Friday, March 30, 2018

Hey hey, ho ho: Those bogus outdated ill-informed egotistical operative tissue-based treatment models have got to go

It's so effing simple really...

1. Humans are social
2. Humans can end up in pain

3. Pain is biopsychosocial
4. Manual treatment for pain is human primate social grooming (yes, we are fancy primates. Human, but still wired as primate). 
5. Brains are predictive. Especially human brains, because the "I"-illusions in there can remember the past and predict the future (see Triple Threat blogpost)
6. When we do manual therapy, we play with people's sensory nervous systems, and somatosensory cortices. And these cortices are full of all sorts of responses that have to do with that individual's psychosocial history. 

7. There is sufficient bio in there that most of the time, we don't have to delve into every detail of any of that. Unless the person really needs/wants to.
8. We have to allow time for their brain, and them, of course, as part of their own brain, to sift with lightening speed through all the cargo they have accumulated over their lifetime, and permit new hierarchical and parallel processing to occur, such that old bits of brain and newer (more recently evolved) human bits can negotiate new communication pathways. 

9. Many of those old bits regulate physiology.
10. It might take a few minutes, but eventually, new orders from rostral areas of the brain will inform the integration areas inside the spinal cord to re-organize autonomic output, and sensory input. Mostly through inhibition.

We, the therapists, must avoid taking credit for ANY of this. It's all nature operating, not us. We are merely interacting with the most complex object in the known universe, the human brain. The reason we can become good at it is due to the fact that we have one that is equally complex and sophisticated, neurologically speaking.

Other attributes that are helpful in our line of work:
 - Patience
 - Curiosity

 - Willingness to get up every day and go do it all over again
 - Good interpersonal boundaries
 - The right mix of respectfulness and playfulness and empathy
 - A bit of fearlessness doesn't hurt
 - Not blame ourselves too hard for all the failures we will encounter, or mistakes/logical fallacies we have made in our own thinking in the past
 - Determination to not fall prey to hubris or narcissism or heroics, or even entertain such notions or behaviours secretly inside our own minds. 

Thursday, March 15, 2018

Triple Threat


This is spurred by a facebook conversation yesterday, here.

The theme was Daniel Dennett, his assertion that consciousness is an illusion, in this review by Thomas Nagel of Dennett's new book, From Bacteria to Bach and Back: The Evolution of Minds.
I've always appreciated Dennett's take on life - he confirms my own bias every time.

Anyway, the conversation rolled along, and someone asked, "..illusion to who? Who is the user?"

I replied, to the "I"-illusion. I first encountered the idea of an I-illusion reading Deric Bownds' Mindblog. Such a handy little idea!

So, there is nothing to stop two illusions interacting in our human brains, is there?

Someone else pointed out he had no problem with consciousness being illusory, or with self being illusory, but what about all that subjective experience that accumulates over a lifespan? Surely that's real.

But wait, what if it's all illusory as well? Then we have the triple illusion, the big three-headed dog, the Cerberus we must all learn how to deal with while staying sane at the same time. Cerberus guards the gates of Hades to keep the dead from leaving but I bet he also keeps the living from entering.

No wonder we get so tired

That idea excited the bejeebers out of me and I rolled with it.

I'm pretty sure one could argue this using Damasio for support, and Sapolsky.
I happen to be reading both of their new books at the same time.
Sapolsky's is Behave: The Biology of Humans at Our Best and Worst.
Damasio's is The Strange Order of Things: Life, Feeling, and the Making of Cultures.

Someone in Scandinavia sent me a link on Twitter, a piece by Galen Strawson about how Dennett is not on track. I read it, but found Strawson wasn't exactly on track either: he ended with:
"If (Dennett's) right, no one has ever really suffered, in spite of agonizing diseases, mental illness, murder, rape, famine, slavery, bereavement, torture, and genocide. And no one has ever caused anyone else pain.This is the Great Silliness. We must hope that it doesn’t spread outside the academy, or convince some future information technologist or roboticist who has great power over our lives."
Really? That seems unnecessarily fear-mongerish. I would call it a strawman from Strawson.
Humans are going to continue being humans, regardless.

Sapolsky studied baboons for many years and laid a strong foundation for good ideas related to stress, stressors, what makes us humans, what sort of primate dominance business we still get ourselves up to. I think he would point out that alpha males have the hardest time self-regulating stress, and tend to deploy it outward by beating up on other members of the troop and thereby end up as dominant. The rest must simply suck it up and go on as best they can, and try to stay out of his way.

Damasio places everything inside the frame of homeostasis, (including stress-regulation probably!) in his new book "The Strange Order of Things". I haven't read very far into it yet, but he lays careful groundwork by pointing out that even bacteria, who no one could accuse of being conscious, nevertheless form communities and jostle for position within them and between them.

Another piece I read recently was Physics Makes Aging Inevitable, Not Biology. I loved it!
Here is the intro:
"The inside of every cell in our body is like a crowded city, filled with tracks, transports, libraries, factories,
power plants, and garbage disposal units. The city’s workers are protein machines, which metabolize food,
take out the garbage, or repair DNA. Cargo is moved from one place to another by molecular machines that
have been observed walking on two legs along protein tightropes. As these machines go about their business,
they are surrounded by thousands of water molecules, which randomly crash into them a trillion times a
second. This is what physicists euphemistically call “thermal motion.” Violent thermal chaos would be more apt.
How any well-meaning molecular machine could do good work under such intolerable circumstances is
puzzling. Part of the answer is that the protein machines of our cells, like tiny ratchets, turn the random energy
they receive from water bombardment into the very directed motion that makes cells work.
They turn chaos into order."
Now we are getting into thermodynamics.
Seriously, we are matter, there is no denying that.
Matter is subject to the laws of thermodynamics whether we like it or not.
We're all gonna die.
At some point.
Everything has to go to entropy. Thermodynamic equilibrium. Our brains, self-stimulating though they are, and giving rise to all those illusions we call "self," and "I", and "consciousness", and "subjective experience", all turn off at the same time the brain does. Because it just stops keeping itself, and them, going.
I am reminded of another great book I read years ago, Into the Cool: Energy Flow, Thermodynamics, and Life. 

"Working from the precept that "nature abhors a gradient," Into the Cool details how complex systems emerge, enlarge, and reproduce in a world tending toward disorder. From hurricanes here to life on other worlds, from human evolution to the systems humans have created, this pervasive pull toward equilibrium governs life at its molecular base and at its peak in the elaborate structures of living complex systems. Schneider and Sagan organize their argument in a highly accessible manner, moving from descriptions of the basic physics behind energy flow to the organization of complex systems to the role of energy in life to the final section, which applies their concept of energy flow to politics, economics, and even human health." 

I'm pretty sure Damasio would like that book.

Anyway, lots of food for thought. I just can't help myself, I'm a reductive materialist I guess. Or a neutral monist. Depends what mood I'm in and what time of day it is. So much self-regulating to do all the time.