Physical Therapists' Use of Cognitive-Behavioral Therapy (CBT) for Older Adults with Chronic Pain: A Nationwide Survey

http://www.ptjournal.org/cgi/content/abstract/89/5/456

The above link is about a telephone survey of PTs from across the USA regarding their use of cognitive-behavioral therapy (CBT). This was in response to evidense in the pain management field that CBT can be effective. The PTs surveyed used CBT techniques minimally due to several factors such as lack of training and time and reimbursement issues.

My take on this: What the conventional medical model is calling CBT is simply another form of connecting the physical body to mental and emotional aspects, which when imbalanced can manifest as physical symptoms. Duh. You see, physical therapy in the USA is trying to find autonomy in the medical profession with advancements in PT education transitioning into a doctorate level and with the evidence-based mind-set (ie. "if it's not perceptible by my five senses, it doesn't exist"). With increasing "got you by the balls" tactics of health insurance companies with decreasing reimbursement for services rendered, the PT profession is being blinded by their own need for autonomy. In other words, the route they're heading for now is a route already tread by the chiropractic and medical professions where trying to establish their "worth" to insurers who care more about the bottom line rather than the actual health care of individuals is an uphill battle.

I've been using so-called CBT approaches for several years now but I never called it that. Back when I was a student right into my early years working as a PT, I had observed a direct relationship between a patient's emotional and mental status to their offending complaint. But whenever direct intervention into the mental and emotional aspects was brought up, it was deemed out of line for our profession and that area of expertise was to be referred to some kind of licensed psychiatric professional. I know what you're thinking: pretty idiotic, right? So you see why if the PT profession continues to neglect the interrelationships of the physical, emotional, mental, and dare I say the spiritual components of the human being, how limited the profession will and currently is?

I walked away from the PT profession in 2007 because I found it to be too restrictive of my nature as a healing professional. Rather than tread the same path as others before me and become frustrated, angry, depressed, and lost, I chose to create my own path in health care.

The good news from this survey is that the PT profession has an opportunity to step outside of what is traditional and explore new avenues.

Meditation & Movement

Many people think they know what meditation is and still have not devoted any effort toward a meditative practice and thus can not really understand it unless they've thoroughly experienced it with open receptiveness and a willingness to change, or explore, their current "thinking"; of which is not truly living thinking but more so "dead" thinking. Thinking, in the ordinary sense, is based upon thoughts which are completed, finished, and the result of as compared to thinking for the sake of thinking itself; the actual process of thinking where the subject, you the "thinker" becomes the object. "Dead" thinking separates the subject from the object disregarding the "process" for the "result" (ie. the actual thought). This leads one "stuck" in the pre-conditioned realm of the subconscious which is based upon past thoughts and previous conditioning. The ego, as a vehicle for one's sense of self attaches itself to the subconscious because it can easily control and manipulate preconceived concepts and contain one's reality. This is how our parents, religion, the government, the media, and multi-national corporations can easily control us.

With "living" thinking there is no separation between the subject and object and it provides a direct link to the superconscious through our intuitions. Our intuitions allow our Soul to be guided by our Spiritual-Divine nature (rather than just our Ego-material nature). With living thinking, or pure thinking, we tap into our essence and experience our eternal capacity. When we are able to bring this capacity back down to earth, we are considered "enlightened", or awakened to a whole new level of existence.

Meditation as a practice allows one to tap into living thinking. Could you imagine if Copernicus did not practice living thinking that he'd ever find the balls to disagree with the norm of his day that the Earth was the center of the Universe?

With meditation, after awhile you become aware of the ability to cultivate refined "energy", or "chi" in the Taoist sense which you can use to harmonize your subtle energy bodies. When movement is added to a practice of meditation it further intensifies the experience and "re-educates" the flow that has become accustomed to stagnation. Stagnation leads to disease. Various disciplines such as qigong, taichi, and yoga utilize meditation and movement which explains their effectiveness.

One does not have to learn the traditional disciplines if one is willing to explore their self. Traditional disciplines may fall into the trap of dogmatism which further tethers one's Soul to the demise of egotism. Meditation and movement can be a free expression of one's Soul individuality which keeps in line with how energy operates, which is constantly in motion in a moment-to-moment dynamic, where nothing is ever the same and is constantly changing. Imagine your life right now if you could experience such presentness.

Who are You?

Two souls, alas, dwell within my breast,
Each wants to separate from the other;
One, in hearty lovelust,
Clings to earth with clutching organs;
The other lifts itself mightily from the dust
To high ancestral regions.

Goethe, Faust I, 1112