Massage Therapy Body of Knowledge

Comment

Comment by Carl W. Brown on October 21, 2009 at 9:19am

Mike, “The only thing starting out dead is your opinion on this issue. No matter, what you say, these entry levels will be set and adopted and they will work to start this process.” I don’t see any levels in the document. It is all optional and no levels of competency are set for the KSAs.

Comment by Carl W. Brown on October 21, 2009 at 9:16am

Christopher, “Well yes, I'm talking about rationality and reason. We're not talking about irrationality, are we?” Irrational is bad rational thinking. There is also perception that is neither rational nor irrational just different. When you look at a person’s face you do not check the color of their eyes, skin, heart, measure the size of their nose, the width of their mouth, etc. No you recognize the person directly without a conscience rational decoding of the face. Likewise we pick up on clues about what the person id feeling etc.

The advantage of rational thought is that we can take what we know and use that knowledge deductively, inductively or whatever to reach certain conclusions. We do that by a serial step by step process using our left brain rational thinking. But is doing so we must limit ourselves to a finite amount of quantifiable data.

Extra rational, intuitive, right brained thinking works with directly perceived very complex issues. The problem is that you cannot process it like rational thought. The problem that I see with energy systems is that it violates the basic tenets of right-brained perception in that one cannot systemize it or process it or derive and conclusions from the perceptions.

Comment by Christopher A. Moyer on October 21, 2009 at 7:56am

Good morning Bert.

I think I'm understanding you better about the Conclusions in that study. Yes, I agree with the researchers - if the TTers cannot pass that test, I am convinced that TT is refuted. You are not. In any case, different tests could be devised and conducted to address any weaknesses of the first one.

Now, I am very interested in your last paragraph.

This is the problem with attempting to generally define energy work. It is not objectively quantifiable. I have experienced it subjectively through Shiatsu and other energy modalities, but I know of no test that can conclusively prove or disprove any of it. That's why I posed the challenge to you to present an objective test study that would.

Questions I have:

How did the original person who developed any specific energy modality realize that (s)he was doing energy work

When you are doing an energy modality, how do you experience the presence or action of energy?

Comment by Bert Davich on October 20, 2009 at 9:44pm

Christopher,
The clerk you refer to is Albert Einstein.

Regarding your comment on assumptions you assert one of the assumptions I referred to which is the assumption that the test itself provides conclusive evidence....
YOUR QUOTE: ".....there should be clear and incontrovertible evidence to show that it is true, if it is true. But instead, the TTers cannot even detect the presence or absence of a hand! To me, this is pretty damning...."

You assume again as the researcher did that if the TT cannot pass this specific test, it constituted "unrefuted evidence". That is an assumption, not a valid conclusion.

Repeating myself again the researcher could have validly concluded that the study could not substantiate evidence of TT's claim. It could not have concluded (by the study itself) that the claim was groundless and "further professional use is unjustified"

Furthermore I am not defending the TT claims, merely saying the study conclusively proved nothing except the subjects did not 'pass' the test as posed.

This is the problem with attempting to generally define energy work. It is not objectively quantifiable. I have experienced it subjectively through Shiatsu and other energy modalities, but I know of no test that can conclusively prove or disprove any of it. That's why I posed the challenge to you to present an objective test study that would.

Comment by Christopher A. Moyer on October 20, 2009 at 8:39pm

Hi Carl.

The problem is that we perceive things that may be valid but cannot be dealt with through reason but we try to fit intuitive perceptions into a rational scheme and follow the scheme. .

Yup, I'm with you so far.

Science works great when we can measure things

Again, still with you. It has been said that there is no science without measurement, and I tend to agree.

and deal with the with our serial/rational mind.

Well yes, I'm talking about rationality and reason. We're not talking about irrationality, are we?

We use our intuitive/parallel mind to deal with things too complex to deal with within the confines of science and in shifting thing to the rational we loose much in the translation.

Well, now you're losing me. I can accept a distinction between rationality and intuition, and intuition is a sometimes fascinating phenomenon, but it is also highly prone to error. In many cases, this is why we need science. Also, it is risky to try and delineate a rational mind and an intuitive mind - the divisions are not distinct like that.

Also, it occurs to me that one could say the opposite of what you said there and be correct - we use science to deal with things that are too complex for our intuition, and when we try to distill something complex into the confines of our intuitive mind, a lot is lost in the process.

I find it far easier to throw out all right brained activity when looking for objective results but you get the best results using both haves of your brain.

Let's not confuse minds and brains. :) Also, let's not take hemispherical specialization too far. Yes, it is known that the two halves of the brain specialize in different types of activity, but we don't turn them on and off at will or shift them like the gears of a car.

(But, did you know that dolphins *can* make one hemisphere sleep while the other is awake?!)

Comment by Christopher A. Moyer on October 20, 2009 at 8:24pm

Bert -

I feel I will be repeating myself in several ways here, but here goes anyway.

The fact that Ms. Rosa was a sixth grader is of no consequence. The study either is, or is not, logically designed and conducted. If you think that it isn't, the way to critique it is not by drawing attention to the honors possessed by the author. Some of the best physics papers ever written were published by a patent clerk who couldn't get a teaching gig.

In science the work stands or falls on its own merits. That's all there is to it. The study is logically designed and carried out to test a hypothesis. It is appropriately double-blind and eliminates validity threats. It uses an appropriately simple statistical test to evaluate the likelihood of the hypothesis. It is easily replicable. One can hardly do better than this. This is why JAMA published it.

You are right that I ignored the assumptions, because I wanted to devote my words to other things. I see their assumptions as some of the least important parts of that study, but I'll address them now. I find them to be unremarkable. TTers claim to be able to sense and manipulate an energy field. Note that this putative energy field goes against all kinds of well-established scientific knowledge on anatomy, physiology, and physics, and so there should be clear and incontrovertible evidence to show that it is true, if it is true. But instead, the TTers cannot even detect the presence or absence of a hand! To me, this is pretty damning. To others, such as yourself, perhaps less so. But the burden of proof is on the TTers - what *can* they do?

Extraordinary claims require extraordinary evidence. To claim that one can detect human energy fields, and then be unable to do so whatsoever, is not extraordinary evidence. Rather, it is exactly what we expect if the null hypothesis is true.

Bias - what difference would it make in that short report if they included a paragraph about bias? The slightest background research on the Rosa's and on Barrett reveal that they are skeptics; so does the fact that they carried out this research. Frankly, I have always found "bias" sections of research articles to be a bit sophomoric; with certain important exceptions (e.g., corporate affiliations, sources of funding), they are more often emphasized in second- and third- tier journals than in top journals.

"Is it possible that you support the conclusions so are unable to objectively assess the study itself?"

Possible? Uh, sure, it's possible. I'm human and have the associated errors in judgment. But again, extraordinary claims require extraordinary evidence. I would need to see a mountain of well-controlled evidence before I am going to believe that people are detecting human energy fields that have so far avoided all detection.

If there are so many folks who can do this, where are the studies? Why aren't they in Science, Nature, The New England Journal of Medicine... Detection of a new type of energy with ramifications for health?! Why hasn't someone documented this and won the Nobel Prize?

Comment by Keith Eric Grant on October 20, 2009 at 7:54pm

Noel,

You might be interested in another paper that I recalled coming across on Nonlinear systems in medicine. As I recall, I came across it while looking up material on cytokine interactions in the body as a potential mechanism via which massage could affect and individuals current "state".

More globally, I'm likely to leave this particular BOK behind and both forge collaborations with others considering the structure of massage knowledge via ontologies and other means. The MTF research conference in Seattle in May may well be a place to pursue such connections.

Several years ago, I'd also toyed with using a technique called Latent Semantic Analysis (LSA) on some collection of accessable massage-related articles to look at concept clustering. The technique basically goes through a set of documents, gets rid of all trivial words, "stems" (take the root part) of remaining words and forms a dictionary. In then forms a matrix in which each document has for each word a weighting (often Log N) based on the number of uses of the word in the document. The entire set can then produce combinations of words that are most effective in describing the documents and that allows some estimation of distance between documents. In short, on a document by document basis, it creates a structure of the knowledge in the entire set. Here's a relatively short and readable tutorial (4 pages). Such an analysis can provide, within the limitations of a particular article set, an objective estimate of the interconnections between topic areas and what clustering occurs within them. One can use multiple sets of articles or subdivisions of a single large enough set to make some estimates of the reliability of clustering estimates. There are some nice color graphs in an article on LSA that was published in a special issue of the Proceedings of the Natl. Academy of Science focused on mapping knowledge domains. The graphics display distance relations between articles in biomedical sciences and medicine. Essentially, some of the tools developed for accurate search engines map over into looking at structure of knowledge. Thus, as displayed in one of the graphs in the article, there can be cross-checks between objective mapping and human-based mapping of knowledge structure.

Comment by Bert Davich on October 20, 2009 at 6:45pm

Christopher,
The study authors did not just 'include' a 6th grader... here is the quote from the paper "Ms E. Rosa designed and conducted the tests and tabulated her findings" THIS CLEARLY WAS HER STUDY.

You ignored the "assumptions" I mentioned, and my problem is not with the particular conclusions, but how they (she) arrived at those conclusions which read ..... "Their failure to substantiate TT's most fundamental claim is unrefuted evidence that the claims of TT are groundless and that further professional use is unjustified" (How does an unqualified 6th grader become qualified to determine professional use of something she does not understand?)

Please keep in mind that I have no conclusion regarding TT's claims as I do not practice it, don't know much about it other than what was in the JMMA paper, and am not interested in it. I am making the point that the study is invalid due to obvious bias and the study itself is designed using unsupported assumptions as if they were fact.
YOUR WORDS:
In the Objective, the researchers clearly state what they aimed to investigate. could TTers detect a human energy field? It seems they could not.

If the conclusion had stated that the study itself could not substantiate evidence of TT's claim...... it would be valid. It rather stated their conclusion as fact.

Claiming that a participants failure to 'substantiate' a claim in a study contrived by someone who is not knowledgeable on the subject or scientific methods is "unrefuted evidence" or that further professional use is unjustified is a grossly biased unsupportable opinion, except by the circular method of assuming that study is absolutely conclusive.

Regarding Bias, see the excerpt below from a pubmed study that included a bias risk assessment. Most well done studies have stated concerns for bias of their own work, especially if they want to be taken seriously.
EXCERPT:
Two review authors selected the studies, assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group, and extracted the data using standardized forms. Both qualitative and meta-analyses were performed.

Is it possible that you support the conclusions so are unable to objectively assess the study itself?

Comment by Mike Hinkle on October 20, 2009 at 5:47pm

Carl,

The only thing starting out dead is your opinion on this issue. No matter, what you say, these entry levels will be set and adopted and they will work to start this process.

The evaluation aspects to determine your BOK assertions are new. Somehow the medical profession made it to this point without them initially and we will too.

Lots of things are hard to test using your methodology. All modalities will be covered. Eventually, separate BOKs may come out of out efforts. We will find a way!

Comment by Noel Norwick on October 20, 2009 at 5:42pm

Keith: Again, thank you very much. I already have several of the books you suggested and have just ordered the others from Amazon. Please let me know when you update your reference list on Melzack & Wall.

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