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From Dorko's Desk

There are about three hundred essays and book reviews here. They are typically  around 600 words and range from purely philosophical to practical matters for all of us handling patients

The Analgesia of Movement

This appeared recently in The Journal of Osteopathic Medicine published in Australia

Discovery and Abduction

There is a category of reasoning that truly leads to scientific advancement, and this is it. 

A Sense of Things

Some exciting news about the possibilities of palpation

Christopher and Daniel

A review of two recently published and related novels by Mark Haddon and Steve Martin

Without Volition: The Presence and Purpose of Ideomotor Movement
This is a major statement about the movement that Simple Contact promotes.

With Death Comes Food-Asperger Syndrome and Physical Therapy Practice

It is easy in the world to live after the world’s opinions; it is easy in solitude to live after our own; but the Great Man is he who in the midst of the crowd keeps with perfect sweetness the independence of solitude.

Ralph Waldo Emerson

A Big Mistake

Some disturbing information about the proposed connection between strength and posture

Asking Why: Evolutionary Reasoning and Manual Care

Another good reason to stop coercing patients

The Re-Enchantment of Therapy

"There is no essential conflict between enchanted living and practical, productive activity; they can serve each other: one delighting the spirit of ambition, the other comforting the heart" Thomas Moore

Beautiful Dreamer

This is connected to "Dreamcatcher" found elsewhere on this page

Negative Space

My attitude toward holism may disappoint those who see me as a thoughtful and “open-minded” practitioner. I hope this essay will help them understand my concerns

The Matrix and Me

Are you Neo or Cypher? Back to the movies for another lesson about changing therapeutic practice 

The Man Beneath the Tree

Over a hundred years ago William James talked about how we inhibit movement that can help us. My patients demonstrate this every day.

The End of Evaluation?

"Physical therapists want very much to appear competent and knowledgeable, but while doing so they have ignored the very thing that makes many of their elaborate evaluative procedures irrelevant..." 

There are some pretty radical ideas here but I think the time has come for us to consider them.

Do Nothing

I expanded on my review of K.C. Cole's book about nothing here. This is all about the absence of technique in Simple Contact.

Alzheimer's Gift

A review of David Shenk's wonderful book, The Forgetting

Wabi Sabi

Something more about therapeutic presence and attitude

Searching for a Firm Persuasion

This is a review of poet David Whyte's latest book of prose

On The River

Something I wrote a few years ago. It still works as a metaphor for clinical life

History and Imagination

More about our patient's stories and how they might change

The Alien View: Consilience in Physical Therapy

Some thoughts about the deep model of pain from our greatest sociobiologist

Magical Thinking

How can you tell when something probably isn't true?

The Morning After

 Hans Christian Andersen's take on Central Sensitivity

Much Ado About...

This was inspired by K.C. Cole's newest book, The Hole in the Universe

Body Counseling

Another explanation of the rationale behind Simple Contact

Topical Issues in Pain-Two volumes edited by Louis Gifford,  P.T.

Back Pain Solutions-A new book by Bruce Kodish  PhD., P.T.

Removing the Door

This is my latest analogy for handling patients using Simple Contact

The Last Sorcerer

This was inspired by Michael White's biography of Isaac Newton and originally appeared in four parts on Rehab Edge.

Not In Kansas Anymore

This is my latest attempt to provoke the myofascial release community into a dialogue about their work. So far, I've heard nothing.

Why The Movie Cast Away Is Precisely About My Work 

Another trip to the theatre will be required to get the most from this one

Butler's Latest

This is a review of David Butler's The Sensitive Nervous System

Doctor Do Little

I can't take credit for all the funny lines here, but I did enjoy writing this.

Creative Movement for Pain Relief

This is essentially what I will speak about to the Performing Arts Special Interest Group at The APTA Conference in San Antonio. 

Escape Velocity

This came from a conversation I've had many times as I travel and teach. Perhaps someone out there can relate.

Back to 34th Street

I'm posting this during the Christmas Season 2000. It's another trip back to the movies for those of us who learn best there.

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

I'm told that this explains things pretty well

Why We Believe

A bit more about how and why belief often drives practice-and why that's so hard to change

No More Mister Nice Guy Part I

Ever hear of Cultural Relativism?

No More Mister Nice Guy Part II

More about "energy medicine" from a reformed cultural relativist

Running With Buckeye

What our dogs might teach us about recovery from trauma

Nothing Special

This begins with a quote from Zen Mind, Beginner's Mind

Touch and Sensation: A Deep Model

This explains why simply touching another can have so widespread an effect

Yoda's Lesson

Some more thoughts on the technique of Simple Contact from Star Wars

No Deep Model: The problem of empiricism in alternative practices

A wonderful essay from The British Medical Journal inspired this

Seascape

I was very impressed with Sebastian Junger's The Perfect Storm. Here's what it inspired.

What Went Wrong: Postmodern Thought and Physical Therapy Practice

Ever wonder why some of your colleagues ignore rational thought?

Moshe's Best Lesson

Another look at the art and science of Feldenkrais' work

Surrender, Dorothy

Back to Oz for another lesson about corrective movement

Ghosts in the Machine

Yet another trip to the movies. This time to a Steve McQueen classic from 1966 

The Third Way

Just a short piece about another way of approaching practice

A Well-Adjusted Child

It's amazing what you can learn in kindergarten

Bones and Me

A conversation with my imaginary friend

Understanding Scott

Ever see a patient change for no apparent reason? Consider seeing them in this way.

Kindergarten Cop

This movie is the best example of restricted expression I know of.

Inner Space

How powerful are our stories?

FAQ's about Simple Contact 

Look here for answers about my method of management

ANT

Some more thoughts on neural tension

The Rocking Horse Winner

A few months ago the Journal of the American Physical Therapy Association asked for thoughts about the future of the profession. This letter was inspired by an old D.H. Lawrence short story.

The Alchemist Within

Some speculation on the meaning of our internal activity

Beowulf, P.T.

The newest translation of this ancient tale inspired this

The Scarecrow's Demise

Once again, The Wizard has something to teach us

Omission

A problem with Gerber's new book about "energy medicine" is exposed

  Lost

Not knowing where to go next can be the best thing to happen in clinical life.

  Movement and Creation

Ever wonder why pushing someone doesn't often help?

  One Hand Clapping: Physical Therapy in the Twenty First Century

What have we become?

  Movement and Imagination

Sometimes little things mean a lot.

Principles in Simple Contact; Letting Go of Technique:
"Principles are sources of discovery; once triggered, they enable the inspired person continually to invent creative strategies for working with others."
          Don Johnson
 Life on Mars:
This is another comment on alternatives to scientific thought, and how our profession deals with that."
 Neuropathic Pathogenesis; The Case for Neural Tension:
This is a brief overview of the recent literature supporting the theory that slight alterations in the neural tension would account for much of the chronic pain seen in orthopedics.
 The Origins of Simple Contact:
Some thoughts on the nature of palpation.
 Someone Else's Life:
"Stress means you're living someone else's life."
                              --Sam Keen
The Wrong Question:
Maybe we need to focus a bit more on theory and less on results.
Creative Movement:
I wrote this for the general public in a local "Wellness" newsletter. Maybe it's something you can use too.
More Thoughts on Simple Contact:
Once again, the art of juggling has something to teach me about the nature of Simple Contact
Sacred Knowledge:
This originally appeared in Advance for Physical Therapists and Physical Therapist Assistants. It might help you clean out your storage areas, including those in your head.
Instinct and Inhibition:
There is a kind of instinctive movement our culture does not like, and it has attempted to replace it with "proper" posture and movement that is little more than cosmetic. Could it be that this has resulted in an epidemic of chronic pain?
Maybe Today:
It's reasonable to wonder how long it will take for a non-pathologic problem to resolve. Here's one possible answer.
Tradition:
I went to one of my favorite musicals to find out why ineffective methods of care remain so popular.
Samurai Therapist:
Sometimes it's not what you do but how you are that makes things happen.
Warmth:
There's a common result to effective handling, and here it's explained.
The Sound of Music:
Sometimes the thing that seems to be making us worse, we cannot live without.
After the Fall:
I think what the patient says here will sound very familiar to most clinicians. This essay offers you a way of helping people move toward recovery when they are stuck in their past.
A Kind of Health:
What does painlessness look like? The answer might surprise you.
Winnie-the-Pooh P.T.:
Being of little brain might not be the worst thing for some therapists, and for this I'm personally grateful.
Searching for Our Own Secret:
Looking in the dark for the things we need might be our only option, especially if that's where we lost them.
Revelation:
This is a companion piece to "Searching for Our Own Secret"
Peg's Piano:
This is a follow up to "The Piano Lesson" also found on this site.
Our Own Two Feet:
Dorothy and her gift are never far from my thoughts. Here's another example.
Layers:
"We cannot live (and society cannot function) without these covers, yet we also bemoan the sequestering of a supposedly true self."

        Stephen Jay Gould

The Choice:
Sometimes therapy hurts.
Jumping Into the Well:
Some thoughts on why we practice in so many ways, and how your practice might be unique to your way of being in the clinic.
A Simple Cup of Coffee:
Sometimes a small act can be seen for what it may contain and imply about something much larger.
When Dorothy Touched the Lion:
Bert Lahr's "Cowardly Lion" was tragically true to life. There's a lesson about pain and fear in his first scene in the movie.
Pain and Poetics:
"Imagine my surprise, sitting a full hour in silent and irremediable fear of the world... The poet David Whyte offers us some profound thoughts about touching our own fear, and relieving our pain.
The Purpose of Attention:
Some men live with an invisible limp,
stagger or drag a leg. Their sons are often angry.

If a man, cautious, hides his limp
somebody has to limp it!

          from "My Father's Wedding"
                                    by Robert Bly
No, Virginia, There Is No Human Energy Field:
Over a hundred years ago a letter from a newspaper editor became a cherished part of our cultural heritage. Perhaps this small parody will also, but probably not.
Therapy as Craft:
This originally appeared in "The Therapy Student Journal Ezine." I think there's something here for those of us long in practice as well.
PT in Service:
Hermann Hesse is not normally thought of as a mentor in therapeutic philosophy, but he's one of mine. This essay explores the possibility of our acting as more than just helpers or fixers.
Assumptions:
How much does a patient's history influence the care you provide?
Picking 'Em Up:
The art of juggling continues fascinate me, and I occasionally see the elements of the therapeutic art within its performance and practice.
Flight From Cincy:
A flight from Cincinnati to Cleveland can remind you of your clinical life. That is, if the weather is just right.
Searching for Symmetry:
"To see what is general in what is particular and what is permanent in what is transitory is the aim of scientific thought."
                    Alfred North Whitehead

This is a sequel to The Forgotten Movement.

The Piano Lesson:
"In the mid-morning my mother sits in her chair, hot tea at hand..."

This was written in '93. It was my first description of ideomotor movement.

The Quantum Scam:
"Energy Medicine" has a way of misusing physics that truly irritates me. This essay asks some questions about that.
The Forgotten Movement:
Between the idea
And the realty...
Falls the shadow
          - T.S. Eliot, "The Hollow Men"
In the Night:
At first
it is the same nightmare:
the pain factory
deep in the interior,
the blast furnace going
half the night,
driving the muffled
engines to make enough
hurt.
          from "Night Shift" by Karen Fiser
 
Why I Never Use the Word "Release" :
I'm no fan of "myofascial release." Here are just a few reasons why.
 
Playing Through:
Errant shots are part of the game of golf. Clinical errors might not be as common, but they are equally unavoidable.
 
Bill's Gift:
Only when we learn to put up with ourselves can we arrive at a place of interior peace.
         Thomas Moore
 
The Body Has Its Reasons:
Interpreting the shape and movement of another will sometimes prove extremely useful, but it is just as likely to mislead us.
 
Crazy Charlie:
Sometimes the most obvious things are not really important.
 
Contemplating Change:
"When the external act decreases,
the internal act increases."
          Marsilio Ficino - Fifteenth Century Philosopher
 
The Neverending Argument:
I don't think that the divide between my form of reasoning and practice and some others will ever diminish much. This describes part of the problem.
 
Therapeutic Absence:
How is physical therapy like astrology?
 
What Do You Think You're Doing?:
When the use of heavy pressure with the hands begins to break down the therapist, it's time we reconsidered the nature of the materials we are trying to alter.
 
The Presence of Magic:
"The most beautiful thing we can experience is the mysterious. It is the true source of all true art and science"
             Albert Einstein
 
Baby Bear's Bed:
"She came finally to a small bed and laid down upon it. It was not too hard, and not too soft. It was just right. Very soon she fell fast asleep."

From "Goldilocks and the Three Bears"

 
The Passive Voice:
The skills we acquire in life are not always chosen. They are often the end result of what we had to do in order to get by.
 
One Note:
How might manual care be like playing the harmonica? Look here to find out.
 
Tin Men:
Some reference to The Wizard of Oz shows up somewhere in my life at least once every week. Here's another lesson from this classic story.
 
The Trauma Trilogy:
These essays are inspired by Peter Levine's new book, Waking the Tiger; Healing Trauma. They contain a brief explanation of his theory of human response to trauma and how we might view its relation to our chronic patients and their care.

There are references to ancient mythology, Star Wars and modern research into human physiology and memory. What more could you want?

Those Moments:
There are moments surrounding the progress that therapy might induce. Knowing what they're like might help us create more of them.
The Second Level:
Were you ever sorry you asked someone how they were? Like it or not, therapists must often do this, and this essay examines the purpose and consequences of going there.
Scars and Opportunity:
Perhaps nothing reveals as much about a therapist's philosophy of manual care as the way they approach scars.
Dreamcatcher
Fans of Native American art will recognize this item and its popularity attests to its charm. Perhaps in another consideration of dreaming we may find some movement that relieves pain.
The Characteristics of Correction:
Pain relief often boils down to simply moving in a corrective fashion. If the relief is not immediate (and often it isn't), how can we know we're at least on the right path? Here's how.
Jennie's Knight:
The purpose of ritual is to wake up the old mind in us, to put it to work. Without ritual our ancient knowledge is ignored.
          Z. Budapest
El Nino:
Everybody talks about the weather, but nobody does anything about it.
          Mark Twain
A Superficial Art:
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.
Backaches and Earthquakes:
Preventative medicine is all the rage, but for all its usefulness, it doesn't often help us to predict whether or not someone will hurt.
Until You Cry:
Patients with a history of painful movement have to somehow be encouraged to extend, to lengthen, to find some alternate or newly discovered path toward movement from the center. Can some elements from the art of juggling offer them that?
The Vase:
Is effective manual care dependent upon our skill, or on something else?
A Hug From Davey:
As this is posted, the Cleveland Indians are playing in the World Series. Here you'll find the reason why.
It Might Only Be Glowing:
Always this fire
smolders inside
If it remains unlit,
The body fills with a dense smoke

from "Out on the Ocean" by David Whyte
Movement and Desire:
To be nobody-but-yourself in a world which is doing its best, night and day, to make you everybody else - means to fight the hardest battle which any human being can fight; and never stop fighting
          E.E. Cummings
Just the Right Words:
"What exactly do you say to people while you're treating them, Barrett?"
Beyond Intuition:
"We become physicians only when we know that which is unnamed, invisible, and immaterial, yet has its effect."
          Paracelsus, German physician/mystic, 1493-1541
The Chaos Primer:
A list of terms and definitions relevant to the body as a dynamical system
Simple Contact and Distant Change; A Hypothetical Model:
When technique produces unexpected effects, understanding usually lies in a deeper appreciation of the body's subtle processes. This details what some excellent research has revealed.
The House on Dover:
Inevitably as we age, we settle, choose less movement and grow softer. Maybe it's time for us to accept that.
The Old Guard:
Our tendency to try and straighten others out is understandable, once you realize how we feel about "The Old Guard."
Timeless:
Are the internal events of correction experienced in ordinary time? Consider this piece about "body time," and see if it doesn't relate to your own clinical experience.
His Father's Voice:
Maybe computer science can teach us something useful about assessment and interpretation of findings. This essay addresses the new tendency to separate testing from human interaction.
In The Forest:
This essay proposes that we interpret stiffness in a very different way, and it contains one of my favorite analogies. I use it in the clinic everyday.
Dorothy and Marvel:
I have a personal fascination with "The Wizard of Oz," and I think one scene in particular speaks to our movement toward nontraditional methods. Watch the movie once again, and see what Marvel does with the photograph.
The Suppression of Flight:
There is a difference between emotion and instinct, and understanding how these relate to dysfunction and recovery in people with pain is essential in the clinic. This essay explains one theory behind the effectiveness of spontaneous movement as a theraputic agent.
The Pollyanna Doctrine:
Within every patient is an attitude, process or movement that, when amplified, will assist in recovery. Assessment and treatment should include acknowledging these, and making the patient aware of them.
Pain and Expression:
Movement toward correction most effectively comes from the patient without effort. Why don't they just do it? Here's one idea.
Rumination - Part I:
A diagnosis of fibromyalgia is typically difficult to manage manually. This is about finding a way to enter the body gently and effectively.
Rumination - Part II:
Manual intervention for fibromyalgia must begin and end without coercion. This is more about how that might be considered.
Us and Them:
How different are our patients from us really? When we assume that we are essentially distinct as a community, the best part of therapy may be lost.
The Loss of Care:
The increasing trend toward training in therapy comes at some cost. And often enough, both patient and therapist pay.
The Tracker:
An effective clinician must see and understand invisible processes by the signs they leave on the surface. Within this seemingly mysterious skill dwells the essence of scientific method.
Woody and Me:
Many common strategies for treating reflex sympathetic dystrophy are chancy. Perhaps a more conservative game plan would be a better choice.
Reverie:
Private practice physical therapy is no walk in the park, and the past couple of years have not proven kind to it. This piece appears as it happened one day. I don't think I could have invented it.
Incantation:
When something is finally named in a certain way, our understanding of it and the control we can exert is altered, almost magically. This essay defines the difference between nominal and essential diagnoses, and explains how naming what we treat can make all the difference.
The First Door:
How do you begin care? This essay offers a way of considering the patient before therapeutic handling can start.
Tributary - Part I:
Which parts of you are like a river? Gaining access manually to things that flow deep within our patients can be tricky, but understanding the nature of the surface may help. Let's start floating here, and dive a little deeper in Part II.
Tributary - Part II:
In Part I, the river we need to affect is described. This is about how to get there.
The Ignorance of Jed:
So, you thought that comedy re-runs had nothing to teach us? Not! Come and listen to my story 'bout a man named Jed, and discover the possibilities of reflexive effect in manual care.
The Fatal Heuristic:
Think muscular strength and posture are related? Think again.
The Caver:
Ask anyone over the age of 75 who Floyd Collins was and they'll probably know. The rest of us are too young. But Floyd's predicament remains as compelling today, and I think we can connect it to the difficult moments we all know when treating nervous irritation.
Angelo's Revenge:
Think that the national obsession with appearance is something new? This might surprise you.
Adaptive Potential; A New Concept in Pain of Mechanical Origin
Sometimes measuring range of motion doesn't help us account for our patient's pain, or lack of it for that matter. Consider this category of function the next time what you see and what you hear don't match up.
As Two Rivers Meet; Some Thoughts on Manual Care
This begins with a few lines from a William Stafford poem about palmistry and meanders through the issues of reflexive effect, the fractal nature of the skin and the cellular response to touch.
The Nonlinear Being
Two essays about the significance of chaos in human physiology and the clinical implications of fractals in anatomy.
Collecting Butterflies
Stepchild
Fractal Geometry in Anatomy; A reference list for further study.
Moving With Sound Alone; The Use of Poetics in Manual Care
Finding a way to speak simply and effectively about the internal processes that touch may produce or enhance is probably the most difficult skill any caregiver seeks to acquire. This is a brief essay about my personal experience with The National Association for Poetry Therapy and how it has affected my practice.
Publication List
I've been writing and publishing steadily for years now. Take a look and see if any titles interest you. You can obtain free copies of whatever you'd like by sending a request along with your regular address to my email.