Wednesday, March 9, 2011

Risk vs. Threat



Successfully getting off the ledge, to the edge, and then doing effective edgework depends on the absence of a looming threat, be it real or perceived. All three ideas I offered (1, 2, and 3) have in common one thing: they all aim at reducing threat.

But, don’t confuse threat and risk. Working at the edge is a risk. But then again, so is walking out your front door. A risk simply means a chance at failure. There’s a lot to be learned from failure and risk can be something that moves us forward if we handle it appropriately. Looming threats on the other hand elicit fear. And fear stops our forward movement and puts us into survival mode.

We need to clear the path to the edge of looming threats, real or percieved.

Monday, March 7, 2011

Or, You Could Always Use Maps

In my last post I talked about lifting the fog to get off of the ledge. I made two summarizing statements:

The fog of reason is the fog of working from bad information. The way out of this fog is critical rationalism.

The fog of faith is the fog of working from maladaptive beliefs. The way out of this fog is through evangelism.

These equate to “talking someone down from the ledge.” But there’s another option.

You could just give them a map.

I mean this both metaphorically and literally. If one has an accurate map one can navigate, even in the midst of dense fog. The thing about navigating by a map such as this is that you are at the mercy of the map maker.

Then there are brain maps. Our brain is a meticulous map maker. We make maps of where we are in relation to other things. We make maps of our own body and the movements available to us. We even make maps of the spaces that objects we hold occupy (even while driving a car!) Our brains, being obsessive cartographers that they are, constantly update our maps. This is both good and bad. It’s bad because we sometimes smudge maps that were previously well detailed and it’s good because we can redefine them relatively quickly. When on the ledge, we may be dealing with a set of smudged maps.

Our brain redefines its maps, at least in large part, through input. At least some forms of input, like various forms of manual therapy, are likely altering these brain maps and filling in the spaces. This is more like sonar, the vessel (brain) is pinging its surroundings to create a working map as it moves along. The brain is creating its own maps instead of being handed one.

So, for a person on the ledge, you could give them a map or you could help them build their own. I think you know which method I prefer.

For a great read on brain maps, I recommend the book
The Body has Mind of its Own
.

Sunday, March 6, 2011

Lifting the Fog

Yesterday, I spoke of the fog.

If one is in unfamiliar territory and blinded by fog it may feel as if the edge is an inch away in any or all directions. This does not feel like an edge. It feels like a ledge and it is crippling. People fall off of ledges unless they are rescued, after all. Either way, ledges rob one of feeling in control. It’s a helpless feeling.


Of course I’m using the fog metaphorically here. So, in reality, what makes up this fog? What is crippling about the fog is not the actual existence of a ledge, but instead the possibility of the existence and nearness of a ledge. The fog makes this possibility more anxiety provoking. It could be anywhere. It holds us down, makes action of any sort too risky. It thwarts coping.

So, how do we come to the thought of the possibility of a ledge? 2 ways, logic and belief. With logic, we reason that given one thing is true the logical conclusion is that other things will be true as well. As I tend toward the critical rational side, this realm is familiar and favorable for me. However, if that initial “truth” upon which our logic is based is errant, then all logical conclusions based upon it will be errant as well. When this is the case, there are logical ways to lift the fog. Providing evidence that makes the error clear, then progressively rebuilding the context through logical reasoning will make one aware that what has pinned them to the ledge is not present after all.

The fog of reason is the fog of working from bad information. The way out of this fog is critical rationalism.

Then there’s the tough one; belief. Belief is based on faith. No amount of reasoning will talk a person out of their faith because it has no authority in that realm. The saying holds true, “Don’t try to reason someone out of a position that they didn’t reason themselves into in the first place.” The problem is that it is not often clear when a person is working from belief or logic.

The fog of faith is the fog of working from maladaptive beliefs. The way out of this fog is through evangelism.

Evangelism occurs through cultural change, the mind of the majority, and its tools range from testimonial to social support to group think. It is therefore a slippery slope and to be treaded carefully and responsibly or not at all, in my opinion.

I’d love to hear thoughts on this.

Saturday, March 5, 2011

When the Edge Feels Like a Ledge

Yesterday I wrote of the body’s edge of protection. I need to spell out an exception. As I mentioned, edges are often blocked from view by fog. If one is in unfamiliar territory and blinded by fog it may feel as if the edge is an inch away in any or all directions. This doesn’t feel like an edge. It feels like a ledge and it is crippling. People fall off of ledges unless they are rescued, after all. Either way, ledges rob one of feeling in control. It’s a helpless feeling.

When at the ledge and blinded by fog, we have 3 choices, as I see it. 1) Use senses other than sight to better define what surrounds us, 2) cut through the fog, or 3) wait to be rescued.

The first 2 give us back a sense of control. The 3rd leaves us helpless and at the mercy (or apparent mercy) of others.

With pain, we can learn to feel our way toward edges until it becomes clear that we are not actually on a ledge. Or, we can lift the fog.

More on the fog in the next post.

Friday, March 4, 2011

The Edge

Edges are productive. When confronted with an edge one must alter the approach to continue. For this reason, at the edge is where creativity exists. At the edge is where most potential for change exists.

The body’s protective responses are an edge.

Sometimes it’s tough to know where an edge begins because some are a gradual transition. Some are hidden by fog. How will you notice an edge if you can’t see it?

Pain itself is not the only characteristic of the protective edge. There are many changes in behavior that may mark the beginning of the edge. Muscles may tighten. Breathing may change. Fear and uncertainty may take hold.

By getting to know the edge, learning to identify it, we can walk up to it with confidence.

The edge is where things happen. Be it good or bad, it happens at the edge. This is why so many choose to stay away from them. It’s quite possible that failure awaits. This uncertainty can be disabling, literally.

Don’t avoid the edge and don’t ignore the edge. Learn to identify it, then work at the edge.

Hat tip to Seth Godin. Until reading his description of “edgecraft” I had always called this movement concept “working at the boundary.” The edge captures this concept so much better.

Wednesday, March 2, 2011

Setting the Stage


Based on the interactions that I’ve had over the years with other physical therapists (and between my friends and colleagues, there’s been a lot) I’m comfortable making a general statement that therapists see the benefit in their patients having self-efficacy. I would agree that this is vital.

Is there’s a bigger passivity inducer than ultrasound? Do you suppose a laser treatment sets the stage for self-efficacy? Why do our clinics remain filled with modalities that foster the very attitude that we hope to alleviate?

Do our actions match our rhetoric?



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