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July 21, 2020: Joyce's article and my belated response

Dear Joyce,

Thank you for sharing your co-authored article, “Call for a Paradigm Shift in Clinical Reasoning.” I apologize for taking so long in passing on my thoughts/ideas/perceptions about this most amazing piece of work. In between doing other things, I reread it several times.

My viewpoint is that of a layperson with an obsessive interest in body awareness. I’m what Malcolm Gladwell, in his essay “Late Bloomers: Why do we Equate Genius with Precocity?” in that I, at a later age, am now making some wide-ranging connections in terms of differing modalities. Your article added to my knowledge base and affirmed what I have been thinking, which is that health care

Tinni next to a big horse

practitioners need to change their developmental perspective and instead embrace the tenets of the perception-action-cognition connection.

I just read an article by Mary Waneless, who is a riding teacher with a background in physics. She incorporates anatomy, sport psychology, and Alexander and Feldenkrais bodywork techniques as well as martial arts, biofeedback, biomechanics, visualization, massage Zen philosophy, and neurolinguistic programming into her teaching methods. Her rationalization for drawing upon so many areas of study is that “often new ideas come from unconventional areas. She writes “It’s actually quite common for any breakthrough within a specific discipline to come from outside that discipline. It has to because in a way, the experts (in that discipline) are already thoroughly versed in all the knowledge that lies within their prescribed boundaries.”

It was with this quote in mind that I read your article. I hope that others in the above-mentioned fields will also read it.

Since I am a layperson, I do not know if you all are frontrunners in making this claim or advancing claims that others are making. I suspect that if you are frontrunners, that you’ll be met with resistance because we as humans are often as mentally as they are physically inflexible. The problem is that of course, we humans have a hard time when it comes to knowledge translation. We find making the cognitive leap from one way of thinking to another to be overly difficult, which is why we end up being resistant when asked to make paradigm shifts. By the way, the term paradigm shift was first proposed by Thomas Kuhn in his book The Structure of Scientific Revolutions. Either way, you all have done a wonderful job in defining your terms and providing supporting evidence. I now understand, and more importantly, have internalized the key concepts of affordance, dynamic systems, and adaptive value.

Some random thoughts, based on ideas that jumped out at me:

“In order to actively explore and problem solve, children need to be able to move without restrictions and learn from their mistakes.” This statement brings to mind Katy Bowman’s books, Move your DNA and Movement Matters. She has a photo of her daughter climbing a steep pitched roof – it shows the angles of her ankles – on her own, this child is creating new neural pathways.

“Spontaneous exploration involves attempting differing strategies to solve a movement task. Those that lead to success are most likely to be repeated, and those that do not are most likely to be discarded.” We recently acquired an eight week old puppy, an Australian Shepherd we named Shadow. We are encouraging exploration and movement, on walks outside and in the house. I watch as she, for example, established new neural pathways recently learned how to climb stairs.

The P-A Approach intervention components complement each other as the small, incremental changes in the environmental set up are matched by the light-touch manual guidance.” Lately, Tinni, who is 31, has appeared to be stiff and short strided in his front legs. I have been doing T-Touches, mainly the Python Lift, and as well putting body wraps on his legs in order to help him form new neural maps. Very gratifying to see him respond so well to this sort of work.

Near the conclusion of your article you offer ways in which the goal of knowledge translation might be achieved. Very important. What it comes down to is this: “Stop teaching the outdated interventions that have been shown to be ineffective and that impede spontaneous exploration and active problem solving in a developing child.” This also holds true for animals. Janet Jones, in her new book Horse Brain/Human Brain: The Neuroscience of Horsemanship reiterates what you are all saying here, the difference being that her audience is horse people and yours is physical therapists.

Again, thanks for sharing this. I do not feel, after reading this, that I did this article justice. Just know that you all added immeasurably to my knowledge base.


Next: 202. 7/22/20: Troubled Times

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