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5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
Integrative Cardiology: The Heart of TCM & Western Medicine
Patient centered therapy is a growing trend in hospitals that are expanding to boutique services.
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
March, 2008, Vol. 08, Issue 03
Relying on Intuition
By Keith Eric Grant, PhD, NCTMB
"When we classify an aptitude as intuitive, it conveniently serves to remove it from the list of things we need to teach or confront. Perhaps, however, this accepted map does not match the territory it supposedly represents. Could it be that achieving mastery beyond technical competence is less innate than we customarily believe? My answer to this question is that I believe that implicit skills both underlie and transcend what we typically think of and teach as massage skills. Following a common terminology from psychology, I refer to these as metaskills. My second premise is that more is known about the structure and communication of these metaskills than we usually believe. A major reason for this disconnection is that much of the knowledge we seek is scattered across the boundaries of several disciplines. The good news is that it is exactly such knowledge, from regions where different disciplines cross and intermingle, that often newly inspires creativity and invention. My third and final thesis in writing this article is that what we learn about our metaskills can fundamentally influence how we conceptualize and teach the practice of massage therapy."3
A little more than a decade ago, I started several years of pondering and slowly piecing together an article on intuition and metaskills. Apart from a few preceding lines, the paragraph above was the opening statement of that article. The passage of a few more years has only strengthened my conviction that much of intuition is, in reality, a simple expression of experience-based expertise operating at an unconscious level of the mind. Those years also have added more supporting resources.
My starting point this round is Malcolm Gladwell's book Blink, a lay introduction to our use of tacit knowledge and unconscious decision-making. In the book, Gladwell ties into the field research on decision-making done by Gary Klein.4 What Klein had expected to see, based on theories and laboratory studies, was experts making rational comparisons of two or more alternatives. What he discovered, however, was this wasn't how the real world worked. The great majority of the time, people unconsciously recognized a situation as "prototypical" of something in their experience and moved directly into action. Klein termed this process recognition-primed decision-making (RPD), something Klein also noted as being a model of intuitive response. When the situation was even more novel and a single response wasn't obvious, people would engage in "satisficing"- mentally simulating possible responses one by one and picking the first one that would likely work. The mental simulation allowed experts to spot weaknesses in a potential response without trying it. The process was rapid, generally occurring in less than a minute. Logical comparison was used only in learning situations outside of prior experience. It resulted in far slower responses and less certainty of achieving desired effects.
Klein recounts research done by co-worker Beth Crandall, who studied how nurses in the neonatal intensive care unit (NICU) of a large hospital judged when a baby was developing a life-threatening infection. Often these premature infants only weighed about 2 pounds each, sometimes less. Crandall saw that the nurses could react to the start of sepsis even when objective tests were still coming back negative. Rather than starting from objective knowledge and developing methods by which nurses could detect the onset of infections, Crandall's research delved into what expert nurses were doing unconsciously. She catalogued that into cues that could be used to more quickly train expertise. In short, Crandall was discovering how to train nursing intuition. This process of eliciting how naturalistic decision-making works is the subject of cognitive task analysis, a domain to which Crandall, Klein and Robert Hoffman have contributed their own field manual.1
In his book,4 Klein provides us with a statement about training that's as applicable to massage as to the professions he specifically studied:
Klein's observations don't say that information is unimportant, but they do emphasize the need for teaching anatomical and other didactic information within the framework provided by hands-on experience. The conclusions Klein makes from research thus run counter to what I've observed as a trend in massage training: delaying hands-on experience while stressing the purely didactic. While Klein focused on challenging situations - those that would place the most stress on expertise - he is also explicit that the results are even more applicable to commonplace situations. He found the same responses in design engineers who had weeks on a project as those who had to make life-or-death decisions within seconds.
With experience, we most often act without conscious consideration of the exact sensory input to which we are responding. Our unconscious minds recognize the patterns of sensory information and our hands "tell" us what to do. When we achieve this ability, we join a wide interdisciplinary corps of experts. It's part of the power of "knowing" just the point that invokes a change.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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