Another reason therapists don't know

[PatrickL]

I don't think Patrick thinks that ideomotion is not useful in treating pain, rather I think he's just questioning it's relationship to self-correction since he's arguing that humans are not self-corrective.

I think it's reasonable to state that there is an alteration in motor output away from "protection" as impediments to such motor output changes (cultural influences, maladaptive central processing, maladaptive afferent signaling, adaptive central/peripheral sensitization) are removed. I don't know if such altered motor output should be labeled ideomotoric... But I suppose it's simpler than saying "non conscious shift of motor output away from protection".

In not questioning the relationship between such altered motor output and correction. I was simply taking up on Barrett's invitation to critically analyze his premise. I think there is an important difference between "we have a capacity for self correction" and "we are self corrective".

[PatrickL]

No responses to post #432?

[zendogg]

I struggle with how heavily culture is accused of being the suppressor of instinctive self corrective movement. Yes I can plainly see how culture could inhibit a range of movements needed to resolve mechanical deformation. But how about one's own interior perceptions? A person went through a windshield, they've had persistent neck pain for 10 years, isn't it most reasonable that non consciously they themselves, independently of culture (if that's possible) have a neurotag of ongoing danger/threat? I am referring to their perception of the world and felt sense of safety internally and externally since the accident.
It still makes way more sense to me that the magic is neurotag (mostly). Emerging ideomotion is the return to normalcy.
By the way, Diane, haven't you said somewhere that you wait for the movement you've catalyzed to STOP in order to know it's time to move on?

Nathan

[Jo Bowyer]

No responses to post #432?

434 and 435

[PatrickL]

Thanks Jo.

[Evanthis Raftopoulos]

"You doubt that ideomotion could ever be used for treatment of painful conditions, "

Hi Nari, assuming that we are talking about the same phenomenon (Carpenter's ideomotion) I don't think that we can intentionally express it or manipulate it in a way that leads to pain resolution. It sounds to me that this is the same as claiming that we can control the unconscious mind and in a very meaningful way.

"so can you come up with an answer for those people whose pain disappears (often slowly, occasionally very rapidly) after its expression. "

I have to ask, where is the evidence for what you are claiming?And not knowing the mechanism of effectiveness (Assuming effectiveness) does not validate the therapeutic claims of ideomotion. Moreover, you say after its expresion and I assume that you are referring to ideomotion. How do you know that it actually occurs at any given moment?

"Why is this considered "unsound"?? What is the alternative hypothesis? Particularly when some movements can be very surprising, fast and incredibly smooth and easy in comparison with any volitional movement."

How do you know that a movement is surprising, fast, smooth and easy if it occurs at the unconcious level? I don't think that you are talking about ideomotion.


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[nari]

Evan, I am sorry but I do know what you are saying and I can't accept your premise. I have been to Barrett's class and experienced large and small movements as a result of SC. Since then, the same, elicited by myself.

How do you know that a movement is surprising, fast, smooth and easy if it occurs at the unconcious level?

Because I know that it is occurring completely beyond any control that I could think of.
OK, what is happening, then? What is behind this nonvolitional movement? Some facet of the nonconscious no-one knows about? Sorry, but this is merging into a discussion between a couple of PTs who have never experienced non-volitional movement. What else can be said?

Nari

[PatrickL]

I struggle with how heavily culture is accused of being the suppressor of instinctive self corrective movement.

I think it's a reasonable, but also an untestable and unfalsifiable proposition. We know our environment influences all that we do... If one prefers to interpret a patient's pain as being driven by the suppressive effect of the culture on instinctive movement, one will always be able to point to specific movement behaviours (or lack thereof) for any given patient and say "that's the culture's fault"

A woman has heel pain when she wears high heels... That's the culture's fault
A fisherman has shoulder pain when he repetitively casts... That's the cultures fault
An office worker has neck pain when she sits statically... That's the culture's fault
A young girl develops crps following a wrist fracture... That's the culture's fault
A patient's pain does not resolve following a 12 week, 36 session bout of joint mobilizing, needling and strength training... That's the (therapy) culture's fault.

The degree to which a patients pain results from the culture's suppressive effect on corrective movement is unknowable. I think we can tease it out a little with good history taking/listening to the patient. That should provide clues about whether one is dealing with adaptive peripheral / central sensitization, maladaptive central processing, maladaptive afferent signaling and/or the extent to which the culture is amplifying any of these processes.

[PatrickL]

Sorry, but this is merging into a discussion between a couple of PTs who have never experienced non-volitional movement. What else can be said?

Am I one of these PTs, nari? I have met Barrett, and he carried out simple contact with me. In standing, he lightly touched somewhere on my lower back and I started moving into left rotation through my torso... Non volitionally. It was a strange feeling to observe myself moving without really doing it on purpose.

Evan,
I'm finding it difficult to understand what you are driving at. Do you disagree with the labeling of non volitional movement that emerges during simple contact as ideomotion? Or do you disagree that non volitional movement actually emerges during simple contact? Or do you disagree that such non volitional movement (if it emerges) during simple contact can be interpreted as a shift from defensive motor output towards resolution?

[Keith]

I think it's a reasonable, but also an untestable and unfalsifiable proposition.

Agreed.

I think we can tease it out a little with good history taking/listening to the patient.

For the same reason, I don't understand how this could be possible.

Respectfully,
Keith

[Barrett Dorko]

Patrick says:

The degree to which a patients pain results from the culture's suppressive effect on corrective movement is unknowable.

That's not quite there. The culture suppresses movement, it doesn't cause pain.

I know it's merely anecdotal, but my father's shoulder didn't hurt when he was reciting his poetry to a crowd. Otherwise, there was an output of pain.

I simply say that creative acts alter the output of pain, and that ideomotion is a creative act constantly ongoing that has various effects. The effect of reducing the output of pain (of which there are numerous means) as well as adding to the instinctive processes of resolution is one of them. Ideomotion is as inherent to life as breathing. Draw your own analogies from that.

If motion isn't inherent to life; if it isn't present to enhance sufficient blood flow, why has it been studied so carefully, why are there so many books on its meaning and its use? Why do we hold the "badly behaved" still? Why do we punish others first and foremost by restricting their motion?

Are these unfair questions? Is it now up to us to demonstrate once again that corrective movement is inherent to life?

[weni888]

Am I one of these PTs, nari? I have met Barrett, and he carried out simple contact with me. In standing, he lightly touched somewhere on my lower back and I started moving into left rotation through my torso... Non volitionally. It was a strange feeling to observe myself moving without really doing it on purpose.

Hi Patrick,

I would be very interested in hearing a bit more re your experience....

when you said " non volitionally" what you meant??

Since it was a strange feeling to you, did you get the characteristics of "correction" after that??

Did anyone try simple contact on you on that day? If yes, what the response you got? What do you think of the role of Barrett himself eliciting your motion??

Regards,

Weni

[Barrett Dorko]

It occurs to me to ask: If the motion is visibly emergent after I deform the skin (touch), what kept it from being so obvious beforehand?

Patrick experienced this and has written of it, so perhaps an answer from him would be especially relevant. More recently, several of the students in Hamilton displayed this behavior last week and they post here and are reading this.

[John W]

I think that when it's is stated as "we are self corrective", Barrett's premise is open to being understood as "regardless of any influence/circumstance/context, people will self correct. This is plainly at odds with one of Barrett's other key ideas... That being that the culture can suppress/inhibit self correction.

I take the phrase "we are self-corrective" to mean that this is an inherent property of being human- and that's all it means. Asserting it doesn't preclude the possibility that this inherent, homeostatic (thank you tallpaul) mechanism cannot be interrupted or suppressed either consciously or subconsciously.

I think one only needs to take a glance at the virtually non-existent incidence of persistent, non-pathological pain problems in more "primitive", tribal cultures to see how important the cultural influence is on persistent pain problems. So, yes Patrick, to the extent that all of those conditions are non-pathological pain problems with a mechanical origin, I think the culture plays an important role in their development and ongoing existence. The reason it will be very hard to tease out how much the culture contributes I think is analogous to how much a person is sensitive to certain foods.

My wife was convinced by her mother when she was young that milk increased her phlegm production when she had a cold or allergy attack, so she didn't drink milk. She still doesn't drink cow's milk for the same reason. The few times she has, she got a feeling of being "phlegmy", and she attributes this to an ongoing sensitivity to milk. I've suggested that it may be a conditioned response- a sort of nocebo- related to her mother's inculcation of the relationship between milk and increased phlegm. I've tried to explain to her that many children outgrow these sensitivities. But, she won't drink milk. However, she eats cheese and yogurt without any problem. I know better than to bring this to her attention.

My point is that just because the influence of the culture is difficult to tease out (and is likely highly individually variable based on genetic/epi-genetic factors and rearing) does not mean that its influence is being over-stated. I think the cross-cultural evidence suggests that it is a very important contributor to the epidemic of persistent pain problems in the West.

Blaise,
My answer to your question about "hairsplitting" is related to what I just said, but I'm heading to the ballpark and then a crawfish boil (:thumbs_up), so I won't be able to get back to that until later this evening.

[Evanthis Raftopoulos]

Hi Nari, please don’t tell me that I need to attend a class to experience ‘ideomotion’. This reminds me of some people in the MFR crowd talking about how MFR helps patients express emotions but you have to attend the MFR class to experience it yourself. btw with the same logic that we see here it can be argued that that behavior (emotions /movements expressed with MFR) is ideomotion too.


Hi Patrick, to refer to your points above, I don’t think that if I place my hands on a patient and movement follows that concludes that 1. the movement can be labeled as idemotion (as defined by Carpenter) and 2. the movement is more therapeutic (in the context of long term pain resolution) than movement that the patient has already been expressing prior seeking any help.