Practical Science on Movement and Pain
Practical Science on Movement and Pain
In parts one and two of this series I discussed Barrett Dorko’s interesting theory that ideomotion can prevent and reduce many sources of chronic pain. To briefly summarize, ideomotion is a non voluntary movement prompted by mental activity. All mental and emotional activity is coupled with motor commands that will be inhibited or physically expressed to different degrees. When pain occurs, it is simultaneously coupled with motor commands that are intelligently designed to reduce pain of mechanical origin.
The problem is that the brain has many thoughts and emotions and only one body to express them. Thus, when two mental representations seek antagonistic movements, there is the potential for physical conflict and inhibition of one of the movements. Dorko hypothesizes that the corrective movements produced by pain are often inhibited by other mental activity, the most likely culprit being mental activity devoted to social concerns. For example, the social need to use appropriate body language could inhibit corrective movements that would send the wrong signals. (Watch the video below of corrective movement in action and you will see why this might not be the kind of thing you would do in a work meeting.)
So, how do we elicit corrective movements that have become inhibited? Dorko’s plan is basically to reverse the conditions that caused the problem in the first place. If the cause of the problem is a social context that inhibits corrective movements, the solution is to create a social context to allow them. The process by which this is done is of course dependent on the individual, but here is the basic plan recommended by Dorko.
First, the therapist should determine whether ideomotor movement will even be useful given the particular type of pain suffered by the client. Dorko distinguishes between three common origins of pain – mechanical, chemical and central. Mechanical pain results from deformation of nervous tissue. The therapist may assume that pain has a mechanical origin if the pain is made better or worse by certain postures or movements. If the pain is completely unaffected by movement, then there is little reason to believe that any kind of movement, ideomotor or otherwise, will help resolve it. But if the client moved their way into this problem, then perhaps they can move their out of it.
Once it is determined that ideomotor movement may help the client, the next step is setting up the proper social context to elicit it. This is done verbally and then with a hands on technique. The verbal part will of course depend to a huge extent on the needs of the client, the stye of the therapist and their relationship. But one way or the other, the therapist should somehow communicate two major ideas: that pain is non-linear and not an accurate measurement of tissue damage; and that the client’s brain has an unconscious talent for solving certain pain problems if it can only be allowed the freedom to do its magic.
The next step is a hands on technique that Dorko calls “simple contact”, and with good reason. He simply puts his hands on the client and then follows whatever movement they make, large or small, without coercing them in any direction whatsoever. Very simple.
The therapist then asks some questions to determine: (1) whether the movements are truly non voluntary and thus ideomotor movements; and (2) whether the ideomotor movements in question are “corrective, i.e. whether they are reducing unnecessary tension and mechanical deformation of nervous tissue. After practicing this technique for many years, Dorko has identified four criteria for determining whether the client will receive benefit from their movements. He calls these the “characteristics of correction” and here is my own description of them and their import.
Two of the characteristics of correction are that the motions in question must feel surprising and effortless. I assume the importance of these criteria is simply that if a movement doesn’t feel surprising and effortless, it probably isn’t ideomotor movement anyway. Recall that ideomotor movement often tricks the mover into thinking that the motion comes from an external source. In fact the client engaged in ideomotion often thinks that the therapist is moving them as opposed to the other way around.
But not all ideomotor movement will correct mechanical deformation leading to pain, and that is where the other two criteria come in. One of these is what Dorko calls softening, which basically means the client’s perception that unnecessary muscular tension has been reduced. Dorko proposes that softening occurs when previously inhibited motor commands are finally expressed. Dorko uses the following example to illustrate. Imagine you feel the desperate need to speak but are terribly afraid to do so. You will likely feel isometric muscular tension in the muscles controlling your speech, a physical manifestation of the two competing thoughts. The only way to release the tension is to speak. Thus, if ideomotor movement results in less tension, that is a sign that you have engaged in a movement that your brain really wanted to make but didn’t feel free to do so until now.
Possibly the most positive characteristic of correction is warming, because that suggests that the movements are correcting the root of the problem – mechanical deformation of nervous tissue. According to Dorko, successful interventions will usually result in the client reporting that a particular part of their body suddenly feels warmer. He reasons that the only source for such warming would be increased blood flow to an area currently suffering anoxia, possibly due to kinking of nerve tissue, or due to an excess of sympathetic tone. In either case, the warming indicates blood flow which is a good thing.
Once the client knows what ideomotor movement feels like, he or she can elicit it on their own by just the conscious act of trying to allow movement in a particular area. My own experience with this is that it is very easy to produce movements that feel completely non voluntary. I will almost always feel “softening”, or release of muscular tension within a only a few seconds, and if I go on longer I will probably feel extremely loose. If I have any pain (which is rare) I can often reduce that as well. I rarely feel any warming, but maybe that’s because I’m not paying attention very well or don’t move long enough to get it. One thing that I find very interesting is that I will definitely feel far greater relief from ideomotion, and far greater need to do it, after a period of stress (such as typing at a computer). My interpretation of this is that the dominant mental representations of getting work done inhibited any corrective movements that could have resolved my developing discomfort. This is certainly good evidence (for me at least) that a brain in conflict leads to a body in tension.
So what does corrective ideomotor movement look like? I asked myself that question for years after reading about it at the somasimple site where Barrett does most of his writing. I asked Barrett and other ideomotor advocates to post a YouTube video of someone engaged in ideomotor activity. No luck! So six weeks ago I got up at 5am to drive from Seattle to Vancouver to see Barrett speak. And within the first hour of the workshop they made the first ever tape of someone doing ideomotion! C’mon! (To be fair, the workshop was excellent and well worth it.)
Here’s the vid, which features Barrett and Michael Reoch, a massage therapist and Canucks fan from Vancouver, who, as far as I know, had absolutely nothing to do with the rioting that occurred there after the last game.