Simple Contact: The Great Conversation

[nari]

To some extent, a movement with focus on sliding /gliding is predetermined, or choreographed. But within that parameter, the patient can do whatever actions they wish. I was introduced to scores of easy, flowing movements incorporating each or all of the three UL nerves; I also made up some and encouraged patients to make up their own. All one has to do is think of the territory of the three nerves - with imagination, spontaneous movements are easy. Dancing and Tai Chi are good.

The advantage of SC is that patients can't overdo "doing their thing". There is a risk that they will think of neurodynamic movements as old fashioned muscle-type exercises, and fall in a screaming heap. Particularly when they feel the pain disappear and dig up the meme of "more is better"..
Shacklock emphasises this feature strongly.

Both have a definite place, and are targeting problems more accurately than rote exercise for segments.

Nari

[rolf-inge nodberg]

hi!
Thanks Nari ,Jon and Diane!
I dont know if im any wiser,but thats not your fault you realy tries to give me some answears!

Quote from Jon:
Simple Contact is defined as a technique of communication, either verbal or manual, designed to enhance another's awareness and expression of their spontaneously occurring internal processes.

jon:do you mean that "spontaneously occuring internal processes"might be thoughts!

If one of our goals as therapists is to educate the patients to be able to be their own heath care provider,who do SC fit in here???

It seems to me by now that SC is too"alternativ medicine" for me at the present moment.Might be I will understand it better in the future!?
I just cant see myself using it as a treatment tool (at the moment) and i dont think it would been axepted as an physio/manulltherapy modality her in Norway(We have a quite conservtive physiotherapy assosiation)we have quite strickt roules what cind of treatment approches we are allowed to use or not.
RIN:angel: :angel: :angel:

[nari]

The usefulness of SC is that it can, with a bit of practice, enable the patient to do a lot of their own health care. We just open the gate for them.

You surprise me, RIN, as I thought Norway was a very progressive country with regards to physiotherapy; how can any organisation prevent someone from doing what is not written in the rule book? Could they deregister you if you did not follow the 'rules'?

This is assuming that a chosen methodology is not harmful in any way, and not based on fairytales. SC is neither of those.


Nari

[Jon Newman]

Hi RIN,

I suppose thoughts could be classified as an internal process but the way I interpret it is more along the the lines of movement, autonomic processes and felt senses. Aren't you the person who thinks that pain is caused by negative emotions? I seem to remember this from NOI.

[Diane]

RIN is indeed our emotion guy Jon.
RIN, it is funny to me how you think any form of physical motion or expression thereof as being outofbounds/ unfamiliar territory for PT, yet you have no problem weaving emotion all through your PT thinking and drawing all sorts of conclusions with regard to its correspondance to various posturing, pain, etc. I'm not saying its wrong to go there and ponder all that, I'm just saying that emotional origin for physical pain isn't supported, while there is support for lack of movement being an origin for physical pain, via mechanisms involving prolonged mechanical deformation of peripheral nerves, their oxygen deprivation etc.

If you would want to consider a connection between the two worlds, yours and this one, how about a person "feeling" they cannot allow themselves to move their own way.. wouldn't the underlying organism find that restriction frustrating?

[nari]

RIN,

I do remember you found evidence that emotional dysfunction can result in pain (can't recall if it was recent or not) but I would suspect that there was a mechanical dysfunction (eg lack of movement) in the first place, perhaps subclinical, that was the reason for a perceived threat.

Do you remember that post where we said you were right in your hypothesis that emotional issues could result in pain?
After all, pain is an emotion.....

There can't be too much wrong, aka alternative, with a method (SC) which can elicit natural, effortless movement without defying the logics of neuroscience as we know it.

I would think SC would be right in your field of practice given your own awareness of others' awareness.


Nari

[rolf-inge nodberg]

hi again!
Nari:Im not shure how to explain this but ill try!
I live in Tromsø city and in our community the are about 20 private physio/manuell therapists which are more or less subsidized by the goverment to "drive" their practise.
you can be subsidized from 20-100%(100%=30000dollar)
this will make about 1/3 of the income .The rest comes from the patients and the government.
when you are subsidized you cant do what ever you like to do with the patients.you have to follow a treatment menu .
exercise ,traction,manipulation ,mobilisation) us.electrotherapy and so on.(20,30 or 40 min)
All these treatment have different costs.
Manuell therapy:Patients costs 20 dollars
The state subsidize some of the costs how much depends on the type of treatment,MTis sub.about 9 dollars.
If i would like to give my patient SC i have to do it outside my regular working our at the clinic if i strictly follow the rules.

Jon:"Aren't you the person who thinks that pain is caused by negative emotions? "
Yes and i still do! And some scientist do agree! i often experience pain in my left suboccipital area due to some cind of negative emotions.Its no probllem for me to understand the reason for the pain experience due to the fact that i have quite good contact with my feelings!
What cind of pain do i experience ?Pathological ,nevrogen psychosomatic ???

I asked a scients and he would classified it as neuropathic pain.
I find ind it interesting that none of my internet colleague abroad or in Norway experience anything like it.!?
A lot of my patients do!

Diane:"while there is support for lack of movement being an origin for physical pain,"
How do we now thats the lack of movment and not the feelings that "create " the pain experience.?

RIN

[nari]

RIN

Now I can understand your situation. Quite different from anything I have ever experienced, and like the USA system, I am starting to really appreciate the freedom we have in Australia.

Do you remember those papers that supported your thoughts about negative emotions and pain?

Nari

[Jon Newman]

Hi RIN,

I think we could agree that negative emotions such as fear (as a marker of physiological events) can bring someone closer to their critical state or increase the size of it.

How do you address patient's negative emotions in the context of your "treatment menu" or do you do this outside of regular working hours?

[Diane]

How do we now thats the lack of movment and not the feelings that "create " the pain experience.?

Emotions can't "create" nocioception, although they can "color" perception of it into "pain".. Lack of movement will deprive PNS of oxygen and be a source of nocioception, which the brain (if it finds itself unable to move the body, perhaps due to conscious inhibition) may then decide is "pain."

[rolf-inge nodberg]

Hi!
This is the answear i got from Birbaumer on the question down below!

Dear Mr. Nodberg,

your description is quite accurate.

Niels Birbaumer

rolf-inge <nodber@online.no> schrieb:

>
> ----- Original Message -----
> From: rolf-inge
> To: niels.birbaumer@uni-tuebingen.de
> Sent: Wednesday, August 31, 2005 11:28 PM
> Subject: emotional stress-hypersensibility
>
>
> Dear Niels Birbaumer1
>
> I have been reading some of your scientic reasearch,on emotional stress
and bodily respons and find them quite interesting!
> Working as an manuell therapist/physiotherpist i see ,at a daily basis, a
lot of chronic pain patients.
> Some of their pain experience seems to be emotionell triggered!
>
> Is it possible to get "muscular pain"((somatic nociceptive pain) or
neuropathic pain due to emotional stress?(which nerve pathways are we then
talking about?)
> In my clinical practise and with personal experience it seems so!
> Just wondering if an emotional stress respons(fight and flight) are able
to ,due to increased symphatic central(amygdala?)efferent impulses
> to decrease peripher bloodflow to the different bodyparts(weak points).In
the affected area ,the deceased bloodflow increase peripher nerve
sensibility,(Increased aic environment?) and a cind of local neuropatic
condition is the result.!????
> Patient(and my self) is then experience local pain,increasd sensibility in
the affected area but no muscular shortening!
> When the emotional(negative thinking/emotions) trigger is gone the
tissue get back to normal sensibility!
>
> I would appreciate if you could give me some comments on my thoughts!
>
> Your Siencerly
> Rolf-Inge Nodberg
> Physiotherapist/manuelltherapist
> Tromsø
> Norway
>



--
Prof. Dr. Niels Birbaumer
Institut für Medizinische Psychologie und Verhaltensneurobiologie
der Universität Tübingen
Gartenstr. 29
72074 Tübingen
Tel

RIN

[nari]

RIN,

Perhaps perception and interpretation is the thing here, as Diane suggests.

I would be curious to know if you still get this particular pain when you are moving, say, walking along or standing/shifting about. If so, then lack of movement may not be the trigger for a pain experience.

BTW, can I suggest the word is 'sensitivity' rather than 'sensibility'


Nari

[rolf-inge nodberg]

Hei Nari!
your wright ,ill rather use the world sensitivity,thanks!
Nari the pain experience has NOTHING to do with movment or not, its the results of my way of thinking(emotions) nothing more nothing less.
i have no problem living with it because its so seldon i get it and its there just the minutes i get emotionaly focused.

RIN:angel: :angel: :angel:

[nari]

OK, RIN, that's clarified things a little for me.

I agree with you that the trigger is emotion/negative thoughts, but if the pain appears to be in one particular area, then there must be some sort of signature/neurotag in the brain that hones in on that area when a threat arises.
Movement certainly affects the pain experience, for better or for worse, but it seems to be only one factor amongst others..if we are talking about consciousness activity and not nonconscious movement.

Nari