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Hey hey, ho ho: Those bogus outdated ill-informed egotistical operative tissue-based treatment models have got to go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


Unknown said...

Love this. Thank you for sharing.

Anonymous said...

Hear, hear! This is something that I have had to learn... we are just part of the process. Nothing turns me off more than a therapist is obviously thinks too much of "their" work and thinks he or she have "fixed" me in one session.