Question
Dear Mr. Gold,

I have read many of your posts, and am concerned.  Your answers all mostly the same and only concern Somatic technique.  According to your bio, you have no formalized didactic training in diagnosis, and there is no indication of any qualification which would allow you to opine on injury, disease or diagnostic matters, let alone treatment.  In the United States it is illegal for someone to render diagnostic and treatment advise unless they are licensed to do so.  Therefore, I humbly ask what your legal certification is, and are you licensed in any state to diagnose and treat musculoskeletal injuries.

I look forward to your response, as I am always eager to expand my understanding of other practitioners and their techniques.

Respectfully,
Dr. J. Shawn Leatherman

Answer
Dear Dr. Leatherman,

First, I must address the tone of your public communication.

Your excorciating comment on my response to a woman with a history of whiplash injury hardly communicates "concern"; it communicated outrage.  The rest of your comment contributed nothing to an understanding of her condition.  Basically, it was an ad-hominem attack and a non-specific attack on a viewpoint other than the one from which you operate, with references made to "studies" but no information content.  This is known as "argument by resort to authority."

Nothing I say can be construed as "diagnosis," as I don't opine on or diagnose "diseases"; the questioners generally provide the diagnosis given to them by their medical practitioners.  I describe functional relationships.  My explanations are rational; they make sense, and they are true-to-form.  They may be, in some cases, oversimplified, but they provide at least a starting point in a forum where limited amounts of information are exchanged.  If you want to argue specifics, I'm open to consideration of specific points, but please keep the tone of your communications collegeal.

In our profession, we do not "treat"; we don't do anything "to" our clients; we don't do manipulations or adjustments; we don't stretch them.  We teach our clients to control their own muscles and movements to alleviate compression and strain and recover freedom of movement and physical comfort; we do what chiropractors claim to do:  we activate, through a teaching process, the body's innate intelligence through an internalized learning process that involves the person's self-awareness and control.

If you are eager to expand your understanding of other practitioners and their techniques, consider learning about their theoretical underpinnings, rather than concerning yourself with the certifications and qualifications that legitimize practitioners and their opinions only within your frame of reference.

The term, "doctor," stems from the same root as the terms, "indoctrinate" and "doctrine."  The best doctors confer understanding and foster self-sufficiency, and do not merely dispense "treatment."

You seem not to understand the somatic viewpoint.  Allow me, humbly, to present some information, which may seem obvious.

First thing:  there is a universal response to stress and injury among living organisms:  they tighten up.  This is known as "Trauma Reflex" -- something everybody has experienced.  Muscular contractions are sufficient in the short term to cause discs to bulge or herniate; to distort spinal curvature; to cause nerve impingements; to cause reflexive reactions such as changes of movement; and to cause stress-related disorders, such as headaches and changes of autonomic function.  In the longer term, they are sufficient to cause disc degeneration and to lead to spontaneous disc fusion.  Incidents of stress and injury leave impressions on the nervous system that often persist indefinitely, unless modified by new sensory-motor learning, impressions that show up as compensatory adaptations -- muscular contraction patterns.

In your professional assessments, you must have noticed that every patient with paraesthesias, every patient with abnormal spinal curvature, every patient with headache patterns, has patterns of muscular contraction directly related to the dysfunction.  These contraction patterns can generally be traced to a traumatic incident, in which there may or may not have been tissue damage, but in which there was a shock to the system and a reflexive movement to self-protect by shrinking inward -- by contracting.

There is no adequate way to modify these patterns of muscular contraction, in the long-term, by outside manipulation.  They brain's adaptive patterns are paramount and supercede outside manipulations.  That's why chiropractic adjustments often don't last and require indefinite repetition.

That said, there are times where there has been tissue damage -- such as ligamentous sprain or strain or a disc tear, or a muscle tear, or a bone fracture.  When such is the case, tissue healing must occur before somatic education can be effective because the trauma reflex continues as a healthy organismic response to prevent further tissue damage and permit tissue healing, and so contraction patterns re-appear.

A final word on neuromuscular reaction patterns to injury (muscular contractures):  they don't come from spinal misalignment or subluxations; it's the reverse:  spinal misalignment comes from patterns of pull communicated through the soft tissue;  bones go where muscles pull them.  16,000 pounds-per-square-inch of force notwithstanding, the long-term residual effects of an incident on posture come from long-term patterns of muscular contraction.

Finally, if you would like to understand somatic education better, get a copy of the book, Somatics -- ReAwakening the Mind's Control of Movement, Flexibility and Health, by Thomas Hanna, Ph.D. You can get it from Amazon.com.

Now, if you'd like to discuss the case about which you attacked me in a public forum, I'm open to intelligent discussion, as we can often learn something new from such discussion.

respectfully,
Lawrence Gold