Warm body with a license

[vancouverRMT]

Yesterday, prof Moseley called the word placebo "daft"
He said it was "not anything but 'stuff' we don't have empirical data for yet".

[caro]

I have to think about that a bit.

[Electerik]

The end result, as a subjective experience of the patient, will most likely be very specific. It's goal oriented. They'll either still have pain, less pain or no pain.

The process needed to get them there is non-specific. More often than not.

[caro]

What we do, us manual therapists, what we have such a hard time arguing for, sometimes produces an Absence.

Absence of pain. Something that is as easy to describe as a sound or a taste. The people we treat arrive inhabiting that space and sometimes they climb off the table and there it is; the Absence.

How can that ever be described as non-specific.

Respirer Dans L'eau, Daniel Bélanger

Le temps est blanc
Le jour fléchit
Belle et douce nuit

La lune est bleue
Je m'assoupis
Je pars le coeur dans l'étui
Voilà que je respire dans l'eau
Je vole même sans plumeau
Je suis enfin moi, enfin moi

Et puis le jour fait ce qu'il fait
Défait le dormeur satisfait
Il chasse tous les corps célestes
Tout y passe bien peu qu'il reste
Il reste moi qui volais
Qui respirais dans l'eau
Moi qui étais moi, étais moi

Moi qui souris
Qui marche enfin
La tête hors des épaules
Libre dans un corps
Moi qui jaillis
Des souterrains
De cent siècles de taule
Libre à mourir de rire

Il reste moi qui volais
Qui respirais dans l'eau

Moi qui souris
Qui marche enfin
La tête hors des épaules
Libre dans un corps
Moi qui jaillis
Des souterrains
De cent siècles de taule
Libre à mourir de rire
De rire

Breathe In Water, Daniel Bélanger

Sky is white
The day bows to the night
Beautiful and sweet night

The moon is blue
I doze off
Leaving my heart in its holster
Here I am, breathing in water
Flying without my wings
Free to be me. Finally.

And then the day does what it does
Defeats the satisfied sleeper
Chasing all heavenly bodies
Everything goes, little remains
I remain, I who was flying
Who could breathe in water
I who was me, I, who was

I who is smiling
Who is walking, finally
Head above the shoulders
Free in a body
I, who sprung from
underground
From centuries of emprisonment
Free to die laughing out loud

[caro]

Butler summed it up very well here. queue to 14:25.

[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.

[Diane]

Check out this table from the Oberg paper:

[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?

[Stephen Jeffrey]

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

Me Too :clap1:

[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.

[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.....

[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

[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.

[Bas Asselbergs]

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

[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.