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Old 23-06-2017, 02:49 PM   #1
Barrett Dorko
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There are a lot of butterflies out there.

Me
I thought this was pretty funny, but I think a lot is funny that others don't get, don't see the humor in or get the reference to.

I was referring to The Butterfly Effect. You could look it up. It's a real thing. They even made a movie about it. I didn't go to it, but I recognized the phrase. I got the reference, but I think there were a lot Michael Bay moments in there.

I'm not immune to these, but tend toward subtlety. I noticed, for instance, that Bay wasn't born until 1965. The Butterfly Effect was written of (and, probably, not called that) in 1960.

More soon.
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Old 23-06-2017, 04:37 PM   #2
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Things aren't always in the past. That is to say that whatever is trendy or fashionable is present. Of course, trying to create "trends" and "fashions" isn't always a sure thing.

Who thought "fidget spinners" were going to be so big? I saw on YouTube that they were invented in the 90s by a lady in Wisconsin. Long story.

Anyway, what "catches on" tends to be a crap shoot. There's not as much skill in craps as, say, poker.

One thing I've noticed gets little play or popularity in the therapy community is any mention of uncertainty. This has several dimensions.

I can think of several. Can you?
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Old 23-06-2017, 05:00 PM   #3
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I am reading "Freakonomics" right now, and they write of how a change in abortion laws was a major factor in the lowering of crime rates, which at the time (I think in the 80's, but I didn't exist back then) was thought to be on the rise, but in fact became substantially lower.

Many people have attributed the lowering to gun control laws etc., but they are claiming that it was indeed a change in abortion laws, allowing poor people to have abortions.

I found it interesting on several levels.

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Old 24-06-2017, 02:58 AM   #4
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Mikal,

Freakonomics connects many things, and they are often surprising. Often full of speculation that some argument can be made for, there's always something to discuss - and thoughtfulness cannot but be present.
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Old 24-06-2017, 12:02 PM   #5
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A connection I've made and wonder about: The failure of the therapy community to understand the complexity of pain and the rise of "alternative" methods to eliminate the same. This lack of understanding has given rise to many methods to reduce pain that might be less than desirable.

What do you think?
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Old 24-06-2017, 02:45 PM   #6
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i feel this lack of understanding causes them to latch on to anecdotal results with almost fervent certainty. They see these methods seemingly reduce pain in their patients, which gives them certainty of their effectiveness, provided they do not look more closely at these results. It is only when these methods begin to become unreliable in treating pain, does this certainty become uncertainty.

I have certainly been there.

Some then move on to other methods in a search to regain certainty, while others, uncomfortable with their uncertainty, treat these patients as anomalies and continue with certainty in their method.

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One thing I've noticed gets little play or popularity in the therapy community is any mention of uncertainty. This has several dimensions.
I would add another dimension to this. The desire for diagnosis, for a label. For there to be definite cause for pain. I say cause, rather than origin specifically when talking about pain. With injury and trauma, many are good at locating mechanical deformation of tissue contributing pain or dysfunction. The uncertainty comes when a cause is sought for pain, that we are able to give a specific tissue blame for the pain the person is experiencing. I feel this is as much for the therapist as the patient. We do not like to provide an uncertainty, lest the patient not be confident in our abilities. We need a picture we can point to that says 'this is the cause of your pain' with confidence, and assure the patient we know what we're talking about.

I think that made sense. I have just been driving for the better part of 10 hours and it's late, so maybe not.

Thoughts?
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Old 24-06-2017, 07:09 PM   #7
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I really appreciate your contributing here Ben, and I certainly agree that certainty and confidence drive many therapists.

I have suggested (perhaps more forcefully than some would agree with) that diagnosis comes in two sorts, nominal and essential. I've written of this but it didn't make much of a dent.

I love that you've brought confidence into the conversation. It's very powerful.
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Old 25-06-2017, 12:51 AM   #8
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diagnosis comes in two sorts, nominal and essential
As I continue to develop my understanding, I think this is something I have become more aware of, and potentially more comfortable with. 'Being comfortable being uncomfortable' to reference a post Ken just put up in another thread. Or in this context, being comfortable with being uncertain.

You draw attention the aspect of confidence. I agree that this is indeed powerful. It certainly provides another piece to the context in which a patient interacts with a therapist. Talking context again, how do we see patients interact with, or speak of, their surgeons (orthopaedic surgeons in particular)? They tend to speak with supreme confidence in their abilities (bordering on arrogance, depending on who you ask).

I think in modern medicine, patients have become use to this confidence, sometimes they will see different therapists or practitioners in search of it. As though the one who has this confidence in their abilities is worthy of their trust.

Confidence is important. It's importance has given rise to a particular title. 'Confidence man', having mostly negative connotations in today's society, is that title.

How do we see interactions play out with such people (both within the therapy community and without)?
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Old 25-06-2017, 03:01 PM   #9
Barrett Dorko
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Benno,

There's a line in House of Games (leave it to me to go to the movies first) given by Joe Montegna as he's instructing another (paraphrased):

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They call us "confidence men" because others give us their confidence, but that's a slight misnomer. We give others our confidence first.
I don't know a therapist who isn't likely to smile at a patient. A smile's power is almost always disarming.

It inspires confidence.
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