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The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
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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