Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, "This is the real me," and when you have found that attitude, follow it.
William James
There are many questions when I teach or write about the movement that I use in an effort to resolve abnormal neurodynamics. So many, that I feel I must make another effort to speak of this movement, hoping that at least one metaphor or classic explanation resonates with the therapist�s understanding and their experience with patients in pain. Here we go again:
The Persistence of Memory is the first Salvador Dali painting I ever remember seeing, and, as I once read his wife suggest, it stays with me because �no one who has ever seen it has ever forgotten it.�
I begin my classes by describing the two most common origins of pain and then suggest that of these, mechanical deformation, is the one we can most easily resolve as therapists if, and it�s a big if, we can somehow elicit or provide the movement that actually corrects the problem however it may have been acquired. Notice I don�t suggest only reducing the deformation, I want the offended part to return to a state where the orientation of mechanical stress through it isn�t sufficient to produce pain at rest and where there is enough adaptive potential present to tolerate normal stressors painlessly and abnormal stressors well enough to recover quickly. �We�re looking for a movement,� I say, �and for our many, many patients with chronic pain (this typically includes half the therapists in the room) we have yet to find it. There�s a hole in therapy; a hole through which many of our patients fall.�
In commentaries on the painting it is often suggested that the �soft watches� Dali shows us imply that time is more malleable than we typically think. Those familiar with Einstein know that this is true in theory, though we commonly don�t experience this personally in a way we can easily describe. I�m reminded of a novel by Alan Lightman titled Einstein�s Dreams. Each chapter is about how any change in time as we ordinarily experience it would alter our world profoundly. I wrote an essay about this, focusing on one chapter regarding bodily sensation and time that said in part: �(Body time) is not predetermined, it makes up its mind as it goes along.� I suggested: �While in body time, we listen to our heartbeats and feel the rhythms of our moods and desires. Time such as this struggles forward when we are stressed and it darts across our vision when we are receiving praise. Body time encourages us to obey our inclinations, not to order them.� I think my patients commonly experience this sense of time, and they describe it as such.
I go on to say, �If some sort of motion is going to close the hole in therapy it�s going to have to be something we haven�t yet considered, because I can�t see that what we have done traditionally and even not so traditionally has made much difference, given the epidemic of chronic pain and, most evocatively, the number of people in this room who hurt chronically. In fact, many of you have already used up your sitting tolerance.� I never say this without seeing several people nod, some with a slightly guilty hesitance, of course.
I remember reading once that the essence of Surrealism as a form of art was �the juxtaposition of remarkably disparate elements� and I immediately thought of how Dali for the first time in history combined watches and softness. No wonder the image is so striking, unsettling and, for me at least, so compelling.
I tell my classes that despite the fact that ideomotor activity has been an acknowledged and carefully studied category of nonconscious movement since it was first described by Carpenter in 1852, it remains almost entirely absent from the therapy curriculum and continues to be seen as an oddity once it is manifest fully. As Ray Hyman states, "Although the effects of ideomotor action have been understood for at least one hundred fifty years, the phenomenon remains surprisingly unknown, even to scientists." I say, �This movement has two purposes, to express us and to reduce the mechanical deformation we acquire as we live our lives (this is seen as the postural shifting done without volition by everyone in the class), yet we don�t encourage the latter beyond what a culture bent on controlling us with �postural instruction� will permit, and that�s a small percentage of what this motion is capable of doing.�
Surrealism is often referred to as some representation of a dream; a fantastical landscape or situation that couldn�t possibly happen except in our imagination. I�ve read that Dali�s astounding technique often made his surreal landscapes seem almost as if they were photographs of an actual place. This further confuses the viewer and �arrests� their attention in a way a simple still life could never do. I wonder, if dreams come from the unconscious, and ideomotor activity does as well, is the latter simply a sort of daydream made manifest as movement? Is this why so many therapists can�t understand it or imagine that it could help? After all, doesn�t our culture deeply distrust unconscious processes?
Throughout the day I work to show the class examples of what William James said over 100 years ago: �Whenever a movement unhesitatingly and immediately follows upon the idea of it, we have ideomotor action. (This is not a curiosity), but simply the normal process...and we may lay it down for certain that every mental representation of a movement awakens to some degree the actual movement which is its object; and awakens it in a maximum degree whenever it is not kept from so doing by an antagonistic representation present simultaneously to the mind.� (Author�s emphasis) I put up a quote by Stanley Milgram: �It may be that we are puppets-puppets controlled by the strings of society. But at least we are puppets with perception, with awareness. And perhaps our awareness is the first step to our liberation.�
My mother knew of my fascination for Dali and bought me a slim copy of a book containing some of his work. I wish I could find that today. Instead, what stays with me is an image of her own dreamy movement that I noticed one day while she was still early in her Alzheimer�s. I watched her playing the piano on her knees, something I�d never before seen her do. Subsequently I wrote: �The legendary psychoanalyst James Hillman states, "The primary function of the human being is to imagine. (Psychology works) not by suppressing our madness, but rather by forming it. And form means art. Art as formed madness." As a physical, rather than a psycho, therapist, I am accustomed to watching bodily expression. I am trained to note postural habits, dysfunctional movement, weakness, and facilitation. It is when I start to note unconsciously motivated movement seemingly unrelated to disability and wonder aloud what it may signify that I invite the derision of some of my colleagues. The unique, artful expressions of the body that make us human cannot be measured or easily interpreted. No graph can contain them, no normative values can be assigned to them. And my failing as a serious researcher probably lies in the fact that I cannot ignore them. I asked my mother if she was playing the piano. She smiled, laughed a little, and said yes, stopping for a few moments before returning to complete the piece, some tune learned decades ago and uniquely expressed through her hands; hands that never forget. The therapist in me wonders what this movement provides her that no amount of exercise, positioning, or manual care could. Perhaps she is in some fashion growing younger through her body though her faculties age. I doubt that such speculation is scientifically defensible in the strictest sense, but I can't help but wonder what my mother is trying to teach me.� I wrote this in �93, and I think it was the first time I described ideomotor activity and recognized its potential for therapy.
I can�t actually describe my mother�s movement to my classes. It�s simply too painful to speak of. But I can talk about how any small child, or dog, for that matter, will unselfconsciously resolve the same mechanical deformation that plagues the child persistently once they�ve been taught to �behave� by a culture increasingly enamored with the cosmetics of a controlled, precise and �beautiful� carriage and shape that has absolutely nothing to do with health and certainly nothing to do with pain relief. I can send my classes to an essay about my father�s ability to relieve his pain by writing poetry; another example of nonconsciously generated movement. Oh yes, I can�t talk about that either.
As I witness this motion that has driven my clinical work and teaching for a quarter century now I feel at times like that young man seeing the soft watches for the first time. I can�t look away-and every time I see them something new comes to mind. Many others see the painting and reject it as �weird.� And then they reject me.
I wanted to include here one more thing about movement and memory. Perhaps this will lay to rest something I always hear from at least one student in every class. They ask, �Don't you believe that the memory of traumatic events can somehow become stuck in our peripheral tissues? That movement of this sort must be accompanied by the emotion associated with that trauma if it is ever going to be resolved?� In response I say, "Well, all of the research done the past thirty years indicates that memory is not something that is contained in any particular part of the brain, much less the leg. And although a sensation might remind us of a past event, studies show that our memories are not reliable. Memory is a confabulation colored by emotion, desire, denial and our need to please others. In short, memory is not a "thing" that can be pushed around by the therapist's hands, but an event of the mind that is essential for normal functioning. It can't always be relied upon to tell us accurately of our past. Loftus and her colleagues in the clinical research community have proven that the "repression" of traumatic memory is a myth and that "recovered memory" is a result of the interaction between the client and the therapist, not the discovery of an actual event. We ruminate about things constantly, and our past traumas might be among them, but allowing the physical manifestation of that to come forth as movement isn�t going to help. In fact, it�s been shown to just recycle it and make things worse. We�d be better off allowing our rumination about correction (another name for ideomotor activity) be the thing we express. Get the conscious mind out of the way of that, and then you have the motion you need.� Of course, this isn�t a very popular thing to say to a therapist that commonly makes their patients cry.
Dali, my mother, my father, Hillman, James, Carpenter, Milgram, my patients-all of them have formed a crowd in my head, and they constantly remind me that movement is the only sure way to relieve most of the pain I am asked to treat. They won�t let me forget where it comes from, its nature or what it looks like.
All I have to do now is to get others to listen to them as well.