Barrett L. Dorko, P.T.

          I have on my office wall a piece of Native American art designed to capture and contain the thoughts we all have while sleeping. I've read that this "dream catcher" is supposed to hold the most disturbing aspects of our nightly journey while letting the "good" dreams through.

          For years I've kept a personal journal of my dreams and I will occasionally revisit them and wonder again at their effect on my waking life. I subscribe to the psychological theory that proposes our dreams are gifts, and that through our contemplation of them we may come to resolve some of the conflicts between our inner and outer lives. My love of symbolism and multiple meanings draws me quite naturally to this.

          A few years ago I sat for awhile and watched Arnold Mindell, a psychoanalyst, work with a few people complaining of pain here and there. I found myself making my own diagnoses as they spoke of the nature of their complaint.

          Dr. Mindell seemed disinterested in the things I was hearing and seeing. Instead, he became fully engaged in something like a minor gesture and how that was combined with the words his client chose. He even placed a significance to the sound of their voice.

          I watched as he suggested that these people speak of their pain as if it were part of a much larger story that might include the power of myth or mystery. I saw him move as they did, the analyst and client now literally acting out some purely spontaneous drama complete with plot and resolution.

          I saw people transformed, and realized how paltry by comparison my own care might have been. I couldn't forget that their complaints were heard daily in my own office, but that, with me, their pain was typically reduced to the form of a simple neurobiologic event.

          The dreamcatcher on my office wall is designed assuming that dreams come from a place separate from us, but it is now generally accepted that they are purely the manifestation of our unconscious.

          Dr. Mindell suggests that through our bodily expression we commonly bring forth material from the same reservoir, and that it is compelling, insightful and healing.

          In a very real sense, I, too, have become a dreamcatcher. I've long taught that pain relief occurs when unconscious expression is seen in the form of spontaneous movement. We normally inhibit this expression in the presence of our rigid and judgmental culture. When I can help a patient feel safe to move as they truly want, they begin to exhibit the signs of correction and recovery we all seek.

          So, although it sounds as foreign to orthopaedic practice as you might imagine, I'm proposing here that we consider the possibility that we use manual technique to reveal rather than coerce. I'm suggesting that we catch the waking dream of the patient. That is, the muscular activity they don't consciously request, and gently allow it to grow toward full expression.

          If such a motion softens and warms them, it's got to be something they need. No less than the dreams I catch in my journal, or the healing stories told by Dr. Mindell's clients.

          Give it some thought, and then ask this; Why not?

For more information on the work of Arnold Mindell, see Working With The Dreaming Body (Routledge & Kegan Paul 1985)