Tip Todd Hargrove, bettermovement.org

[Diane]

Todd Hargrove in the Seattle area maintains "Better Movement" blog. His latest post is a classic, explains manual therapy, perfectly, as the two-faced offspring of dualism from 400 years ago (which also still afflicts, permeates, biomedicine in general).

Soulless bodies and Bodiless souls.

"This post is a little philosophical, and you may even find it offensive, so I will apologize in advance and keep it mercifully short.

I have done a lot of reading on the internet about the many different approaches to manual therapy. Some of it is good, some of it is bad. And some of it is rather obviously wrong, but somehow extremely resistant to correction in the face of huge amounts of conflicting evidence. And it seems to pop up everywhere, in different therapies that have different origins, like a weed that always needs to be pulled. Of this latter group, two different patterns of thinking really stand out in my mind.

Structuralism

The first pattern is one that I have written about a lot on this blog – the tendency to treat the body as a mindless piece of meat, while ignoring the role of the brain in giving it all the qualities we actually care about, like how it moves and feels. This leads to a treatment approach that completely ignores the nervous system while focusing exclusively on the physical tissues of the body. Eyal Lederman calls this the “postural structural model“. Paul Ingraham calls it structuralism, and Diane Jacobs calls it mesodermalism. Whatever you call it, it basically means an approach that is all hardware no software. Many physical therapists have expressed a lot of frustration that education for PTs remains mired in structuralism, and fails to incorporate new and interesting information from neuroscience and pain science.

Vitalism

A second common belief that is quite resistant to conflicting evidence (especially among massage therapists) is that clients can be treated with “energy” work. There are many different forms of this idea, but all essentially embrace the philosophy of vitalism – that idea that there is some essential force or energy (chi, prana, elan vital, the breath of life) that is unique to life, that a therapist can manipulate or balance to optimize a client’s health. It doesn’t matter that such an energy has never been discovered, or that it’s discovery would be the most profound and shocking development in the history of science, requiring a major overhaul of physics, chemistry and biology. The belief in vital energy persists even in the face of all the obvious arguments against it’s existence. And yes, this stuff gets taught at massage schools that should know better.

Are we born dualists?

I have always suspected that the tendency to think in structuralist or vitalist terms is due to some deep seated human bias built into the way we think. So I was very excited to read a great quote the other day by Paul Bloom which in my mind helps explain both points of view in one sentence.

Bloom’s quote is from this article, where he is attempting to explain why humans evolved in a way that makes them very predisposed to create magical or supernatural explanations for observed phenomena.

Bloom explains that humans evolved separate mechanisms for understanding the physical behavior of inanimate objects and the intentional acts of agents such as animals or humans. So humans have a built in hardwired intuitive sense of physics, and completely separate intuitive sense of psychology.

For Bloom, the consequence is that:

For those of us who are not autistic, the separateness of these two mechanisms, one for understanding the physical world and one for understanding the social world, gives rise to a duality of experience. We experience the world of material things as separate from the world of goals and desires. The biggest consequence has to do with the way we think of ourselves and others. We are dualists; it seems intuitively obvious that a physical body and a conscious entity—a mind or soul—are genuinely distinct. We don’t feel that we are our bodies. Rather, we feel that we occupy them, we possess them, we own them.

And this means that:

we perceive the world of objects as essentially separate from the world of minds, making it possible for us to envision soulless bodies and bodiless souls.

For me this is a great description of why vitalism and structuralism are two sides of the same dualistic coin. Vitalism is an example of belief in a “bodiless soul.” Vital energy is considered to be an animating force that exists outside the physical realm and is not reducible to it. And structuralism is the metaphorical flip side of the coin – the tendency to treat the body as a physical object, as opposed to an intelligent agent with feelings, thoughts and intentions.

Well there is a lot more I am tempted to say here, but I promised I would make this short, so I will leave it at that.

If you enjoyed this post, here are some related posts on this blog:

Is the Mind Body Connection New Agey?

More Deepities: Energy

More Deepities: Does Intention Have Power?"

[toddhargrove]

Thanks for the mention Diane!

[Diane]

Thank you for writing it! It is exactly the problem.

[Diane]

Does anterior pelvic tilt cause low back pain? - another great blogpost from Todd.

[smith]

To me seems like the ancient debate of idealism vs. realism of Galen and ancient Greeks. Where idealism/rationialism represent vitalism; and realism/empiricism repesent structuralism.

We may have kicked this around already. "Galen proved by studies that the brain controlled the motions of the muscles by the cranial and peripheal nervous systems." Wikipedai

[byronselorme]

Great writing Todd!

[SophieRose]

Just a quick question for Todd regarding structuralism - I noticed from your website that you work as a Rolfer, obviously a form of Structural Integration. As a current SI student myself (KMI) I am finding it difficult to reconcile the neuro-based stuff I am learning from sources such as your website and these forums with what I am learning in class, a lot of which is currently well, structural, with an emphasis on body reading and working with fascia.

The ideas seem to conflict in many ways (although I probably need to do more reading) and I wanted to know if you you have had to adapt your Rolfing at all to accommodate these new ideas, particularly regarding the lack of evidence in structure and posture having a significant impact on pain? When you go through the ten series with a client, are you still trying to change them posturally?

[toddhargrove]

Hi Sophie,

That is a great question. Yes I do adapt the way I work, which is a challenge. My clients come to me expecting that I have the ability to deform their structure into a different shape, and I don't really believe I can do that. I try to convince them that I will make changes by communicating with their nervous systems. Some are pleased because then the work doesn't need to hurt. Some are actually disappointed because for they wanted me to push as hard as possible while they try to deal with the pain.

As some of the people on this board have said, you don't necessarily have to change your tools, just your rationale for why you are using them. By the way, there are some roflers who are far more into the nervous system perspective than others, as you may have noticed. Robert Schlelip, Don Hazen and Jon Martine come to mind.

[Diane]

Another good post by Todd on foam rolling. Following the bread crumbs will lead you to A Critical Appraisal of the Foam Rolling Research by Greg Lehman, by Bret Contreras. I don't know if Bret is here (he may be), but I recognize Greg's name. Also mentioned are Paul Ingraham and Jason Silvernail.

Good posts!

[Curious One]

Thanks for posting in this section. I am slowly learning the set-up of the forums, and hope to come back to this in the near future and do some more indepth reading.

My comment here is a bit of a tracker, so I don't loose the info.

[Ken Jakalski]

Hi Todd!

I really enjoyed your insight, as well as the comments in the subsequent exhanges. I liked Byron's "Fascial Frenzy" line, and your response to the "meat metaphor."

"Perhaps I could have said in my post that butchers and cooks don’t use foam rollers – they use knives and hours of boiling."

Good stuff!

[toddhargrove]

Thanks Ken,

Yes the comments on that post are definitely better than the post itself. I had some very good help from my readers!

[zimney3pt]

Originally Posted by Curious One

Thanks for posting in this section. I am slowly learning the set-up of the forums, and hope to come back to this in the near future and do some more indepth reading.

My comment here is a bit of a tracker, so I don't loose the info.

Curious you can go to Thread Tools drop down and select Subscribe to this thread. It will then be saved for you in your Quick Links under subscribed threads so you don't lose track of it.

Great post by the way Todd

[Diane]

Another great post from Todd, The Paradox of Placebo and the Health Governor, talking about The evolutionary psychology of healing: A human success story, in this months Cell Biology, open access, by Nicholas Humphrey and John Skoyles.

Excerpt from Todd:

".. there will often be times when deploying a particular defense will not be advisable. For example, it is probably better not to mount an energetically expensive full-blown immune response to an infection when there is a shortage of food. Pain can help to protect an injured ankle, but is probably more costly than beneficial when trying to outrun a predator.

Based on these facts, the authors conclude that there would have been selective pressure on human ancestors to develop a way to anticipate the costs and benefits of various self healing mechanisms, and then make intelligent judgment calls about whether to deploy them. The authors propose that such a system could be called a health governor, and created a chart to outline the factors it might consider in making decisions....
So how would the health governor work in the context of pain?

David Butler and Lorimer Moseley start their explanation of pain by noting that pain is an action signal. Its purpose is to motivate you to take action to protect the body from perceived threats to the physical tissues. Once appropriate action is taken, the pain serves no further purpose. The items on the left of the health governor chart look quite a bit like many of the actions that Moseley and Butler suggest might be sufficient to end the need for many kinds of pain. Ever notice that your pain went away on the same day you went to the doctor? Or restored energy reserves by getting a good nights sleep? Or fooled your brain into thinking it’s summer by going someplace sunny? Or got some social support by talking with an empathetic or a caring friend?...
The reason I like this paper is that it is yet another reminder that it is always a good idea to give the brain good news about the state of the body. Most of the things that bother us about our bodies or movements – stiffness, pain, poor coordination, fatigue, weakness – are simply the result of the brain trying to protect us from perceived threats.

The brain usually errs on the side of seeing threats and protecting us from them because it cares more about our survival than our comfort. So we can make ourselves more comfortable by giving the brain good news about the state of the body.

And I think that most therapeutic approaches to the body, such as manual therapy or corrective exercise, work primarily on this basis."

[Barrett Dorko]

In The Bridge on the River Kwai there's a scene where the doctor explains to Alec Guinness that the men can't heal because they aren't being fed enough. This was a movie from 1957.

This seems to fit here, and, once again, Hollywood leads the way (yes, yes, I know it was a British film, but they don't have a town with a catchy name like that, to my knowledge).

[zimney3pt]

Link to article about Central Governor, that Todd posted on.