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  • Walt,

    While my writing about Barnes’ method and theory is voluminous, my comments about it as I teach are terse and direct. I actually timed the extent of this discussion during three courses this week and found it to take a total of 48 seconds out of 18 hours of speaking. The subject wouldn’t have come up at all if people hadn’t asked me about the relation of ideomotion to “fascial unwinding” they had seen or been taught. All I have to do now is give them the web address of this discussion. I also pointed it out on the power point presentation of web surfing that I do. This didn’t add any more time at all and simply represented more provision of resources. Ironically, to Barnes’ writing itself.

    Here’s an idea: Go to the MFR Chat and invite everyone there to join in here. If you’re convinced that you and Dave have fairly and adequately represented your practice this will then be known to Barnes and those who proclaim their love for him so often. Remember, I read the posts there for years so I have some sense of what is regularly said there.

    What you say about finding proof for what you believe to be true is precisely what Harriet Hall said characterizes pseudoscience in an earlier post. Of course I repeated what you said publicly, that you're "not a scientist." It helps us understand who's claiming what. If you didn't want this known you shouldn't have said it. Perhaps this "not a scientist" attribution is something to be proud of in the MFR community, as if scientific thought or a respect for physical law somehow limited our imagination.

    Two more things: Jon-you failed to calculate the number of times therapists (mostly massage therapists) repeat the same course. This is strongly encouraged, and a discount is provided.

    Walt again-In “Not in Kansas Anymore” I compare Barnes to Professor Marvel, not The Wizard of Oz. They are played by the same actor, and perhaps this is the source of your confusion. Both are sociopathic con men, of course, but only one exists in the world we both actually live in.
    Barrett L. Dorko

    Comment


    • Walt, you must have missed this link that I posted very early on in this thread,

      "Myofascial Pain Management
      Evaluated material for both the health care provider and consumer.
      REFERRED PAIN OF PERIPHERAL NERVE ORIGIN:
      AN ALTERNATIVE TO THE "MYOFASCIAL PAIN" CONSTRUCT

      John L. Quintner and *Milton L. Cohen"

      It was written quite some time ago, but is still a very good read. It mostly directs its comments at the concept of trigger points in muscle tissue, and deconstructs that particular hypothesis: It can, however, deconstruct the fascial tension hypothesis you propose as well, even more sensibly than it does the muscle tension hypothesis, in fact, since most of us do give muscle tissue credit for being able to contract and then perhaps not fully lengthen again, whereas most of us do not credit fascia with that same capacity. Just substitute the word "fascia" everywhere you see the word "muscle" and you're set.

      Some selected excerpts:
      One of our main criticisms of the construct of myofascial pain is that its major proponents have incorporated their preferred hypothesis of causation within the definition. As will be shown elsewhere in this article, this error in reasoning has limited the discussion of other explanations for the various clinical phenomena observed in these syndromes. Metaphysics of trigger points
      In this article, the hypothesis that pain arising from trigger areas within muscles is of primary myofascial origin is critically examined. It will be shown on epistemological, clinical, and pathophysiological grounds that the myofascial pain syndrome (MPS) construct is invalid and that the phenomena it purports to explain are better understood as secondary hyperalgesia of peripheral neural origin.
      Peripheral neural pain: The connective tissues of human peripheral nerves are well-innervated. They derive their nerve supply from axons within the nerve and from fibres accompanying the extrinsic vessels that provide its nutrition (39). As well as regulating intraneural microcirculation, this intrinsic nerve system, the nervi nervorum, is thought to have a nociceptive function (40).
      The weight of evidence does not support myofascial TrPs as the anatomical sites of pain origin. By contrast, the presence of hyperalgesia in muscles that are structurally and electrically normal suggests that it must be secondary (referred) hyperalgesia (58). This hyperalgesia could be due to peripheral mechanisms such as antidromic activation or sensitization of nociceptive afferents (59) or, more likely, to a state of central sensitization, including spontaneous firing and expansion of the receptive fields of nociceptive dorsal horn neurones (60).
      (Other than copying/pasting/posting the whole entire thing, I just don't know how to lead this particular horse any closer to this particular water.. )
      Diane
      www.dermoneuromodulation.com
      SensibleSolutionsPhysiotherapy
      HumanAntiGravitySuit blog
      Neurotonics PT Teamblog
      Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
      Canadian Physiotherapy Association Pain Science Division Facebook page
      @PainPhysiosCan
      WCPT PhysiotherapyPainNetwork on Facebook
      @WCPTPTPN
      Neuroscience and Pain Science for Manual PTs Facebook page

      @dfjpt
      SomaSimple on Facebook
      @somasimple

      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

      Comment


      • TrP Vs. MFR

        Thanks Diane, Yes, I missed the link, I'll read the entire article later this PM. But please be very aware, that MFR as taught by John Barnes is not about the treatment of trigger points. Here is a common confusion that people get, those who do not educate themselves on the nature of different teachers out there. Trigger point therapy, as taught by followers of Janet Travel, is vastly different from MFR as taught by Barnes. Travel narrowly focuses on trigger points, or intersection points of tightened fascia, as the locus of pain. John uses a more whole body appraoch to pain, nervous system well included, to both identify problems and treat them Not enough time to go into this now, have kid duties to attend to, but do read up on the differences.

        Barrett, sorry for confusing the two Wizard characters. As you said, both are con men. I've been reading up on your explanations of Simple Contact. As I stated from the onset, I really do enjoy your insight, interpretations, and writing style. I especially noted your citing Peter Levine's work and "Waking the Tiger", as this is one book that John Barnes cites and encourages all of this students to read. Great book. Amazing similarities to our work...more on this later. Have a good one.

        Walt

        Comment


        • Walt,
          You certainly do skim over things, don't you? You must have missed this sentence in my post above:
          It was written quite some time ago, but is still a very good read. It mostly directs its comments at the concept of trigger points in muscle tissue, and deconstructs that particular hypothesis: It can, however, deconstruct the fascial tension hypothesis you propose as well, even more sensibly than it does the muscle tension hypothesis, in fact, since most of us do give muscle tissue credit for being able to contract and then perhaps not fully lengthen again, whereas most of us do not credit fascia with that same capacity. Just substitute the word "fascia" everywhere you see the word "muscle" and you're set.
          You said:
          do read up on the differences.
          I have. Turns out fascia and muscle both derive from mesoderm. Muscle is the puppet at the end of the string, fascia is analogous to the string, and the puppeteer is the brain. Brain and skin are both made from ectoderm. Ectoderm trumps mesoderm for being sensitive/responsive. Your turn now.
          Last edited by Diane; 08-01-2006, 08:44 PM.
          Diane
          www.dermoneuromodulation.com
          SensibleSolutionsPhysiotherapy
          HumanAntiGravitySuit blog
          Neurotonics PT Teamblog
          Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
          Canadian Physiotherapy Association Pain Science Division Facebook page
          @PainPhysiosCan
          WCPT PhysiotherapyPainNetwork on Facebook
          @WCPTPTPN
          Neuroscience and Pain Science for Manual PTs Facebook page

          @dfjpt
          SomaSimple on Facebook
          @somasimple

          "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

          “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

          “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

          "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

          "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

          Comment


          • Walt,

            About Waking the Tiger. My writing about Levine’s work has been confined to his insights regarding the instinctive “escape behaviors” that, when unrequited, would lead to a perpetual increase in sympathetic tone. This makes sense to me (and many others) and led me to, again, point toward ideomotion as a logical way of using movement to help my patients while remaining within the confines of my practice act.

            Levine doesn’t sound like a fan of what Barnes has done with his writing. There’s a paragraph on page 215 you really ought to read. I quote: “Unfortunately (emphasis mine) many therapists employ intense emotional release techniques to work with traumatic (or other) symptoms. It is just this type of emotional pushing that can activate states of high arousal. When this happens, we see the appearance of powerful experiential collages that are perceived (to the degree of their intensity) to be “true” memories. It is not important whether memories are objectively accurate. Of prime importance is whether the associated activation is escalated or resolves.”

            Doesn’t this sound like work best done by a carefully trained professional counselor? Someone who clearly understands that “recovered memories” represent a movement into extremely dangerous territory? Did you read “The Memory Wars” yet?

            How's that invitation to the MFR folks going? I'd do it myself but, well, you know.
            Barrett L. Dorko

            Comment


            • I have followed this conversation with great interest and am quite impressed with the energy of the exchanges! I am a Physical Therapist with 25 years of practice experience mostly in pediatrics. Obviously when I was trained we did not exit with doctoral degrees or PhD’s so even though I have diligently tried to stay up to date over the years I do not have the science background many of you obviously have. That being said I think I am a pretty good PT…..! Now to my two cents: I have practiced MFR since I first encountered it in1990 – it is one of many modalities I have to chose from but to me it has proven irreplaceable in many instances. Over the many years of going to conferences and learning new treatment approaches I have learned that the theory behind many of them is often shaky from a science perspective. My husband is a biophysicist and I cannot count how many time I have come back from a conference and have excitedly talked about my new knowledge only to get one comment when I talk about the theory of the work: “You have got to be kidding”. Kidding I am not but the real test for any and all of them comes from trying what I learn in the clinic and low and behold sometimes it actually works great. I have been around long enough though to see that many times the truly great approaches will stay around but the theory will change over time (we used to base treatment of CP on reflexes now we have motor learning but the actual treatment looks pretty much the same). MFR as I know it and use it is immensely useful which brings me to my “second cent”: I am also a MFR client who has first hand experience of how amazingly helpful this treatment approach can be. When I first learned some MFR many years ago I happened to volunteer for treatment by the instructor and the experience was profound in that I felt that this was something that really could be helpful. Many years and a bad car accident later I was in such a bad shape that I was considering giving up my practice because I could no longer get through my days due to pain. I had exhausted all the conventional methods of surgery, pain management, traditional PT etc. MFR turned out to be what gave me back my health as I found a very experienced therapist with whom I worked weekly for several months. It took only a few treatment sessions to know that I had finally found the treatment approach I needed because soon I became pain free enough to begin to be active and to regain strength again. I too experienced emotional releases and was never in any way pushed to go places where I did not want to go nor did my therapist offer judgment on my experiences, which remains mine alone to interpret. And how do I think the emotional releases are related? I do not know but as we all have experienced there can be certain things that trigger memories – smells, sights, movement, so to me it is not a far reach to experience memories and emotions when work is being done on areas of my body that are in pain. As I see it the memories must be in the brain but they are triggered from the tissue as it responds to releasing the restrictions caused by stress.
              As a client of MFR I do not really care what the science is just that it gave me back what is most precious to me: my health. As a PT I DO care what the science is and I am convinced that as with so many other great approaches we will eventually understand why it works and I am equally convinced that MFR is here to stay.

              Comment


              • Pia,

                An interesting post, and very balanced in outlook!

                I think the debate is simply the rationale as to why it works; if method A works, but so do methods B,C,D..there is a common reason,or two, behind it all. People can cry and release emotions if someone gives them a good massage, or talks with them in an understanding way. It is a therapeutic process, but it doesn't require 'therapy' as such.

                It is that 'WHY' and 'HOW' behind MFR or Simple Contact or McKenzie or anything else that works, anecdotally or otherwise. Simple Contact is based on known neurophysiological processes; MFR seems to be based on uncertain assumptions. McKenzie..well the jury is still out on that one. Depends on which hill you stand and what you interpret in the view before you, according to your needs and desires at the time. There is no absolute truth in anything.

                It may well be that MFR, SC, and a half a dozen other approaches all operate on exactly the same physiological processes. What they precisely are is the crux of this thread; and simple resolution is no easy matter for scientists, PTs and anyone else in the game of pain management.


                Nari

                Comment


                • Welcome Pia, I don't think anyone here has suggested that people don't get better with MFR. You state:

                  As a PT I DO care what the science is and I am convinced that as with so many other great approaches we will eventually understand why it works
                  I think there is quite a lot of explanation available for why some of what you do works so it makes me wonder how much you DO care. It is not for the reasons cited by John Barnes per his literature and if you did care about the science you would quickly reject those explanations. You would also likely be agitated by the fact that 50,000 therapists have paid a lot of money to learn anti-scientific theory.

                  You also state:

                  As a client of MFR I do not really care what the science is...
                  I have no reason to think that the folks I see are drastically different from the ones you see. My clients almost always want to know what's wrong. They care and seem to be caring more and more about what is wrong. What do you tell those folks who ask, What's this doing? What's wrong with me? Do you suppose that you are accountable in any way for the answer you give?
                  Last edited by Jon Newman; 09-01-2006, 02:57 AM.
                  "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                  Comment


                  • Jon,

                    That is a VERY good question. I wonder if it will be answered.

                    Luke
                    Luke Rickards
                    Osteopath

                    Comment


                    • I am not the least bit agitated by the fact that 49.999 health care professionals other than I has learned from John Barnes becasue what I have learned is very useful in my clinical practice. As I stated in my first post I have learned over the years to take the theory behind many of our great therapeutic interventions with a grain of salt but in the end it is the clinical usefulness that is my first concern. I work in pediatrics so look at for example the theory behind the well respected intervention of sensory integration or look at some of the other neuro interventions that are commonly utilized and I think you could repeat all the arguments you have against MFR. I was in Salt Lake City for the III Step conference this summer - yes, I am trying to understand the science- and the neuroscientists that were invited to be there gave a very harsh critique of much of what they had heard from PTs over those 8 days.

                      As for if I speak with my clients (or in my case with the parents) about what is wrong - of course I do. They would not be there if they did not think something was wrong. I tell them about the interventions I choose and if they want to know the rationale behind those I do the best I can and I am not shy about stating that we as PTs often do not have the hard science. Most parents however are much more interested in knowing if I have seen the interventions I choose work for someone with a similar problem that their child presents with. Thus goes most of those talks which is not that different when I am the patient and want to know from my therapist if the chosen intervention has helped someone like me.......
                      As Nari said: "Depends on which hill you stand and what you interpret in the view before you, according to your needs and desires at the time. There is no absolute truth in anything."

                      Comment


                      • Pia,

                        What are some of the unique things that you learned from John Barnes that are important enough that, despite your claim to be interested in the science, you still endorse the anti-scientific explanations in the course. I guess what I'm asking is what hill are you really viewing this from? Also, what hill would you have the PT profession stand on?

                        One more thing. Is there such a thing as a disease?
                        Last edited by Jon Newman; 09-01-2006, 04:55 AM.
                        "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                        Comment


                        • I don't often disagree with Nari but that looking from one hill or another comment is not something I can go along with. It smacks of the sort of postmodern thought that might be appropriate in art and design but has always proven to be the sort of thinking that suppresses scientific thought and advance. See "What Went Wrong" on my site.

                          It appears that Pia has answered the question in a way. This attitude toward theory is common among therapists in my experience and perhaps they feel it's justified. Of course, it always makes me wonder what they went to school for aside from a license.

                          No one benefits from this, not our profession and certainly not our patients.
                          Barrett L. Dorko

                          Comment


                          • Barrett,

                            You are probably right in your assessment of my metaphor - that's fine. But the vast majority of PTs, in my experience, usually 'go' with what computes readily with their thoughts and understanding of what is right for their patients' particular conditions. Call it intuition, or whatever; if they learn about a certain model or method and it has some back-up from a physiological point of view plus a few supportive studies thrown in, they will use it. It doesn't mean it's right; and if down the track it is shown to be inaccurate or faulty or misses the mark - then they either do not use it or continue, if the results are consistently positive. Someone tells them : "do you know that has been shown to be not relevant (or similar adjective) then they say "it works well for me". This is probably where divisions in clinical decision making occur.

                            If a small fortune is charged for a method that has not been demonstrated as appropriate or has no proven physiological back-up, that is a problem. But the reality is, to me, that some PTs will still look at the view and choose what they feel comfortable with, and obtain good results.

                            I'm not supporting MFR in any sense - but in the big picture, I think my metaphor still holds. However, there are always those who think otherwise; and that is fine. PT schools do have a long way to go, I think, to catch up with the move away from universal segmental attention to body bits, especially those with chronic pain. It won't happen as quickly as some of us would hope.

                            Nari

                            The Dawkins quote below is pertinent; I like his last sentence.

                            Comment


                            • Hi Pia, welcome.

                              Nari, I love your Dawkins quote.

                              I agree with Jon (can't remember which post on what page) who says the disagreement is over memes.

                              You've always been a staunch sider of the nervous system understanders over the bone&joint people, Nari. You are more familiar perhaps with that particular issue because of Aus being littered and peppered with mobilipulators and mobilipulation systems developed by gurus.

                              This is the same thing, only more a North American phenomenon, that differs only in that yet another type of mesoderm is being credited with being the source of all evil/pain in the body by having "behavior" that doesn't line itself up with what is desireable, and in that yet another crew of Cartesian based treaters are coming along as experts in fixing said tissue. Oh yeah, plus they are basing their treatment concepts on some shiny flimflam as well. Slowly unveiled at great expense by a ... wouldn't you know.. 'nother guru.

                              That is what this conversation is about... not about what works or doesn't work.

                              If treatment professions are ever to pull themselves out of the primordial ooze we will have to apply Occam's chainsaw mercilessly. (Butler applied Occam's sandpaper to get the process started..)
                              Last edited by Diane; 09-01-2006, 06:25 AM.
                              Diane
                              www.dermoneuromodulation.com
                              SensibleSolutionsPhysiotherapy
                              HumanAntiGravitySuit blog
                              Neurotonics PT Teamblog
                              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                              Canadian Physiotherapy Association Pain Science Division Facebook page
                              @PainPhysiosCan
                              WCPT PhysiotherapyPainNetwork on Facebook
                              @WCPTPTPN
                              Neuroscience and Pain Science for Manual PTs Facebook page

                              @dfjpt
                              SomaSimple on Facebook
                              @somasimple

                              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                              Comment


                              • What happened to get you kicked off the MFR chat line?

                                Barrett,

                                Ran out of time to go into Levine, and I just printed out Memory Wars, will get back to you in the next few days...plus to compare notes on just how alike our therapies are!


                                Barrett,
                                How's that invitation to the MFR folks going? I'd do it myself but, well, you know.
                                No, I don't know. Why couldn't you do it yourself?

                                Walt

                                Comment

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