Barrett L. Dorko, P.T.
Charles Brooks’ Sensory Awareness: The Rediscovery of Experiencing (The Viking Press Inc. 1974) contains a chapter entitled “Simple Contact” that describes touching people (and other objects) in a fashion that, to me, was remarkably reminiscent of my own thoughts on the subject, though I read his book several years after forming them. For this reason, I chose Simple Contact for the name of my method. Here I’d like to restate Brooks’ chapter a bit and add some information that helps to explain the effect of this approach. 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. As a physical therapist primarily interested in pain relief via manual methods, I emphasize the corrective movements that manual contact might elicit if employed with the proper pressure and attitude. I feel certain that many valid correlates exist between what I do manually and what many counselors do verbally, but I am not qualified to deal with the emotions that might result from this kind of communication, and I do not encourage therapy of that sort in my office. Not that I’ve got anything against it. In essence, Simple Contact is a method of manual care that avoids coercion whenever possible. It is most effective when the therapist understands the characteristics of corrective movement and subtly encourages any activity associated with those (see The Characteristics of Correction). It may be employed without fear of worsening any condition, and it will help to the extent that it promotes learning. Not every painful condition will be resolved with its use, and, to my knowledge, it does not significantly speed the resolution of pathologic processes. It is for the relief of pain due to mechanical deformation, and, I’ve come to feel that it is the reduction in the deformation of neural tissue that accounts for its pain relieving effect. Quite simply, I’m saying that twisted, taut, or compressed neural tissue hurts, and that movement in the right direction makes it feel better. This is by no means an outrageous assertion, and there’s plenty of literature to back it up. Simple Contact is the method I use to elicit instinctive, corrective movement. I say to my patients, “You hurt because you’re twisted. Let’s show you how to untwist, and how to continue to do that as needed.” And then I touch them. Brooks states, “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. Touching another in this way is increasingly rare in our culture. In public (and often at home), the slightest accidental contact of our body with anyone else’s is cause enough to apologize. In most clinics, every manual contact implies an agenda on the therapist’s part either to provoke or promote change from the outside. Judging another with your hands is essential at times, but Simple Contact is the manual act of acceptance, and must be perceived as such if ideomotor movement is to be sensed and expressed. It is not enough to say that it is always gentle, because heavier pressure is often necessary to recruit stretch-activated ion channels deeper in the system. This should not be mistaken for some kind of connective tissue stretching. Its intent is quite different, and, knowing what we know about connective tissue, that wouldn’t work anyway. Finally, Simple Contact is largely about the issue of control. And I mean to say that in order to make it a meaningful and useful method of managing painful problems, the therapist must relinquish control of the patient’s movement and instead appreciate it for what it is; an intricate, somewhat mysterious and (for me anyway) beautifully expressive way for instinctive correction to emerge. In all these years, I’ve never had to teach anybody how to do it, I’ve only had to remind myself and the patient that it was already there. Simple Contact makes it obvious. |