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Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
September, 2003, Vol. 03, Issue 09
What Memories Can Bring
By Keith Eric Grant, PhD, NCTMB
Teaching massage has many rewards.One of these comes from simply enjoying the interplay of individual personalities working together closely, as we do in massage classes. An even deeper satisfaction comes in watching how students' skills develop and their confidence increases over periods as small as several weeks. These developments imply that our teaching is making it into our students' sensory input through the filters of awareness and practice, and into their multiple types of long-term memory. Without memory, we would begin anew each week and never get far. Understanding more about the structure of memory gives us a hint of how learning occurs.
Neurologists have broken the structure of memory into sensory working and long-term memory.6 The first stage, sensory memory, receives the river of input from our senses. It has a large capacity, but only holds information for about one second. The next stage, working memory, has a more limited capacity (seven items, plus or minus two) and holds information for 20 to 30 seconds. Neurologists believe working memory can be divided into a central executive controlling attention, an auditory (phonological) input loop, and a visual input sketchpad.1 The final memory stage is long-term memory, which handles anything we remember longer than working memory can hold. Long-term memory has a near-infinite capacity and seems to be broken up neurologically to process different types of input and content. Long-term memory is thought to divide into declarative memory (conscious memory for events and facts) and implicit memory (unconscious memory for skills; habits; repeated recognition; emotional responses; skeletal musculature; and reflex pathways).9
What neurologists and psychologists have learned about the structure of long-term memory functioning has often come from examining the effects of brain injuries. More recently, functional magnetic resonance imaging (fMRI), which measures oxygen flow to different areas of the brain, has been used to display activity in different structures of the brain while doing specific mental tasks. Foster and Jelicic discuss research with amnesia from brain injury in introducing a recent compendium of articles on the structure of memory:5
The term 'memory' can refer to numerous different kinds of remembering and types of knowledge. We will be dealing with information, which is retained in long-term or secondary memory, also referred to by some authors as the permanent memory store. This memory store spans a period from a few minutes to a lifetime. Within this system, evidence from amnesic subjects has proven particularly informative in determining the organization and operating principles of memory. Thus, amnesic individuals have profound memory loss for events which occurred after their brain damage (i.e. they manifest a severe anterograde amnesia), but relatively better preserved memory for events which took place before the occurrence of the brain damage (i.e. their retrograde amnesia is typically less severe). Amnesiacs also typically have preserved functions in other psychological domains; for example intelligence, perception, language and motor functions. Importantly for the theoretical view of long-term memory organization, amnesiacs continue to be able to learn specific types of new information, such as perceptual and motor skills.
It's striking that motor skills can be learned by amnesiacs when they no longer have the ability to memorize facts or remember events for more than a few seconds. This "dissociation" between brain functions indicates to neurologists that conscious (declarative) memory and (procedural) memory for motor skills are physically separated in our brains. Even more intriguing, amnesiacs presented with a word, such as "reason," tend to complete the word fragment "rea" as "reason," rather than other alternatives, such as "reader " or "reality."3 Although conscious memory was lost, some previous experiences remained at an unconscious level.
There is a profound implication in this research that the touch we provide in massage will interact with both conscious and unconscious memories. This provides a pathway for working with life experiences our clients may have consciously forgotten but still recall in their body usage. Such research also adds direct neurological support for pediatrician Mel Levine's observation that neurologically based memory deficits can be very specific, compromising performance; for example, in the massive detail recall used on tests while allowing near normal processing in the less memory-intensive activities of everyday life.7
The physical separation of different facets of memory helps explain the observation that the activity in which facts are presented is an integral part of what is learned. Situations co-produce knowledge through activity. Learning, and the ability to use what is learned, is fundamentally linked to the situation in which it occurred. There is a strong indication that competence can only be measured in situations approximating actual usage. Even the medical profession is becoming aware that objective knowledge and competence are not equivalent, leading to a proposal that "professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served."4
Working with the memory we each have been given, there remain ways in which we can prompt our memories. Elizabeth Phelps describes ways that emotional content may improve recall, perhaps explaining Elizabeth Bowen's observation in my opening quote:8
For instance, although we know that there are several different types of memory in humans, the predominant one is the ability to recollect information at will. These memories for emotional events seem to have a persistence and vividness that other memories lack. There are several possible ways emotion may alter this explicit, hippocampal-dependent form of memory. Emotion may alter the rate of forgetting for emotional stimuli. Emotion may also provide an organizing theme to aid in later recall. Emotion may influence attention or perceptual encoding, which may effect later recollection. Emotion could also add a component of distinctiveness. All these variables may act independently to influence our ability to recollect emotional information.
Before the printing press was invented, techniques for memorization held greater importance for maintaining and passing on knowledge in an oral tradition.10 People used mnemonic strategies that grouped information using acronyms for easier recollection. We still do this today, using the acronym SITS, to help remember the muscles of the rotator cuff, the Supraspinatus, Infraspinatus, Teres minor and Subscapularis. We still use acrostics, in which the first letter of each word in a sentence is the first letter of a bone or muscle. Thus, the phrase, "Some Lovers Try Positions That They Can't Handle" helps us to remember the eight carpal bones: Scaphoid, Lunate, Triquetrium, Pisiform, Trapezium, Trapezoid, Capitate, and Hamate.
A more involved visual format of mnemonic, the Method of Loci or "Memory Palace", dates back to the Greek orator Simonides in the 5th century BC. Supposedly, Simonides was at a banquet, but had left the room just before the roof collapsed. He helped identify the bodies by visualizing a walk through the room, as it was when he left it, noting where different people were in the room. Later, remembering would be visually associated with specific settings in visualized buildings, or so-called "memory palaces." To remember the material, one simply walked mentally through the buildings, often to recalling sequences of items that numbered in the thousands.
Memory brings us much in our senses of self and embodiment. Living within our bodies, sensory input - touch; texture; odors; and light - acts as a direct pathway into accessing memories held below our conscious recollection. In touching our clients' skin, we touch their entire lives - history, present, and future. It's something to remember.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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