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Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
February, 2013, Vol. 13, Issue 02
CranioSacral Therapy and the Multiple Therapist Approach
By John Matthew Upledger
One of the qualities of CranioSacral Therapy that has always fascinated me is how well the modality lends itself to multiple therapist work. I have watched, as well as experienced, the coming together of two or more therapists as virtually one set of hands, assessing and responding to areas of restriction within a client's body. Through the process I have seen exponential improvements in a person's health.
The approach always reminds me of a concept I learned while working as a waiter in college. The restaurant brought in a wine expert to teach us about the "synergistic" effect of pairing certain foods with different wines. He explained that, while the food and wine were very good individually, when the right ones were combined they were even better.
I like how Sue Cotta, MSPT, CST, describes it in terms of the practice of CST, "In multi-hands work, one plus one equals more than two. More gets accomplished when two therapists treat for one hour than when one therapist treats for two hours." A longtime proponent of the multiple therapist approach, Cotta regularly joins with fellow CST practitioner Susan Steiner OTR/L, CST-D, to work on each others' clients. While they maintain their own practices in separate locations, Steiner in Providence, R.I., and Cotta in Swansea, Mass., they have developed a partnership of sorts, born of more than 20 years each of practicing and teaching CST.
Two of their most challenging cases on which they collaborate are a boy, now 4, with cerebral palsy (Steiner's client) and a girl, now 10, with microcephaly (Cotta's client). For both of these children, life has been a succession of medical and therapeutic interventions; it will be that way throughout their lives. Yet, in the years that each child has received CST, there have been profound breakthroughs — the kind that can't be attributed to anything but CST Cotta says.
Steiner remembers the first time she saw Robbie (name changed). Six months old at the time, he presented with cerebral palsy and severe brain damage due to anoxia resulting from birth trauma. His behavior was characterized largely by screaming and posturing, particularly when placed in a seated position. Just getting him into a car seat to get to the appointment was almost impossible for his frazzled mother.
Assessment showed that Robbie held a restriction, like a whiplash, in his neck. His dural tube was so tight that his hips curled forward and his back arched, causing him to go into spasms. Through the course of the session, Steiner felt Robbie's neck restrictions begin to release and his dural tube to elongate. By the end of the first session, he was able to sit in the car seat without crying. "That was a huge change in quality of life not just for Robbie, but for his mother, too," Steiner said. "Imagine being able for the first time to drive your child around without him screaming."
In the case of Carla (name changed), the challenges to treatment were just as great. Legally blind and fitted with tracheostomy and gastrostomy tubes, the then 2-year-old reacted to her initial sessions in an unexpected way. "She would go upside down almost every session and wanted to stay that way the whole time," Cotta said. Asking the mother about her daughter's birth, Cotta was told that Carla had gotten stuck in the birthing canal. When the delivery actually occurred, she came out so quickly that her clavicle was broken. By going into the upside down posture during sessions, "It was like she wanted to relive her birth except slow it down this time," Cotta said.
CST treatments with both children over the years have been a combination of individual and dual therapist sessions focused largely on their dural tubes and cranial membranes. "To paraphrase Dr. John E. Upledger," Cotta says, "The cranium is like the foundation of a house. If we can get that foundation corrected, it will help the house to be balanced." In other words, "We'll improve the ability of the brain to function (more efficiently)." Over the course of time, both Robbie and Carla have experienced improvements and reached milestones that no one expected.
With Robbie, there is a visible decrease in his tone and pain, and an increase in his ability to sleep and eat. His facial structure has become symmetric and the quality of his skin is much better. His mother described the effect of CST on her son as being "intensely calming" and helping him to "transition from a traumatized, defensive, clenched being into a more relaxed baby, better able to absorb some of the world around him."
Carla, who started with vision of 20/1200 is now at 20/132 and no longer considered legally blind. Doctors are working to reverse the tracheostomy because the tracheomalasia (softening of the trachea) is no longer an issue. She also has seen improvement in the areas of digestion and communication. Just as significant as these physical and functional improvements are the issues that haven't manifested. For example, Carla hasn't developed scoliosis, which doctors expected to happen because of the severity of her diagnosis. Steiner says, "We may never know all the issues that have been prevented because of the cranial work."
Working In Tandem
When working as a part of a multiple therapist team, Steiner and Cotta emphasize that a key to success lies in letting go of ego. Just as in an individual session, the multiple therapist CST experience is about blending and meeting the client where they are. "If both therapists think of themselves as one therapist with four hands, you treat what you find," Cotta says. "Susan and I don't treat independently. Our hands are an extension of the other person's hands."
By working this way, Steiner says, "There is an increased energy and awareness, and more areas of the body can be addressed in one session. Oftentimes, Sue will have the neck and I'll have the sacrum. Sometimes there's a tension involved, and one will have to stabilize while the other mobilizes. We end up being able to treat the entire structure."
Robbie's mom describes the experience from her vantage: "As an observer, the sessions feel like a dance to me. There is an indescribable energy in the room, something that brings about an emotional fluidity, the same way music can strike your soul. The difference between the individual session and the multi-hands session seems to me like the difference between a dancer dancing alone to swinging with a partner. There is a mutual support between the therapists that both broadens the treatment and heightens the awareness of the client."
"Parents who bring their children to CST feel like their children are being touched and seen in a way that is important," Steiner says. "Sometimes we think of CST as helping those who have a pain or want a better quality of life or wellness. These cases show how CST is valuable for anybody with any challenge. When you meet the individual at the place where they are and treat from there, great things can happen."
So whether you are pairing the right wine with dinner or pairing the right therapists for a treatment, the concept that I learned back in my college days holds true. As these cases attest, CranioSacral Therapy and the multiple therapist approach has a synergistic effect.
John Matthew Upledger is the CEO of Upledger Institute International. For 25 years, he has been actively engaged in all aspects of the organization — from education to clinical services. For more information about CranioSacral Therapy and other modalities offered for study through Upledger Institute International go to www.iahe.com.
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