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  • Well, I agree with Bernard, and Randy did make the statement
    we are a difficult crowd
    which I have thought about, since.

    To those who follow 'scientific' presentations without questioning their validity, we probably seem difficult.
    Perhaps because they are not accustomed to questioning whatever come their way, regardless of references which can be manufactured, selective and sometimes way off.
    Perhaps they are simply interested in results and outcomes, regardless of the hypothesis behind the presentations. We do not know how they explain the reasons behind pain and/or stiffness resolution to their clients/patients; and if the premise is that mobility means less pain, then that is correct.

    What we try to do is look further, at specific reasons why mobility lessens pain; and this is the major moat separating us difficult ones from others. It doesn't seem to matter what resolves pain, until we explain to our patients what is going on.

    Then it does matter.

    Nari

    Comment


    • At this point we might as well be posting on Barrett's thread of the power of dissonance.

      When these discussions happen, every time we go through a post discussion period exactly like this. This is what I observe and think:

      The point at which these perceptions arise is when someone feels they've been personally attacked. What is actually attacked is faulty logic in whatever system we happen to be discussing. However, almost universally the defenders of the systems have fallen into the "believe in it" trap. When you make something a belief system, an attack against that system is an attack against you in your mind. I know, trust me. Belief by definition requires faith. Faith is what is used in lack of support or evidence. Lack of evidence or support will be exposed here.

      So, at this point the next step in the conversation is for the defender to make a post littered with emotion that takes logic out of the equation even further. These posts are difficult to answer and it is also difficult not to respond with defensive emotion as well. This is after all what we are built to do instinctively.

      This is typically when
      1) sarcasm begins in place of emotion, a good substitution in my mind considering the alternative.
      2) the thread loses usefullness to a large degree. After all, how do you argue with someone who just uses it because they believe in it?

      Another, "I've been attacked" perception might be that you feel you are being portrayed as silly or lacking for using this method which is being attacked. This is a bit different than belief, but still involves a personal relationship you've developed with your method. This again prompts emotion for defense.

      These are of course just my observations and I'm sure many will disagree, but based on this a few suggestions come to mind:

      1) When you think you've been attacked, think hard about whether it is you, or the logic behind the method you are defending that is being attacked.
      2) If you still think it is you, think hard about whether you still think this way because it sounds as if you are silly for having used the method. Instead of getting defensive, YOU MUST SUPPLY LOGIC FOR WHY YOU USE THE METHOD. Not results. We've all gotten those with all kinds of approaches. Not anecdote. We can all supply anecdote in the opposite direction. Logic. Sensible, supported if possible. Realize that if your logic has evidence that points out it is not supported we will point this out. You should thank us at this point and not be defensive although it is to be expected, knowing what we know about dissonance theory now.
      3) Leave emotion out of your posts if you don't want to encounter sarcasm. If you still encounter it you've got more credibility in defending yourself.
      4) Read Barrett's thread I linked above. It is brilliant and should be made common knowledge to all who teach. That includes clinicians. After all, isn't teaching primarily what we are doing for our patients?
      Cory Blickenstaff, PT, OCS

      Pain Science and Sensibility Podcast
      Leaps and Bounds Blog
      My youtube channel

      Comment


      • BB, couldn't agree more.
        Re: Randy's first paragraph in post #159, and the "where is the compassion, I've clucked my tongue at these people all along" tone of it, I'd like to point out that therapeutic niceness and politeness is likely what got us the deepest into this boggy morass in the first place, the swamp of erroneous belief, unsupportable treatment construct, and mesodermal bias, out of which grow giant trees of nonsense, treatment systems with deep roots down into the economy, choking out rational thought and real scientific advance of our human primate social grooming professions.

        We each wake up one day and realize we have a choice to make - continue playing nice and do nothing, the mental equivalent of living wild and swinging from vine to vine like our primate siblings, OR.... learn to exercise our minds and their capacity to think, sort, discriminate, categorize, make sense, link, develop and strategize a way out of the mental jungle we have found ourselves in. Occam's razor isn't nearly big enough to do the job required in this profession. We need Occam's chainsaw. And when wielding Occam's chainsaw, inevitably some sawdust will get in someone's eye from time to time, or a wood chip hit them on the head, or the roar of the machine itself may sound uncomfortable.

        But it's necessary. We mean no one any personal harm. Wear a hard hat and stay out of the way when the big trees topple. We're going to do this, blaze a trail of deconstruction, because we have to find a way for this profession to get itself out to the main road. Don't worry, it's far from being a clearcut.

        Personally I'm determined to cut down whatever I need to, and in my tiny backpack I'm salvaging and carrying the essentials of soft kind gentle manual therapy. I get ever more invigorated to the task when more mesodermal bias looms in front of me, blocking my way.
        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


        • Yes, Diane and Cory, you're doing it again. And I mean that in a good way.

          Another instructor who contracts with Cross Country Education attended one of my classes this week. I had had some previous dealing with her a few years ago when invited to debate the merits of “alternative medicine” in a national magazine (Advance for Physical Therapists). She took the pro and I the con.

          This is a pleasant and friendly woman, an academic and clinician, and a strong proponent of her brand of “myofascial release” and, if our debate was any indicator, a big fan of “energetic” medicine. We met civilly and with evident good will and spoke briefly of our mutual experience as teachers with this company. Quite kindly she invited me to lunch though I declined. I don’t eat lunch while teaching – I stay in the room.

          I heard not a single objection from this therapist to anything I said. She bought a copy of my book and I signed it for her, she took a copy of a monograph I’ve written titled Manual Magic with her to lunch and returned it without comment. She left early and quietly as I continued to teach.

          I can’t help but wonder what she must think but if she doesn’t come here as I had invited her to do I guess I always will wonder. The only clue I have is my observation of the way she casually tossed Manual Magic back on the front table after lunch. To me, the impact was a little loud – but I’m perfectly willing to admit that my own instincts toward dissonance reduction inflated that way beyond its reality. Maybe. I’m almost sure.

          Perhaps.

          (This entry was also posted to The Power of Dissonance thread)
          Barrett L. Dorko

          Comment


          • I guess this has become predictable. Once again I will ask, is it your intention here to simply act as a peer review, to have people present their ideas while you critique them, or is it your intention here to teach, learn and share? Because I believe that I read somewhere that the latter is part of the purpose of this forum. Yes, we can be committed to the practice of science and rational thought, this does not REQUIRE alienating everyone who we believe does not share this. We gain no converts, we make no difference if we do this. The only ones who will share or stay are the ones who already share our views on HOW to think. If the goal is to bat around ideas among a group of like minded individuals, while occasionally bumping into a new one who already shares our like mindedness, then this is a fine approach. If the goal is to change the way people think (and maybe just possibly be influenced that we haven't figured it all out yet, even about the HOW to think thing) and to promote scientific thought among others, then it is a crappy approach. Perhaps I'm just confused as to what the goals here are.

            Diane, you ask why am I here? Because I was committed to thinking objectively and scientifically long before I came here, even though I didn't always do it well. I think it was partly a matter of aptitude and personality, but I also had it taught to me, nurtured and developed by people I liked and respected and who treated me with respect even when my thoughts didn't deserve the same respect. I wasn't taught this through sarcasm and mockery (ok, I was but I always knew it was good natured). This committment allowed me to remain on this forum when I otherwise would not, but the complaint is that others don't have this committment, chasing them away won't give them that.

            Comment


            • Randy asks: "...is it your intention here to simply act as a peer review, to have people present their ideas while you critique them, or is it your intention here to teach, learn and share?"

              Since when are these mutually exclusive?

              All of that is done here, and the often horrified and exasperated response to a little sarcasm is really wearing on me. There are few ways aside from that to convey justified impatience with the non-answers often offered by those who make claims without support. You can't see my face when I grow tired of that and so I have no choice. If you could hear me this wouldn't be necessary.

              From what I hear, therapists don't post here because they "don't feel smart enough," not because they're chased away.

              What are we supposed to do about that?
              Barrett L. Dorko

              Comment


              • Randy,
                Diane, you ask why am I here? Because I was committed to thinking objectively and scientifically long before I came here, even though I didn't always do it well. I think it was partly a matter of aptitude and personality, but I also had it taught to me, nurtured and developed by people I liked and respected and who treated me with respect even when my thoughts didn't deserve the same respect. I wasn't taught this through sarcasm and mockery (ok, I was but I always knew it was good natured). This committment allowed me to remain on this forum when I otherwise would
                Then I guess you feel you belong here after all.
                the complaint is that others don't have this committment, chasing them away won't give them that.
                No one can chase anyone away from here. You have to be a moderator for only about 5 minutes to realize this sad truth. Whoever gets a nose out of joint over any perceived slight and leaves, that's their own business. Really, at age 56, personally I'm past suffering fools gladly and am more than happy when they thin themselves out. I feel no need to coddle anyone over the internet, especially anyone I don't agree with. I'm not going to make virtual submission gestures or human primate social grooming gestures toward anyone whose ideas I find baseless, no matter how cute, young, innocent, naive or cognitively helpless they may be. Seriously, I'm past all of that and I save whatever I still have left for actual patients in actual therapy.
                Last edited by Diane; 12-08-2007, 01:26 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


                • Hi Randy,

                  I've been telling these guys forever that if they actually want people to hang around and participate that they need to lighten up on the hostility.
                  Well forever is a pretty long time but you bring up a good point none the less. Not so much the one about hostility but rather the goals of particular threads or even specific posts. It is true that I would like people to hang around and participate but sometimes I'm simply trying to demonstrate a lack of justification for claims. Sometimes I'm trying to gain publicity for my point of view and sometimes my goals are even less proper than that if I reflect on them. I suppose it is wise to remember to clarify one's objectives (at least to one's self) prior to posting but doing so does lose a sense of spontaneity and that seems like a loss to me (for reasons that currently elude me).

                  I wrote the above comments this morning but didn't post because I was hoping to come to appreciate the reasons that eluded me. Now that I haven't been thinking about it for a while I think I'm a little closer to knowing.

                  I'd prefer not have people hanging around here because we're such great people and Soma is a place where never a mention of sarcasm or cynicism is uttered. In fact, I'd like to have people hang around despite it; like yourself.
                  "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                  Comment


                  • Cory, very well said! And, BTW, having been in a somewhat mellow mood on this thread, and thus having employed little to NO sarcasm - I am still awaiting responses to my questions. Those ones I posted waaay back. There was not one ounce of personal or derogatory tone in that post. Yet, the supporters of the Z-concept decide to to post on the perceived "personal" stuff and choose to forego the chance to really expand on the proposed structure, science and theoretical model of "Z"?
                    We don't see things as they are, we see things as WE are - Anais Nin

                    I suppose it's easier to believe something than it is to understand it.
                    Cmdr. Chris Hadfield on rise of poor / pseudo science

                    Pain is a conscious correlate of the implicit perception of threat to body tissue - Lorimer Moseley

                    We don't need a body to feel a body. Ronald Melzack

                    Comment


                    • Bas,
                      You make an interesting point. I too have noticed that your questions with lack in sarcasm have been most ignored. It brings to light that sarcasm may also be a way of actually getting a response. Don't get personal, but give them something to defend against so that they will defend at all. People do of course have the option of ignoring sarcasm.

                      Randy,
                      You make an interesting point as well. In my view we are here to teach, learn, and share. However, a perception of arrogance or condescension could be the result in a right off the bat, "let me hold your hand through this" approach. I know if I went to a forum thinking I was sharing good knowledge and that is how I was approached, condescension, arrogance, and mis-understanding of my point is how I'd feel. This brings us back to where we already are. As much as I wish an "ah shucks. Let's all be a team." were the way to make such things happen, that approach is part of the problem we inherit. A feeling of alienation is likely a part of cognitive dissonance. It is for me.

                      I'm glad you've stuck around.
                      Cory Blickenstaff, PT, OCS

                      Pain Science and Sensibility Podcast
                      Leaps and Bounds Blog
                      My youtube channel

                      Comment


                      • Jason,

                        Sorry to revive this post but …

                        On the issue of whether Z is unique. I think you misread my post in regard to the “three essential elements of Z.” I never said that no other therapy has ANY ONE of the three elements. The point is that no other therapy (at least that I am aware of) COMBINES all three elements. So yes, a great many programs emphasize motor control, and that is exactly what my post says. The point is that none of those programs also have the second and third elements as well. Your statement that the second element (extremely gentle subtle deliberate movement ala feldenkrais or tai chi) is “covered by any modern training regime or anyone who trains athletes for a living” is completely incorrect. Are you honestly saying that all modern training programs use movements that are as gentle and slow deliberate as feldenkrais, somatics or tai chi?

                        Here’s a quick way to summarize what I’m trying to say with the three elements thing - Z is kind of like a standing isolated version of tai chi, somatics or feldenkrais. Can this really be as bad an idea as scientology?

                        You also state that: “motor control theory suggests that the body moves in ways that are goal oriented, rather than joint oriented. That's a bit of a problem if we're going to try to break movements down into individual joint movements first and pretend that's a superior way to learn.”

                        I think this raises an interesting issue. Are you referring to the finding in motor learning theory that learning is more effective when the client focuses on external instructions (e.g. reach for the wall), as opposed to internal instructions (e.g. activate this muscle, move this joint, etc.)? If so, I disagree that this is an impediment to teaching isolated mobility drills, because it would appear that this rule is really more about how you cue a movement rather than whether you should prescribe a movement that is isolated or integrated. For example, I could cue the isolated movement of a thoracic a/p glide with this rule in mind by asking the client to “move your sternum forward and back”, as opposed to “alternately contract the muscles in the back and then front to cause movement in your thoracic spine.”

                        Maybe you are suggesting that one couldn’t improve an integrated movement such as an overhead squat by retraining the isolated components of that movement? If so, I disagree. I would expect overhead squat performance to improve after doing some isolated joint mobility drills to improve either ankle dorsiflexion, hip abduction, thoracic extension, or arm flexion. Motor learning theory suggests that new complex skills will be learned easier if the movement is composed of simpler skills that have already been mastered. That doesn’t mean that you should never perform an integrated exercise without first learning all the component parts, it just means that you can expect performance of integrated actions to get better when performance of all the component parts get better. Performing the drills in isolation makes it easier to assess which components parts need work.

                        On Explaining Z results. Jason wrote – “surely you've got to be kidding when you say this has been done. It has neither been covered by you nor Courtney, and Randy's post that I believe you are referencing simply summarized the proposed mechanisms behind joint-focused movement and therapy systems of all kinds.”

                        Well that was all I was trying to do, summarize the proposed mechanisms by which Z could offer pain relief. I never said these mechanisms were unique to Z or that other therapies would not use the same mechanisms. I’m honestly not sure what else you are looking for here. Just to make sure we are on the same page, would you dispute that joint mobility work could reduce pain perception by increasing proprioception? Is it possible that joint mobility work could improve motor patterns and/or reduce mechanical deformation of nerves? Is it possible that gentle pain free movement could reduce the threat value of movement? Is this in the realm of star trek or do these ideas rest on fairly solid ground?

                        On answering some of the other questions. Bas made the point that several questions went unanswered. I’ll admit that I didn’t answer all the questions posed, and this is for two reasons – one I didn’t have a good answer, or two, I just didn’t have time to write one. I can guarantee that my failure to answer was NOT caused by insufficient sarcasm in the question. So, here’s my attempt to answer some of the unanswered questions.

                        Keats had the question regarding the scientific basis for the “corresponding joints” theory. This proposes that a problem in the right hip, for example, might be helped by mobilizing the left shoulder, or the right knee and left elbow and so on. Although I certainly do not know the specifics of the theory, I understand that it is based on research on interlimb neural coupling. If you look that up on the internet you’ll find some articles that are frankly over my head, but the gist is that central pattern generators related to gait will cocoordinate muscle activation patterns in upper and lower limbs. In other words, what’s going on in the forearm might affect what’s going on in the calf. So, this theory is used as one of the ways to assess what drills will have the highest payoff – e.g. if I have a problem in my left knee, you could try mobility drills on the left knee itself, left ankle, left hip, OR right elbow. Of course, it is also acknowledged that the body is enormously complex, and that pain really could be coming from a problem anywhere, so the assessment techniques including the corresponding joints theory are really just attempts to find the highest payoff areas to work, and they do not purport to be deterministic diagnostic techniques.

                        There were several other questions related to the visual and vestibular work. I’m sorry, I haven’t attended a training on these issues and I really can’t answer at all. I can tell you this though. I have been practicing Z myself for almost two years on a daily basis, (have gotten great results, sorry about the anecdote), and have never done anything that involves visual or vestibular work, and have never really done any self assessment that involves the opposing joints theory. My point is that although these aspects of Z have generated a lot of debate and attention, they are, in my mind, only a small part of the whole, most of which rests on some pretty common sense and non controversial principles described above.

                        Here’s one more observation which you can add to your internal debate on the personal attacks/hostile environment issue. I don’t want to start a fight here, I just thought these were some valid thoughts and they are offered in the spirit of debate. Take them for what their worth. I disagree that the Z crowd was the first to “litter” “emotion” into what was previously a completely scientific and logical exercise. Many of the posts by the soma crowd were primarily directed at expressing emotion (such as disgust, frustration, contempt, disappointment, annoyance) etc. and/or trying to provoke an emotional reaction in its targets (such as feeling foolish, incompetent, ignorant, etc.) I acknowledge that such expressions of emotion are natural human reactions and difficult to resist. But I don’t think they are necessary for the advancement of science or learning (and in fact I think they usually hinder it). Several of the posters admitted that they used sarcasm. Sarcasm is not a scientific technique, its a debating technique whose purpose is to make the other side look and feel foolish. Wikipedia defines sarcasm as : “sneering, jesting, or mocking a person … a type of verbal irony intended to insult or wound. The American Heritage dictionary defines sarcasm as: (1) a cutting, often ironic remark intended to wound; (2) A form of wit that is marked by the use of sarcastic language and is intended to make its victim the butt of contempt or ridicule.

                        I’m not saying that a little sarcasm is a big crime, particularly when mild or offered in a familiar situation, and I’m sure you can find some example of it in what I’ve written here or elsewhere. I just think that sarcasm is essentially a form of mockery that is unnecessary for science, and can be expected to cause emotional injury and defensiveness on the other side. This usually slows or stops a good debate and the exchange of good information. Yes, you are right that sometimes people think there is a hostile or mocking tone, even when there isn’t, because of cognitive dissonance. But people also feel attacked when they are greeted with excessive sarcasm and mockery. I’m not advocating any new age relativism here, or trying to discourage vigorous debate, just pointing out some ways that a potentially good debate can go bad.

                        I fear that by writing this I will generate more of the negative emotion and unproductive fighting that I just discussed above, but please understand that’s not my intent. Anyway, I’ve spent way too much time on this post and I appreciate the consideration of anyone who has bothered to read it.
                        Last edited by toddhargrove; 17-04-2010, 10:25 PM.
                        Todd Hargrove

                        http://bettermovement.org

                        Comment


                        • Sort of like applying TFT to members of soma?
                          Christopher Bryhan MPT

                          "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
                          Daniel Kahneman - Thinking Fast and Slow

                          Comment


                          • Chris,

                            Whats TFT? I did an internet search and found the following: Thought Field Therapy, Thin Film Transistor, Task Force Tips and Texas Federation of Teachers.

                            By the way, I don't know if you remember this, but we met a few months ago at your office. You helped my wife Jemila with some back issues. Thanks for that.
                            Todd Hargrove

                            http://bettermovement.org

                            Comment


                            • Yes, I remember you. It was nice to meet you. Hope everything is well. TFT is a bit of a joke... and like most I tell, usually only I understand them or laugh at them.

                              Chris
                              Christopher Bryhan MPT

                              "You are more likely to learn something by finding surprises in your own behavior then by hearing surprising facts about people in general"
                              Daniel Kahneman - Thinking Fast and Slow

                              Comment


                              • Todd,

                                I was speaking in terms of all of "these types" of threads that have occurred here. This one has been relatively less emotional. I'd like to comment on your post for the 3 contributions of this approach.

                                Of course the feldenkrais, somatics, tai chi sorts of movements are great. I think the biggest point of contention at this point is going to be the joint mobility as a point of emphasis. I'd like to offer another option that I feel is better supported.

                                If you think in terms of a novel input being necessary to decrease pain, would it make sense that a body part that uses less options for movement has more opportunity for novel movement? In other words, it has a limited repertoire of movements and therefore a larger potential for changes to be considered novel.

                                So, joint mobility may not be the problem, but rather an indication of the tendencies in which this person moves. This might give an indication of places where novel movement can be introduced in numerous ways.

                                The isolated to integrated approach sounds like graded exposure to me.
                                Cory Blickenstaff, PT, OCS

                                Pain Science and Sensibility Podcast
                                Leaps and Bounds Blog
                                My youtube channel

                                Comment

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