What we do: Listening Skills

By Cintain Quintana

Photo by Greg Smolonski @ Photovibe

At the heart of the diagnostic skillset of any practitioner is the ability to understand the patient's concerns and the reason they have for coming to see us. We do this in many ways: we look at posture, we ask questions, we perform special diagnostic tests, such as pain and mobility tests, feeling the pulse and observing details such as the tongue and patterns of skin coloration. All of these share one thing in common: the ability to apprehend passively and understand deeply what is really going on. The short-hand term for all of this is "listening".

In visceral manipulation, craniosacral therapy, and myofascial release, one of the main ways this "listening" happens is through the hands of the therapist in direct contact with the body's tissues. This is a skill that, when performed by an experienced practitioner, seems almost magical. In this age of overt (and somewhat excessive) reliance on technology for accuracy and objectivity, it is suspicious, and easily dismissed by the skeptical. How would someone know what is going on inside the body without the help of a machine that costs millions of pounds and coughs up intricate-looking readings that require a post-graduate degree to interpret?

The too-frequent answer to this question is usually a combination of buzzwords: 'intuition', 'sensitivity', 'experience', and so on, along with a self-conscious hand-wave and the silent hope that we can move on. This is unfortunate, because what is really going on is actually much more amazing and less arcane than that.

The human body is a bio-tensegrity structure (more buzzwords, but bear with me). What this means is that is is held in space and in defiance of gravity through a combination of tension and compression forces in balance (tension-integrity), like one of those toy balls that expand and contract, made of rubber bands and sticks put together. One of the most important (and relevant for this discussion) characteristics of tensegrity structures is their inter-relatedness. Whatever happens to any part of it has repercussions for the whole. In the case of a human body, any organic change that changes the ability of any part of the structure to convey information will wind up affecting the whole.

Here is where the sensitivity piece comes in. The practitioner also has a body, which is also a tensegrity structure, 'wired' (pardon the pun) the same way as the patient's, so by establishing physical contact (and thus a relationship) with the structure and feeling through it (with the proper training), one can detect the places where it seems to be having trouble or being stuck.

Think of the last time you went to the dentist and had a filling put in. Do you remember how rough it felt, and how many times the dentist had to file it down and polish it so that it felt "normal"? This is your sensitivity at work. We can detect thicknesses that are much less than that of a sheet of paper, both inside our mouths and through our fingertips. Close your eyes and touch the table where your computer is sitting as you read this, or the armrest of the chair where you are sitting with your smartphone. Can you feel the roughness, the pits and cracks, the place where you scratched it with a stray knife the last time you opened a parcel?

This is exactly the same natural ability that we use to "listen" with our hands on the patient, whether it is on the top of their head, their abdomen, or their leg. The only difference is the training, and the amount of time we spend doing it. Like every skill, after a while it becomes second nature, and looks like an intuitive, magical activity of some sort.

Knowing what you are feeling helps, too. We study anatomy over and over, to learn what bits there are to feel and where to find them. Tissues in the body are in intimate contact -- the only separation that exists in there is the result of taking things apart with a knife. Luckily, we have this ability to touch things, and feel the connections through them, without needing to take everything apart in order to explore.

I mentioned information. Your body is very busy talking to itself all the time. Nerves convey impulses that are interpreted as messages about position in space, compression and shear forces, pain, and so on. In your blood, chemicals are being pumped to turn on and turn off all kinds of functions, and also cause the more subtle but ever-present states of being we call emotions. The body also communicates with itself mechanically, responding to changes in position and gravity, as well as the patterns of habitual usage it is subjected to, sometimes without even consulting your brain.

When trauma, pain, inflammation, a scar, or any other change in the body causes these information pathways to be disrupted, your body adapts to maintain its functions as best it can. Sometimes it cannot, and then you have a life-threatening condition, but most of the time it causes discomfort and pain, or an illness that is in many ways the response to conditions that are less than optimal.

Because the body is a tensegrity structure and has a very strict hierarchical organization (some parts are just more important than others for the survival of the whole, that's just the way it is), the problems that you see might be flare-ups occurring quite far from the actual obstruction in the tissues. Treating them locally will not resolve the problem.

This is why 'listening' is so crucial: whilst we care deeply about you and want you to feel better, we really don't need to know where it hurts, so much as where is the thing that is throwing your entire system out of whack, causing that bit to hurt. This is why your practitioner might not treat your shoulder or your knee but instead push on your tummy, put needles on your back, or ask you to eat less bread. We are *listening* to the intelligent system that is your body, because it knows what it needs to fix itself, and we are there for you, to give it that crucial, and often overlooked, nudge.

Photo by Greg Smolonski @ Photovibe

'Alternative health' people are frequently practitioners of last resort, meaning you'll come see us after everything else has failed to work. When you do, you want to be paid attention to and know that the person who is sitting in front of you has the skills to help you. When you come to Healing Space, know that even if we don't touch the bit that hurts, we *are* listening, through our hands mostly, to the whispers of your body, and that we want to help what we find there so that the intelligence of your body can find the space to correct what's wrong and feel more like itself again.