One Hand Clapping

Physical Therapy in the 21st Century


Barrett L. Dorko P.T.  

What is the sound of one hand clapping?

Zen Koan


I was recently listening to the poet David Whyte speak of this Zen question and what it has come to mean to him. He had previously been talking about how we become an individual by meeting the world, by reaching out toward it with attention and awareness. If you don�t take the time to quietly observe the world in all its dimensions, he says, �The world can�t find you.� 

This, to me, sounded both a bit odd and poetic. I hadn�t expected him to say that we were being looked for, but I realize that the use of surprise is part of the poet�s art. 

Whyte went on to say that he�s interpreted the �one hand clapping� thing to mean, �What would it be like to live in exile?� By that he means that it might be possible to reach out in an effort to engage something and find, instead, emptiness, a space unoccupied where you had fully expected to touch something familiar. As he said this he waved one hand before him, the other behind his back, illustrating the frustration of the first hand�s effort to connect with its partner and make a sound. �That sound,� says Whyte, �is the moment we engage the world, and become an individual.�  

I�ve been asking people lately if the phrase �one hand clapping� means anything to them. Some immediately identify its Zen origin, but most are far less sure where they might have heard it. It echoes in their head a bit, but they don�t know why. Still others are completely unfamiliar with it, but are immediately engaged by this odd phrase. Its possibilities intrigue them. Of course, that�s what makes it a Zen Koan. It evokes thoughtfulness, and, hopefully, enlightenment. 

Think of Whyte�s original contention that individuality begins at the point of engagement, at that moment when we meet another to whom we can relate and create something together. He speaks of his experience as a guide in the Galapagos Islands years ago, of how the animals seemed not to have read any of the books about their behavior that he had, and how it took months of quiet observation on his part before the islands revealed themselves to him �on their own terms.� 

I imagine that any clinician would relate to this. At least, I do. As I think back over my long career, it seems obvious now that my patients often behaved in ways that I never anticipated, having only read about what they were supposed to do. And I�ve spent a lot of time quietly waiting for them to reveal ways of understanding their problems. I found that this happens in its own time, and that my attention and presence is all that is required. No less than that, though. 

This brings me to my last point-that if our practice does not commonly include our actual presence; it will resemble the �one hand clapping�, in fact, the feeling of exile and frustration that the image evokes.  

This cuts both ways. The patient arriving for care who can find nothing other than a machine to grasp (or a piece of paper with an exercise protocol), according to Whyte, will not become the individual they seek to be. This only happens when something with which we can truly relate meets us. In the case of therapy, that would ideally include actually being touched. This is something that happens less frequently in our profession every day. Consider for instance how the McKenzie Institute says with some pride that it is �hands off� therapy. 

Beyond that, the therapist who goes into this work because they seek some way of connecting to others on a level that requires our expertise and insight will be unable to do that unless they have the opportunity to sit quietly with their patients, waiting for their problems and solutions, i.e. their true behaviors to emerge. Each day I hear of the growing trend to use PTs as evaluators only. The actual care is the responsibility of the PTA or some other form of �extender� service. Therapists have expressed to me how this situation might be lucrative for their employer�s practice, but that it is breaking their hearts. �This isn�t why I went to school,� they say, �To spend an hour with someone, write out a plan and fill out a form for the insurance company. I wanted to be a therapist, I wanted to be present when change occurred, and to know that my unique presence was a part of that. All of that�s been taken from me, and now I want out.� 

I imagine the hand waving, searching for its partner, finally giving up and remaining the same as when it began. It will not truly exist as an individual until it resonates with another of its own kind, and it won�t grow as it wishes without the presence of another who attends with care and compassion. For me, this is the essence of therapy, and it is becoming rare in the twenty first century. 


Author�s note: For more information about the work of David Whyte, go to his web site or email: [email protected] or write Many Rivers Company PO Box 868 Langley, Washington 98260