Barrett L. Dorko, P.T.
Simple Contact is defined as a technique of communication, either verbal or manual, designed to enhance another s awareness and expression of their spontaneously occurring internal processes.
FREQUENTLY ASKED QUESTIONS
1) Why don t you use manual force to stretch connective tissue?
Josef Threlkeld, PhD. P.T. studied the effect of manual care in the aptly titled essay The Effects of Manual Therapy on Connective Tissue (Physical Therapy Volume 72, Number 12/December 1992). Please note that this reference is the Journal of the American Physical Therapy Association.
After a prolonged discussion of connective tissue (CT) properties (including fascia, of course), Threlkeld concludes, If 100% of an externally applied force could be transmitted to a selected portion of a connective tissue structure, then it could be presumed that forces commonly produced during manual therapy could produce permanent elongation the external forces, however, are not direct and are not completely transmitted to a preselected segment of a CT structure. He goes on to describe the dispersal of manual force inherent to our body s reaction to pressure. Threlkeld points out that there is no evidence that manual force results in connective tissue elongation that is prolonged or therapeutic.
2) If ideomotor movement is inherent to life, why don t we see it without employing Simple Contact?
Well, you do. The problem is that it may be too subtle for those unaware of its presence or typical expression. Every shifting from one position to another that is unplanned begins with an unconscious motivation. This movement is fairly easy to inhibit, and it will be if it is felt to be to our disadvantage. I m of the opinion that the culture has numerous strategies for reducing its expression, not the least of which is the physical therapy profession. I think that most of us underestimate the power of the culture to control our bodily expression, and in my clinic and classes virtually everyone becomes aware of this restriction quite rapidly. In the presence of touch that accepts us, as opposed to the typical judgment of exam or coercive care, ideomotor activity is almost always immediately visible. It is always palpable.
Think of how readily and freely you might speak (which is really just another mode of bodily expression) if you sensed acceptance as opposed to judgment in those around you
3) How is it that simply deforming the skin is such an effective way of enhancing the expression of ideomotor activity?
Deforming the skin i.e. touching another enough so that they are aware of it, is not a small event when you consider the sensory possibilities and responses it might set off. How another interprets this touch is dependent upon so a vast variety of factors that listing them here would not be possible. However, if seen from the perspective of the cellular mechanics leading to sensation and adding that to the potential of reflexive effect, it is easy to imagine that gentle stimulation of this sort might be profound.
Charles Brooks Sensory Awareness: The Rediscovery of Experiencing (The Viking Press Inc. 1974) contained a chapter entitled Simple Contact that described touching people (and objects) in a fashion that, to me, was remarkably reminiscent of my own thoughts on the subject: We are actually working when we touch another-working to try out our hands not as agents of our will but as organs of perception (emphasis mine). Indeed, however we may touch him, we may somewhat disturb our partner s freedom. Our hands may feel hard to him, or heavy, or light and fluttery. He may feel handled, restrained, pressed, or-sometimes a very disappointing experience-not really touched at all. Accordingly, one might expect such contacts to be downright unsatisfying, if not downright inhibitive. But in a great majority of cases it is exactly the opposite. The mere fact that one comes to the other quietly and without overt manipulation is normally very moving to the person touched (emphasis mine). He feels cared for and respected. And the one who touches, if he is really present in what he does, is apt to feel something of the wonder of conscious contact with the involuntary, subtle movement of living tissue.
Brooks reference to involuntary, subtle movement of living tissue comes close to describing the palpatory characteristics of ideomotor movement. Sensing and encouraging this forms the major component of Simple Contact. Of course, this movement is best described as instinctive and unconsciously motivated, rather than involuntary, and there is quite often nothing at all subtle about it. That is not to say that corrective movement cannot be minute, and, in fact, it is often not visible. It is still palpable in most cases, and the patient senses it in various ways.
4) When is Simple Contact indicated?
I realize that I am biased, but if we understand that Simple Contact will enhance healthful and, possibly, pain relieving activity, when wouldn t it be indicated? Remember, I m just trying to elicit unconsciously motivated movement, diaphragmatic breathing and a restoration of a resting posture that reduces neural stress. These are not unimportant things, but they re not potentially harmful in any way either. To me, this is the essence of conservative albeit non-traditional practice. Don t expect this to resolve pathological problems. How could it?
5) How do you know where to put your hands?
I don t. I simply land somewhere and assess the response. When the characteristics of correction emerge, I stay. If they don t, I move on. I presume that areas of tautness will produce a larger reflexive reaction, but these are not always perfectly obvious. See Simple Contact and Distant Change on my web site http://barrettdorko.com for an explanation of this.
6) How do you know when to stop?
There is no clear stopping point. In effect, Simple Contact reveals and amplifies something that would have been there before its employment and will continue to some extent after the patient leaves. A big part of your job is making them aware of that.