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An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
June, 2011, Vol. 11, Issue 06
Reflections on the Two-Person Biology
By Sharon Desjarlais, CC
Daniel Goleman was only a toddler when a momentary encounter in a grocery store mirrored a neurological concept that's subtly advancing the nature of CranioSacral Therapy today.
As Daniel wandered down the aisle with his mom, a woman passing by gave him a warm smile. Instantly, he felt his own mouth involuntarily curving up to match it. "It felt as though somehow my face had become puppet-like, drawn by mysterious strings that widened the muscles around my mouth and puffed out my cheeks," he says in his latest book, Social Intelligence. "I distinctly felt that my smile had come unbidden – directed not from within but from outside of myself."
That inexplicable mirroring of smiles is now recognized in scientific circles as the reflection of "mirror neurons" in two brains synchronizing, a development that has promising implications in the light-touch treatment room.
According to Michael Shea, author of Biodynamic Craniosacral Therapy, this synchronization between two people reflects the emerging field of interpersonal neurobiology. "When two brains come together like they do between an infant and caregiver, their neurons synchronize to create a two-person biology that enables the child to begin processing emotions effectively."
Remarkably, those same neurological dynamics take place when two adults come together in a therapeutic relationship, creating a brain-to-brain bridge in the treatment room. This phenomenon emphasizes the need for clear and healthy boundaries between practitioner and patient. And, in Michael's eyes, that's the therapist's primary responsibility. "You have to spend more time paying attention to your own body in session, because a self-regulating therapist literally creates the neuronal pathways for a self-regulating client."
The new science on the subject also stresses the need to balance focused attention – what you're doing when you're tuning into a client's body hands-on – with unfocused attention, because that's the way the autonomic nervous system of the client develops, Michael says. "There are periods of approach behavior, like the contact and attachment that occur when your hands meet a client's body, which is mediated by the sympathetic nervous system. And then there are periods of withdrawal, when attention is moved away from the client, which is mediated by the parasympathetic nervous system. So, what we're doing as therapists by balancing focused with unfocused attention is mimicking the way the nervous system develops, which increases empathy and compassion."
Three Focal Points
How can CranioSacral Therapists make good use of these scientific developments in practice? Michael recommends incorporating three focal points in every hands-on session:
Focal Point 1: The Slow Tempo
In Biodynamic CranioSacral Therapy, the therapist attunes to a very slow body tempo called the "long tide." Michael believes you should start each session by synchronizing your attention with this slow tempo. "Tuning into yourself to activate the circuits of a two-person biology cannot be done quickly," he says. "It's a function of tuning in to the rhythmic balance interchange between the slow tempo and the natural quiescence that inherently exists in and around the body. Embryologists now recognize this natural stillness for its organic ability to bring order and integration to the human body as a whole." In a cranial session, he suggests you start by looking at the whole and synchronizing your attention with this natural stillness, because "that's how the whole gets organized. Then there's a dynamic later in the session when you can focus on parts that are holding a restriction."
Focal Point 2: Your Heartbeat
Next, Michael recommends tuning into your own heart. "As you sit by your client's side, take a moment to orient to your body three-dimensionally, like sensing the total surface of the skin. Then gradually shift your attention to the center of your chest and the movement of your heart and blood, a process called 'interoceptive awareness.'"
There's no need to take your pulse manually, he adds. "It's more important to sit still and feel the motion of the heart and blood as it moves through and around the heart and fluid body three dimensionally from head to toe." If your mind begins to wander (and it will), simply bring yourself back to your heart. "That alone changes brain structure and gives you the ability to differentiate yourself and your own internal processes from that of the client, and again, it deepens empathy and compassion."
Focal Point 3: Nature
Another natural way to balance focused and unfocused attention is by intentionally connecting with nature during each session. As you're working hands on, "move your attention out the window to the sky or to a tree for a minute," Michael says, "then bring your attention slowly back to your hands and your own body." When you're able to do this rhythmically, it helps reset your autonomic nervous system, which in turn resets your client's.
If you don't have a window in your treatment room? Bring in a potted plant or hang nature pictures on the wall. Michael says images of the horizon, like a sunrise or a sunset, are especially powerful. "It triggers the neurological head-righting reflex, which supports the vestibular system." And when you support your vestibular system, you naturally support that of your client's.
As new advances in interpersonal neurobiology appear on the horizon, science likely will continue to confirm that hands-on therapists have a deep and enduring impact on clients, in and out of the treatment room.
Click here for more information about Sharon Desjarlais, CC.
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