[Question] First ideomotion attempt

**PatrickL** · 13-03-2012, 07:28 AM

Today I made my first ever attempt at utilizing dnm and a client's ideomotion to treat pain. I should point out that i was essentially experimenting, having not had any training from barrett or diane. For the ideomotion part, I stood behind my client as she sat on the table. Put my hands on her shoulders and waited to feel something. She tilted her torso slightly to the left so I went with it. At some point she started to swing back the other way. This pattern kept repeating, left to right side bending with varying subtle degrees of flexion and extension. She thought I was moving her. I thought I wasn't. That's good I thought. She was surprised when I said I wasn't moving her. That's good too I thought. It didn't look effortless but didn't look like strained movement either. What does that mean, I thought? There was no warmth reported. Hmm did I fail? Her pain decreased after the DNM style work (significantly actually, this was really cool), but was no better from my makeshift attempt at simple contact.

While i acknowledge the role my inexperience would have played in this instance, I consequently thought the following;

It was mentioned in another post that ideomotion might account for the error in a Therapist's test-retest of e.g. Manual muscle testing. I.e. Therapist unconsciously provide less resistance during retest resulting in a positive treatment effect. How can this potential error be accounted for in simple contact? How can we be sure that the Therapist's own ideomotion is not directing the patient's movements?

**PatrickL** · 13-03-2012, 10:57 PM

What a massive fail of a post... 90 views and no replies. The silence is deafening.

Is it not possible that the Therapist's own ideomotion drives or at least contributes to the movements that arise during simple contact?

Pat

gollygosh · 13-03-2012, 11:19 PM

Patrick,

It was not uncommon for me to question who the mover was in ideomotion. When I observe, teach, elicit, catalize, or as a co-worker calls it "open a door" to motion, my touch is very light. So light that if it were resting on a pillow, it would probably not leave an impression. The following conversation typically ensues:

Me: do you notice that motion?
Patient: yes, that feels good.
Me: who do you think is doing that?
Patient: you.
Me: Think about how much pressure I am putting on you right now, could I really be moving you?
Patient: Well, I don't know>
Me: This motion is coming from you. Science identified this motion in the 1800's, but I learned about 5-6 years ago. This motion is your body's instinctive motion to sort itself out.
My hand is giving you the confidence, awareness to move in a way that isn't threatening. This motion is typically accompanied by Warmth, effortlessness, softness, and surprise--not planned, not predictable. You might feel warmth now come and go, and might be warm at someplace other than you'd expect. This motion cant hurt you.
Patient: Are you sure you're not doing it?
Me: let's just explore the motion for awhile( I begin to lighten and intermittently remove my hand.

Is my nervous system involved? absolutely. Am I driving? I don't see how I could be-- MY hand really is not touching with enough force to move anything. Can I get distracted, and start driving? Yes, but that's just a question of technique.

Sometime the range of motion is amazingly huge, sometimes incredibly small. Same for the warmth.

Congratulations on trying. I also frequently see ideomotion emerge secondary to DNM--like a surfing like motion under one, or both hands.

Geralyn

**nari** · 13-03-2012, 11:22 PM

Hello Pat,

Quote:

It was mentioned in another post that ideomotion might account for the error in a Therapist's test-retest of e.g. Manual muscle testing. I.e. Therapist unconsciously provide less resistance during retest resulting in a positive treatment effect. How can this potential error be accounted for in simple contact? How can we be sure that the Therapist's own ideomotion is not directing the patient's movements?

I am a bit puzzled by this comparison, but in simple contact the therapist does nothing except a very light touch. It can't be compared with muscle testing where the therapist provides some force, ie intervenes. Patient moves, therapist follows (or maybe not follow at all).

No warmth doesn't constitute a failure. It may be so slight the pt doesn't sense it.

I think it is difficult to realise the role of the therapist is nil. I know I did at first. Stick with it - you've made a good start.

Nari

**Barrett Dorko** · 13-03-2012, 11:24 PM

Pat,

Take heart. This has happened to me countless times.

Please note that the characteristics of correction are the things you're supposed to be looking/listening/sensing for. How could the therapist know how to produce these with movement?

As does commonly occur, therapists focus on the visible movement and ignore the neurophysiologic effect. It's there.

**PatrickL** · 14-03-2012, 05:35 AM

Hi Geralyn,
Thanks! I don't think my touch was as light as you described. I'll try lighter next time. Despite that I really thought she was doing the movement. I intervened only when she moved so far that I thought she might fall off the bed. What's the protocol there? Let them correctively move themselves into falling?

Hi Nari,
Thanks for the encouragement. I wasn't comparing sc to mmt. Rather, their reliability. mmt is unreliable because the tester is his own control. If tester uses mmt as outcome measure, his/her desire for a good result could unconsciously influence the resistance applied in a post intervention retest. I thought sc could be subject to the same problem, PT wants corrective movement, pt's subconscious delivers it with directive movement. But yours and Geralyn's comments re light touch put this thought to rest

Hi Barrett,
Thanks for the encouragement. Do you fancy a trip to NYC? I'm spreading the SS/SC word at my work and my boss is interested in inviting you to run your course. I'll shoot you an email.

gollygosh · 14-03-2012, 05:00 PM

Quote:

Originally Posted by PatrickL

I intervened only when she moved so far that I thought she might fall off the bed. What's the protocol there? Let them correctively move themselves into falling?

I think it is important to provide for the patient's safety. In my experience, if I see them looking as if they might fall off a table, I do intervene. I've seen them go right back into that motion.

this is a skill. it is the skill of subtracting everything we don't need to bring to the intervention, and of leaving a purely therapeutic context for the patient.

Keep practicing. And by all means, take time to tune into your own ideomotion.
Geralyn

**Barrett Dorko** · 14-03-2012, 07:57 PM

Patrick,

Yes, as Geralyn says, don't let people fall on the floor.

Ideomotion doesn't disappear when you get in its way, unless the patient dies at that point.

I would come to NY in a heartbeat.

13-03-2012, 07:28 AM	#1
PatrickL Senior Member Join Date: Feb 2012 Posts: 654 Thanks: 450 Thanked 460 Times in 166 Posts	First ideomotion attempt Today I made my first ever attempt at utilizing dnm and a client's ideomotion to treat pain. I should point out that i was essentially experimenting, having not had any training from barrett or diane. For the ideomotion part, I stood behind my client as she sat on the table. Put my hands on her shoulders and waited to feel something. She tilted her torso slightly to the left so I went with it. At some point she started to swing back the other way. This pattern kept repeating, left to right side bending with varying subtle degrees of flexion and extension. She thought I was moving her. I thought I wasn't. That's good I thought. She was surprised when I said I wasn't moving her. That's good too I thought. It didn't look effortless but didn't look like strained movement either. What does that mean, I thought? There was no warmth reported. Hmm did I fail? Her pain decreased after the DNM style work (significantly actually, this was really cool), but was no better from my makeshift attempt at simple contact. While i acknowledge the role my inexperience would have played in this instance, I consequently thought the following; It was mentioned in another post that ideomotion might account for the error in a Therapist's test-retest of e.g. Manual muscle testing. I.e. Therapist unconsciously provide less resistance during retest resulting in a positive treatment effect. How can this potential error be accounted for in simple contact? How can we be sure that the Therapist's own ideomotion is not directing the patient's movements?

13-03-2012, 11:24 PM	#5
Barrett Dorko Writer and Clinician Join Date: Nov 2005 Location: Cuyahoga Falls, Ohio Age: 61 Posts: 12,674 Thanks: 612 Thanked 1,485 Times in 870 Posts	Pat, Take heart. This has happened to me countless times. Please note that the characteristics of correction are the things you're supposed to be looking/listening/sensing for. How could the therapist know how to produce these with movement? As does commonly occur, therapists focus on the visible movement and ignore the neurophysiologic effect. It's there. __________________ Barrett L. Dorko P.T. www.barrettdorko.com

14-03-2012, 07:57 PM	#8
Barrett Dorko Writer and Clinician Join Date: Nov 2005 Location: Cuyahoga Falls, Ohio Age: 61 Posts: 12,674 Thanks: 612 Thanked 1,485 Times in 870 Posts	Patrick, Yes, as Geralyn says, don't let people fall on the floor. Ideomotion doesn't disappear when you get in its way, unless the patient dies at that point. I would come to NY in a heartbeat. __________________ Barrett L. Dorko P.T. www.barrettdorko.com

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13-03-2012, 10:57 PM	#2
PatrickL Senior Member Join Date: Feb 2012 Posts: 654 Thanks: 450 Thanked 460 Times in 166 Posts	What a massive fail of a post... 90 views and no replies. The silence is deafening. Is it not possible that the Therapist's own ideomotion drives or at least contributes to the movements that arise during simple contact? Pat

13-03-2012, 11:19 PM	#3
gollygosh Geralyn Giuffrida PT Join Date: Nov 2010 Posts: 376 Thanks: 139 Thanked 124 Times in 62 Posts	Patrick, It was not uncommon for me to question who the mover was in ideomotion. When I observe, teach, elicit, catalize, or as a co-worker calls it "open a door" to motion, my touch is very light. So light that if it were resting on a pillow, it would probably not leave an impression. The following conversation typically ensues: Me: do you notice that motion? Patient: yes, that feels good. Me: who do you think is doing that? Patient: you. Me: Think about how much pressure I am putting on you right now, could I really be moving you? Patient: Well, I don't know> Me: This motion is coming from you. Science identified this motion in the 1800's, but I learned about 5-6 years ago. This motion is your body's instinctive motion to sort itself out. My hand is giving you the confidence, awareness to move in a way that isn't threatening. This motion is typically accompanied by Warmth, effortlessness, softness, and surprise--not planned, not predictable. You might feel warmth now come and go, and might be warm at someplace other than you'd expect. This motion cant hurt you. Patient: Are you sure you're not doing it? Me: let's just explore the motion for awhile( I begin to lighten and intermittently remove my hand. Is my nervous system involved? absolutely. Am I driving? I don't see how I could be-- MY hand really is not touching with enough force to move anything. Can I get distracted, and start driving? Yes, but that's just a question of technique. Sometime the range of motion is amazingly huge, sometimes incredibly small. Same for the warmth. Congratulations on trying. I also frequently see ideomotion emerge secondary to DNM--like a surfing like motion under one, or both hands. Geralyn

14-03-2012, 05:35 AM	#6
PatrickL Senior Member Join Date: Feb 2012 Posts: 654 Thanks: 450 Thanked 460 Times in 166 Posts	Hi Geralyn, Thanks! I don't think my touch was as light as you described. I'll try lighter next time. Despite that I really thought she was doing the movement. I intervened only when she moved so far that I thought she might fall off the bed. What's the protocol there? Let them correctively move themselves into falling? Hi Nari, Thanks for the encouragement. I wasn't comparing sc to mmt. Rather, their reliability. mmt is unreliable because the tester is his own control. If tester uses mmt as outcome measure, his/her desire for a good result could unconsciously influence the resistance applied in a post intervention retest. I thought sc could be subject to the same problem, PT wants corrective movement, pt's subconscious delivers it with directive movement. But yours and Geralyn's comments re light touch put this thought to rest Hi Barrett, Thanks for the encouragement. Do you fancy a trip to NYC? I'm spreading the SS/SC word at my work and my boss is interested in inviting you to run your course. I'll shoot you an email.