Another reason therapists don't know

[Johnny_Nada]

Barrett,

If this is true, what is the relevance?

I realize asking would typically get me an enormous amount of links to your previous writings or wikipedia. If you could summarize the relevance without a link, in a matter of fact fashion, I would appreciate it. I'm not asking for you to shut up, I'm attempting to better understand the 'plausibility' of what you speak of.

[nari]

Does it assist to use the word 'nonconscious'. not unconscious? There is no awareness with an unconscious person.
I cannot grasp the concept of a therapist choosing the best movement to do for a patient.
How on earth do we know what is going on in the brain of a another person in pain?
(Obviously if there is a busted leg or a THA we advise what to do, how to do it and what not to do).

The debate between the relevance of the nonconscious/conscious brain has been going on for nearly 50 years or more. There is no clear solution but evidence is piling up from a lot of researchers that the conscious brain has a relatively small role to play if at all.

Things of real interest are always uncertain to some extent.

Nari

[Barrett Dorko]

Matt, You're right, there are more links than you might imagine.

Ideomotion is unplanned. Of course. it's generated by thought, and, as it turns out, most if not all things are decided before they're done. This is difficult to explain and it certainly doesn't follow our intuition.

Nonetheless, unconsciously generated motion is extremely useful and fulfills Wall's admonition that the third instinctive response to an output is RESOLUTION. When we stop at protection, well, that's where allowing others to move ideomotorically comes in. Simple Contact, whatever that is, seems to both understand and catalyze that.

At least, according to me.

[John W]

Luke Rickards uses the term "non-volitional" in his paper, which Barrett cited earlier.

I think we can all agree that our bodies move in ways that we don't consciously control or expect. We just move. The point is we might not move in this way if we take heed of instructions like "sit up straight" from those in authority over us, or who we would like to emulate (e.g. supermodels, classical dancers and other celebrities).

If this behavior is linked to persistent pain, why wouldn't we try to figure out how to intervene in a way that promote its expression? If ideomotor movement is inherent to life, and it's being suppressed, then it follows that the individual is not living a fully expressed life. If we can help someone to live more fully through a more complete expression of their physicality, why wouldn't we? Isn't this what we are supposed to do?

Frankly, I don't understand why this so difficult to grasp. But, I very much appreciate why it's so difficult to implement in practice.

[John W]

By the way, regarding that last point...
Sometimes I wonder if the cognitive dissonance that this topic seems to predictably create is really more about the fear of having to honestly look at the fix we have gotten ourselves into professionally. Even someone as forward thinking and intelligent as David Butler gets squeamish when asked about ideomotion.

My mother and brother work with the families of addicts and alcoholics. One of their biggest challenges is convincing the family member, spouse, significant other, that they are as "sick" as the addict. They call this aspect of the "disease" "co-dependency".

Our culture- in health care and certainly in PT- is riddled with it.

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[nari]

This is simplistic, but the need, cultural or otherwise, to be seen being busy and being paid for complex manual therapy methods some of which do not have a strong EB, seems inherent in a lot of health systems.

It's about justifying the need to be busy, employing complex means in order to do so and it goes back to the bean counters needed for survival. Rather like the snake swallowing its own tail.

Nari

[Barrett Dorko]

Sometimes, okay, typically, therapists simply cannot imagine that the culture or their teachers or those they admire could possibly be wrong. They're overwhelmed by the need to coerce, the culture's premium on appearance and The Puritan Ethic deep in their inheritance.

This is a powerful combination of influences, and they have formed a wall surrounding the fortress therapy has built around customary practice. The walls have been reinforced with piles of $$$$$.

Given that, I doubt things will change.

[Johnny_Nada]

Matt, You're right, there are more links than you might imagine.

Ideomotion is unplanned. Of course. it's generated by thought, and, as it turns out, most if not all things are decided before they're done. This is difficult to explain and it certainly doesn't follow our intuition.

Nonetheless, unconsciously generated motion is extremely useful and fulfills Wall's admonition that the third instinctive response to an output is RESOLUTION. When we stop at protection, well, that's where allowing others to move ideomotorically comes in. Simple Contact, whatever that is, seems to both understand and catalyze that.

At least, according to me.

Thanks Barrett for that. So much easier to understand than your typical writing style (usually requires multiple reads for me to grasp)

If this behavior is linked to persistent pain, why wouldn't we try to figure out how to intervene in a way that promote its expression? If ideomotor movement is inherent to life, and it's being suppressed, then it follows that the individual is not living a fully expressed life. If we can help someone to live more fully through a more complete expression of their physicality, why wouldn't we? Isn't this what we are supposed to do?

How can we determine if the behavior is linked to persistent pain? If discovered how to we educate or encourage the 'expression?' What words do we use or actions do we (therapist) take? What actions does the patient take?

[Barrett Dorko]

Matt asks:

How can we determine if the behavior is linked to persistent pain?

The behavior's always there. Its relation to the mechanical deformation responsible for the nociception contributing to the output of pain will be guessed at after a while. I have the impression that its expression is to found in creative activity but I have no way of demonstrating that.

Authenticity is what I seek. Simple as that.

[John W]

How can we determine if the behavior is linked to persistent pain?

Matt,
Can you think of a better rationale for a person experiencing persistent, non-pathological pain? If you subscribe to the existence of an abnormal neurodynamic, how else would you explain this physiological state coming to be? I think you'd agree that an abnormal neurodynamic can end up hurting.

If discovered how to we educate or encourage the 'expression?' What words do we use or actions do we (therapist) take?

I use formal pain neuroscience education- I appeal to their reason. I do other stuff, too.

[Evanthis Raftopoulos]

I still DIS-agree.
It's not physically invasive (not as much as ortho treatment, at least..), it's psychologically invasive.

I agree with you in that the explanatory narrative can be psychologically invasive, and this is a bigger problem if the recipient actually believes what the practitioner is saying, and/or has a serious health condition that is not seeking medical treatment for because of Reiki. But if the recipient finds it relaxing and doesn't mind the practitioner talking nonsense, then in this context it is not more ‘psychologically invasive’ than any other passive treatment that suggests: you just rest there and I’m about to do something therapeutic with my hands, or these needles, or this equipment, to address your pain problem or help improve your health and well being.

Maybe I should ask you what you think "Reiki" is, exactly - your definition please.

Reiki is a ritualistic procedure where the recipient is resting and the practitioner is moving their hands along the body without actually touching the recipient. I imagine that for some people this context has the capacity to engage their anticipatory systems which may lead to placebo analgesia (descending inhibition etc).


advantage:

To quote Jo you would still have to hit the metaphorical mute button to block out the explanatory poo. What you describe above is manual therapy with neuroscience education and self management. Also, by calling the manual techniques Reiki, you give the patient the impression that energy is being chanelled as well as any other poo poo idea that goes with it.

You are right. It's like describing 'myofascial release' as DNM but insist on calling it myofascial release.

[nari]

Barrett,

Is it fair to say that authenticity becomes overt only when permission is given for the person/patient to - umm - be authentic? Which is rarely allowed in today's cultures?
We are coerced to learn from being taught, rather than via autodidactism.

Waiting for instructions, advice, counsel and directions removes this expression?
That is my inclination, anyway.
This thread is raising interesting conflicts of understanding - including for me. I can elicit ideomotion easily in myself - so it must be difficult to come to grips with the nature of the beast for many people.

Nari

[Evanthis Raftopoulos]

Mark,
Unconscious=out in my context,hence our disconnect.

I agree, subconscious makes more sense to me.


Barrett:

Ideomotion is unplanned. Of course. it's generated by thought,

The definition of ideomotion seems to be blurry, but at this point in time I understand it as a quality of the body that is independent of conscious awareness. Thought implies mental effort. So if ideomotion is movement that is indeed independent of conscious awareness, then ideomotion is a result of predictions of somatic models and not mental models (cognition, memory, thought etc.).

[nari]

I once treated a Reiki practitioner, who said after the session, I can try Reiki with you if you like. So she did.
I had great trouble trying not to laugh with the seriousness of the hand hovering over my arm. When she said: How did that feel? I replied: Umm, sorry, I didn't feel anything. She was nice about it and said: Not everyone does, but I thought you would.

Umm why? (I didn't say that to her)

Nari

[Jo Bowyer]

Could thermoreceptors in the skin detect a hovering hand?