Barrett L. Dorko, P.T.

          There are a series of scenes in the center of the movie Titanic that, I feel, emphasize the importance of creative activity and its relation to our health and well-being.

          You may recall (assuming you saw the movie, and most of us did) that after the mother of the young heroine discovers her infatuation with the artist, she successfully persuades her to break off this relationship. She does this while pulling the girl's corset strings tighter and tighter.

          After the breakup, the young woman watches a little girl being ordered to sit perfectly erect and still in the dining room, her hands and napkin placed just so. Seeing this, she returns immediately to the artist and says, "I've changed my mind." Ultimately, this rejection of posing and posturing saves her life. Later in the story she gets rid of the corset as well.

          As a physical therapist primarily concerned with painful problems, I've learned that it is primarily through the use of movement that enduring relief is acquired, but the question remains; "Which movement?"

          When faced with this dilemma, therapists have traditionally chosen to impose movements chosen for their ability to strengthen muscles or lengthen connective tissue, and, occasionally, these help.

          But physical therapy has gained a reputation for exertion and force that truly scares many who sense that these methods might worsen their pain, and, I feel, this is a reasonable concern.

Instinctive Movement

          Movements that provide pain relief "work" for a very simple reason; they reduce the deforming of tissue. When I untwist a twisted finger, come out of a hammer-lock, or simply shift in my seat, I am reducing the mechanical stress on my body and I do so simply to grow more comfortable.

          Activity such as this requires no planning and virtually no effort. We don't have to be taught to do them, we are born with the instinct to do this as a matter of simple survival. It can be reasonably assumed that these motions are unconsciously generated and, in fact, we know that they are.

          You may ask, "If movement of this sort is always available, why don't we simply do it? I hurt, but I can't find the movement I need."

          Consider this; In a culture where appearance is thought to be an indication of our character, where the "ideal" stance or sitting posture includes only erect stillness, is there any place where instinctive movement toward correction might be freely and safely expressed?

          I don't know of one, and it seems obvious to me that the place where this movement is least likely to be accepted is the physical therapist's clinic. After all, that environment is traditionally dominated by control, strictly choreographed regimens of exercise and admonitions to maintain "ideal" posture. Perhaps this accounts for my own professions's difficulty with the management of painful problems.

          In short, our culture rejects unique and spontaneous bodily expression and restricts it no less than that mother aboard the Titanic, and the "posture police" are the very people assigned the task of relieving pain.

The Alternative of Creative Movement

          If you look up the word "posture" in any dictionary, you will find among its definitions, "to pretend to be what one is not." Indeed, when we are aware that we are being watched by others, our tendency is to try and appear competent and poised, to carefully plan our movements so as to conform to distinct cultural norms and expectations.

          What if these movements do nothing to reduce our uniquely acquired twists and turns? Imagine that many of the ways we consciously choose to hold ourselves actually worsen the deforming of sensitive structures. Under such circumstances, we become trapped between what we feel is expected of us and what we truly want to do. As the psychologist Sam Keen says, "Stress means you're living someone else's life."

          Most of us know that not speaking freely results in a tight throat, and that relaxation only follows the unique and spontaneous movement of our mouth. Might we also consider the tightness elsewhere in the body to be the desire to move, but unexpressed? Would it follow that this movement must be creative in nature?

          In my experience, such movements are eccentric, unexpected and markedly counter cultural. They are also warming, softening and, most importantly, pain-relieving. As a therapist, I promote their expression with what is known as "Simple Contact."

          When we first meet the female lead in Titanic, it is many years since she rejected the pretense of stillness and perpetual calm her mother insisted upon. She is now a very elderly woman at a potting wheel. She has embraced the artist within her and, I presume, she finds physical comfort in the unconscious expression that is unique to her being.

          When physical therapy embraces the creative nature of corrective movement, it will be less about control and more about the willingness to enter into the fear and turmoil surrounding uncontrollable processes. Only then can it hope to use the vast creative resources of the unconscious. Only then will it no longer be seen as the judgemental and restrictive mother, but as the artist who invites us to be what we truly are.