Barrett L. Dorko, P.T.

          I've concluded that truly effective care contains moments that are distinctly different from our ordinary life. These moments have a timeless and surprising quality and they provide the ground upon which something can begin to grow.

          Creating a clinical environment that encourages these moments is possible, but only if we understand the qualities of bodily movement, attitude or sensation that characterize correction and self-revelation. I'll mention three of them here.


          I'm speaking here literally of the warming effects of blood flow. When it rises to the surface, we blush, and this can both be sensed by the patient and palpated by the therapist. To my knowledge, nothing but an increase in blood support would account for this, but that this would be enough. The body's capacity to do this is remarkable, and the movement necessary to enhance it needn't be large or powerful, but only corrective. This warmth is the signature of parasympathetic flow and without that, pain and dysfunction are inevitable.

          Sometimes you can elicit warmth with your touch, your smile, your voice, or your presence. Try all of them, and what you do can be enhanced well beyond your expectations.


          Given therapy's emphasis on goals and elaborate strategies to achieve them, it may sound strange to suggest that acceptance is an essential aspect of correction or progress. But what I'm saying is that there must be a moment when all that is present is seen. This will include both our gifts and our deficits simultaneously. In fact, when only the disability is seen and documented, our capacity to overcome it may be invisible.

          Acceptance is not resignation, and it does not imply that we will settle for the current situation. Acceptance is a non- judgmental vision of the present moment and all that it contains. It precedes change, and when change occurs, we should then help the patient to pause briefly in the course of their care, and find acceptance again.

Personal Expression

          This is probably the hardest characteristic for me to explain, and it was the aspect of therapeutic progress that I came to understand last.

          No matter the disability or the therapy that engages it, an individual human is involved, and their unique ways of being in the world often hold the key to progress.

          Al Huang writes in Embrace Tiger, Return to Mountain - the Essence of T'ai Chi* (Real People Press 1973)

          "One of the nice things about working in the arts is that they don't deal with the measurable, countable parts of the human existence. The things that really tie us together as human beings, as people, are the things that we really have no visible means or approachable way of measuring. Maybe we find a new way of expressing a feeling, a new way of saying, a new way of doing, but most of the time we are repeating the same old thing. Life is this way. Every morning begins the same but develops differently. And t'ai chi begins the same, but it's always different."

          Huang is speaking here of the essence of a movement that many pursue in an effort to improve their health. It is full of acceptance and warmth, and it emerges uniquely from each individual.

          When your clinic invites such things, the moments that contain some therapeutic movement will multiply, and your practice will transcend the ordinary.

          I'd suggest you look for them in your own life as well.