Arrogance and condescension

[Barrett Dorko]

After spending some time carefully posting a reply in this thread I listened to a few minutes of a popular podcast, The Skeptic’s Guide to the Universe.

There I heard Steve Novella talk about the conflicts that often arise between those that promote reason, evidence and logic and those who are “certain” they are right despite the fact that nothing relating to their position has been proven. Their position might not even be provable.

He says, “We are willing to say that those who disagree with us are simply wrong. We don’t contend that that are evil.”

Jason’s post regarding the word arrogant comes to mind here.

The second person, instead of addressing the evidence behind the argument, makes the accusation of arrogance.

In this case it’s the accusation of condescension.

I’m 60, and I understand a thing or two about the varieties of experience, opportunity, motivation, support and reinforcement in this life. I understand how lucky I’ve been and I understand a thing or two about my ways of being in this world. I know that nature and nurture are intertwined to such a degree that we cannot separate them. I don’t judge others and refuse to categorize their being. I’ve treated people personally familiar with the President and ex-cons (No, they weren’t the same person). I treated them both individually, uniquely and with as much compassion as I am able to muster. It’s my job – and it’s my passion.

But I challenge and question those who are supposed to be caring for others. They have a responsibility to learn and change as the science surrounding us dictates. They have an opportunity to help, and they should take that seriously. When I find they’ve grossly misinterpreted something or never even bothered to study on their own my disappointment turns into questions here and into silence when I stand beside them.

This isn’t condescension, it’s a further contemplation of human nature and how it might be that others given our charge don’t feel it.

I think I will wonder about that for the rest of my life, but I can’t prove that.

[Jason Silvernail]

Something I've noticed about the name-calling in some of these conversations - why is it almost always from someone who doesn't post with their real name?

[TexasOrtho]

A pretty good chunk of my doctoral curriculum at Tech is devoted to educational theory, teaching, learning, and assessment. It seems that until you can completely homogenize your audience, you will always get a range of learning experiences from your courses.

Looks like you've got two options - alter your message to accommodate the diverse minds of your audience, or seek a more specific audience. People like Butler and Moseley have found a way to accomplish the former for some reason. If reaching more people with less perceived condescension is your goal, I'd look to see what they might be doing differently.

Otherwise, you could just stick to hitting those of us right where we're at and not stress over the whiffs. Hall of Fame hitters are only successful 1/3 of the time right?

[tonyf315]

Originally Posted by TexasOrtho

Hall of Fame hitters are only successful 1/3 of the time right?

I like that quote, Rod...I think I need to remember that in the clinic on my tougher days...

[Barrett Dorko]

Rod,

I have the distinct impression that Butler believes he's been far more successful than he has actually been. Of course, I'm only going on the basis of the several thousand therapists I've asked, 99% of whom never heard of him.

That's an estimate, of course. I suspect the actual number would be higher. But, like Bobath's name, some within that small percentage remaining would know his name, but would have no clue what he's done or what he thinks and says.

This is in distinction to a name like McKenzie's. Of him the ones who know the name say, "He's the one that think's extension resolves backache."

Oh brother.

[proud]

Originally Posted by Barrett Dorko

Rod,

I have the distinct impression that Butler believes he's been far more successful than he has actually been.

Practically every Physiotherapist I know has been to a "Butler" course....and yet.....the same old BS persists.

I'd agree with the above statement Barrett.

[TexasOrtho]

Thanks Tony. Like most things, I wish I could take credit for it.

Maybe it's my perception of Butler's influence that's inflated. As I spend more time talking to folks about pain science in the context of orthopedics, it will probably normalize to a more realistic estimate.

You obviously spend a great deal of time thinking about how you come across to your audience. I'm a pretty good case study for the opposite- rarely having an unspoken thought.

[nari]

I may be a bit out of date here, but I got the feeling that Butler was more interested in demonstrating how pain science thinking should be behind every method/treatment one uses, including the very mesodermal treatments.
I also feel that neurodynamics may still be misused, in the sense that the actions are still seen as stretches in the mesodermal sense, rather than nerve mobilisation.

Quietly, slowly, catches ze monkey. (In this case, the CNS/brain).

Nari

[zimney3pt]

I drove 6 hours this weekend to support one of my best friends from Middle and High School even into College where we were roommates for 3 years to be at a prayer service for his younger sister that passed away earlier this month. While I don't know all the details, she did pass away from suicide after struggling and battling with fibromyalgia for many years.

My heart was heavy wondering if she ever encountered a therapist that interacted with her and explained pain to her or was her treatment more the operator fashion trying to manipulate and change her tissues. While blame or guilt can not be placed on any one person or treatment for such a tragic event, as I drove home it only affirmed my personal vow to continue to learn and interact with care and compassion more for every painful patient that I encounter. And if I am seen as arrogant or condescending by some in my passion to share knowledge and understanding to other therapist to do the same then I will be proud to bat .300 for my career.

[Bas Asselbergs]

Thanks for that Kory.
You are among a select few PTs like the ones in this thread who make me proud to be one.

[John W]

As many of the regular participants here know, I've struggled with tinnitus for many years. I recently attended a lecture by a surgeon who was crippled with it to the point of being bedridden for a solid year. He cited some statistics on suicide rates among tinnitus sufferers and found, interestingly to me, that they were no higher than the general population. However, suicidal ideation is higher among tinnitus sufferers. This is something I can attest to.

I've been intrigued over the years of the neurophysiological parallels between pain and tinnitus- of the "phantom"-like qualities, the cortical re-organization, the frustrating variability and unpredictability of both of these conditions. This condition that I deal with has given me the "gift" of at least a peak into what my patients are dealing with.

But, as the suicide rates among chronic pain sufferers suggest (stat's show the highest rates among those with intractable abdominal pain), the aporia of pain occupies a space that is singularly profound in its effects on human functioning and relationships to the point where it drives individuals to the deepest depths of despair. This poor, young woman whose memorial Kory attended this weekend certainly, at some point in her search for relief, was provided inaccurate and unhelpful treatment, information and/or advice.

It's stories about and interactions with patients like these that compel me to vigorously question any idea, construct or notion that might contribute in even a small way to yet another young woman with fibromyalgia or an aging Vietnam vet with phantom limb pain to commit the ultimate act of escape from that aporia. A place I know I can't go, but I must try anyway.

Maybe that decision- to try to go there even though I know I can't- is perceived as arrogant? Maybe when I ask my colleagues why the won't try, they perceive that as condescension?

I don't see that there's a choice.