Friday, August 27, 2010

Yet another level

In manual therapy one is taught that one can push bits of body around, and that this makes them feel better to the person whose bits one is pushing.

I call this the "operator model" of manual therapy.

One quickly learns (or should) that manual therapy is much less about the bits one thinks one is pushing, much more about one's speed and force, mostly minimalizing thereof, waiting for the opening, waiting for the person's physicality to let one in.

I call this the "interactor model" of manual therapy.

However, it's quite possible to remain stuck in the operator model for good.
As one proceeds through life one begins to realize that it is impossible to prove to oneself or anyone, through any method, specifically scientific but also logical or philosophical, that what one "thinks" one is doing has any bearing on reality. I.e., you cannot prove, even to yourself, that the SI joint, actually is what you are "feeling" with your fingers, as you perform what has been taught to you as a "test" of its "function." Yes, you can feel stuff... stuff is moving, or not moving, but what one feels moving or not under one's fingers, from on top of skin, has absolutely NO bearing on whether or not a buried SI joint is literally moving. There are many layers and structures all moving on each other between skin and joint, even inside "skin" (cutis/subcutis) itself.

It's merely a convenient assumption. It's a belief. There is absolutely no way to show that it is or isn't moving, or that people can or can't palpate it clinically.

In this case, what do you do? You realize (with a sickening feeling) that you've managed to paint yourself into a conceptual corner. There is no way out, except:

1. ... tromp out over wet paint, spreading dirt and paint.

This is the equivalent of insisting that it's possible, it must be, you've always thought so, your patients' results have always verified your magic-hand ability to ferret out movement/non-movement in the SI (except for when they didn't), therefore the premise must be right. Right? (Those patients who don't fit, well, there are always a few patients who don't fit, outliers, right? We can ignore them, can't we?) Wrong.
Trying to set up tests to "prove" you are right/how right you are is a version of what Harriet Hall calls, tooth fairy science.

2. ... admit defeat, stop thinking about escape, sit in the corner, deal with your feelings, and wait for the paint to dry, however long that may take.

This is the equivalent of waking up yet another rational level on the manual therapy mesodermal mesmerization coma scale, reconfiguring/allowing reconfiguration of your own mentation to accept the facts as they are, including that you were a victim of your own conceptual hallucination, perceptual fantasy, that you were dreaming your own bad-logic dream. But it's OK, you're more awake now, and can move your mind differently, more reasonably. You can now reinterpret your work more correctly as interactive with somebody else's neuromatrix, and whatever it is you think you felt in the past, can go ahead and just be whatever it is/isn't, a mystery of function/dysfunction, not having to have any anatomical identity whatsoever. It will change anyway, just like patterns in clouds change. Continuously. That's a good thing, especially when the patterns are associated with something feeling 'wrong'.

Especially freeing is to know you don't have to prove anything, because there is nothing to prove. Instead from now on you can sit back and disprove, which is a heck of a lot more fun.

Tuesday, August 24, 2010


I found out that I've been accepted into a pain management certification program at U. Alberta in Edmonton. This online post grad program would count a bit toward a masters degree at U. of S. (if I decided to pursue one).

Also, plans are afoot for an RCT for me to be involved in. It's still tentative, but if it becomes reality, I'll be making a lot of bus trips back and forth to Saskatoon, 4 hours each way. Fortunately, buses have wifi these days. :)

Still no big urge to "work" (as in, for money), but I've been dreaming about working lately, treating people, so maybe my brain is working up an appetite for doing that once again.

Meanwhile, I look forward to seeing Ron Melzack and meeting some people I know but only from online.

Tuesday, August 10, 2010

Montreal and Melzack

I finally came up out the long summer torpor I've been in since coming back from St. John's, to get ready to go back east, this time to the IASP World Congress on pain, in Montreal at the end of this month. One of the items under "related events" is a reception on Aug 28 for Ron Melzack, my hero. I managed to get two tickets, one for me and one as a hostess gift for the friend I'm staying with, also a PT and also in our CPA Pain Science Division.

I'm actually excited about this. Feeling pleasantly excited instead of feeling stressed and anxiety ridden is a welcome change. I'll be able to see him in person, and even if I do not get to meet him in person, at least I'll be able to say I was in the same room.

More clothing angst, however, had to be battled - what does one wear to a reception in Montreal? It's a bit like going to Brazil - Montreal is the fashion capital of Canada after all. Therefore motivated by the unfamiliar-to-me default female flap of having 'nothing to wear', plus actually caring about the fact I have nothing to wear (for the second time this year in probably 20 years or more), I went out and bought some black shoes that actually have heels!! (- not high, but still, in order to not break an ankle I'll have to practice walking in them), and a few items of clothing that I think may help me escape fashion police disapproval. Get this - I even bought a necklace! That is how determined I am not to look like a complete fashion schlub at a reception for my hero, Ron Melzack. I'm hoping a) I get to meet him in person and b) that I don't stand out as not dressed properly for the meeting.

Honestly, I can hardly believe that buried under all the years and decades of being depressed and not giving a rip about how I look, as long as I smelled OK, I'm actually going to try to look like a female from across a room. Wearing a necklace and shoes with heels. I feel like such a female impersonator! Nothing motivates my inner fembot, it seems, more than a chance to see Melzack up close and in person. :^)