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  • Tip Facebook Trackback

    Well like it or not tons of good conversations are happening on Facebook. It is extremely difficult to search, log, or refer back to those posts however.
    I am creating this thread so you can link a particularly good discussion there here so it is searchable.

    When you enter a new post, please post the link to the thread and indicate the date as well as whose Facebook account or page is hosting the discussion. Thanks!
    Jason Silvernail DPT, DSc, FAAOMPT
    Board-Certified in Orthopedic Physical Therapy
    Fellowship-Trained in Orthopedic Manual Therapy

    Certified Strength and Conditioning Specialist


    The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

  • #2
    Chris Johnson's page
    April 2014
    Discussion on his comment that 'pain is 100% an output of the brain'

    Discussion
    Jason Silvernail DPT, DSc, FAAOMPT
    Board-Certified in Orthopedic Physical Therapy
    Fellowship-Trained in Orthopedic Manual Therapy

    Certified Strength and Conditioning Specialist


    The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

    Comment


    • #3
      Jason Silvernail's page
      April 2014
      I share a wikipedia link on psuedoscience topics

      Discussion of the lack of critical thinking in the critical thinking / skeptical community and the paradox of psuedoscience practioners who have partially emerged from that thinking but still self identify that way.

      discussion

      A couple responses to my chiropractic colleague:
      f one slightly off statement kills the credibility of the piece by all means don't look into the topics covered - by that standard you agree with the piece Bobby/Brian.

      Thanks for your comments Bobby. I know we disagree on a great deal of things, and instead of focusing there I'll talk first about what we agree on. I do agree that many people in the skeptical and critical thought communities are often missing the mark. I've seen people in that community thoughtlessly share misinformation they haven't vetted or considered fairly, use skeptical language (such as naming logical fallacies) as nothing more than a weapon to tear down their ideological opponents without fairly understanding their position, and show a complete inability to acknowledge their own biases. I've seen childish name calling interspersed with logical reasoning toward people they disagree with. I've seen them emotionally reactive when a member of their community dares to disagree with what they consider an accepted position and be quite intolerant of fair variances of opinion around sets of facts. I've seen them do exactly what the psychological research says educated and intelligent people do - they show a heightened ability to critique and reject other people's arguments with reasoned facts while simultaneously being unable or unwilling to examine their own positions and critique them to the same standards. I think everyone in that community would be well served by reviewing The Principle of Charity in argumentation and interaction - it's certainly helped me a great deal. Frankly, many people in the skeptical and freethought communities are smug, self-righteous jerks and seem to enjoy acting as intolerant thought police. But to the extent they are like that, they are not following the principles they claim to be, in my assessment. The problem isn't with skepticism and scientific reasoning, it's with our uneven application of it. So, to the degree you assent to this, we probably agree.
      and

      However, that doesn't change certain other facts as I see them, and this is where we will diverge.

      Issue 1: The value of the freethought community. I think the skeptical and critical thought community can be exasperating at times but represents a popular version of the best of what human reasoning can be in practice when appropriately channeled and learned in a framework designed to acknowledge and reduce bias and learn to be as fair as possible. While also evaluating claims against established scientific standards. Many of our societal problems could be markedly improved if we taught children from a young age how to critically reason and use the tools of thinking. So the skeptical community is 'my people' at the end of the day, warts and all.

      Issue 2: The pseudoscience vs critical thought balance of power. For at least the past 200 years, peddlers of bad reasoning and pseudoscience have held the upper hand. Not enough people were educated, especially in the methods of thinking that might protect them against those that would mislead them. There's a quote from a skeptic floating around about how education in science and critical thinking protects you from being abused by charlatans - and it's true! We have a huge history of crazy beliefs and practices in human society that just can't be justified. I just can't have any sympathy for the whining of elements of the pseudoscience community about unfair treatment from skeptics - jesus, 5 years of social media activism versus 100-200 years of essentially unchallenged claims, advertising, and an ocean of dodgy products and services? CRY ME A RIVER. For crying out loud, how is homeopathy still a thing? Seriously. Its JUST WATER. Wow! If we can't agree still as a society in the 21st century that plain water isn't magic then I'd hardly say the skeptical community is some underground conspiracy wielding enormous power in our culture.

      Issue 3: Emerging from pseudoscience is difficult. Many people who are trained in a questionable method emerge from the pseudoscience community intellectually but still self-identify as a member. As a result they have a tremendous amount of cognitive dissonance and what I can imagine is a frustrating feeling of difficulty in resolving some professional issues. They either return to pseudoscience, go full skeptic, or remain in the gray area. As Mr Miyagi tells us, being on either side is safe but being the middle is where you get squished. Edzard Ernst is an example of someone who went full skeptic after being trained in pseudoscience (for him it was homeopathy). Sam Homola is an example of a chiropractor who I think it's fair to say went full skeptic. I most commonly see these gray area folks in the chiropractic community as, unlike other pseudoscience fields (like naturopathy, homeopathy, or crystal healing), there's value to some of their processes when stripped of the unsupportable claims. Those who reject chiropracTIC but function well as chiropracTORs in a science based paradigm for conservative care of spine conditions are examples, and I'm fortunate to have many of them as social media contacts. I try to support them when I can as I recognize the predicament they are in and I'm sympathetic. But at the end of the day, Bobby, when you went to chiropractic school you knew you were getting a package deal in the alternative medicine community. I recognize you don't always sign on intellectually to the full package, but there are advantages and disadvantages there. As a DC you have far more cultural authority for people in the alt med community than I will ever have, and as a DPT I will have far more cultural authority for people in the biomedical science community than you will. Even if we have some superficial processes (like manual and manipulative therapy) in common. That's just a fact and I don't see any way around it. You've said before that you wish chiropractors could 'play' at skeptical processes like commenting on the SBM site, but I think you signed on to a different package deal that doesn't include that option unless you are prepared to go full skeptic as Dr Homola has. Based on some of your posts about vaccines, going full skeptic seems unlikely for you. Whatever we call that tension between aspects that are more and less science-based, we can't say it isn't fair and not reflective of a real inconsistency in standards - because it is.

      Issue 4: Tribalism and honesty
      Humans are inherently tribal and like to boil down complex issues to us/them, good/bad and black/white. You are either a conservative or liberal, you do strength or cardio, you like the red sox or the yankees. The critical thought community is no different and for good examples see what they do to prominent skeptics who express political opinions that are different from what the group prefers (consider Michael Shermer or Penn Jillette). Just as I won't have a political litmus test for people I will listen to (conservative vs liberal vs libertarian vs socialist vs other) I won't support or oppose someone based purely on an affiliation in most cases. I do not like black/white thinking and I will continue to support without question people who reject pseudoscience and devote their time and attention to thinking and practicing better, whatever their community affiliations are. I will continue to have lukewarm support in a limited way for people who still incorporate some aspects of what I personally consider unsupportable claims and concepts in an overall setting of good critical thought whether they are in my community or not. I will continue to not support people who I perceive are involved in the pseudoscience community and do not incorporate critical thought and reasoning whether they are in my community of practice or not.

      Believe me, that's not always a popular position because people have such limited tolerance for complexity. Many of the skeptics think I'm 'enabling' or 'apologizing' for pseudoscience or non-EBM when I show some tolerance for different approaches that I consider still within the realm of primarily a science based practice, and many of the pseudoscience gray area folks like yourself think I'm a dyed in the wool thoughtless skeptical axe-grinding jerk when I share some links like this. I don't see a resolution to that essential tension but I'm comfortable with my approach and I doubt it will change any time soon. So I think I understand why you are apparently upset with me but I think there's nothing to be done about it. I would say I'm sorry you feel that way - but I'm not. I'm open to hearing from anyone who thinks I am misjudging things here and can provide a rationale that I should consider for changing - as I have my own biases that mislead me on a regular basis and I have no problem acknowledging that.
      Jason Silvernail DPT, DSc, FAAOMPT
      Board-Certified in Orthopedic Physical Therapy
      Fellowship-Trained in Orthopedic Manual Therapy

      Certified Strength and Conditioning Specialist


      The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

      Comment


      • #4
        The Education of a Fitness Professional page
        April 2014
        Great discussion of ZHealth with Will Stewart and Lars Avemarie
        https://m.facebook.com/groups/520407...28890090519674


        Sent from mobile using Tapatalk
        Jason Silvernail DPT, DSc, FAAOMPT
        Board-Certified in Orthopedic Physical Therapy
        Fellowship-Trained in Orthopedic Manual Therapy

        Certified Strength and Conditioning Specialist


        The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

        Comment


        • #5
          Thanks for these Jason.

          Issue 2: The pseudoscience vs critical thought balance of power. For at least the past 200 years, peddlers of bad reasoning and pseudoscience have held the upper hand. Not enough people were educated, especially in the methods of thinking that might protect them against those that would mislead them. There's a quote from a skeptic floating around about how education in science and critical thinking protects you from being abused by charlatans - and it's true! We have a huge history of crazy beliefs and practices in human society that just can't be justified. I just can't have any sympathy for the whining of elements of the pseudoscience community about unfair treatment from skeptics - jesus, 5 years of social media activism versus 100-200 years of essentially unchallenged claims, advertising, and an ocean of dodgy products and services? CRY ME A RIVER. For crying out loud, how is homeopathy still a thing? Seriously. Its JUST WATER. Wow! If we can't agree still as a society in the 21st century that plain water isn't magic then I'd hardly say the skeptical community is some underground conspiracy wielding enormous power in our culture.
          Gold!

          Comment


          • #6
            Facebook Trackback

            Doug Kechijian's page
            April 2014
            The downsides of internet skepticism

            https://m.facebook.com/story.php?sto...151&id=1008483

            "Speaking as a skeptic it usually goes like this:

            A says 'I talked to B and C who says G uses System2 and it's like this. Sounds like System1 which has the following known issues: 1,2,3. Anyone know more? G out there?'
            G comes in - 'hey System2 is totally awesome and [anecdote x5]. Take a course in System2 or be quiet I help people all the time while you just complain online about stuff, tough guy. [anecdote x2] Also what do YOU do???'
            A says 'uh what? Thought we were talking about System2 here. If you want to know what I do I'm happy to discuss it separately. How about issues 1,2,3?'
            G says 'I'm too busy to play around online. I have to do serious System2 work now like [anecdote].' G rage quits.
            A says 'I'm happy to discuss and defend what I do since it's part of my professional responsibility. So G I'm happy to take your questions.'
            [silence]
            The end."

            "I don't disagree with much of that Doug.

            I've called out fake skeptics before here:
            http://www.somasimple.com/forums/showpost.php?p=178570
            for example. I agree that many people label themselves as skeptics only so they can use the language of skepticism to reinforce their existing opinions and marginalized those they disagree with without having to fairly consider their positions. But that's not skepticism, that's just the perils of biased human reasoning.

            I have become over time (and primarily through the internet interactions some are so disillusioned with) a lot more tolerant of various approaches as long as they 1. Are consistent with established basic science 2. Involve a self-critical reasoning process and 3. Limit specific claims made to specific published evidence only.

            I've found you can make a lot of clinical processes (but not all) fit that mold if you are willing to do the work required to take Occam's Razor to it instead if being a cheerleader for it.

            I've got people I respect who do all types of different clinical approaches but we all seem to come together on those three basic foundations.

            I'm uncomfortable with the 'take a course to understand it' position for lots of reasons we can get into separately if you'd like."


            Sent from mobile using Tapatalk
            Last edited by Jason Silvernail; 29-04-2014, 05:04 AM.
            Jason Silvernail DPT, DSc, FAAOMPT
            Board-Certified in Orthopedic Physical Therapy
            Fellowship-Trained in Orthopedic Manual Therapy

            Certified Strength and Conditioning Specialist


            The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

            Comment


            • #7
              When clicking the link, every single one of these leads to a "requested page not found" from FB for me.

              I guess you have to be a member of those groups to see these comments ?
              Dan
              Tactile Raconteur

              Comment


              • #8
                Originally posted by Dan84 View Post
                When clicking the link, every single one of these leads to a "requested page not found" from FB for me.

                I guess you have to be a member of those groups to see these comments ?
                Zhealth link is a closed group: https://www.facebook.com/groups/520407931367891

                I can't figure the other (Doug Kechijian's page), either.

                Respectfully,
                Keith
                Blog: Keith's Korner
                Twitter: @18mmPT

                Comment


                • #9
                  Yes you do have to be a member of the group or a friend if the person has a closed profile. Good opportunity for building a network. I will try to put some quotes with each post so if you can't see the original post you at least have something to go by.


                  Sent from mobile using Tapatalk
                  Jason Silvernail DPT, DSc, FAAOMPT
                  Board-Certified in Orthopedic Physical Therapy
                  Fellowship-Trained in Orthopedic Manual Therapy

                  Certified Strength and Conditioning Specialist


                  The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                  Comment


                  • #10
                    Fitness Conversations group page
                    April 2014
                    Postural Restoration
                    https://m.facebook.com/groups/123548...46584578877299

                    Great comments from regulars here too.

                    "It's important not to pick sides and be pro or con, but (whether you use the system or not) to honestly evaluate it according to accepted standards. Standards like evidence, plausibility, validity and reliability of assesemts, etc.
                    I can do that for the system I use (Maitland) and I am upfront and honest about it's shortcomings as well as it's advantages. It doesn't bother me if people have different clinical processes than I do as long as the foundations of critical thought, basic science consistency, and claims:evidence match are there.

                    It's our professional responsibility to be able to intelligently defend what we do, it's part of our obligation to our patients. It's part of our professional responsibility to collectively hold each other to high standards also. I welcome critique of my processes - it's how we get better and the crux of residency and fellowship training."


                    Sent from mobile using Tapatalk
                    Jason Silvernail DPT, DSc, FAAOMPT
                    Board-Certified in Orthopedic Physical Therapy
                    Fellowship-Trained in Orthopedic Manual Therapy

                    Certified Strength and Conditioning Specialist


                    The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                    Comment


                    • #11
                      Facebook Trackback

                      Jason Silvernails page
                      August 2013

                      Getting added and them removed from a discussion group-whoops I mean seminar mailing list.

                      https://m.facebook.com/story.php?sto...&id=1299482045

                      ""Its a testament to how over sensitive people are and how completely unwilling to engage in any rational debate that they become so easily offended. You cannot determine my tone or motivation from my words, but feel free to interpret them in as negative a manner possible and then blame that on me. I'm sure it makes it easier for you to remove me from your seminar mailing list. Whoops I mean discussion group. There are many, many people offering seminars and assessment methods similar to the people you are accusing me off offending and my criticisms apply in large part to many many people. Despite the fact I haven't mentioned them at any time, feel free to assume that what I've said applies uniquely to them and that it was some sort of deliberate affront on my part. It's your group, [name], do what you like. Please just don't pretend there is serious discussion or challenge there - very obviously there isn't. It's a mutual congratulation society for the purpose of selling seminars. That's fine with me. There are growing number of folks like me who will take a skeptical look at things and you might consider a reaction less emotional and more rational in the future if you would like to engage and retain those people. All the best to you-"

                      "That expression is often used in these debates. Problem is, there's no baby - no value to these old methods other than anecdote. This simply isn't the standard of reasoning and evidence in a modern society in 2013. Where is this baby - this value in these old outdated disproven methods?
                      If people were running these seminars and saying - 'hey I am using some of this stuff it works for me lets give it a try' I wouldn't have much of a problem. The problem is the *claims*. They are claiming to do very specific things and diagnose very specific problems that are causing very specific issues. Claims must be justified with evidence. I teach a well-supported (in terms of published evidence) manual therapy and exercise approach to physical therapy but I NEVER make claims I can't back up with published evidence. I just hold people to the same standard. I say 'we don't know for sure' and "i'm not sure about that' and 'I don't know' a lot when I teach.

                      I think people join those types of groups to form a mutual congratulation society where they talk about how awesome everyone's material is to boost seminar attendance. When each seminar and approach is contradictory to the last. We can't all be right, now can we Nick?
                      It's your group I won't tell you how to run it. Do what you like. But call it what it is - it's a mailing list for seminar attendance. Nothing wrong with that. It certainly isn't a discussion group as we all found out."


                      Sent from mobile using Tapatalk
                      Last edited by Jason Silvernail; 07-05-2014, 04:14 AM.
                      Jason Silvernail DPT, DSc, FAAOMPT
                      Board-Certified in Orthopedic Physical Therapy
                      Fellowship-Trained in Orthopedic Manual Therapy

                      Certified Strength and Conditioning Specialist


                      The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                      Comment


                      • #12
                        'The pseudoscience playbook on display'

                        Jason Silvernail's page
                        August 2014

                        My deconstruction of being booted from a discussion group I did not ask to join, being called 'aggressive' and 'arrogant, snide' for speaking plainly about the nonsense that is meridian theory in acupuncture.

                        A participant from that group followed me to my page and does a wonderful job of illustrating the logical fallacies and poor reasoning that is so common in the 'alt med' community. This thread reads like a course in critical thinking and argumentation - how to do it poorly in particular and the typical responses the pseudoscience community engages in when beliefs are challenged.

                        Link

                        Peter [Faletto] you continue to demonstrate the logical fallacies and misunderstanding of evidence that is so prevalent in the alternative health community. Plainly stating facts about the incompatibility of alternative beliefs is cast as 'aggressive' and being 'blinded by science' or 'insisting on being right.' Beliefs about health and medicine that are incompatible with physiology and science can only be defended by casting those who dare to question them in as negative a manner as possible. Even the most base insults are slung - because they are out of ideas. That's the essence of the 'ad hominem' fallacy. Being unable to justify magical thinking and nonsense beliefs they resort to the adult equivalent of a temper tantrum. The same people who talk about love and light and caring body energetic meridians turn into some of the most virulent name callers when they are challenged. And when called on their obvious inappropriate, childish, and shameful behavior, they hide behind weasel words like 'intent' and 'clarification' and 'assumptions.' And then when that fails, instead of apologizing, to try to weasel even further!

                        This is classic behavior right out of the pseudoscience handbook, so to speak. It's good periodically to see examples of it - but this thread is a more complete collection than I've seen in some time.
                        Peter then states he has apologized and so I must therefore do so also.

                        And now the false equivalence! Wonderful. The whole purpose of the insult is to provoke an emotional response with the hope that I will then act in a similarly inappropriate way. At the end you can then point out we both acted poorly and therefore both should apologize.

                        The problem with this strategy is when I don't take the bait. When I keep my composure, do not act unprofessionally, and do not engage in childish behavior such as insults, I don't owe anyone an apology. Least of all you. So readers should learn to recognize this approach when they see it.

                        Since I didn't engage in similar behavior, Peter is stuck, having painted himself into a corner. He can continue to try to weasel out of his previous statements with comments about 'tone/intent/ context, etc' - though when his behavior is so obvious no one is buying that. He can insult me further in the hope of provoking an emotional response from me, and use any insult I supply back as an excuse to apply the 'tu quoque' and exit the conversation claiming I was just as bad. Or he could apologize and admit his behavior, or alternately just disappear from the conversation. The people most likely to make such insults are the ones least likely to admit their behavior and apologize to try to exit gracefully.

                        So it's good to see these patterns demonstrated so you can learn to spot them. This is quite the education in critical thinking and argumentation.

                        Let's see which option Peter selects next.
                        1. Further weaseling or demands for an apology he isn't owed
                        2. More insults
                        3. Honest apology or an attempt at one
                        4. Disappearance
                        5. Final restatement of discredited positions in a 'parting shot'
                        Last edited by Jason Silvernail; 30-08-2014, 08:51 PM. Reason: add quotes
                        Jason Silvernail DPT, DSc, FAAOMPT
                        Board-Certified in Orthopedic Physical Therapy
                        Fellowship-Trained in Orthopedic Manual Therapy

                        Certified Strength and Conditioning Specialist


                        The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                        Comment


                        • #13
                          It says "This content is currently unavailable" but I take your word for it. From what I've seen on the internet, most CAM proponents have no trouble taking the fallacy route.
                          -Evan. The postings on this site are my own and do not represent the views or policies of my employer or APTA.
                          The reason why an intellectual community is necessary is that it offers the only hope of grasping the whole. -Robert Maynard Hutchins.

                          Comment


                          • #14
                            The Elite Athlete Gambit

                            Jason Silvernail's page (also available on Paul Ingraham's)
                            July 2014
                            Link to Paul's version


                            Another story I'm tired of - the elite athlete gambit. The idea that coaches and sports medicine pros deal with fundamentally different problems than the rest of us with other clients and patients - it's just untrue. Even worse, when they imply or outright state that that a non-athlete must be overweight, sedentary, or old and therefore somehow less important or easier to care for or more likely to not have a "real" disorder like an athlete does.
                            I've seen in clinic the full spectrum of patients from the elderly to the young, from office workers to Special Forces operators, and the basic process for caring for them is the same - since they are all human. They all deserve an individualized, evidence based, comprehensive care program tailored to their needs.
                            Recently I had a coach say that my clinical approach to pain must mean I'm out of touch with the needs of "elite athletes". My response…
                            He hasn't the first clue what my perspective is. He should ask all the Soldiers and SF Operators I've treated and reconditioned before he decides I don't live in the world of elite sports performance.
                            The difference between sports medicine and orthopedics is slight, and it mostly has to do with some characteristic injuries associated with certain activities and the more lengthy rehab and reconditioning process for athletes. So the initial acute and subacute phases of injury and treatment should be pretty much the same - things should only change when we move into the (somewhat less controversial and established) reconditioning process. The world of elite athletic conditioning is every bit as opinion based and empirical as musculoskeletal medicine is based on the state of the evidence - so we should take claims of coaches achieving performance results with the same caution that we take clinicians claims in achieving clinical results.
                            I don't buy for one minute that the world of high level sports medicine and performance is somehow superior to or significantly different than the processes used for other people - we are all humans. I put the same effort into personalizing the rehab and reconditioning process for a administrative clerk as I do for an SF Operator. It's just that the processes and stages for reconditioning take longer for the Operator. The process is EXACTLY THE SAME. -Jason Silvernail
                            Jason Silvernail DPT, DSc, FAAOMPT
                            Board-Certified in Orthopedic Physical Therapy
                            Fellowship-Trained in Orthopedic Manual Therapy

                            Certified Strength and Conditioning Specialist


                            The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                            Comment


                            • #15
                              Jason, you are the best!

                              Recently I had a coach say that my clinical approach to pain must mean I'm out of touch with the needs of "elite athletes". My response…
                              He hasn't the first clue what my perspective is. He should ask all the Soldiers and SF Operators I've treated and reconditioned before he decides I don't live in the world of elite sports performance.
                              I know you wouldn't be surprised to find out how many times I've been told that my approaches to training are not only out of touch, but completely inapplicable to elite athletes.

                              Heck, I don't coach those kinds of athletes, so maybe they are right.

                              But I don't like the notion that my perspective might be less valuable because what I do applies to high school kids, the majority of whom they believe will never achieve the performance levels worthy of their time and effort.

                              Comment

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