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NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
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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