Barrett L. Dorko, P.T.

          When dealing manually with problems of nervous irritation, we are challenged to somehow effect structures deep within the body, while our hands remain on the surface.

          My colleagues in this specialty are often frustrated with this fact, and this frustration typically emerges as a tendency to dig into the skin with the hand's bony prominences. If the knuckle seems not enough, they'll resort to the elbow.

          It would be nice if the body would just comply to such forces, but there's plenty of evidence to indicate that pressure on the skin is dampened, dispersed, redirected and opposed by protective muscular activity.

          I came through school in the 60s, so I sometimes revert to the philosophy of Carlos Castenada. When asked why I no longer push people as I once did, I say, "The impeccable warrior never enters into a battle he cannot conceivably win." When the student looks at me quizzically, I refer them to Journey to Ixtlan. I've found that this tactic cuts down on the number of questions I get, and I like that.

          Seriously, I just never found that forceful technique took the patient in the direction I felt was best for them, and after a few years of losing that battle, I concluded that my weapons were insufficient, and that my vision of the situation needed to somehow change.

          Coincidentally, I spent several years in my youth diving into a pool no more than three feet deep. We didn't realize the danger, and, in fact, were simply told by my father to "shallow dive" so as to not hit our heads. He always combined this advise with a sweeping gesture of his hand to demonstrate our mid air posture.

          This image and gesture began to haunt me near to the completion of my book, and I exorcised it only by realizing its symbolic nature. Once I named the book, I never dwelt on it again. Until recently, that is.

          In a book about the poetic form, haiku (Seeds from a Birch Tree by Clark Strand), I read, "Haiku is a shallow art...(but) this does not mean it lacks depth. It means that we find meaning in what lies right before the eye." Suddenly, I saw myself shallow diving once again, and I knew that writing of it was the only way to dispel the vision.

          Perhaps manual care of the sort that makes no effort to mechanically deform deep structures, but rather to transform them through reflexive effect can be considered similar to the art of haiku. While staying lightly in contact with the surface we can sense and encourage internal processes and movements that we know to be healthful. Maybe this is why an accepting touch affects us more than a playful (but coercive) rub. The former dives deeper than the latter, although it is rarely employed in traditional techniques of manual care.

          When I began to gently sense the surface of others, I found that my knowledge and appreciation of the materials truly affected what I felt and how I interpreted it. Like a tracker in the wild, I came to understand that I didn't actually need to see something in order to sense its presence and nature.

          These days I'm seeing a connection between my peculiar methods of non-forceful care and the "shallow art" of haiku, between the subtle inflection of a trusted and effective voice and the therapeutic effects of an infant's grasp.

          I've found that my hands can be quite effective, even if only superficially placed.