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Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
The Truth About Herbs
I appreciate the effort and research put into the article written in the June issue of Acupuncture Today regarding pesticides and Chinese herbs.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
June, 2008, Vol. 08, Issue 06
Feel the Read: An Unconventional Approach to Bodyreading
By Raymond Bishop, PhD
When a local Pilates instructor asked if I would be interested in teaching a class in bodyreading to her instructors, I initially was very excited. As I began to contemplate how I might structure such a class, a number of difficulties occurred to me.The most obvious is that teachers in my profession have a very different language for describing and (more importantly) experiencing what we read than Pilates instructors, in part because of very different intentions as to what we wish to teach and accomplish with our clients.
I started imagining what the first steps of such a review process might look like, basing this bit of speculation on my teaching experience, my work in this area and reviewing various texts.1 I decided to start by formulating a basic model for how bodyworkers are taught assessment. The first part of such a protocol had to do with looking at a body standing in an anatomical position in the gravitational field - the most familiar way most of us first learn to evaluate deviations from established postural norms. The type of assessment in which I am interested here is simply the "reading piece," rather than the application of a rigorous set of palpatory and movement tests such as those an experienced physical therapist might perform before developing a treatment protocol or corrective action.2
Such a reading might start with placing a body in front of an actual or imaginary grid and looking at deviations from "true verticals or horizontals," and describing such asymmetries with a simple and consistent language. Conceivably, we would notice such obvious discrepancies as higher or lower with respect to the same structure on the opposite side, or focus on how each side's shape fails to fall precisely where it should on our grid. When considering patterns in the sagittal plane (along the side), we might employ a hypothetical plumb line from the ear lobe to the lateral malleolus. We would then describe those structures that fall farther in front of or behind that line than we would expect.3 Such structures are either too anterior or posterior.
We might finally consider relationships in the transverse plane, focusing on the balance and symmetry of the stacked horizontals from the arches of the foot to the sphenoid or the cranial vault. We can think of these horizontal planes as joints or, to use a term more familiar in the SI community, diaphragms. The latter is perhaps a nicer metaphor in that it allows us to consider soft-tissue planes such as the respiratory diaphragm, the arches of the foot and the floor of the pelvis (the levator ani and related structures), as well as boney articulations (such as the knee) as fluid relationships that become distorted in a number of ways.
Shifting our awareness to relationships in the transverse plane is a bit more conceptual because the actual number of soft-tissue structures that are purely or even largely horizontal is quite small. Yet, "seeing horizontals" actually proves very important for most models of "structural reading."
We now assume all three planes have been studied and the results tabulated. Once the student has completed their model of asymmetries, they would then begin to match the locations of imbalances with specific anatomical landmarks. These would be the boney attachment points for muscular structures4 most likely involved in pulling the body out of alignment. Once the anatomical landmarks are identified, the student then starts laying the muscles on them and formulates a working list of the usual suspects that contribute to any deviations we observe. They do this by organizing groupings based on similar locations and actions, but also should consider relative depth of the structures involved and perhaps extend their seeing to the layer at which this deviation occurs. At the same time, they need to consider not only synergists, but also those antagonists they certainly will find just as compromised by any local fixation.
A further step in this evaluative process involves seeing larger-scale adaptations created as a result of a local strain. For instance, a shoulder girdle torsion and elevation will create adaptations in the cervical and upper thoracic spine, as well as in the ribs. These regions must therefore be studied if we wish to do more than free up a very specific strain pattern. By logical extension, not only will we find adaptive strains in the pelvis both on the ipsilateral and contralateral sides, but we also will find lower thoracic lumbar adaptations that reinforce or counteract the patterns in the upper spine and thorax. Prioritizing and strategizing as we see these larger-scale adaptations snaking through the axillary skeleton adds an inevitable level of complexity.
If you agree with my thinking so far, you will anticipate my next shift in attention from the girdles to the limbs. How is it possible that an elevated and anteriorly displaced shoulder girdle will not shorten and twist the arms in similar or oppositional patterns? Of course they do. Therefore, as we extend our seeing through the appendicular skeleton, we begin to see a more intricate representation of how a local asymmetry sets up multi-level matrices of unique adaptations in the system we began evaluating with our seemingly simple imaginary grid not so long ago. All this makes the process of structuring a single intervention much more complex than if we choose the less interesting option of "just fixing the shoulder."
Such a sobering conclusion begs the question: If I am doomed to be overwhelmed by the complexity of such patterns, what do I do? While any effort to answer such an enormously complex question in a short essay is doomed to failure, there may be another way of attacking this entire problem, one rarely considered in those classes in which we address problems of seeing and strategizing. I will shift my focus and leave such a discussion for another time.
Before proceeding, I need to briefly speak to an important dimension of traditional bodyreading: the study of bodies in movement. Since in my view, this is such a difficult issue, any effort to demonstrate how one might structure readings in motion, even at the most basic level, would take us too far afield. Those interested in this topic might begin by delving into the books by Myers and Maupin.5
Many argue that the real key to creating meaningful and sustainable change begins in having good movement evaluation skills. The notion is that if static release is good, asking for movement while manipulating soft tissue is at least three times as good. Seeing and being able to correct movement patterns in gravity while shifting movement often proves essential for a sustained rehabilitative outcome. Such information is essential if we intend for our therapy to help re-educate and empower the client by giving them a repertoire of simple tools to "keep that tight hip free." Touch therapy without movement education has been repeatedly shown to be of less sustained value. There is no judgment in this opinion; it is simply an important underlying point.
Movement obviously is a kinesthetic experience. It's this underlying notion of the value of kinesthetic sensing that provides us with the key to our alternate approach to reading bodies. There are a few interesting pieces of the puzzle that will prove very useful for the novice "kinesthete." One piece is the value of having some sort of formal training in experiential anatomy. Without such training, how can any student begin to translate what they see to what they feel? Any bodyworker interested in developing such skills has a number of excellent trainings available.
Whatever the source, any interested student wishing to enrich their ability to "feel the read" will quickly find a movement program that fits their needs. Once such training has been successfully integrated into the practitioner's experience of body as movement and self, they will begin applying this knowledge to how they read. Some practitioners of a highly kinesthetic and intuitive orientation will feel drawn to this affective approach to reading and will be quietly working this way, even in their more traditional classes. Such folks will read more by feel than by external descriptive models, although they will lack a coherent level of specificity of language in their readings.
There is an implicit assumption that those who work mostly by feel have different ways they process their sense impressions. We can think of these approaches as falling into two broad categories: literal readings and metaphorical readings. In a literal reading, the bodyworker forms a clear anatomically based three-dimensional image of the client's strain pattern. They easily label the specific muscles that feel compromised and see some approximation of the degree to which the structure deviates from the norm. Certain qualitative issues such as excessive density, the nature and location of adhesion to related structures, and specific movement restrictions sensed locally and more distally will, to varying degrees, reveal themselves during such a reading.
On the other end of the spectrum are those sense impressions that are more "energetic," for lack of a better descriptor. In this type of sensing, the therapist perceives deviations of shape, texture and other properties, but the words employed are less exacting, being mostly more allusive or evocative. We find in such readings qualitative terms such as dense, heavy, sticky, stringy or desiccated.
If I seem to be presenting a rigid "either/or" scenario, then a correction is needed. Sense experience is highly variable and extremely difficult to describe. Also, anyone who reads by feel may receive a series of rapid impressions that contain random literal or metaphorical elements, or both. Certainly, sense impressions have great range, rather than falling into discrete quanta. Our problem in describing such impressions is a function of their volubility and ephemeral nature, and our inability to measure them. We usually are left with only the client's reporting of the accuracy of our descriptions of their pain as confirmation that our descriptions are "right."
As I read my audience now, I fear the kinesthetic intuitive approach remains shrouded in mystery, as if many of you believe only that which we can measure is real. In my view, the mystery is rather that those who work this way remain so timidly silent and cloak their abilities in the language of mainstream bodyreading or esoteric doublespeak, rather than attempting to be as clear, precise, and direct in their wording as the skilled anatomist. This concern is magnified when we learn many scientifically trained practitioners are equally adept in both "kinespheres." Much of the misunderstanding around the intuitive approach comes from a reticence to play esoteric "name that tune" games, because of the difficulty of finding a clear descriptive and, more importantly, the "excludedness" felt by those who do not process this way.
My intent in presenting such ideas is to evoke openness and inclusiveness, rather than elitism and separation. Just as sense experiences exist on a continuum, so does our understanding. We must always aspire to reach beyond ourselves in the search for greater understanding. Fear and intellectual laziness are no excuse, nor is the ego-driven need to appear more intelligent or sensitive than another. We all have our own gifts and distinctive ways of working. No one approach ever trumps another, since decisions based on preference are subjective and individual. In the case considered here, there is no inherent advantage to one approach to reading bodies over another. Our intent is rather to expand the range of possibilities by offering creative alternatives to the more commonplace mode of how we see.
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