Warm body with a license

[PatrickL]

What story are you referring to here?

the story of of ectodermalism. this...

• "you're questioning ectodermalism???? You must be a mesodermalist!"
• "What's my deep model? How about I tell you who doesn't have a deep model!"
• "You don't think the brain preferentially attends to input from the skin? You must think you can specifically affect deeper receptors while ruling out the influence of skin!"

... may trigger learning, in that it picques interest. but ultimately, it limits the spread of useful info to willing learners. As I've said in another thread recently, no one comes here with the specific intent to teach others, so no one is obliged to assist others in their learning.

But man, the framing of pain science around an ect/meso divide, the inability to articulate the "deep model" while also being critical of those who don't have one, the hair trigger labeling of the "mesodermalist".

I dont know where this ship is sailing... probably in circles. Maybe that ok. Maybe as it goes in circles, it will continue to pick up willing learners and drop them off when they've learned what can be learned.

[Bas Asselbergs]

Patrick:

I'm still not sure what the deep model is. So it makes this conversation about it a bit strange. Can you articulate it, bas? Perhaps the deep model is "people in persistent pain need only three things. Empathy, permission to move and some hpsg?"

My point is that out of the "iffy methods" there would be some for which a major change in explanation would not be necessary in order to be congruent with the "deep model" (obviously some would need a major overhaul). And that would be because the "deep model" is very broad in scope (as it's strength is drawn more from loose consilience of hypotheses than robust evidence.

Thanks for that, Patrick.
I would like to change it to read: empathy, education, movement, and possibly some hpsg.
The key element for most iffy and woo methods is the operator technique; that means that their acceptance of the deep model as proposed here, requires a major shift in the explanation of those methods, and basically invalidates their whole foundation.

[Diane]

I fail to see any good evidence for ANY manual therapy technique.
I think every flavour of mobilipulation has been studied to death, hasn't it? And in the end any improvement in outcomes (after careful statistical non-biased analysis) has boiled down to "non-specific effects."
Am I wrong?

[PatrickL]

I fail to see any good evidence for ANY manual therapy technique

i agree.

[beatmama]

But


Doesn't the manual therapy (whatever it may be) technique delivered at the right time and in the right context add to the positive (hopefully) non specific effects that are occurring ....

[caro]

Manual therapy is the hardest thing to argue for.

Also, I think the term non-specific effects needs to go do a little dodo. More research needs to be done as to how specifically all this comes into play, but I think most neuroscientist have a fairly good handle on what goes down. Of course the science will adjust accordingly.

It's up to us to reason what stays and what shouldn't.

I'm glad you stuck around Patrick. For many reasons.

[Bas Asselbergs]

Yeah, Caro - I am a fan of "contextual effects". Not perfect, but better.
Especially better than "placebo effect".

[Diane]

Manual therapy is the hardest thing to argue for.

I couldn't agree more.

And tissue-based or bio-mechanical or postural or structural imaginings just don't cut it.

I agree with Paul Ingraham, who (I think) calls manual therapy models "mental apps".. mostly cobbled up for the therapist's benefit, not for the patient... most of them noceboic to patients when discussed too much with them.

[beatmama]

contextual effects is a wonderful expression , I'm deep in to Louis Giffords 3rd book of the Aches and pains series and he describes what we do so much better than any lecturer , guru, teacher has ever done

[Bas Asselbergs]

Patrick:

pain is in the brain?

After my initial dismissal of that question (sorry about that), I realized that there is a LOT of value in considering that as a "deep model", especially if it can be framed in a bio-psycho-social flavour.....

[caro]

I am presently looking at and enjoying the pictures of NOI's ''The Protectometer'' launch in warm and sunny Australia.

A sample of what I am hearing inside my head and what's making me giggle, on this cold, snowy late morning:

Jo (imagined british accent) : That Lozza's really workin' the room isn't he. Just look at those ladies's faces!

Barrett: Well, that would never fly in Ohio...

Diane: That artwork is amazing...

John: Butler and his crazy shirts...

Etc, etc, etc.

You don't need a body to have your body warmed.

Yeah, I agree with Diane, nothing is deeper than the brain.

[Stephen Jeffrey]

I'm glad you stuck around Patrick. For many reasons.

Me Too :clap1:

[Diane]

I'm all for non-specific effects. After all, they are effects that are non-pharmacological, non-medical, non-surgical.
We are more than just warm bodies, we are warm bodies with hot nervous systems. We are enactive and embodied ourselves. We are phenomenological. Not everything has to be objective or quantifiable to be acceptable. Does it?

[Diane]

Check out this table from the Oberg paper:

[Electerik]

As complex a process defining a "deep model" might be, I also suspect that it boils down to being simpler than most care to admit.

pain is in the brain?

Perhaps the deep model is "people in persistent pain need only three things. Empathy, permission to move and some hpsg?"

1.provide non threatening sensory/discrim input
2.provide novel salient sensory/discrim input
3.don't provide a noceboic treatment narrative/context

"contextual effects"

I'm all for non-specific effects. (...)
We are more than just warm bodies, we are warm bodies with hot nervous systems. We are enactive and embodied ourselves. We are phenomenological. Not everything has to be objective or quantifiable to be acceptable.