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Health, happiness, comfort or survival?

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  • Health, happiness, comfort or survival?

    I’m reading The Happiness Trip – A Scientific Journey by Eduardo Punset. This book was recently translated from Spanish and I found it in a bookstore in the San Francisco Airport last week. This is why I don’t just walk by these places.

    Punset has for years hosted a very popular TV show in Spain directed toward a greater understanding of science for the general public. I wish I could get it on cable – translated, of course. This book has a forward written by Antonio Damasio so I was immediately intrigued. Punset repeatedly points out that the relatively recent increase in our life expectancy has run ahead of our brain’s primary job, which is to just keep us alive long enough to procreate. Now that we have all this time on our hands we have sought to fill it with activities, achievements and the acquisition of goods that we hope will make us “happy,” whatever that means. What we’ve come to understand about what makes us happy is the subject of this book and I found it fascinating.

    I’d like to focus here on a specific passage in the center of the book about bodily positioning that is obviously germane to our work.

    We never relinquish the idea of survival. When a herd of antelope flees from a lioness, the main adversary of the slowest animal is not the lioness, but the faster antelope. However, antelopes are not concerned about their health, but about saving their lives. When our ancestors froze in their tracks when faced with a hyena attack, this was the optimal posture for having a chance of not entering the animal’s visual field. They were not thinking of their health but of survival.

    These words reminded me of how often my contention that self-correction lies within us waiting to be expressed and how often therapists find that hard to believe. They presume that our primary goal is comfort and that our chief instinct would be directed toward it. But Punset makes it clear that we have lost sight of the fact that comfort and happiness are new to our species. We shouldn’t be surprised when we seek them in ways that don’t work especially well or, in fact, prove to be counter-productive.

    Perhaps if we realized this we’d understand a bit more about why we struggle to help our patients with persistent pain that seems perpetuated by simple behaviors we can see quite easily but cannot change.

    More soon.
    Barrett L. Dorko

  • #2
    Hi Barrett.
    I have read this book a year ago, in the Spanish version (is easy for me). I think it is a very interesting book. Eduardo Punset has wirtten several books and his program in the TV, REDES, has discovered the science to a lot of people here in Spain.
    Javier González Iglesias


    • #3

      Do you know of any others which have been translated into English?

      I like the sound of Punset's writing. We have extended our lifespan so far over the centuries (particularly the last one) that we may just have too much time to worry about whether we are happy or not.



      • #4
        Hi Nari
        This one is going to be published soon, but I don´t know if you can buy it now:
        "Mind, life and Universe: conversationswith great scientists of our time"
        I have read both of them in Spanish and I think they are very interesting.

        Javier González Iglesias


        • #5

          I’m so pleased to hear that another PT has read this book. It sounds like you choose books in a manner similar to my own.


          Punset’s point is precisely that – we’ve all sorts of time on our hands not given to previous generations yet we’re supposed to understand things and then behave appropriately given the same brain we’ve had a lot longer than that.

          I say to my classes, “Ever since you’ve sat down today you’ve been intermittently, visibly expressing ideomotoric activity. Perhaps someone in here is seated near to someone else they wish would just sit still. But what is this person doing? They’re instinctively moving in a fashion that reduces the mechanical deformation that has accumulated in their system. In short, they’re moving quite naturally in the directions you want them to move if you’re the therapist responsible for helping them with their painful problems.”

          Hopefully, this wakens the therapist to a movement therapy they’d not previously considered – and often it does. It’s reasonable to ask however, “What keeps this instinct to move toward comfort so restricted?”

          Ultimately, I seek to get therapists to understand that the restriction begins with their own ignorance. In addition to that, Punset’s insights regarding our instinctive way of being are shown to be decidedly in opposition to the culture’s admonitions to be something else.

          More about that in the next post.
          Last edited by Barrett Dorko; 19-07-2007, 02:51 PM.
          Barrett L. Dorko


          • #6
            This thread’s been bouncing around in my head and the following shaped itself last night.

            By any measure, we are in the midst of an epidemic of chronic pain and if mechanical deformation for which there is no surgical solution is the origin in many of these cases (and I’m pretty sure it is) those of us providing movement therapy have failed.

            A book like Punset’s reminds me of the initial stages of our failure according to David Morris’ in The Culture of Pain. I reviewed it years ago here and said in part:

            David Morris says, "The most distinctive feature of this contemporary epidemic... is that we cannot recognize it as an epidemic." I've long referred to the large percentage of my colleagues who can be said to suffer from chronically painful conditions as the "great shadow" of the therapy profession, and I see no indication that it is lessening in any way.
            Morris traces our problems with understanding, and therefore treating, chronically painful problems successfully to the demotion of pain from a perception to a sensation in the middle of the 19th century. He explains this in a variety of ways, perhaps best in a quote from the anatomist and physiologist Allen I. Bausbaum; "Pain is not just a stimulus that is transmitted over specific pathways, but rather a complex perception, the nature of which depends not only on the intensity of the stimulus but on the situation in which it is experienced..."

            It seems to me that the phenomenal rise in life expectancy paralleled this “demotion” of pain to a sensation. This changed the way medical science approached pain, with disastrous results. (read the book) It also occurred at about the time the numbers of people who had the means to live without concerning themselves continually with survival began to rise.

            See a trend here?
            Barrett L. Dorko


            • #7
              Consider this: We don’t possess an instinct for happiness, and, in fact, comfort per se isn’t something we instinctively seek either. What we are primarily concerned with on a primitive level is survival.

              Now, we might not sense this easily. In the absence of any obvious concern for survival our desire for acceptance and approval is close to the surface and we act accordingly, even at the expense of comfort or our authentic desire to behave otherwise. In order to preserve order many of our instinctive behaviors are sublimated and this is probably best. But might it be that there’s a baby here we’ve thrown out with the bath water? Might it be that our natural tendency to move in ways and directions that are unique and designed to fulfill our own long term needs for mobility and power have been ignored and abandoned? Wouldn't pain ensue?

              In Cindy Engel’s Wild Health: Lessons in Natural Wellness from the Animal Kingdom the author makes it clear that “health” isn’t sought by animals in the wild through careful manipulation of their diet, but rather that they insure their survival by whatever means necessary when it is threatened. This is a scholarly text, and the studies done on animals ranging from giraffes to caterpillars raised my awareness of the brilliance of instinct and the range of adaptability available in the animal kingdom.

              It’s clear that animals in the wild seek neither comfort nor approval to the extent that we do and it’s obvious in our dress, enforced stillness and posturing that approval wins out over comfort in our world. Survival is way down the list of things we seek though our instinct toward it is no less strong than it was when we typically survived just long enough to procreate.

              Perhaps we need to explore more carefully this conflict between instinct and actual behavior. In my opinion, this is where a lot of chronic discomfort finds it home in our psyche.
              Barrett L. Dorko


              • #8

                I've had a reasonably long think about your latest post.
                It would seem to me that animals might engage comfort when there is minimal threat; food in the belly and no predators visible or audible. Comfort comes in very short bursts and can be negated in a few seconds.

                Our threats are complex and sometimes imaginary; survival is indeed low on the list unless we choose to engage constant threats such as climbing Cerro Torre or walking the Atacama. Most people do not seek out threats to survival.
                This sense of security from avoiding all known threats may be false, because most of us then are not prepared for the real thing. So if we are stricken with pain, it becomes a huge threat to comfort.
                It's back to predictability; we treasure predictions, in the clinic and outside of it. If a PT cannot promise to deliver full relief from pain and dysfunction, we as patients register hope with a threat attached. Our actual behaviour then remains dependent on what the PT says and does to us.

                Instinctive behaviour is not dependent on what we are told to do or say or think. This may be why I think that some PTs would find your class philosophy a threat to their professional survival and ethos. Patients would find it liberating because it means freedom from some identified and unidentified threats.

                Funny lot, we homo sapiens.



                • #9
                  I’m right with you Nari. Many things I say and most of what I demonstrate about the possible consequences of Simple Contact may be seen as a threat to their happiness, comfort or survival (as a clinician within the context of their current clinic anyway). I doubt that they see me as a threat to their health, of course. Oddly, many sense that their own problems with pain might be resolved in this manner but that they're going to have to keep this secret from their colleagues and patients. What a mess.

                  Let's consider happiness a bit more.

                  Before heading to the restaurant where I write each morning I scanned my bookshelves for another idea about this thread and found An Alchemy of Mind: The Marvel and Mystery of the Brain by Diane Ackerman. A wonderful book.

                  Here you’ll find Ackerman has thought a great deal about happiness and its correlates in the brain, referencing Damasio’s work among others. She points out that while we’ve yet to find any instinct toward it, a happy or positive disposition might be found in a certain bias toward or away from this in amygdalar activity, and that this bias is massively influenced by our formative environment. In short, we can make a choice, but others have a lot to say about what we might choose.

                  We study the absence of this emotion primarily and have often been confused by its presence, seeing that it was present only in retrospect and during times of continual struggle. This was Proust’s great revelation. (I learned this watching Little Miss Sunshine for a second time last night, by the way) Many famous thinkers have had a lot to say about happiness; its slippery reputation and the difficulty we have creating it at will and Ackerman notes a few. My favorite is Franz Kafka’s diary entry in 1910:

                  Happiness is really something effervescent that fills me completely with a light, pleasant quiver and that persuades me of the existence of abilities of whose nonexistence I can convince myself with complete certainty at any moment, even now.
                  Last edited by Barrett Dorko; 22-07-2007, 03:38 PM.
                  Barrett L. Dorko


                  • #10
                    Salvador Dali goes a bit further:
                    There are some days when I think I am going to die from an overdose of satisfaction
                    and Seneca:
                    A man's as miserable as he thinks he is
                    and I like Camus (as always):
                    To be happy, we must not be too concerned with others.



                    • #11
                      Four aspects of our being are mentioned in the title of this thread - health, happiness, comfort and survival.

                      It might be argued that physical therapy has become increasingly interested in health, or what some call wellness. I never personally felt comfortable doing this. In any case, I’m unaware of its relation to pain, which is what I decided to focus on a long time ago.

                      Happiness has been mentioned here and I intend to return to it.

                      For now, I think it’s safe to say that we have no instinct for either health or happiness.

                      Comfort and survival however seem inextricably linked, to me anyway. After all, both result from ideomotion and that is undoubtedly instinctive. I always ask therapists what they worry about when a patient is unable to move ideomotorically and they invariably answer, “skin breakdown” but agree that pain would show up long before then. Clearly, the purpose of this motion is twofold, and its primary purpose is the reduction of mechanical deformation when it begins to exceed the tolerance of the ectoderm.

                      Unless that’s accomplished sufficiently discomfort rises and many, many people live with this regularly. We survive with enough ideomotion to prevent pathology but we won’t feel the relief it can produce unless we understand its place and use it fully within our array of instinctive expression – our survival instinct – and that seems to include our movement toward comfort.
                      Barrett L. Dorko


                      • #12
                        More about our instinct to survive and its relation to comfort.

                        Oddly, ideomotion seems to be the one way of moving instinctively that I have to focus upon if I am to do it efficiently. Breathing and swallowing (excitomotion) pours forth precisely as needed and startling (sensorymotion) is something never trained out of me to any great extent. They remain intact and contribute to both my survival and comfort. Of course, there aren’t many rules about their expression that I’m aware of. (In fact, therapists promote their fuller expression with lessons in diaphragmatic breathing, aerobics and “core strengthening” in challenges to balance in a variety of ways)

                        But ideomotion has two purposes and though they might be considered sides of the same coin they aren’t linked in a fashion that makes them appear the same. One side of this coin leads to physical comfort through metabolic economy in our tissues and the other to an expression of our thoughts. Do we have to spend the whole coin each waking moment? It seems not.

                        I use the increasingly popular activity of playing poker as an icon of our culture’s suppression of ideomotion and have yet to meet any reasonable therapist who can disagree with this as a perfect example of how becoming physically inauthentic is encouraged. I cite a popular poster for tournaments in Las Vegas showing a player gazing over the top of his chips. Beneath it are the words, The blanker the stare, the fatter the wallet. That’s fairly explicit, don’t you think?

                        But this is nothing new. We are all taught early on that submission to authority is rewarded, and that that submission should include stillness and quietude until something else is ordered. The better a child is at “playing poker” the easier it will be for them to move through their environment without being threatened with harm or further restriction. They learn to choose those moments when they can become who they actually are with care, attending to the possible consequences. Nonjudgmental friends see us in ways others won’t. If we have too few of them, well, we pay a heavy price. Poker players commonly hurt as they play and this shouldn't surprise us. After all, they haven't any real friends at the table.

                        We move instinctively in just three ways (see The Analgesia of Movement) and only one of these is regularly suppressed. Its relative absence leads first of all to discomfort – which according to no less than Patrick Wall is the largest epidemic in the western world.

                        Maybe we ought to study it. Maybe we ought to consider how it is that therapists promote its suppression.
                        Last edited by Barrett Dorko; 23-07-2007, 02:11 PM.
                        Barrett L. Dorko


                        • #13
                          Instinct and Desire

                          Cory put this together a while ago so I’m pretty sure he’s got some neuroscience behind it. Maybe he can tell us what it is.

                          Options and Considerations for motion

                          • Avoid Pain

                          • Resolve Pain

                          • Don’t get laughed at

                          I don’t know about you, but this always makes me laugh. I suppose that’s because it’s both surprising and true – two elements essential for effective comedy. The first two represent instincts and the last a desire. Which is stronger?

                          I’ve just begun reading The Happiness Myth: Why What We Think Is Right Is Wrong by Jennifer Michael Hecht and feel that it will inform much of what remains of this thread. It begins with a description of the corsetry popular for women in the 19th century and rapidly points out that though this has largely disappeared from fashion today it has been replaced by obsessive exercise, dieting and plastic surgery. I’ve been saying this for years, so, as yet, the author and I agree entirely.

                          Chapter Two is titled “Control Your Desires” and the first few paragraphs say a lot about how we so often find ourselves in the fixes we, well, find ourselves in.

                          I’ll put a few passages from this into the thread eventually but today I want to make this point: Comfort and survival are strongly linked and both are driven by a primal instinct we all possess. It is more powerful than most imagine and examples of its expression form the basis of countless stories – stories that endure for centuries.

                          Health and happiness are both something we desire, but I can find no evidence that we have an instinct for either one. We literally have to be told that we should seek these things and, predictably, the ways that our culture offers various paths toward them is strongly influenced by what it wants us to buy. Therapists who don’t recognize all of this often find themselves in situations catering to these desires in a number of ways and not actually dealing with or honoring the patient’s instincts toward comfort and survival. This is despite the fact that pain relief is what the patient came to them for. Instead, the patients find themselves in a place where perpetual and choreographed exercise designed to shape their bodies is the order of the day. They are often rewarded with smiles, laughter and encouraging comments from those in authority as well, therefore “happiness” surrounds them and they are often glad to be there.

                          But I heard this from patients with increasing frequency for 35 years: “They were really nice and I worked really hard there for a long time, but I still hurt.”
                          Last edited by Barrett Dorko; 24-07-2007, 02:21 PM.
                          Barrett L. Dorko


                          • #14
                            I see by the number of visits that this thread is gathering steam. As it happens, I have a whole bunch of ideas for posts over the next few days that I can barely keep from writing but must because I've other things to attend to. In another hour I'll board my first plane of the day on my way to the west coast where I have to focus on scheduling some rest in order to teach well and drive safely each day.

                            Many jobs would be easier to do but this is it for me now and I'm willing to endure the isolation and fatigue that comes with it because it fulfills for me a unique desire to read and think and write and talk about what it is I've discovered. I know that others sensing this drive in me have exploited it in the past, getting me to do it so that they might profit financially. I have difficulty avoiding this situation, as you might imagine.

                            The bottom line is this: Desire doesn't rise from instinct so much as from a variety of influences. I'm reminded of the classic Dan Fogelberg tune Run For The Roses and the line:

                            It's breeding and it's training
                            And it's something unknown
                            That drives you and carries
                            You home.

                            I wrote of instinct in this way several years ago :In The Wisdom of the Body by Sherwin Nuland, the author traces the origins of the word "instinct" to the latin "stinguere," meaning to goad or to prick. He points out that the word instigate has the same origin, and emphasizes the persistent and compelling nature of our inherent and genetically acquired tendencies to behave in certain ways. (see INSTINCT AND INHIBITION)

                            Look at your clinic and the way that you practice. A good question to keep in mind is this: Am I using my patient's instinct toward comfort and survival or am I exploiting their desire for health and happiness?

                            The answer might surprise you.
                            Barrett L. Dorko


                            • #15
                              I think these statements are relevant. They come from Desmond Morris' now quite old book (1969) The Human Zoo. Ch 6

                              1. If stimulation is too weak, you may increase your behaviour output by creating unnecessary problems which you can then solve.

                              2. over-reacting to a normal stimulus.

                              3. inventing novel activities.

                              4. performing normal responses to sub-normal stimuli.

                              5. artificially magnifying selected stimuli.

                              If some or most of us are exploiting the patients' desire for health and happiness, the above seems to apply, particularly (1) and (5). Lack of stimulation is perhaps the precursor of failing to recognise patients' instincts.
                              A busy therapist can also be bored and under stimulated without recognising these states.