Another reason therapists don't know

[Diane]

Of course they could. Also mechanoreceptors, from static electricity, or small breezes bending hair follicles maybe.

[Barrett Dorko]

Evan says:

Thought implies mental effort.

I disagree. Having NO thought is much more difficult. Do you mean "planning"? You seem to be referring to awareness here, and that's a difficult subject. I'll be writing about a new book on that soon.

What is a "somatic model" and how does it differ from a "mental model"?

[Johnny_Nada]

John

Can you think of a better rationale for a person experiencing persistent, non-pathological pain?

With the population I see, yes I can. I have recently had more than a handful of individuals tell me they have pain but cannot identify a location. For those without negative psychological or social factors, no I can't

I do other stuff, too.

Such as?

[Barrett Dorko]

Matt,

Can these people alter their pain with position and/or use? Have you asked? Do you know yet what that implies quite strongly?

Location is the least important finding when it comes to a painful complaint because the problem is in the nervous system rather than a specific nerve.

Do I sound like a broken record?

[Evanthis Raftopoulos]

I disagree. Having NO thought is much more difficult. Do you mean "planning"? You seem to be referring to awareness here, and that's a difficult subject. I'll be writing about a new book on that soon.

Mental effort in my mind relates to cognition, it does not necessary imply difficulty or concentration.

I don’t think that movement that is generated by the subconscious, or movement that is truly instinctual (I think that these two are not exactly the same) is directly related to thought, as in thought happens and ideomotion follows. But like thought, the capacity for the organism to evaluate the need for movement (goal= optimal health) and generate this movement behavior is pre existing. Perhaps when memories or thoughts of movement are encoded, new opportunities for movement behaviors arise that can allow for ideomotion, but this is just a speculation on my part. If this theory is true and assuming ideomotion exists and has a purpose (optimal health), then it supports therapeutic exercise and novel movement patterns.

What is a "somatic model" and how does it differ from a "mental model"?

The mind is a mental model,as it guides and predicts behavior. It is encoded in the organism. Say for example one is afraid of heights, then the behavior when standing at the edge of a cliff is pre determined and can be accurately predicted. Similarly, when culture is thought to pre-determine movement behaviors, this relates to mental models. Somatic is related to the body, and we have no direct control over somatic behavior which includes truly instinctual movement. However, it gets blurry to distinguish these two by observation as mental and somatic models are in constant interaction.

[Evanthis Raftopoulos]

references:
Anticipatory Systems
Philosophical, Mathematical, and Methodological Foundations
Series: IFSR International Series on Systems Science and Engineering, Vol. 1
Rosen, Robert, 2nd ed. 2012

[nari]

Could thermoreceptors in the skin detect a hovering hand?

I agree with what Diane says. Awareness of a thing or person where sight, taste, smell and touch is not involved is another one of our alert senses.

Nari

[nari]

Evan,
I find your posts interesting and thoughtful. One question: if the conscious 'mind' exists, then your arguments hold some water. If it is ever shown clearly that consciousness does not exist then they don't. I think.

The real difficulty lies with assuming that we have control over nearly all our actions and therefore eliciting ideomotion is a challenge before we even try to elicit instinctive movement.

Kids, before the culture has got hold of them, elicit ideomotion without any effort.

Nari

[Bas Asselbergs]

Josh, I want to get back to this:

Of course the patient directs speed, amplitude, and direction...

Could you explain how you see these parameters are arrived at in the patient's conscious brain. I am truly curious.

And what would your instruction or advise be to that patient for the motion to begin?

[Bas Asselbergs]

With regards to consciously generated motion: there is VERY little of that in most people's lives on a daily basis, except in some parts of athletic performance and specific exercises, and a few chosen motions (learning to dance or any other specific skill).
Jo's example of the surgeon is a good one to illustrate that. Same thing with an assembly line worker, having a deep debate about politics while the hands are busy doing.

[John W]

With the population I see, yes I can. I have recently had more than a handful of individuals tell me they have pain but cannot identify a location. For those without negative psychological or social factors, no I can't

Congratulations, Matt, it sounds like you are becoming the "pain guy" where you work.

If someone is not distressed by their non-pathological pain, then I don't why we would should even be seeing them. Is distress a psychological or social factor? I think so.

In addition to pain education, I do manual therapy- mostly skin deep, but some oscillatory stuff from time to time. I teach patients to do novel movements per Cory Blickenstaff. I use some Hannah Somatics and Feldy stuff as well. Often I'll note to the patient when they are moving non-consciously, so I guess I do some Simple Contact, too. I emphasize graded aerobic training for my long-term deconditioned fibromyalgia type patients. In fact, I contract with them that they must begin a 3 day/week program of graded aerobic activity based on a combination of target heart rate and RPE. The amount of time per week varies, but usually starts at a minimum of 10 minutes per session. I've begun using more sensorimotor training with some of my spinal pain patients, including sensory discrimination: two-point discrimination and graphesthesia.

[Barrett Dorko]

Fine John.

I'd like to know if Matt has answers to my questions in post #141 as well.

[Johnny_Nada]

Matt,

Can these people alter their pain with position and/or use? Have you asked? Do you know yet what that implies quite strongly?

Location is the least important finding when it comes to a painful complaint because the problem is in the nervous system rather than a specific nerve.

Do I sound like a broken record?

Barrett,

This is one of my first questions with those I see. Many answer no. For some this is true. For many i find a lack of tolerance for movement is most common; high pain levels that only progress with movement. No movement provides comfort, reduction or reported benefit. You may call this an abnormal neurodynamic. I wouldn't disagree.

As far as location, I understand your statement and I do not 'chase' pain. I am always looking for a movement, position for reduction. It just so happens this was the first time I had heard this. "I have pain, but I don't know where."

[nari]

"I have pain, but I don't know where."

I find this an intriguing statement. I wonder if they mean they can't point specifically to a smallish area? As if looking for an origin? cause? That is how I would interpret it.

If that is so, (yes, I hate to admit it), ideomotion can be helpful in reducing the pain. Then, once a degree of comfort is obtained, take it from there in whatever way you wish.
Depending on how you win rapport with the patient; with some that never really happens, I found.

Nari

[Evanthis Raftopoulos]

Hi Nari

consciousness exists, clearly, and it maps to neural firing patterns. And so is experiencing pain.

I don't think that we can purposely elicit true instinctual movement. Movement that is part of the subconscious mind (neural firing patterns ready to be encoded) is not necessarily instinctual.