Let Us Now Praise Those Who Challenge Us

A massage therapist recently asked the question, "Who was your mentor and what did you learn from them?" Immediately, a particular individual came to mind and I began to think of how I would answer that question. Then I thought of the first massage therapist I considered to be a mentor. And then the second one. Shortly after, I thought of two individuals who came into my life a couple of years ago. They challenged me in ways that changed and improved my thinking. I thought back to my science-minded father who did little experiments with me and bought an encyclopedia for me when I was five years old. The list kept growing longer. It seemed to have no end.

My mind turned to some recent controversial conversations and a fundamental problem that holds our profession back by interfering in our ability to have thoughtful, professional discussions. Some folks don't like to have their ideas challenged and take it as a personal affront. They think that questioning their ideas somehow challenges them as a person and that questioning their assumptions is a threat. I feel fortunate to have learned that asking the hard questions and subjecting our ideas and assumptions to scrutiny is the way that we get smarter. When someone points out the flaws in my thinking, I have the opportunity to correct mistaken notions and move on to more accurate thinking. When someone questions how I arrived at a conclusion, I have the opportunity to examine that and either support it with evidence, which can then be discussed, or perhaps rethink my position if I find I don't have a good answer to that question. I welcome the opportunity to think, to grow. Those who have been my mentors have often been the people who have asked the most challenging questions, caught me off guard, or taken me aback, because I had not examined assumptions that needed examination. I have a debt of gratitude to them for taking the time to patiently explain that which I didn't know, to point out the inconsistencies and logical fallacies in my arguments, to teach me not just facts but how to think. I know that when those who are well-informed and not hesitant to disagree affirm what I have to say, I'm probably on the right track.

So, I would like to now express my gratitude and acknowledge a few of the people who have played an important role in my development as a massage therapist and as a person, the ones who have fed my curiosity and challenged me. Many of them may not consider themselves my "mentor," but I do. They are in no particular order and to list them all would be impossible, because every person in my life who has challenged me could make the list, especially my clients who have taught me so much over the years. I thank all of them.

Most recently, one of the most important mentors in my life is Diane Jacobs, a physiotherapist whose writing on the nervous system and pain science has been been instrumental in my understanding of it and my ability to apply in practice. Her article on trigger points instigated a personal crisis that later led to finding the Quinter and Cohen explanation and a shift in thinking. The result has been a better understanding of pain problems and more successful outcomes. Her approach to manual therapy, DNM, has given me new tools and enhanced my use of ones I already had. Her frequent invocation of Occam's Razor (and Occam's Chainsaw and Occam's Shredder, when it has been called for!) has given me a valuable tool for assesssment.

Christopher Moyer, Ph.D., is a psychologist who does research in massage therapy and has written a number of brilliant and thought-provoking papers. His meta analysis on cortisol startled me at first because it contradicted what I had been led to believe for ten years. I got over it and through that initial challenge I began a professional relationship that not only helped me to better understand research and rethink many ideas, but I also got some good pizza recipes out of it! Moyer is co-editor of Massage Therapy, Integrating Research and Practice, a book that every massage therapist should own and read.

Paul Ingraham, author of PainScienc.com, is a retired massage therapist turned science writer. Paul's writings, probably more than any other single source, made me confront the fact that much of what I'd accepted as true was unsupported. I blame him for my almost giving up, at a point, when I began to wonder if there was anything at all we could say for sure! And I also credit him with supporting me through that crisis and encouraging me to continue. I came to realize that it was okay to give up everything, briefly, and start from scratch, building on a solid foundation of what we can say with confidence rather than fantasy and misinformation.

Bodhi Haraldsson organizes the Evidence-Based Massage Therapy FaceBook page and was my first consistent source for relevant research. Bodhi's thoughtful, insightful contributions to discussions was an early inspiration.

Ravensara Travillian is author of POEM, the Project for Open Education in Massage. If Carl Sagan were a massage therapist, he'd be Ravensara. She is brilliant, her knowledge of science is broad, she is articulate, has the patience of a saint. She is a model of excellence.

Barrett Dorko, physical therapist, is one of the more active contributors at SomaSimple, a forum for science-minded manual therapists. Soma can be intimidating for a massage therapist and I remained a lurker for months. It was Barrett's encouragement that finally got me to screw up the courage to participate. I found out that, in fact, it wasn't so scary after all. It has become one of my primary sources for learning and discussing pain science. Barrett is fond of saying, "Change your thinking, not your tools," and, "Show me where I'm wrong," two ideas I refer to frequently.

Jason Silvernail, a physical therapist in the army, based out of Texas, has been a model of down-to-earth, pragmatic, straight-talking thinking about manual therapy. I love Jason for his willingness to say what he has to say and to engage in difficult conversations with respect. (By the way, Jason was in Afghanistan when I first wrote this. He is now back in the States. All of us who know him and love him are grateful for his safe return. Welcome home, Jason!)

The SomaSimple forums, as a whole, have taught me what it is to have truly rigorous discussion. Some get lengthy as participants try to get it right, look at a subject from all the angles, understand the implications, examine contradictory evidence, and try to make sense of it. In spite of my lack of formal education, I've never been treated as if I were less. They have provided the best model of being challenged and accepting the challenge and of staying focused on the information rather than the person.

My gross anatomy teacher, a pathologist who has taught med students at St. Louis University Medical School for decades, would sometimes look at us with a puzzled look and raised eyebrow, like Dr. Spock, and ask, "Where did you get that information?" when massage therapists would come out with some nonsensical ideas. I once found a mistake on an anatomy quiz he'd thrown together rather quickly and we were going over in class. At first he rejected my answer but then his own retired instructor showed him the appropriate section in an anatomy book. He corrected the error without ado and moved on. No big deal. In that moment he taught me an important lesson. Even he, with his brilliance and breadth of knowledge, could be wrong and he knew that. The body was the authority. He retracted his statement without fuss and moved on; it was about the information, not his ego.

My Russian Massage teacher Zhenya Kurashova Wine was certainly a mentor. Her blunt, straightforward manner could take you aback at times but I welcomed it. She would often say, "Don't take my word for it, find out for yourself."

The NMT instructors with whom I assisted for ten years provided information about research, which was hard to access before the internet, and focused attention on accuracy and making use of the best information available at the time. Don Kelly, in particular, was a model who strove to use precise language. He had a wonderful way of challenging your thinking, would question you and invite you to question him. All of my instructors welcomed questions and never evaded them. I took this freedom of inquiry for granted. I didn't realize how rare it was.

Long before I entered the field of massage therapy, there were others who challenged me, mentored me, taught me how to think. Several high school teachers were outstanding. My high school religion teacher, a nun with whom I still maintain a relationship, never discouraged inquiry and I felt a complete freedom to ask questions that some others might discourage. Not long ago, I thanked her for this and she responded, with a smile, "And you used to ask the most interesting questions!" My high school biology teacher, another nun, had an enthusiasm for science which came bubbling out of her. She brought joy to the exploration and discovery of nature. My high school art teacher, another nun, taught us the value of critique, helped us get over the initial discomfort and discover how it would help us to improve our ability to fully express ourselves.

My engineer father encouraged my curiosity from a young age. When I was five years old, he bought the Encyclopedia Britannica Junior for me and I spent many, many hours exploring its pages. He would do simple science experiments with me and taught me how one makes careful observations, measurements, and draws conclusions from them.

My mother taught me about the solar system when I was no more than four years old, using a grapefruit, an orange, and a grape to represent the sun, the earth, and the moon. I was so excited by this that I had to show my dad when he came home from work that night.

There are others who should be represented here but I will stop for now. Many of them are here precisely because they confronted me with facts and questions that led to the cognitive dissonance that changed my thinking. They taught me how to adapt when the evidence suggested that my ideas needed to change. These changes have, without exception, felt like progress in the end, though often the initial reaction was a little uncomfortable. They continue to enhance my learning and help refine my thinking. If my information or reasoning is flawed, they will let me know!

Some folks think it impolite to point out when someone says something in error. I say those who challenge us care about us and our profession the most because they take the time and keep us from continuing down the wrong path. At a tea party, perhaps, it is fine not to correct Aunt Claire if she has some off idea, but in professional discussion, we are trying to think accurate thoughts so that we can work more effectively as individual practitioners and as a profession. I thank those who are willing to ask the hard questions.

Who has challenged you? Take time to thank them.