Barrett L. Dorko, P.T.
On either end of the front row at a recent workshop sat two therapists, each representing one end of a spectrum, the spectrum of physique.
The young female, Diane, is tall and slim. She's a powerful, competitive swimmer with excellent strength and endurance.
Jim is thirty years older, short and rotund. There is little evidence that he is endurant or especially fit. I imagine that his numbers on a stress test would indicate a need for conditioning if he were to display the kind of health our culture prefers. A diet wouldn't hurt either.
During the course of my first hour's lecture, I saw Diane acquire a large variety of postures. Each of her long limbs stretched and angulated for awhile and then changed a bit. Her head shifted constantly on her neck, forcing those directly behind her to dodge about in order to still see the slides.
With the exception of his breathing, Jim was still as a stone. You could have balanced a full teacup on his head the whole time and not lost a drop.
After speaking for an hour, I brought the class' attention to Diane and Jim. I didn't mention their physiques or evident fitness, but rather the nature of their being as indicated by their unconsciously motivated movement. Several people behind Diane were well aware of her movement. Those behind Jim had ceased to even notice he was there. They served as a reminder that a steady stimulus produces accommodation, while one constantly changing cannot be ignored.
I wasn't surprised to hear from Diane that for years she has experienced an upper thoracic tightness that has not resolved with any form of exercise or posturing. Her calves are similarly tight, and her feet are always cold.
Jim couldn't think of a symptom that troubled him with any persistence and, although he didn't regularly stress himself cardiovascularly, he was ordinarily warm and perfectly comfortable throughout the day and slept easily.
I can tell you that he had about him a simple serenity and openness that I personally equate with ideal therapeutic presence. I sensed no judgement or anxiousness, just a dispassionate observational skill that can only come in time to one who has learned it in the clinic.
The famous English physician and writer, Jonathan Miller, once said, "In living things, all restlessness is directed toward the achievement of tranquillity."
I often mention this quote to my patients when they decry the fact that they "don't know how to relax," and explain to them that their movement would probably correct something if they only let it fully express itself.
Diane's fidgeting markedly decreased as soon as she was allowed to move as she wished without fear of judgement and when her internal admonitions to hold herself still and erect were relinquished. This takes just a few minutes in the presence of a therapist like Jim. That is, once he learns how to properly handle the materials.
Jim's kind of health, like Diane's is the end result of processes and kinds of use, some subtle, some obvious. I noticed the disparity in their breathing patterns immediately and would have bet on Jim's relative comfort, despite his physique, every time.
I try to let my patients move in Jim's direction. Not his size of course, but his willingness to accept others and himself as he naturally wants to be. This is quiet work and the results are not easily measured.
The payoff is displayed in a decreased need for motion. A kind of health our culture does not honor, but the kind most of my patients desperately want.