Practical Science on Movement and Pain
Practical Science on Movement and Pain
I’ve written before on this blog about how manual therapists can develop some very questionable ideas about exactly how they are helping their clients. Like thinking they can manipulate energy fields, chakras, chi or cerebral spinal fluid patterns. Interestingly, my own observation is that many therapists who believe the craziest things actually get some pretty good results! How could this happen? How could they get good results without knowing how they do it?
There are probably very many good explanations. I thought of a new one while reading an excellent book called Incognito, by neuroscientist David Eagleman.
The theme of the book is that most of the activity of the brain is completely inaccessible to our consciousness. The brain is thinking and solving problems all the time, and our conscious selves basically have no control over these processes or even knowledge of them. We become aware of answers to problems long after our subconscious brain has been working them out.
The conscious brain is like a CEO who is handed a final product that has been slaved over by thousands of workers for years. The CEO might have provided some general guidance for the basic process (and might even take all the credit afterwards) but he or she knew nothing about 99% of the actual work that went into making the product.
So when problems are being solved and things are being figured out, the conscious brain is often the last to know. Which brings me to the topic of chicken sexing.
When chicks are born, farmers often want to figure out which ones will be someday be laying eggs and which should be fattened for meat. Deciding whether a chick is male or female is much harder to do than you might imagine, because chicks are more androgenous than a 1980s pop star. So farmers hire special employees called chicken sexers to determine who’s a boy and who’s a girl.
The interesting thing is that many of the world’s best chicken sexers seem to have no real idea at all how they make the call. They just pick up a chick, look at its butt, then decide that it’s either male or female. When its time to train a new chicken sexer, they don’t give the trainee a procedure to follow or a set of criteria. They just tell the trainee to look at the chick’s butt, ask them to make the call, and then tell them if they are right or wrong. Sooner or later the trainee learns to make reliable decisions, but never develops any conscious understanding of how they do it.
Similar principles can be seen in a more controlled and scientific environment. In one interesting study, volunteers were asked to pick a card from one of two decks. Some cards were “good” and provided monetary rewards while others were “bad” and caused losses. Further, one deck contained more bad cards then the other. The question for researchers was: when would the players learn which deck to pick from?
It took players about twenty five draws before they stated a preference for one deck over the other. But their unconscious brains figured things out much quicker. How do we know? Because the researchers monitored physiological data from the players’ skin to determine the state of their autonomic nervous systems (the “fight or flight” system.) After as few as thirteen picks, players were showing some anticipatory fear prior to choosing a card from the bad deck. In other words, they were already getting an accurate idea about which deck was bad, before they had any conscious awareness of having that knowledge.
I think that many massage therapists are kind of like chicken sexers. Their unconscious brains figure out what makes clients feel better without ever gaining any conscious awareness of how they do it.
A massage therapist needs to make many decisions every minute. Where do you push, how hard, at what angle, at what frequency, for how long, and with what part of your body? Many therapists will deny that they have any specific criteria for answering these questions, or even that they consciously consider them at all. They just start working and their hands seem to have a mind of their own.
And if you ask them what they are doing, they might not be able to give any kind of specific explanation. Whenever I asked my Rolfing teachers what they were doing when they were giving a demonstration, they usually said something like: “I’m having a conversation with the shoulder”; or “I’m listening to the hip” or something similarly ambiguous. They really didn’t know exactly what they were doing or why. But they were definitely doing something right, because when they put their hands on you, you knew right away they were experts.
The lack of conscious awareness over the actual methods used in a massage session might have some advantages. When you are learning a new skill, you need some level of conscious attention to perform the skill. But once you get good at it, the unconscious takes control, and at this point, too much conscious involvement can hurt performance. This is why you can sabotage your skills with too much self conscious analysis. Imagine trying to hit a pressure putt in golf while thinking about whether you breathe out at the point of contact.
This reminds me that Ida Rolf (the creator of Rolfing) and Moshe Feldenkrais, (the creator of the Feldenkrais method) each recommended that their students avoid an analytical mindset during sessions. Rolf sometimes admonished students that they were too “in their head.” Feldenkrais stated that in order to be optimally effective during a session, he had to think as much as possible in terms of creative imagery as opposed to formal logic. Even though both Rolf and Feldenkrais were trained scientists, and each proposed scientific explanations for why their methods worked, each wanted to get as far as possible from their scientific and analytical minds during a session.
I think part of what they were doing was making sure that their unconscious brains were in charge of the session, because most of the knowledge of “what works” was stored there, inaccessible to the conscious brain. They didn’t want their conscious minds to interfere with the process.
I think this goes along way towards explaining why many therapists seem to have no idea why their therapy works, why they are attracted to explanations which are magical as opposed to scientific, and why some are even hostile to very idea of applying science to massage at all.
To put it another way, I think that it is in the large gap between knowledge and awareness that magical thinking creeps in.
What do you think? Let me know your thoughts in the comments below.