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New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
April, 2001, Vol. 01, Issue 04
Touch and Rapport
By Keith Eric Grant, PhD, NCTMB
There go my people. I must hurry and catch them, for I am their leader
- Mahatma Ghandi.
The Path of Touch Unfolding
Facilitation, like true leadership, is paradoxical in that it often requires us to chase after those supposedly being led.Within such facilitation, there is a deep appreciation for the abilities and resources of the client, and an acknowledgement that the full outgrowth of the interaction will only become apparent as it unfolds. It is an orientation that obliges us to be flexible in our attitudes and approaches.
Depending on our therapeutic orientation, we may approach a client from a sensory-driven perspective of finding and gently releasing areas of unconscious holding and restriction. More formally, we might take the orthopedic perspective of assessing painful lesions stemming from structural and functional dysfunctions, then proceeding to systematically alleviate them. In any approach, having our interventions take hold often requires a change in body perceptions and use from our clients. I am particularly struck by Deane Juhan's (Job's Body) comments about massage opening a window for the client toward a new, less strained way of experiencing their body, and by his repeated emphasis on the importance of bodywork as client re-education:
Beyond what Juhan provides, there are several paths along which we can delve into underlying mechanisms and clinical experience. Pain researcher Ron Melzack continues on from the gate theory of pain (Melzack and Wall) in considering the neurological basis and implications of phantom limb pain. He conjectures that we possess an inherent neurological analog of our physical bodies . This analog system, he theorizes, can independently generate perceptions of pain until it is reorganized by new coherent sensory input, such as that provided by bodywork.
A second perspective is provided by psychologist E. L. Rossi's review of the new field of psychoneuroimmunology. In The Psychobiology of Mind-Body Healing, Rossi discusses research indicating that stress on the nervous system produces chemical messengers that have profound effects on immune system functioning. In providing a supportive emotional environment and nurturing touch, we address the effects these neurochemical systems have on perceptions of pain and quality of embodiment.
Choreographer Eric Franklin (Dynamic Alignment through Imagery) is one of a line of dance movement instructors who have achieved their results working with the interrelations of imagery, body use, and neuromuscular patterning. These dance educators have noted the role our mental imagery plays in organizing the neuromuscular patterns that facilitate the ease or strain of our posture and conscious movements. We have only to think of movement or conflict and our body has responded, beyond the speed of our conscious thoughts. Just imagining a movement or a posture causes the body to activate muscles and to integrate optimal pathways towards that vision. Our positive body images can act to alleviate tension that results in unnecessary limitations and wear as equally as our negative body images can limit our effective use of space and increase the effort of our movements. We begin to understand the wisdom behind Juhan's assertions that bodywork can add new possibilities to a client's world of embodiment.
The Dance of Rapport
Psychiatrist Milton H. Erickson was notable for his abiding faith that, apart from unnecessarily limiting beliefs and lack of experience, clients possess all the resources they need to live full and rewarding lives. Starting from an attitude of accepting and utilizing the client's worldview and abilities, Erickson was a master at providing the needed experience and flexibility that allowed positive changes to evolve naturally for his clients. Neuro-Linguistic Programming originators John Grinder and Richard Bandler similarly stress the importance of pacing and leading. Pacing is a process of acknowledging and matching a client's current experience in a manner to establish rapport. If we attempt to lead without rapport, our efforts will fall short. Likewise, if we limit ourselves just to pacing, we lose the opportunity to effect positive change.
Part of the skill of pacing is simply to be fully present with our clients. To promote this skill, I teach my students a simple yet unexpectedly profound exercise; actively pacing a supine client's breathing with a hand on their anterior torso while staying conscious and present to observe subtle changes in their appearance and position. It is hard to over emphasize the emotional impact of such quiet presence and support in a culture in which it is so rarely encountered. This exercise draws on our skill at pacing and leading our clients in their perception and use of space, effort, and time. These are ways of organizing our embodiment that are used by dance instructors such as Constance Schrader (A Sense of Dance). I find they provide useful frameworks for understanding a client's body image and use. Each can be further refined, such as dividing time into tempo, beat and rhythm.
When we work on people, we act to increase the ease and comfort with which they inhabit their body. Amid the gentle stretching of fascia and facilitation of muscles, we send countless sensory signals throughout their nervous system. We focus intently on them, pacing, nurturing and supporting their emotional needs. In so doing, we provide them with a new sense of themselves as embodied human beings.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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