Canadian RMT Spring 2018 Canadian RMT Spring 2018 | Page 18

that body wide problems stem from poor
foot alignment and that until the feet are
properly aligned, via manual therapy or
orthotics, pain/dysfunction will continue.
I truly could continue this comparison
for a lot longer (I’ve peeked into a LOT
of rabbit holes!), but do you see where I
am heading? We get so convinced that
our modality’s story is accurate, and
so enamored by our outcomes, that we
make claims such as these and turn a
blind eye to everyone else’s work. All
methods of interventions can claim a
certain amount of positive outcomes and
each method has validity. But how can
such seemingly disparate methods of
intervention all have good effects?
Recipes
All modalities and approaches introduce
the therapist to recipes and I am not
using that word in a negative way. Even
modalities such as MFR, which prides
itself on not working from protocols
and that each individual is treated as a
unique being, has recipes. The recipes
I was taught were to always have the
patients dig deep for their emotional
holding patterns, as “it is common knowl-
edge that emotions are stored in the fas-
cia and not in the brain”. Yes, those con-
cepts are actually taught. The therapist
then advertises these concepts on their
website, inviting prospective patients
to enter the world of somatoemotional
work, for until the patient digs deep to
get at the emotional holding patterns
buried and stored in their fascia, they will
never truly heal. Recipe.
I too teach recipes, applied in the con-
text of the MFR style of engagement that
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I’ve used for the past 26 years. Though
my hands still do much of what I was
taught, with my mind I am heading in
different directions. I teach that the prob-
ability is low that I am able to selectively
target fascia to the exclusion of other
tissues with my interventions. I teach
that we are not really treating individual
tissues or pathologies, but we are treat-
ing the human being on our table. We
are treating their skin, fascia, muscles,
lymph, nerves, tendons, joints, viscera,
bones, etc., and it is highly unlikely that
we are so skilled as to be able to magi-
cally select one tissue for our attention,
though that runs in conflict with most
rabbit hole modality trainings. I teach
that we are impacting skin as a primary
certainty and that our ability to primar-
ily impact deeper tissues and structures
is a bit of guesswork. I teach that there
may be a hierarchy of plausibility as to
what we are effecting, from less-wrong to
more-wrong. I accept that all therapists
have good outcomes and effects when
they apply what they’ve been taught and
when they hone their craft over time. I
teach that perhaps the most important
aspect of my work is to frame it from the
perspective of the patient, allowing them
to direct the care, rather than applying
it from the perspective of ego. I take
a risk by saying that many of us were
trained to work from our ego, but I say
it anyway. What I mean by this is that we
are taught principles of our modality and
then encouraged to dive deeper by taking
additional training and moving into mas-
tery. The more experience we attain, the
greater our abilities to detect and solve
problems, which is all very ego-based. I
have a lot of experience with MFR and
am very good at what I do, but one thing
is for certain; I do not know what my
patient is feeling. I do not know of their
full past or present. I do not know their
beliefs as to what is wrong with them nor
what they think will help them get better.
I do not know these things unless I ask.
And I do ask. Frequently.
If you come away from one of my
workshops with one bit of understanding,
it would not be about fascia, neurology,
techniques, or other things, but it would
be to always include your patient in the
process of treatment decision-making.
Not just setting goals, but fully immers-
ing them into how areas of intervention
are determined, how much pressure they
feel is necessary, and to be fully in con-
trol of the sessions. Not controlling, but
in control.
Bringing a higher emphasis on patient-
directed care is what I hope to be
remembered for. I do so in the context
of a myofascial release style of engage-
ment, but what I teach can be applied to
any and all modalities, whether the work
is wet or dry or still or movement-based.
I believe that all rabbit holes can benefit
from a tune-up; a tune-up that adds in a
stronger component of patient-directed
care. If you take one of my workshops, I’m
not going to try and grab you by the ears
and pull you out of your rabbit hole. I am
going to introduce you to a new model of
patient care that applies to all modalities.
Rabbit hole therapies will always exist
as long as continuing education require-
ments are in place for us. But I believe
that these rabbit holes can all benefit
from a strong dose of patient-directed
training. I do hope that you will join me.