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Barrett's Forums This discussion is devoted to the latest advances in neuroscience and the clinical phenomena it explains.

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Old 21-04-2008, 01:50 PM   #1
Barrett Dorko
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Default True Enough

I’ve begun reading True Enough: Learning to Live in Post-Fact Society by Farhad Manjoo and immediately felt that the author’s insights could be used to explain a great deal about the mess therapy finds itself in these days. Now, when I say “mess” I mean that sincerely. A large percentage of the people I meet as I teach suffer from painful problems that are indistinguishable from the ones we treat. They have worsened as the years pass and have abandoned the care they are paid to provide. It is as if a bunch of dentists had stopped brushing their teeth.

Does that sound like a mess to you?

As I often do with books that capture my interest, I underline passages and write in the margins. Let’s start with the first portion of the book that got this treatment from me:

Quote:
(There’s) a critical danger in what you might call the modern infosphere. People who skillfully manipulate today’s fragmented media landscape can dissemble, distort, exaggerate, fake – essentially, they can lie – to more people more effectively, than ever before. In this environment evidence doesn’t matter. What they manage to do is a sign of things to come.
Stay tuned.
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Old 23-04-2008, 01:32 PM   #2
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Manjoo’s premise, as far as I can tell, isn’t all that complicated. Though we would imagine intuitively that more information would yield a clearer, more precise and accurate description of reality, the opposite has occurred. In fact, the flood of images and interpretations from countless sources has given us an opportunity to defend and reinforce our own preconceived notions and prejudices.

When someone skillfully manipulates the dissemination of information even the goofiest ideas are spread effectively and believed by those leaning in that direction anyway. Studies indicate that selective exposure and selective perception play an important role here. In other words, we ignore certain portals of information (certain news channels, for instance) and then actually “see” only that which bolsters what we already believe to be true. This probably doesn’t surprise a thoughtful person, but Manjoo points out that this age old tactic has been made more powerful and accessible today.

Then there’s this: Studies also indicate that though everybody does this (me, certainly), politically conservative people are measurably more likely to. Any liberal will be glad to hear this, of course.

The implications for those of us trying to move therapy forward seem clear to me. If we replace the descriptor “conservative” with “traditional,” which seems fair to me, those who follow the reasoning taught in or schools; reasoning that begins with a strong mesodermal bias when it comes to the sources of pain, it will be hard to realize any significant change no matter what Ectodermalists say or demonstrate. The phrase “brick wall” comes to mind. Of course, the same could be said of those on the other side of the issue. But according to the research Manjoo cites, Ectodermalists (“progressives” in my mind) are at least less likely to selectively read or interpret literature.

Scientific reasoning cuts through this when it is done persistently and dispassionately, and our profession’s stunted growth when it comes to actual practice has everything to do with its absence from the schools and clinics.

Am I wrong?
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Old 23-04-2008, 11:16 PM   #3
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No, I think you are right.
Keeping the science "filters" clean of emotional and personally insulting debris, is essential to move forward in the critical appraisal of scientific theories, studies and issues.

I am afraid that too many people have too much personal (i.e. emotional, psychological) investment in their skill/mind-set that letting go of it , or even considering the possibility of having it challenged, is too threatening.

It is due to the personal value they ascribe to having a certain "skill-set" that such vigorous and often blind defense is required. They are not talking about skill or theory - they are talking and defending their very self. (Of course, laziness is a motivation of others..)

The dean of health sciences who strongly favours introducing "reiki" and "therapeutic touch" into the post-graduate massage courses, gets extremely upset when the programme director and I talk about science and the lack thereof in these "techniques".

A dean of health sciences.....
She was cured of terrible facial pain and scarring, thanks to a reiki person. Thus it works. Thus science sucks. Yet she loves the data I have collected on the student evaluation, because it gives "us the facts to make decisions on".

In my own way, I understand your frustration on a much more personal level now, Barrett.
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Old 23-04-2008, 11:46 PM   #4
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I also think you are right, Barrett.

After reading Darwin's biography and the huge battles he faced with those academics whose entire 'selfness' and existence depended on traditional thinking, I can understand much better his enormous drive for some kind of truth rather than emotion-based 'facts' which did not explain things in a satisfactory manner.

It almost smacks of a sense of honesty and innate interest which fortunately coincided with acute observation and challenges to be delivered when required. It is difficult to see anything like that occurring in PT where thoughts flow along the same delta decade after decade.

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Old 24-04-2008, 01:36 PM   #5
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Thanks for the replies guys.

Manjoo also explains the concepts of dissonance and consonance and how we react to them in ways I’d not previously considered. He shows how a strong consonant argument in favor of our point of view is nice to hear but that a weak argument in support makes us slightly uneasy. Instead, we’d prefer to hear a weak argument in opposition (weak dissonance) so that we might undermine it with ease. As he puts it, “Putting forward the other guy’s dumbest ideas is a surefire true tactic.”

What examples of this might we find in the heated discussions regarding the theoretical constructs behind manual care and the controversy surrounding their application?
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Old 25-04-2008, 01:35 PM   #6
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I'll get back to the question at the end of the previous post soon. In the meantime:

Quote:
A person’s speaking style can strongly seduce an audience The way you say something is more important than what you say, and significantly so.

Paraphrasing the conclusions drawn from several studies reported in True Enough in the chapter titled Questionable Expertise
Where I am, who’s in front of me, when I’m there and what I actually say has very little affect on what the class eventually says about the day they spent in my presence. I’ve long known that the tiniest bit of truly felt frustration expressed on my part will be the thing they remember most of all. For most, it is the only thing they remember or report. Thus, I am mindful of how fragile those before me are and how much they need in the way of “milk and cookies” from me. (A good link, by the way)

In the latest episode of Radio Lab titled Pop Music they discuss the nature of auditory hallucination. At one point it is revealed that 70% of the neuronal support to the hearing apparatus descends from the brain. This makes me wonder what I need to do in order to overcome the messages continually flowing into the student’s auditory experience. My words are paltry by comparison, and, as it turns out, my manner is more important.

I am not a man who is naturally friendly or all that interested in the welfare of others (see this for more about that) but I am forced to appear so while speaking to my students about the healthful aspects of authenticity.

Ironic, huh?
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Old 27-04-2008, 03:06 PM   #7
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Now back to that thing about the other guy’s dumbest ideas.

I’ve concluded that the dumbest ideas about traditional treatment for painful problems revolve around a single concept; ignorance. Traditionalists “know” that muscular dysfunction and pain are intimately related and they support this reasoning (and I use the term loosely here) with endless anecdote. Their care (another loose use of a term) consists largely of manual manipulation, forceful stretching, externally imposed alterations of temperature and strengthening regimens. I needn’t explain to those reading this thread the problems inherent to such a practice or the massive ignorance exposed when it is examined carefully. But for most therapists the muscle thing is "true enough." But in fact, it is weak dissonance; it's a dumb idea, plain and simple, and we should be glad to hear of it and refute it.

Still, it endures as it always has. Maybe it’s that “charming teacher” thing previously mentioned, but I think there’s more to it than that. The satisfaction it provides our kluge of a mind has yet to be replaced by anything else, and we who know otherwise have yet to come up with an effective way of offering another meme (see this for more about that).

Three current threads I’m working on; this one, kluge and this one are inextricably linked. In short, we are trying to change minds ill-suited for rational thought while using a forum rarely used (the Internet) by professions whose behavior is deeply entrenched, institutionalized and driven by financial considerations that actually encourage ignorance.

A cynic who often appears on these pages would say we were all dead men. But is there a path toward turning this around?

More soon.
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Old 27-04-2008, 04:28 PM   #8
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I suggested at the end of my last post that I had an answer to our dilemma, but, in fact, I didn’t. An hour later while walking Buckeye I heard the latest This I Believe on National Public Radio and there I found my answer.

Take five minutes to listen to this or read the text. You’ll find it’s worth it.
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