Much Ado About�

Barrett L. Dorko, P.T.


Every craftsman searches for what�s not there to practice his craft.


As a clinician, there�s something about the phrase, �The doctor told me there�s nothing wrong� that lights me up. After many years of hearing this and then proceeding with care, I began to sense that this sort of circumstance often preceded recovery in my office. I have nothing resembling a study or statistic to point to regarding this, it�s just a feeling I�ve had for some time.

I think. 

I�m almost sure.

Fortunately, I�ve come to understand the concept of �nothing� much more clearly since reading K.C. Cole�s latest book The Hole in the Universe: How Scientists Peered over the Edge of Emptiness and Found Everything (Harcourt 2001). This UCLA professor and regular columnist for The Los Angeles Times wrote The Universe and the Teacup a couple of years ago and forever altered my understanding of mathematics as well. 

There�s a great deal in this book about the nature of nothing, about what might be contained within what we ordinarily consider a void, and about how various cultures have been altered by the introduction of the number zero into their numerology. You might not think that a subject like this would be especially compelling, or, for that matter, related in any way to the practice of physical therapy, but bear with me a while and perhaps I can change your mind. I have the impression that K.C. Cole could write about anything and make it interesting, relevant and entertaining. The fact that she accomplishes that with nothing is even more impressive. In fact, in this book, she does nothing right. 

Okay, I�ll try to stop that. 

The following passage from the first chapter really caught my eye: You can�t change nothing by definition because nothing you do to it would make a difference. This immutability makes nothing the most fundamental stuff in the universe. 

            When nothing changes, we know it right away. When nothing changed, the universe was born. Something, by this definition, is any deviation from nothing. Nothing is the norm; something is derivative. We create something by breaking the perfect symmetry of nothing, cracking the silence --- like drawing black lines on a white piece of paper, or introducing ripples into perfectly still water or kinks into energy fields. 

            This way of thinking suggests that nothing is perfection --- or at least, perfect symmetry, which to many physicists is the same thing. Nothing is perfect, but not very interesting. Of course, this notion of nothing leads smack into a tautology: If nothing is by definition undetectable, then you can only prove it exists by its absence. 

            Physicists can�t deal with this nothing because there�s nothing to be seen. Besides, the nothing behind the physical universe --- which is after all the real subject of physics -- is not a perfectly transparent perfection. Rather, it is a shattered perfection, like shattered glass. The cracks in perfection allow it to be studied. 

            The nothing that concerns physicists is what you have left after you remove everything you can possibly take away. Nothing, in other words, is the state of lowest possible energy.  

There�s something here that reminds me of several things. Long ago I began telling my students that my own growth as a clinician was concurrent with a reduction in my technique of handling. I told them that the less I coerced my patients, the more they were likely to respond in ways that proved helpful. �Eventually,� I say, �I tried to do nothing, and that seemed to be the best way of approaching patients that had �nothing wrong� with them. And when I got them to stop trying to create a helpful movement, the stillness revealed all that they truly needed to do.� (This is a little complicated, I know, but stay just a little longer. A Zen-like approach to care such as this is also difficult to bill for without fudging just a little) 

Consider the remarkable run (and rerun) of Seinfeld, a show literally �about nothing,� and referred to in that way by the writers themselves. It remains remarkably popular, and it typically follows a story line about the simplest and most mundane aspects of living from day to day and relating to others. If �nothing� is truly boring or unimportant, why do so many (including myself) find it so fascinating to watch? 

I presume that you  know it�s not possible to recognize that something is present without understanding that its opposite also exists, usually nearby. Simply put, light must have some dark edge in order to be perceived. So it is with the phrase �nothing�s wrong� when spoken by the physician. He or she is simultaneously saying, �something�s right.� For the physician, �nothing�s wrong� typically means the end of care, but for me it�s the beginning. This �something right� is what I seek as a therapist enamored of naturally occurring movements and processes that might be enhanced. I�ve found that they can be found and expressed through a kind of handling and presence that honors their presence and does little more than make the patient aware of them (The technique is Simple Contact and the movement is ideomotor). These movements begin in the unconscious, which is often thought of as a void of some sort. Manual coercion will not reveal this because it always introduces something else that is not necessarily helpful and must often be dealt with by the patient�s protective reactions. This does not leave the void necessary for movement that is corrective in nature. Cole points out: �If there were no empty space� Lucretius wrote, sensibly enough, �everything would be one solid mass.� If you believed in atoms, nothing was a necessity. In order to move, atoms, and objects composed of them, needed a space to move into when they changed places. Without the void, there would be no elbowroom for motion. The material universe would be like a game of musical chairs with no open seats and no place left for anyone to go.� 

Therapy has conformed to a world increasingly filled with activity, obligation, information and exhortations to produce something. �Nothing� (like silence) is �a-voided� whenever possible. A therapy department where nothing is done and as little as possible is said is truly hard to find, but for my patients with �nothing wrong,� it seems to be ideal. Out of this nothing emerges all that is normally held in by the social conventions of posturing and posing. To say that such an atmosphere promotes relaxation reveals, to me, a misunderstanding of the power and necessity of relaxation�s opposite; expression. Expression, especially unconscious, creative expression finds a place to do its job of making us better in a number of ways only when �nothing�s wrong� is understood as an opportunity for healthful movement to fill the void.

Like a Seinfeld episode full of nothing more than the ordinary and very familiar trials of living, my patients move and speak in ways that emphasize the �something right� in all of us when we aren�t overwhelmed by pathology or disease. This would probably help a large percentage of the patients we see with chronic pain. 

I think. 

I�m almost sure.