How do you know you know what you know?
As therapists, every time we perform our techniques we also engage in a variety of other ritualistic and protocol-oriented tasks. For example; the client comes into the space, they lay down on the table, you dim the lights, you play soft music, you engage in assessment. The client prepares mentally, they expect to be treated, they look forward to the event, they undress carefully because it’s not their room, they are touched in a way they normally not, they become passive and let you move them around. Each one of these actions has a cognitive, proprioceptive, or experiential value. So how do we know which of these actions, in isolation, is responsible for the outcome? Are any of them? Are some of them? Is it you? Is it them? Is it just a perceived outcome?[divider_flat]
The ancient Egyptians believed that the sun was moved across the sky by the god Kephri, who was the great insect god. In their minds, they connected the movement of the sun to that of a dung beetle moving its ball of dung across the sand. So powerful was their belief that the gods moved the sun that they made scarabs (a totem-carved beetle figure to be worn) that were inscribed for both common people and royalty alike. They also believed that the male beetle fashioned his ball of dung as an egg from which he could spontaneously generate a new beetle. With no need for lady beetles, it gave the beetle the power of life. As a result of this strong belief the scarab became the symbol of life in Egypt. (here is some interesting reading about that). In actuality, what was really happening was the female beetle laying its fertilized eggs inside the dung ball. If you asked an ancient Egyptian how they knew these things to be true, they would likely tell you because they can see it. The sun indeed moves across the sky, and the beetle does roll its dung and new beetles spring from it.[divider_flat]
The modern day mythologies we tell ourselves about care are equally as strong. The attachments we have to fascia, triggerpoints, ‘it’s all connected’, and all the various other modalities all carry weight. Therefore we must be careful not to jump to conclusions just because we were taught it, can see it, or feel it. Seeing and feeling does not mean it is true. The problem arises when we seek to fill in the blanks while only holding part of the picture. So ask yourself daily; what is it I actually know about massage and science rather than what I have been taught. Does the sum of the total add up? Or am I creating more mythology to fill in the blanks.[divider_flat]
The body maintains itself reasonably well with contained self management due to some lovely features like homeostasis and feedback loops of various kinds. As therapists, we can work with those concepts, find ways to be a part of them and use treatments that aid them, but it’s unlikely that change is coming from an entirely external source unless that source is a surgeon or internal medicine. For the most part people get better, or they don’t. As manual therapists we could have a great benefit and place in health care as facilitators, but only if we attribute and analyze our outcomes correctly. The dung beetle has an important place in the ecosystem but it certainly does not move the sun or spontaneously create life. I guess my last note is…let’s not be the dung beetle.