understand the ectodermal reality of pain, I spent years actually teaching other things; things that I am now perfectly willing to admit were way off base, to put it kindly. But what I had back then (just as I still have today) was an acute desire to learn more and change if doing so seemed reasonable. I was profoundly influenced by the culture of orthopedic care soon after leaving school, but I never became a member of any cult. Bottom line: not everyone escapes this movement into the cathedral of mesodermal belief, but if they don’t, I’m willing to understand.

What’s important here is that we all remain willing to do two things:

1)Remain completely persuadable - a new idea supported by good evidence should be adopted as soon as we see that it is better than the one we currently have

2)Guard against the tendency to make the outcome of any inquiry match our own previously drawn conclusions

Cults provide many with comfort, and the power of the meme they offer shouldn’t be underestimated. Our task is to offer our colleagues an equally comforting idea and way of practicing. Unfortunately, the ectodermal model leads us quite often toward uncertainty and, these days, direct opposition to our boss’ desire for efficient billing as well.

No wonder most would rather stay aboard the “mothership” than jump with us into the unknown.

[Diane]

I'll have to think it through some more, but for now I'm going to go with the biological underpinnings of all "needs", including spiritual ones, and the tendency "cult-ure" has of exploiting any need to serve/perpetuate itself rather than the people who comprise it.

[nari]

Perhaps most PTs are in spiritual need of 'belonging' to the profession as well as blindly following the cult-ure; establishing their identities by following the well-travelled roads of physiotherapy curricula and cont ed. A sort of standardisation process which more or less guarantees that patients receive the same clinical reasoning process from one PT to another.

I can see the rationale behind that. Especially in North America with its insurance giants who hold sway over PTs. To me, it is stifling and destructive, but that's another story that's been well-barbecued.

Barrett's point 2:

Guard against the tendency to make the outcome of any inquiry match our own previously drawn conclusions.

I think that is important, too.
Predicting how a patient will respond to a certain treament/approach according to previously drawn conclusions is crystal-ball gazing. It may fulfill our spiritual needs, but it sure doesn't do anything for the patient that is useful beyond an expression of platitudes.

Nari

[Barrett Dorko]

Who are these people?

I’m seated at the front of a meeting room in a beautiful hotel in Wichita as I write this. Slowly the room is filling with therapists of various sizes and shapes. They all look relatively normal. The sniper seats are already full. What I can’t tell by looking is whether or not they’re among the abducted. In order to sense that I’m going to have to watch their reaction to a few statements I make during the first hour. Things like: “No one has demonstrated a connection between posture and pain” and “Posture and strength are unrelated.”

These statements are supported by literature on the table I set up in the front, and aside from the sudden cessation of breathing I sense in students when I say this, I also note that almost without exception no one takes five minutes to open the file I place before them.

Later I’ll let you know what happens today.