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Treatment stance: Operator or interactor?

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  • #31
    Updated version with a "locus of control" feature added.
    Attached Files
    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


    • #32
      About treatment, and about our role as interactionists.. on Facebook, Will Stewart linked to this nice open access paper, The Effect of Arousal on the Emotional Memory Network Depends on Valence, about which he says this:
      Negative information affects the limbic systems and its input to the neuromatrix while positive information decreased amygdala output.

      How do you as a trainer or therapist disseminate information to those in front of you? The way we communicate (verbally as well as non-verbally) affects them in ways we are just beginning to understand. Thoughts???

      "For negative information, arousal increased the strength of amygdala connections to the inferior frontal gyrus and the middle occipital gyrus, while for positive information arousal decreased the strength of these amygdala efferents. Further, while the effect of arousal on memory for positive information was restricted to amygdalar efferents, arousal had a more widespread effect for negative items, enhancing connectivity between other nodes of the emotional memory network. These findings emphasize that the effect of arousal on the connectivity within the emotional memory network depends on item valence."
      Nice thought! How we interact with patients will affect how their brain takes on what we provide them in terms of information. Providing pain ed needs to be done in a way they can hear, in a way that won't scare them, in a way that helps them be less scared. Same with any sort of contact, especially physical contact, from manual therapists. Explain explain explain is my default approach.
      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


      • #33
        interaction

        Exactly Diane ....I feel the 'woolliness' , the often cited comments like 'psychobabble' and the general reluctance to engage in the less measurable but possibly most important aspects of health care are increasingly being teased apart and worthy of study.....One concrete reason other than the sensible reason that people have much better outcomes with empathic and extended consultations see enclosed article on Rheumatology outcomes and homeopathy for example is the fact that some of the most costly complaints are due to arrogance and attitude rather than procedures i.e. a lack of care.

        http://rheumatology.oxfordjournals.o...eq234.abstract
        http://rheumatology.oxfordjournals.o...gy.keq265.full

        Deric Bownds (as usual) has a whole series of article that are relevant to some of the factors you might be interested in under the embodied cognition link....http://mindblog.dericbownds.net/sear...ed%20cognition
        One brilliant article was on metaphors http://opinionator.blogs.nytimes.com...-on-metaphors/

        No doubt you have read all of the above or they have been posted before but apologies if this is the case!
        ian

        Comment


        • #34
          Thanks Ian, it's a nice digest.
          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


          • #35
            I stumbled over this, while looking for the Bialoski paper on pubmed, and was glad to see it was open access. It's the letter Jason drafted last year, and we submitted together. It's in print, and citable, and open access. Therapist as operator or interactor? Moving beyond the technique.

            (I got to admit, it's kind of fun/I kind of like seeing this come up in pubmed. )
            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


            • #36
              Here is another letter to the editor, from a year ago, by Cory Blickenstaff. It should go in this thread too. Therapist as ‘contextual architect’
              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


              • #37
                Link to "Shared Space" thread.
                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


                • #38
                  Thanks so much for that chart you provided above. I like that you also added Music Therapy.

                  We have a Music Therapy Center in our city and for anyone who is no familiar with it (I have only recently connected with them and am just starting to learn a little more myself), it is described this way:

                  "The American Music Therapy Association defines music therapy as an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of individuals of all ages. Music Therapy improves the quality of life for persons who are well and meets the needs of children and adults with disabilities or illnesses.”

                  I am not sure how that helps this thread, but maybe it becomes useful along the way.
                  C.O. ( gender: ) - LMT, BS(Anatomy), DC
                  Music Fog... pick a song to listen to... you can't go wrong.
                  Need relaxation samples for your office? I have made a Deep Relaxation Massage Music Pandora Station and have others that may also be useful - about 8 massage music stations and about 49 other nifty options.

                  Comment


                  • #39
                    I thought that Karen Litzy's most recent podcast with Adriaan Louw (and his remarks quoted below) was pertinent to this thread:

                    What we may find is that if you do something to the tissues [the patient] may feel a little better right there; they will often get worse afterwards or they have these latent periods of flare, because what happens is if you work on those tissues with soft tissue or manual therapy (or whatever you do), you are giving input to the system, but remember that input gets magnified/amplified and the nervous system is a very tricky thing. It doesn't hurt when you are there - in the clinic - it will hurt this afternoon, tomorrow or tonight. It flares and patients go through these flares - they go up and down the boom-bust cycle. So tissues that are super sensitive will feed the brain and if the brain doesn't understand it (we go back to Lorimer Moseley) the brain is going to produce pain. Pain protects.

                    We talk about a top-down effect and a bottom-up. The bottom-up effect is what we do from the tissues towards the brain. The top-down is from the brain down and you really need to start with the brain, so when you do soft-tissue [work] that message ends up towards the brain and if the brain understands it, it will not amplify [the message], it will actually say, "We're gonna be okay. Lets calm you down."

                    The most important thing is to turn on the brain-part of it. We need to be careful. We need to think of all of the manual stuff that we do - that is all very good - and put it in the right context for the brain before we do those.
                    Respectfully,
                    Keith

                    PS: Great interview, Karen!
                    Blog: Keith's Korner
                    Twitter: @18mmPT

                    Comment

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