Creating the Patient Wall; More thoughts on the technique and effect of Simple Contact

Barrett L. Dorko, P.T. 

Iím often asked to provide some kind of detailed manual explaining just exactly what it is I do to my patients. People want a book full of pictures with arrows and captions. They want a protocol or a list of techniques to use in opposition to certain symptoms or diagnoses. 

Well, Iíve seen many books with pictures over the years and I honestly donít think theyíre worth the effort it takes to either produce or read them. Iím certain that many will disagree, and perhaps my feeling about this has more to do with my personal learning style than anything else, but Iím not sure about that. I donít describe protocols and lists of techniques because when dealing with neural tension such things are not very helpful. My opinion is based upon what we know about the behavior and biomechanics of that system, its geometry (fractal), and, not the least important, my twenty years of employing Simple Contact. 

So, instead of specific and traditional descriptions of technique, I try to describe what Iím thinking when I handle others. What Iíll attempt to do here is to describe an important aspect of my attitude while treating and combine that with an analogy Iíve recently come up with. 


Consider this quote from the poet David Whyte: Patience is the genius that allows us to touch the world in a way that does not turn it into gold, but allows it to reveal itself, as itself, in ways that continue to astonish, frighten and delight. 

I try very hard not to manually coerce my patients in any specific direction. I touch them, of course, but itís perfectly possible to simply ďlandĒ on another with your hand and not imply to them that you would prefer they move in one direction or another. Since I have no personal preference for the direction I want them to go, but only the nature of their movement, eliminating my tendency to direct them is pretty easy. Itís not there to begin with. As stated many times elsewhere in my writing, I want a movement that is effortless, warming, softening and surprising (see The Characteristics of Correction). When the patient reports that these qualities are present, I figure theyíre going in the right direction. I never begin knowing what that direction will be. If I knew Iíd either take them there myself or tell them where to go. I donít, so I canít. Manipulation of the dermal layers in various directions in order to elicit the desired movement and sensation is not the same as telling people manually which way to move actively, and I certainly do that. This nuance of technique is explained and justified in Touch and Sensation: A Deep Model. 

I feel that patience is an essential aspect of this technique. This is because the movement the patient needs to do doesnít always show up immediately upon touching them. You simply have to wait. If you donít, youíre not going to sense it or see it, so please wait. As Whyte suggests, patience allows the thing youíre touching to reveal itself. 

Creating a Wall 

Iím often asked why ideomotor movement isnít within the patientís awareness until I touch them. Typically, they become acutely aware of it very soon afterward, even if itís too subtle to see. This is a perfectly reasonable question.

Hereís my latest analogy. Imagine being seated a few feet from another person in a small room. When you speak, they will hear you even if you speak very, very softly. Now imagine being seated the same distance from that person, but this time in the center of a gymnasium. You probably know that youíll have to speak louder in order to be heard clearly. And you probably know that this is because the sound waves are dispersed as soon as they leave you. Without a nearby wall to reflect them back itís simply harder for the other person to catch them with their ears. 

Now think of a motion within your body, your cardiac rhythm for example. You wouldnít sense its presence under ordinary circumstances, but if I place my hand on your chest wall it becomes evident to you. It was simply a matter of giving it something to ďbounceĒ off of. In this instance my hand created a ďwallĒ for the movementís vibrations and, effectively, made your bodyís expression easier to sense because the ďroomĒ became smaller. Thousands of patients have told me that a gentle shower has a similar effect, and this makes perfect sense to me. Iím talking here about the room your body occupies and sends its messages of movement into. Of course, itís the nonverbal, unconsciously generated ones that interest me. I can feel them easier than see them, and, if I touch you with patience and no intention to coerce, your conscious mind will begin to sense them as well.

Having said all of that, I can now say this; Simple Contact makes the room occupied by the conscious and unconscious smaller, thus making it a lot easier for one to hear the other.