Wednesday, April 30, 2008

The strangeness of neural crest

At last I found, bought, and am busy reading a book that goes into excruciating scientific detail about neural crest, Neural Crest in Development and Evolution (1999), by Brian Hall at Dalhousie, Halifax, Nova Scotia.

Neural crest is considered by Hall as "the fourth germ layer". It makes a large amount of surprising structure in the body and head beside peripheral nerves (sensory and autonomic) and the support cells for them. There is a large amount of info here about ectodermal/mesodermal interaction, what induces what, etc. Hall is careful to point out (see the online lecture linked to below) that what is currently known about neural crest is from work done on chicks, and has only been extrapolated to humans - human neural crest may have some variations to offer up to future investigators.

Because of what we do as manual therapists, I think it's good to understand what this embryonic "layer" does and what it makes. It derives from ectoderm, after the neural tube is already well on its way to forming, and long after mesoderm has already been kicked off by ectoderm and is busily making things out of itself. Like mesoderm, it migrates inwardly, but unlike mesoderm, it makes nerves and a few structures, e.g., connective tissue inside glands, something I never knew about neural crest. I knew it made most of the face including bits of jaw and the teeth.

Apparently (according to Hall) it was neural crest cells which may well have made bony plates inside skin in our ancient finny forbearers. It was mentioned in Your Inner Fish that teeth are bony remnants from long long ago, although the neural crest connection wasn't pointed out specifically. The neural crest cell populations that make teeth have been separate from those that (can, ostensibly) make (dermal) bone for 500 million years.

Hall is now "retired" and working on a revision of Strickberger's Evolution 4th Ed., a textbook on evolution. This is Ch. 1 (18 page pdf).

Other links:
1. Unscrambling the egg
2. Online lecture by Brian Hall on cranial neural crest (as opposed to "truncal" neural crest, which behaves differently in modern mammals and birds). (The slideshow takes frequent rests; patience is advised.
3. Short summary of his achievements (about a third of the way down the page), contributor to the emergence of Evo-Devo
4. The book, Variations, which he co-authored
5. More info on Brian Hall and his work

This, along with reading the Sensory Hand, will no doubt keep me busy for quite awhile.

Wednesday, April 23, 2008


I love how one thing leads effortlessly to another. In the course of preparing the transcript of Buzsáki's interview, I got interested in Vernon Mountcastle.

These days I'm busy reading Vernon Mountcastle's 2005 book, The Sensory Hand. What a great read. What a great researcher. Here's a great review by someone named Edward Jones.

I'm only on page 9, but already he has me by my neurons. He states in a section containing his general hypothesis, his thoughts on small fibre relevance:

1. The small fibres are just as important to sensorimotor "understanding" and function as large ones:
"A general hypothesis I consider at several places in this book is that the small-fibered afferent systems, long known to contain the essential neural substrates for pain and temperature sensibilities, also contribute to the higher-order aspects of the several varieties of mechanosensitive sensibility. They are activated under many conditions by the same mechanical stimuli processed in the large-fibered system, and carry signals to the forebrain that evoke the overall affective components of the sensory experiences. These small-fibered afferent systems activate many distributed areas in the frontal lobe, the limbic areas of the cerebral cortex,and the insula."
He got me with the word "insula." I've followed A.D. Craig, and Sandra Blakeslee's exposition of his work, for a long time now. I first got excited about the insular part of the brain when I found the Olausson paper (see link at end).

2. The small-fiber and the large-fiber afferent systems work together:
"At the same time signals in large-fibered afferents are processed in an elegant and quantitative manner and present to higher-order cortical systems signals that can be detected, discriminated and rated with precision, in quantitative correspondence with the parameters of the stimuli that evoke them."
Indeed, how could they not?

3. Research on the two systems became separated:
"Until now we have learned very little about the final "integration" of these varied inputs in producing overall somesthetic experiences. This integration and its varieties are obvious in everyday life - the touch of a loved one's hand carries overtones not found in more ordinary tactile experiences. The hitherto perceived dichotomy of these two classes of systems has resulted in a parallel separation of investigators. Those talented individuals who have made such spectacular discoveries about the functions of the small-fibered systems in pain and temperature sensibilities now sense that the deepening knowledge of these systems, particularly the molecular aspects of the peripheral transducer mechanisms, will lead to chemical methods of blocking pain at its level of inception,with no effects on the function of the central nervous system. Yet, only a few have taken full account of the broader - or perhaps I should say, other - meanings for behavior of activity in the small-fibered systems. Of course, the same is true inversely for those investigators involved in quantitative studies of the brain mechanisms in mechanoreceptive sensibility. They have because of the constraints of experimental design and execution not been able to take into account the accompanying activity in the small-fibered systems and the powerful contributions they make to the overall somesthetic experience."
Maybe we can lay the blame on Cartesian dichotomy.

4. Mountcastle is trying to bring the two fields of investigation together again: this book is his effort to provide a "sublation":
"This division now ends, and concerted efforts are directed to study of the somatic system, complete. That such a dichotomy has not occurred, or at least not to the same extent, in studies of the visual and auditory systems is attributable to the relative simplicity of those systems. Compare, for example, the 12 different sets of first-order fibers innervating the primate hand with the much smaller number of afferent sets leaving the eye or the ear. The visual and auditory systems are by no means simple, but only appear so when compared with the somatic afferent system, in which a number of afferent sets with congruent peripheral distributions feed many ascending systems. Moreover, at several transition stations of these systems there is a complex interaction with motor mechanisms. I make here an effort to begin the process of unifying these two major fields of research. The reader will find in several chapters descriptions of the small fiber systems, with some effort to show how they condition the overall mechanoreceptive sensory experiences."

Let's repeat something in there for emphasis:
That such a dichotomy has not occurred, or at least not to the same extent, in studies of the visual and auditory systems is attributable to the relative simplicity of those systems.
What? Relative simplicity of vision and hearing?
This explains why touch has been ignored for so long. Production and perception of sensory physical contact is more complicated to study/make sense out of than either vision or hearing.

I looked for some good links to bring here on "somesthesis", but all I could find (so far) are simple definitions like this one.

I have high hopes for this book. I'm hoping to uncover material that will make sense out of human primate social grooming, make meaningful connections. I hope it will clarify a path that can be taken by people (like me) who want to see this form of human interaction not just lifted up out of the muck of institutionalized human greed and exploitation, but restored clean and shiny and science-based to those who want to bring hands-on care back into good use, good service, ethical service.

Additional Reading:
1. The Brain Voyager; includes a picture of Mountcastle in his retirement
2. See Sandra Blakeslee's article, A Small Part of the Brain and its Profound Effects (6th one down the list)
3. Unmyelinated tactile afferents signal touch and project to insular cortex; nature neuroscience 2002; Olausson et al.

Monday, April 21, 2008

Transcript For BrainScience Podcast #31

I have prepared a transcript of Dr. Ginger Campbell's Episode #31, Brain Rhythms with Györgi Buzsáki, with her permission.

You can read it here: Synchrony and Oscillation in the Brain.

The transcript was written to assist my own learning of the material in both the book and podcast. Here is a link to Brain Oscillations: Ten Part Series, on the same topic.

The ideas in the podcast are much easier to follow if one can read along as one listens; the intention of publishing this transcript is for it to be a listening/learning aid for anyone who wishes to dig deeper into understanding the presentation, and the book upon which it is based.

Sunday, April 20, 2008

More on Lorimer Moseley, and mirror therapy

I stumbled upon a blog called Psychology of Pain (in which I found a link to humanantigravitysuit, about which I'm pleased), authored by Gary Rollman, Professor of Psychology at UWO in London Ontario.

In it I found a post, The Mirror Cure for Phantom Pain, which is linked to an article by Lorimer Moseley, PT and currently pain researcher at Oxford.

The article by Moseley, also called The Mirror Cure for Phantom Pain, has just been published in SciAm.

"To consider how mirror movements might reduce pain, it might be helpful to first consider what pain is. I argue that pain emerges from the brain in accordance with the brain's unconscious perception of danger to the body part in question. Sensory input of danger (called nociception) is important, but not sufficient (nor necessary actually), for pain. Perhaps mirror movements simply convince the brain that all is exactly as it should be, which removes the brain's need to evoke pain. Alternatively, perhaps mirror therapy is a great distracter: distraction remains our most effective analgesic. Such explanations are very reasonable, but not particularly exciting.

Here is a more exciting theory, one the authors' introduction suggests they had in mind. It is based on the idea that phantom limb pain results from an internal conflict in the brain. Although sensory feedback, from the nerves that used to supply the missing limb, tells the brain that the limb is still present, visual feedback tells the brain it is not. According to that theory, seeing the phantom would remove the conflict and attempting to move the phantom (i.e. the other two conditions) might exacerbate it (although removing visual feedback didn't help, which doesn't fit neatly into the theory). That anaesthetizing the stump can eliminate phantom limb pain seems consistent with this theory. Perhaps anaesthetizing the stump brings sensory feedback into line with visual feedback, whereas mirror movements bring visual feedback into line with sensory feedback."

He goes on to discuss implicit versus explicit movement, citing one study showing no difference, and another that does.

References, additional reading:

1. The Neurotopian: Mirror Box Therapy

2. The Neurotopian: Pain for Dummies

3. Neurotonics: blogpost search for Virtual Body

4. List of publications by Lorimer Moseley (up to 2005)

How I really feel about chiro

In reference to What the ....?:

What is irritating about the chiro blogathon site mentioned previously (to which my own (PT!!!!) blog has been attached without my permission), is that there is no contact address provided so that I can protest directly about my blog being lumped in with chiro blogs.

There is, however, a little paypal thingy so that people may "donate" to help "maintain" the site... how chiropractic. Really.

I haven't been very outspoken on this blog about how I really feel about chiropractic. When I say anything much about manipulative therapy, I usually lump orthopaedic manual therapy in with chiro as being nearly indistinguishable on the surface, i.e., in that both groups love to manipulate, want to keep SMT (spinal manipulative therapy) alive as a treatment. I think this is still true; however, I may have been a bit myopic because of how I've been a PT for nearly 40 years and have never needed to use SMT on anyone. Upon digging deeper, and as a clarification, and to reassure ortho PTs that when I have to pick, I will always pick them over chiro any day, I offer this blog post.

Evidence in Motion

At Evidence in Motion, there is a nice thread about chiro in general and about cervical (neck) manipulation (which I have always, always been opposed to) in particular. The thread points out the video, Kinsinger Report on Chiropractic (about a half hour). It's worth talking about this very informative video for awhile, which I will do in a minute. But first, I want to say that I think this thread represents a good example of what "evidence" can be used for - i.e., it can be used to highlight chiro hubris, blow holes through chiro hegemony. A chiro came on the thread to attempt to dissuade readers away from the Kinsinger video, and a PT came on to say, au contraire, here is evidence to support the contentions made in the video about cervical manipulation risk. If you would like to examine this more closely, read the thread itself.

The Kinsinger video

So, I want to discuss the actual video now: In it, Bill Kinsinger, an MD, points out the public perception of chiropractic: i.e., an
"advanced form of physical therapy with a focus on treatment of low back pain."
He points out the perception chiropractic has of itself: i.e., an
"alternative comprehensive health care profession whose practitioners see patients on a primary care level treating everything from ear infections to PMS."
Then he points out the medical and physiotherapy view of chiro: i.e.,
"a philosophical belief system based on ideas that are not only unscientific, they are actually anti-scientific."
I agree. In fact, I couldn't agree more.
He says chiropractic has remained virtually unchanged since 1895. The ideas it is based on have not evolved, that the field more closely resembles a religion or a cult than a health care profession.

Kinsinger covers the main details on how chiropractic originated (a Canadian immigrant to the U.S., D.D. Palmer, founded it. As a Canadian, I apologize deeply for this..). By way of example for how non-evolved chiropractic is, he points out its superglue-like adherence to a concept called "vertebral subluxation complex" that has never been shown to exist, was something dreamed up by Palmer, and still rules chiro thinking. He goes on to outline what he terms "milestones to legitimacy", or how chiro has managed to crowbar its way into legitimacy through political ways and means. He discusses the fight (won by reason) in Florida a few years ago to keep a chiropractic program out of Florida State University. He talks about how PT has done most of the existing research on manipulative therapy. He points out:

1. the questionable benefits for musculoskeletal concerns and flat-out non-benefit for non-musculoskeletal concerns

2. the anti-vaccination statements emblazoned over doorways in chiro schools

3. risk of stroke associated statistically with over utilization of neck manipulation

He invites people to check out the grass-roots advocacy groups such as Neck 911. He ends his presentation by saying that PT provides the best hope for the future of manipulative therapy.

Other than my own personal dislike for manipulative therapy (i.e., the high-velocity kind) I agree entirely with this entire video.

Further links and resources

1. Neck 911

2. Petition: Legislate to Warn Public that Neck Manipulation can cause a Stroke (an Australian initiative)

3. The Kinsinger video, The Kinsinger Report on Chiropractic

4. The Evidence in Motion thread, Extra! Extra! The Kinsinger Report on Chiropractic

5. (read about the foiled plans to insert a chiropractic school at FSU, Jan/2005.)

6. Science-Based Medicine blogs in their chiro category

7. Chirotalk: The Skeptical Chiropractic Discussion Forum

8. Confessions of a Quackbuster (many many many more counter-chiro links at this blog)

9. Screwed4life ex-chiro blog

10. Chiropractic is Quackery squidoo page

11. Duplicitous Primates ex-chiro blog

12. (Added June 13/08) Alberta woman sues chiropractic after being made quadriplegic by a chiropractor, also this.


Thursday, April 17, 2008

What the ....?

Somehow humanantigravitysuit has ended up on a list of chiro blogs.

I would like to state for the record, that I an NOT a chiro, and this is NOT a chiro blog.

I am now, always have been, and always will be, a physiotherapist, and this is a physiotherapy blog. Remove me from the chiro blog list. Whoever you are. Thank you.


I don't usually talk much here about belief, because I'm usually too busy trying to sort out what to think. I've "believed" (mentally entertained for limited lengths of time) various things over the course of a life, most of which turned out to have been a complete waste of mental and emotional energy as more information came to light. So long ago I decided the simplest option was to scrap beliefs altogether, including religion (because it is so fraught with intrinsic contradiction it'll drive you crazy if you let it) and just pare away any lingering dopamemes. Not that I still don't know how to have a good time in the private rooms of my own brain..

Just yesterday I spotted this blogpost from an atheist vet, Dr. G, who calls his blog, Wandering Primate. (Sounds like he's embraced his inner primate social groomer as I have.)

I liked this post, A Nice Statement. It seems he saw this posted originally, at Pharyngula, by PZ Myers and did this currently trendy thing called 'hat tipping', which means he acknowledged the post and reproduced it, sort of like what I'm about to do.

I run in a slightly different human primate troop and don't wear a hat, so don't have one to tip, but perhaps tilting my head briefly in the direction of both these bloggers, smiling and raising a thumb in the air would suffice...? So, thumbs up to Dr. G and to PZ Myers, who may have authored it:
"An atheist's creed

I believe in time,
matter, and energy,
which make up the whole of the world.

I believe in reason, evidence and the human mind,
the only tools we have;
they are the product of natural forces
in a majestic but impersonal universe,
grander and richer than we can imagine,
a source of endless opportunities for discovery.

I believe in the power of doubt;
I do not seek out reassurances,
but embrace the question,
and strive to challenge my own beliefs.

I accept human mortality.

We have but one life,
brief and full of struggle,
leavened with love and community,
learning and exploration,
beauty and the creation of
new life, new art, and new ideas.

I rejoice in this life that I have,
and in the grandeur of a world that preceded me,
and an earth that will abide without me."

I really like this. It's simple and clear. I don't "believe" it, I agree with it. I'd like to place my favorite Dawkins quote here:
"We are all atheists about most of the gods that humanity has ever believed in. Some of us just go one god further."

And thus ends my one and only blog post on "belief."

Here is an interesting 2-part video, featuring Daniel Dennett, Richard Dawkins, Christopher Hitchens, Sam Harris, called The Four Horsemen:
1. Four Horsemen - Hour 1 (58 minutes)
2. Four Horsemen - Hour 2 (59 minutes)

Saturday, April 12, 2008

"Noise" in the brain

Here is an interesting comment from Carl Zimmer about noise in the brain, Your Brain Is a Mess, but It Knows How to Make Fixes. It suggests that the noise is a problem for the brain to overcome, "damages" its "signals", whereas Buzsáki wonders instead if the brain uses noise, if it serves a fundamental purpose for moving processes along more easily.

The comment on size is interesting - my understanding was speed of transmission was limited by size (as well as by myelination or lack of myelination) but didn't know noise was another issue that related to size:
"our neurons could be much smaller than they actually are. If you packed all material necessary for sending signals as tightly as possible, the branches of a neuron (called axons) would measure just .06 microns [about 2.3 millionths of an inch] across. In fact, the thinnest axons are about .1 microns [about 4 millionths of an inch]. Recent studies have shown that it's noise that prevents them from getting thinner. The thinner an axon gets, the noisier it becomes. Below .1 microns, the noise abruptly rises so much that it drowns out any signal. We might be far smarter if noise didn't keep us from growing more neurons."

Zimmer makes it sound like noise is a problem the brain must overcome. Buzsáki figures it's there for a reason, calls it "deep brain activity", even suggests it is necessary for cognition.

Friday, April 11, 2008

"Monkey College"

In this video, a little primate cousin is being trained to help human cousins with disabilities. The monkey will go to live with a disabled individual, will do all of the handling of objects, even scratch itches and push eyeglasses back up noses, fill watter bottles, lift paralyzed arms up onto wheelchair arms, change CDs, magazines, switch lights on and off. It has agile hands (with a very big S1M1 same as we have, I imagine) and it has a trainable brain reinforced sufficiently through affection and positive reinforcement.

Apart from the admiration one feels for those who have designed and executed such a useful "primate social grooming" facility, and the endearing qualities these monkeys demonstrate, this whole idea puts a really interesting twist on the matter discussed in the previous post - kind of blurs the edge between species.

Tuesday, April 08, 2008

Where did the term "human primate social grooming" come from?

I coined this term, have used it for a few years now. I suppose I should explain what I mean by it.

It arose out of thinking about the whole problem we have with PT having evolved as a culturally specific form of health care, along with most of the others, without good biological foundation (i.e., embryology and evolution), therefore rudderless. Although I've tried to grow myself a rudder, the profession lacks such a thing collectively.

Anywhere humans have a culture, there exists "healthcare." Culturally specific forms of health care we are familiar with in the western world include:

1. manual/physical therapies: PT, chiro, osteopathy, massage (many kinds), and the multitude of techniques named after individual originators who came out of the woodwork, Rolfing, Bowen, all these..
2. medical, surgical and nursing care for life-threatening trauma and disease
3. care for emotional, mental and psychological difficulties, e.g. psychotherapy, psychiatry

Other cultures combine these three main forms in other ways. All are categories of interventions sought, instinctively, by people who are undergoing life-disrupting or life-derailing problems with their bodies or their ability to think or relate appropriately.

Humans are primates, and primate survival is enhanced by being a member of a "troop". All three of these categories represent "help" extended to an individual who seeks it from the social human "troop" in times of either overt or perceived need. One can quibble over what constitutes "true" need; however, usually the most prioritized need is the one that bothers a given individual most within a given time frame. This would include such things as the "need" to breathe, to drink if thirsty, etc. Of the array of "need" states that can be defined, many of which the individual can instinctively take care of, a few seem to be recalcitrant to self-help for some people; e.g., pain is one (defined as a need state by Patrick Wall) that looms quite large for many people who have an active and functional nervous system. Pain is a frustrating phenomenon to endure; it can cause stress, and stress can in turn worsen pain. Pain can reduce one's ability to cope in a mature manner, thus interfering with relationship. Relationships interfered with may threaten one's place in a troop, and threat like that can lead straight to anxiety - for a primate - and more stress.

When stressed, primates (including human) seek social grooming. There will always be those among us who feel best when able to access "social grooming" of some sort for pain or distress or illness, and there will always be a supply of groomers ready to help, because humans are primates. Other primates groom each other instinctively, and so would we, if we were not constrained by "culture" and laws in place to regulate boundaried contact (for good reason). Social needs blurred into biological needs have a way of making culture adapt to them. Enter quintessentially "human" primate social grooming.

Also, enter the collision between who and what humans (collectively) think ourselves to be, and who or what humans (individually) default to in times of stress or physical need - biology takes over. Enter the "professional" splintering of a nurture behavior once fueled by nature into a bunch of modern (correction - let's make that postmodern, counter-enlightened) fragmented, rigorously (or not) regulated, politically defensive turf-raiding, territory-defending groups that are operationally primate troops in and of themselves to a great extent. Some are science-based while others are thoroughly a- or even anti-scientific. They exist in relation to each other, like rail cars on a train track, their position in the train having emerged by their relation to science; they all move along (some eagerly and some reluctantly), clashing, colliding, all ultimately pulled along through time by the chugging engine of Science and Society, the caboose of anti-science bringing up the rear, linked by that primate biological troop mandate "to help" and "to serve" and restore quantity and quality of living to fellow human primates, doomed to never escape the train - unless sidelined permanently, decommissioned due to dwindled popularity or de-legalized by future social contracts. This train is not bound for glory. It is slow and lurches uncomfortably. Cars routinely collide into each other. Any individual can climb aboard anytime onto any car of choice. Individuals that belong to one car can move about the train and visit other cars, check them out.

The whole point of the interaction of human primate social grooming (the non-medical kind, the more strictly manual therapy kind), or the establishment of any therapeutic relationship, is to get the right placebo response (in the Patrick Wall sense) started. All forms of health care are therefore veiled forms of human primate social grooming, and manual therapies are more direct forms, attempts to physically elicit said placebo response.

Social grooming started out as the simple 'nurture of nature', you might say - an animal activity, i.e., mammal mothers attentively licking their pups/kittens/calves etc. Primates took it further into wider social arenas, intra-troop behavior, maintenance of relationship.

Primatologists think one of the factors that may have driven development of our big brain in the first place was that it may have come in handy for keeping track of who was who, and to keep the peace (see Dunbar's number). The initial bonding that goes on between humans (e.g. parent/child) may well need to be reaffirmed artificially once in awhile, such as when there is a period of personal drama or trauma,, chaos or growth, which may or may not include physical injury. What we know for sure is that physical injury is certain to knock one off one's tracks for awhile; how it is handled socially, therapeutically, can be/often is pivotal to good resolution. See here, and here, for old blog posts about the insula.

If that's all true, then good old, non-nociceptive/unresolved 'pain', physical and/or psychological, is a need state all right, one that may require consummatory movement on a spectrum that ranges from just practicing some creative motor output at one end of the scale, further along to active physical relating e.g., hugging/sex with a partner, way over to the far end of the social spectrum to boundaried input of a physical sort from a therapeutic 'stranger', all depending on the individual. In the latter case perhaps the bond inside the patient, their intra-psychic balance, the bond they have, perhaps with their perceived relationship to their own biological life itself, can only be restored through physical human contact, from way outside the immediate family.

I think this is probably so fundamental that everyone just ignores it completely.

There are likely to be social groomers out there who because of human belief systems, won't entertain the possibility that we evolved instinctively doing this merely because of how healthy it feels, both for the groomer and the groomee. (Manipulation is likely more of a latecomer on the social grooming scene. It has its own unique sensory charm for some, I suppose.) There are still more who insist on trying to turn (manual) human primate social grooming into something quantifiable, standardized, objectified, reproducible... something more "human" (by mechanized western cultural standards), but possibly something at the same time less "humane" (by human primate social grooming standards). Still others get the kinesthetic part, love the kinesthetic part, but refuse to try to understand such a phenomenon scientifically - they even reject it, preferring to adopt mystical explanations instead, presumably because these "feel" better. We probably all get held back by all these proclivities.

This was once a huge problem/obstacle/quandary for me.. I could barely see the outline of it and it felt awfully big, like a chasm in the fog. When I came up against it in my own thinking I just didn't quite know where to go with it, how to dissect it, deconstruct it, deal with it, digest it. I understood it but not well enough to dispel it. I felt capable of nothing but blatting it out halfbaked. It made me feel cognitively dissonant, weak in the knees. Maybe the whole faintly nauseated feeling cognitive dissonance confers is what drives PTs and other "groomers" off to once again cling to religious anti-evolutionary belief systems. The truth (and I think this is truth) kinda sucks, doesn't it? - adds no glamour at all to our profession, makes us humble, puts us in our place at the bottom of the health care hierarchy, confronts us with the probability that we mostly deal with the non-human underpinnings of physical human existence, the deeper ways that bodies and nervous systems are connected. To go there boldly means confronting the fact we are primates, I think. And that like monkeys, our various manual therapy professions, by virtue of being "hands-on", and more primally primate than others, perhaps.

Yet, when I pondered the matter from another side, as one who instinctively moved toward this type of work when I was still a child, driven perhaps by overactive mirror neurons, it feels real and honest and natural and honorable by comparison with lots of other human activity going on that is greed-based and disgusting and destructive. What I find more disgusting is when human primate social grooming is dragged down further by greed and scam and dopamemes.

Fast forward a few years and I'm still not quite sure how all this fits together, but I think this sociological/evolutionary/psychological overview deserves at least a mention in the overall consideration of manual therapy. Acupuncturist/medical physician, Anthony Campbell, wrote:
"Among primates, we are the only species that does not routinely perform physical grooming. The manual therapies provide one of the few occasions when it is socially acceptable for comparative strangers to touch another's body in a manner that approximates to primate grooming. It seems likely to me that part of the success of the manual therapies depends on this, and differences in success rates among therapists are probably related to differences in how they apply touch.

The mechanism of touch as therapy is no doubt complex but is likely to involve the limbic system (cingulate gyrus) and release of oxytocin."
(See his whole comment in "Rapid Responses" after this article, Characteristic and incidental (placebo) effects in complex interventions such as acupuncture.)

Saturday, April 05, 2008

"Mindfulness Based Stress Reduction" - Jon Kabat-Zinn

I finally checked out Jon Kabat-Zinn more closely, after having heard about him and his work several years ago. He has written several books, some or all of which entered the world of persistent pain via pain clinics, probably because of the obvious overlap of stress reduction. I heard him interviewed on a radio program a few years back, and very much liked his blend of common sense coupled with description of the kinds of ordinary stressors meditation can help with. His book, Full Catastrophe Living (one of many) has been around since 1990, and I'm embarrassed to admit I've never read it.

Here are some links:

1. Mindfulness Meditation, 72-minute you-tube presentation to google employees (recommended)

2. "Coming to Our Senses" a short (9.15 minute) you-tube video

3. Coming to Our Senses, a 57 minute google video (long intro by someone at UCSD Medical Center)

4. A simple bio. Excerpt:
Dr. Kabat-Zinn received his Ph.D. in molecular biology from MIT in 1971 with the Nobel Laureate in Medicine, Salvador Luria. Dr. Kabat-Zinn’s research between 1979 and 2002 focused on mind/body interactions for healing, on various clinical applications of mindfulness meditation training for people with chronic pain and/or stress-related disorders, on the effects of mindfulness-based stress reduction (MBSR) on the brain and how it processes emotions, particularly under stress, and on the immune system; on the use and effects of MBSR with women with breast cancer and men with prostate cancer; on patients undergoing bone marrow transplant; with prison inmates and staff; in multicultural settings; and on stress in various corporate settings and work environments.

5. Wikipedia entry on JKZ.

6. An interview, "Mindful Medicine". Excerpt I:
Jon Kabat-Zinn was one of the earliest students of Zen Master Seung Sahn and was a founding member of Cambridge Zen Center. Over the years he has studied with a number of Buddhist teachers and incorporated their teachings, especially the practice of mindfulness, into his practice of medicine. His book Full Catastrophe Living (New York: Delacorte Press, 1990) was on the New York Times bestseller list.
Excerpt II:
"The two fundamental things that most people get out of the program, independent of symptom reduction, are these. First, the breath is an ally and can be used to calm down and see more clearly. The other, related discovery, is that you are not the content of your thoughts. You don't have to believe them or react to them. That's incredibly liberating."- JKZ

After seeing him, especially in the 72 minute video linked higher up, I might actually acquire and read that book. What he says is simple and it makes total sense.