Nothing Special

Barrett L. Dorko, P.T.


As long as we are alive we are always doing something. But as long as you think, �I am doing this,� or �I have to do this,� or �I must attain something special,� you are actually not doing anything. When you give up, when you no longer want something, or when you do not try to do anything special, then you do something.   

If you continue this simple practice every day, you will obtain some wonderful power. Before you obtain it, it is something wonderful, but after you obtain it, it is nothing special.

From Zen Mind, Beginner�s Mind by Shunryu Suzuki 

At this point in my career my manual skills don�t really interest or impress me much. In fact, I�m often surprised when others speak glowingly of what I seem to be able to do. More often than not I�m silent on the matter, preferring to wait until this issue passes and then emphasizing again how skillful the one I�m touching actually is. 

But here I want to write a bit more about this aspect of Simple Contact and what you might consider if you want to get the kind of reaction to gentle handling that I get all the time. 

Much of what I end up seeing is really nothing other than what I expect. I expect nonconsciously generated movement to be present. I expect this movement to produce a sensation of warmth. I expect muscular relaxation to follow closely upon the expression of this movement. And I expect this movement to be effortless and surprising. I feel certain that my expectations go a long way toward shaping the patient�s behavior, and I am certainly aware of how much my expectations can alter my perceptions. This is something I try to balance with my study of bodily processes that I cannot sense but only the patient can report. 

Without listing the references dealing with ideomotor activity and its consequence (that I�ve done many times elsewhere) I feel it is perfectly reasonable to assume it will be present and helpful. I can defend that aspect of my practice quite easily. What I want to do here is write a bit about what others get when they touch their patients and demonstrate how powerful expectation can be, both in its effect on the therapist�s perception and on the patient�s behavior. 

Consider for example the palpation of cranial bone movement. In two published studies the presence of any movement at all, much less a rhythmic motion has been shown to be highly questionable. (See The Controversy of Cranial Bone Motion by Rogers and Witt JOSPT Vol. 26 No. 2 and Simultaneous Palpation of the Craniosacral Rate at the Head and Feet: Intrarater and Interrater Reliability and Rate Comparisons by Rogers, Witt, Hacke and Genova Physical Therapy Vol. 78 No. 11) The latter of these two studies revealed quite clearly the delusion of reliability in this palpatory technique. 

Still, the people in the cranial community continue to describe this �rhythm� and use it to drive their technique in one direction or another. You�ve got to wonder what they�re talking about. To my knowledge, they never discuss these studies. 

The behavior of the patient is equally compelling. It appears that an integral part of recovery in response to the application of so-called myofascial release (MFR) is a dramatic emotive response, often described by the practitioners as crying, trembling, �chaos� and spontaneous expressions of grief and anger. There are visions reported as well.  

I elicit movements similar to those seen in this work, but I virtually never get any really dramatic emotive responses. Visions are never mentioned. I will admit that I can�t see why these would be necessary for simple pain relief, so I certainly don�t expect them. The MFR practitioners insist upon such things. If you think not, listen in on the MFR listserv for a while and you�ll see what I mean. 

When I touch another they typically move without volition, warm up somewhere, soften previously hardened muscles, and, ultimately, are relieved of pain. I expect all of this, I encourage it, and I can explain it. My attitude as I proceed with handling is summed up pretty well in that intricate quote from the Zen Master at the beginning of this essay, and, after all these years, it seems my technique is quite wonderful to some, though it�s nothing special to me. 

Do you want the same ability? Just sit quietly with your hand on a living body, think of what a remarkable thing you hold, encourage the characteristics of a corrective response however you can, and do nothing more. 

Before you know it, you will be given credit for all kinds of sensitivity and skill. But if you�re like me, you�ll remember where the real skill lies.