We notice that many of the presenters who purport a structuralist view of the body have a strong and passionate and powerful charisma about them and, I have no doubt, portray this to their patients.  Their patients, of course, see them as body part experts (he’s the best knee guy in town) and will no doubt, under the placebo treatment of confidence and charisma (which is all good to me) get better just by interacting with them.

Provider: “Ah yes, it’s your malleoli.  We know everything there is about this joint and the surrounding tissues.  Here is your solution!”

Patient: “How marvelous, it was my malleoli and I’m in the right place to get this thing fixed!”

This affect should be looked at by the ectodermists and neuromatrix-ists and those that view the nervous system as the great interacter.  Problem: the brain is not as clearly understood.  As Diane Jacobs says ” The brain is a verb, not a noun.”  It is much easier to talk about the meat and bones to patients because of the level of common understanding.  The meat and bones are on our human scale, at eye level if you will.

Provider: “Ah yes, it’s your brain.  We know very little about the intricacies of the brain.  We do know that pain is a perception!”

Patient: “This clown is talking about my brain when my foot hurts.  He thinks I’m making something up in my head, I’m in the wrong place.”

Patient education about what pain is can be very tricky.  Especially when it is not a clear nociceptive input that can be just removed. So the point is, be truthful to your patient.  Try to avoid making false statements just to get some more positive placebo results.  Is there a way to bridge the gap here?  Jason Silvernail has a great thread on somasimple.com addressing this issue of switching from a mesodermal-structuralism model to one that respects the position of the brain and perception.  I would like to recommend this reading as some thought-food to chew.  Here is a Youtube vid: Crossing the Chasm as well.

Thanks!

– Matt D