August is Just Breathe Manual Therapy’s birthday! Throughout this past month, I’ve been organizing the most important lessons I’ve learned during my first year in business. The lessons came fast, but only one made a real philosophical difference in what I do and how I think of my practice. Here I’ll tell you why manual therapy is a framework, not a gospel.
What matters in manual therapy?
When I opened the doors of Just Breathe Manual Therapy, I thought it was going to be a pretty straightforward operation. I do a specific type of bodywork, called Be Activated, and it would work like this: I’ll inform people what Be Activated is, they’ll realize they need it, and they’ll hire me.
I quickly learned that my original approach was totally inflexible.
My thought was simply, “This is what I do,” and when a client walks in the door, that’s the work I’ll do. I realized through working with my regular clients, as well as with people who came in once and didn’t come back, that the role I wanted to play is much more dynamic. I was presented with a simple question: what’s more important, the sequence or the client?
What’s the difference between a framework and a gospel?
If the sequence is the most important, it becomes a gospel. Like a religion, it becomes dogma. It becomes the mold into which all clients are forced. The space for individualization and interpretation gets reduced.
There is truth… But the doctrine you desire, absolute, perfect dogma that alone provides wisdom, does not exist.– Herman hesse
If the client is the most important, their experience becomes the focal point. The sequence then shifts from a gospel to a framework. The sequence remains the road we travel, but we take detours based on what works, what doesn’t work, and where we see opportunities.
Which method of manual therapy works best?
Rigid frameworks have their place in our world. They are repeatable, they have defined feedback loops, and they are scalable. In the medical field, I would rather receive a physical therapist’s gospel as I recover from an ACL replacement, or a cardiologist’s gospel when recovering from a heart attack. However, in less defined areas and with less acute issues, gospels do not serve us. In these cases, a framework can be more useful. For example, I have clients who initially come in for back pain and as we begin working together, we may work specifically on their back, or we may work on breathing, or we may find out that the real driving force to their becoming a client is managing stress or anxiety.
What drives manual therapy?
No man ever steps in the same river twice, for it’s not the same river and he’s not the same man.Heraclitus
In my shift to frameworks, I begin by acknowledging that the client is a complete human being with their own history, and their individual mental and physical states. This makes them central to the work I do. The same person never enters the room twice. The person in front of me is the culmination of their circumstances on that day – the next day they will be different. The relationship between client and practitioner will influence the outcome of the treatment, which is why it’s important to understand a client’s singular circumstances. With all this in mind, what I bring to each session is what I think is possible and embrace the reality that we are going to forge our own path together.
This path takes input from both of us. What is my client experiencing and noticing? What’s being felt? What am I finding? Is there a new and unexpected road that might be useful to pursue? What other tools in my toolbox may help here?
These questions are typical to my sessions because I am constantly assessing and reassessing how my client is responding through their felt experience. In a practice where the work is inflexible, these questions may be left unasked.
Where do you want manual therapy to take you?
In a gospel-based practice, an individual’s unique needs may be put aside in favor of efficiency.
In a framework-based practice, the work may seem less efficient when measured by gospel-based metrics. However, in a framework-based practice, the only metric that matters is the progress and satisfaction experienced by the client. In a world that’s focused on productivity and efficiency, discarding tightly held gospels in favor of loosely held frameworks is to actively take the road less traveled. The road less traveled, in the words of Robert Frost, has made all the difference.