I have always been fascinated by the interplay between the intuitive and the rational. I have always felt that this is a relevant topic for chiropractors attempting to provide optimal care. I recently read a fascinating book by Elizabeth Mayer, PhD, called Extraordinary Knowing.1 The story tells of a rational, scientific woman, trained as an analytic psychotherapist, who has an extraordinary experience.
Her daughter's expensive and unique musical instrument, a harp, is stolen and can't be found. After the usual avenues are exhausted, a friend suggests that if she is serious about recovering the harp, she should engage the services of a dowser. Skeptical, the woman calls the dowser, who says it's still in Oakland, Calif. (her home town), and asks her to send a map. He marks a particular location where the harp is. She goes to the police, who say they cannot issue a search warrant based on dowsing evidence. She then goes to the site in an impoverished west Oakland neighborhood, and puts up reward signs in a two-block radius around the house. Two days later, the harp is returned to her, in a dark corner of a parking lot.
The story could end here. Many of us have had isolated extraordinary experiences that we either ignore or separate from our day-to-day life. In this case, Dr. Mayer is profoundly affected by this experience, and begins a long period of searching. She reviews the literature and seeks out stories from her patients and other professionals who have had similar experiences.
Her book outlines the difficulty the world of science has with recognizing anomalous events. Western science has such a hard time integrating knowledge that doesn't fit within its model. Real-world science has a tendency to become a belief system of its own, with its own ugly politics.
How does this relate to practicing chiropractors? I suggest that many of us, if not most of us, have a form of anomalous knowledge, which we may or may not recognize or utilize. What do I mean by extraordinary or anomalous knowing? I mean information or knowledge that comes to us beyond the bounds of ordinary sensory experience. I suspect that many of the best chiropractors are intuitive and know how to "listen to the body" beyond the simply logical. Is this intuitive information really from unknown sources, or is it just the product of our hands' and brains' ability to recognize patterns faster than our logical brain can keep up with? I recommend Malcolm Gladwell's book, Blink, for further exploration of this topic.2
Extraordinary Knowing reviews many studies of various forms of anomalous knowing. Even the best practitioners and the best medical intuitives do not have a 100 percent hit rate. Significance starts where chance ends. If chance gives you 25 percent odds of being right, and you achieve a 33 percent odds of being right, you are doing something significant. I think we need to remember this when we use muscle testing, leg or arm checks, or just have an inner feeling about something. We need to recognize and appreciate that our intuitive methods are not accurate all the time, but that they can take us beyond chance.
I started out my career, which now spans almost 30 years, as an applied kinesiologist using muscle testing to evaluate the body's knowledge of itself. I have been exposed to arm-length and leg-length testing, Toftness technique and other intuitive methods. I still use some of these methods daily, although I attempt to ground this information in more reproducible evidence.
What do all of these intuitive methods have in common? I would suggest they all allow us to access some knowledge that is different from our logical left-brain step-by-step processes. I know the practitioners of these various techniques might say that their particular system is different, has evidence and uses known mechanisms. I am not disagreeing; I am just looking at the big-picture pattern and using my soapbox to speculate.
In hands-on healing work and diagnosis, we know there is a subjective element. We know there is both operator and patient influence. The best chiropractor tries to take into account the preponderance of the evidence. We practice in a world of "soft" evidence; one in which the same patient can get five different diagnoses for their pain.
Perhaps we need to add palpation to the list of diagnostic methods that has a strong intuitive component. Researchers have had a hard time finding palpation methods that are reproducible, but few of us would be willing to give up or ignore the information we get from our hands. A recent case comes to mind. I was working with a woman with headaches and chronic shoulder and neck pain. She was referred by another DC after she failed to respond to a short series of unsuccessful treatments. Our first few treatments seemed to only give her very temporary relief.
I switched gears and asked myself, "What else?" I have many tools in my toolbox. Using a variation on muscle testing and a variation on the matrix repatterning model, I found a few other areas on her body that held potential for treatment.3 The model purports that distant areas can have fascial tensions that affect other areas. I treated these. The key area for this patient based on this model was the lower abdomen. We released the fascia of the lower abdomen, using methods from Barral's visceral manipulation. I asked her about her history with this area of her body. She was a uterine cancer survivor, which I had not known previously, and she had extensive abdominal scarring from a series of surgeries. After working on this area, her neck profoundly relaxed and we turned the corner in her care. Her neck and shoulder finally stayed better.
Now, I could quote Lewit or Barral.4-5 I could find a logical basis for this particular treatment. But how did I get there? First, I try not to get stuck in thinking that I know what is wrong. I try to listen to the body. If two or three adjustments are not changing anything, it's time to switch gears and try something different. In this case, it was about getting my left brain out of the way and letting the patient's body lead me to the most profound, most significant lesions. If I didn't have extensive training in visceral manipulation and awareness of the significance of scar tissue, I probably could not even conceive of these possible lesions, let alone correct them.
One of things I love about treating pain is that the body often gives us clear, immediate feedback. Significant areas are almost always tender to the touch and have tissue-texture changes. When we do something useful, the tenderness diminishes immediately and the tissue textures change. I don't have to tell the patient to go home and see whether we made a difference over a month. I can get immediate feedback. When the change is temporary, it usually means something else needs addressing, whether it is a recurrent movement pattern, a nutritional factor, an emotional stress pattern or another structural factor.
The question for you, as a practitioner, goes something like this: Are you willing to let go of your knowing, of your expectations? Can you let in other information; can you get out of the way? Can you switch gears and be a multiple-technique doctor? Can you be a different chiropractor for one patient than for another? I'll note that this is just my view of mastery, and that some clearly look at this topic differently.6
I love the osteopathic technique called strain-counterstrain. When it works, I simply place the patient in a position and the tender area melts away. In my practice, counterstrain seems to be what I call on about 5 percent of the time. In those 5 percent of cases, usually nothing else is working, and the counterstrain technique is the key.
It's not just intuition. You have to have training in whatever you are doing to be good at it. You have to have the basics down at whatever you do. You have to develop your left brain and then let in the other parts (the intuition).
Malcolm Gladwell, in his new book Outliers, talks about extraordinary individuals and groups, such as Bill Gates and the Beatles.7 His basic premise is that it is not just brilliance and drive that makes masters. Opportunity is an essential element. He estimates that it takes 10,000 hours to develop mastery. I calculate that to be about eight years of chiropractic practice. It doesn't mean you will automatically be a master after eight years. It means that if you pay attention, are somewhat driven and continue to learn, you may develop mastery after many years.
Most of us are not going to spend 10,000 hours on the golf course and become master golfers. Most of us are going to spend 10,000 practicing chiropractic. They don't call it "practicing" for no reason. You have the opportunity to become a chiropractic master, if you so choose.
- Mayer EL. Extraordinary Knowing. Bantam Books, 2007.
- Gladwell M. Blink. Little, Brown and Company, 2005.
- Background on matrix repatterning. www.matrixrepatterning.com.
- Lewit K, Olsanska S. Clinical importance of active scars: abnormal scars as a cause of myofascial pain. J Manipulative Physiol Ther, Jul-Aug 2004;27(6):399-402.
- Barral JP. Visceral Manipulation, Vol. 1. Eastland Press, 1998.
- Fuhr A. "What It Takes to Become a Master." Dynamic Chiropractic, Feb 12, 2009.
- Gladwell M. Outliers: The Story of Success. Little, Brown and Company, 2009.
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