In my experience most therapists (this occasionally includes me) practice clinically as if certain things were true despite the fact that researchers have learned that they are not. Here s a short list of what I call therapeutic illusions :
Strength and posture are related
Pain and posture are commonly related
Strength and pain are related
You can stretch connective tissue with your hands
You can reliably palpate vertebral joint movement
There are more, but I suppose you get the idea. I have found that these ideas endure due to a combination of ignorance (of the literature), reverence for the traditions of therapy and fear of change. This is not a situation conducive to change, and I find that I have to approach my colleagues carefully with the news of research contrary to their beliefs. Often this doesn t work either. Let s return to The Matrix.
Neo isn t just told of his body s imprisonment, he is carefully offered a choice; either to learn that all he normally perceives is a prison for (his) mind or be painfully wakened to the desert of the real or he can remain ignorant of this and return to the familiar. This choice is represented by the ingestion of either a red (reality) or blue (The Matrix) pill. He chooses the red pill.
Coincidentally, when I teach I always carry with me what I call the red file. In here I have compiled the peer-reviewed literature demonstrating that many dearly held notions of therapeutic practice are, in fact, based upon a model of the body that is incomplete at best and often just wrong. You could say that the traditional ideas listed above are illusions maintained quite easily until one reads the contents of the red file. I offer the contents of the file quite literally to my students both as lecture subjects and as a palpable and immediate resource for learning. Some choose to listen and read and some don t. In addition to the file I have a table full of books that support my assertions about self-correction and esoteric knowledge of neural functioning. These are available for anyone s perusal but only a small percentage of my students ever touch them. The red pill might be tempting but not everyone is going to swallow it.
I mentioned the character of Cypher at the beginning of this essay and I want to return to him now. Like Neo, Cypher lived in the imaginary world of The Matrix for many years but chose the red pill once given an opportunity. In the movie Cypher has lived the difficult path of reality for nine years and he wants to go back. His recent existence may include the use of his own consciousness but The Matrix is warmer, safe and the food is much better. Cypher knows full well that all he perceives there is an illusion, but he no longer cares. He says, Ignorance is bliss.
I offer my students an arresting and perhaps startling vision of normal function, principally by introducing them to ideomotor movement. Having never before seen this, the therapist is suddenly confronted with a world of therapeutically useful movement they hadn t known existed. Once shown how to elicit it, they find that alterations in painful function may rapidly and unexpectedly occur without any real effort on the part of the patient or therapist (I ve watched this happen in my clinic and at workshops for over twenty years so I say this with a great deal of confidence). Faced with this, many therapists are initially confused and then thrilled with their newfound skills, to say nothing of what they ve just discovered about their patient s ability to improve.
It s at this point that my mind turns to Cypher. Evidently it s hard to stay with the kind of thinking and practice I advocate, and I know from long experience that most of the people who learn how to elicit ideomotor movement do not continue to do this for any significant length of time after the course. The traditional rituals of practice followed by most clinics outweigh the potential effects of care that includes counter cultural movement and the distinct alteration in methods of handling can be remarkably disruptive to the roles played by ancillary caregivers. I know that billing patterns and documentation must also be changed, and I don t know how that might be avoided short of simply abandoning the entire theory of care I propose. For most therapists, Cypher s reasoning is the best choice.
I live with that.