WAWADIA Update #19: Thomas Myers Misdefines Pain. But Why?

WAWADIA Update #19: Thomas Myers Misdefines Pain. But Why?

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The ideas and trainings of Thomas Myers (of Anatomy Trains fame) have been popular amongst the yoga therapy professional class for over a decade. What Myers says carries weight in hundreds of yoga teacher training programmes throughout the world. In many ways, his impact is positive. In general terms, it has expanded the language of embodied mindfulness for many practitioners by opening a horizon of deeper anatomical consideration. Specifically, it has enriched the lay understanding of tissue connectivity, and of how loading patterns track systemically through living structures.

Looking carefully, we might say that Myers’ work is resonant in the yoga world because he has built his ideas in true modern-yogic fashion: charismatically weaving an inextricable fascia of intuition, metaphysics, and claims from complementary and alternative medicine that appear to intersect with the hard data more often than they actually do.

When it comes to his ideas about pain, for example, Myers’ followers may not be any better off if they’d gone to neuro-anatomy school in the 17th century. On November 4th, he released a sun-kissed and breezy video called “Why does Massage Hurt?”

Amongst many other things, Myers says that:

  1. pain is “a sensation accompanied by the motor intention to withdraw”,
  2. pain consists of three types: “pain that enters the body”, “pain stored in the body”, and “pain leaving the body”. Although he says at (4:30) that he doesn’t share the no-pain-no-gain ethos of many of his fellow Rolfers, Myers implies that the “leaving” kind of pain might actually be therapeutic, because “stored pain” must be felt as it’s “coming out” (6:45)

The claims are poetic, and might be inspiring for many. But they also avoid or ignore the last fifty years of neuroscience. Additionally, they might actually be dangerous in a therapeutic context, if they create the expectation between yoga teachers and students, or bodyworkers and clients, that pain is an inevitable part of the healing or “releasing” process, and should be provoked and/or tolerated to prove that the therapy is working. As this project so far is showing, this sacrificial description of pain is common in yoga discourse.

Nick Ng debates each one of Myers’ pain claims in this thorough article of November 10th. Joseph Brence makes some additional refutations. I encourage you to follow both links, but I’ll also summarize the critique here, as best I can (not being a pain researcher):

Pain does not necessarily involve the “motor intention to withdraw”. Several types of pain – including chronic pain, or the excruciating cramp of a phantom limb – do not provoke any such intention. Additionally, nociception – “the neural process of encoding noxious stimuli”, according to the International Association for the Study of Pain – may not register as pain at all, as in the example of the quick, pre-pain withdrawal of one’s hand from a hot surface. If pain seems to saturate the burned tissues over time, it does so after the reflex to withdraw has activated and completed the protective movement. Most mystifyingly, pain can also emerge in the complete absence of a noxious stimulus, or tissue damage.

There is no “pain from outside the body”. This is Myers’ most Cartesian anachronism. Simply refuted: there is no “pain” but that the coordination of feeling and naming makes it so.

Pain is the collaborative product of tissue stimulus, nociception, cognitive awareness, and numerous psychosocial factors. It is a neurological and then cognitive meaning that evolves in a person responding to stress. The tissue stimulus may not even be noxious, as in the case of the feather-stroke that causes searing pain for those who suffer from a particular type of neuropathy.

The full background for this non-mechanistic understanding of pain can be gleaned from the work of Ronald Melzack’s “neuromatrix theory”. The upshot is: pain does not “enter” the body. Pain is a relationship between sense and meaning. Like every relationship, it is co-created by its constituents in the moment. To his credit, Myers does elaborate on pain as an interpretational process, which makes his language of “entering” an odd choice.

“Pain stored in the body” might be a misunderstanding of adaptation. In the video, Myers supports a popular claim: that the effects of injury, trauma, or emotional stress constitute a kind of “latent” pain. He suggests that latent pain accumulates silently, manifesting through symptoms that are actually pain itself, though disguised: lack of vitality, distorted posture, or distorted movement. He then goes on to claim (admitting to going out on a limb from 7:15)  that latent pain not only builds through an individual’s gathered experience, but through the social and historical fascia within which the individual is bound.

While this last bit is supremely evocative, and could definitely shed insight into the physiological effects of intergenerational trauma, the larger idea seems to be built on a confusion of terms. Ng’s informant Jason Erickson says Myers is “misinterpreting changes in posture and movement as pain instead of as non-painful co-occurring symptoms.

The problem with identifying postural and kinetic adaptations to stress as signs of stored pain is that it may encourage practitioners to believe that correcting those adaptations will force latent pain out. The likelier reality is that the adaptations are preventing the experience of pain. That’s why they exist. If correcting them is painful (as is likely), the practitioner might believe they’re doing a good job, instead of ignorantly violating the Hippocratic Oath. This leads to the last problem:

There is no “pain leaving the body.” If it’s not “stored”, it’s not leaving. This is more than semantics. Through Myers’ suggestion that massage or other forms of tissue manipulation “release” embedded pain, instead of more likely causing it, the “releasing therapist” becomes more aligned with an exorcist than a health care provider. In this model, both the exorcist and the possessed client are taught that the stored pain will cause as much damage going out as it caused going in. Pain is seen as the angry demon of one’s history – sleeping in repression, a terror when awoken.

The idea of “pain leaving” shares an affinity with the literature and practice of psychoanalysis and psychotherapy, in which the past emotional wounds of the client are actively evoked and perhaps recreated in a transference relationship with the therapist, so that they may be observed transparently and navigated differently. Setting aside the fact that this seems to work for some and not for many others, are all the bodyworkers who use Myers’ ideas also qualified as mental health care workers?

At about 7:00 in the video, Myers acknowledges that the release of stored pain can be “really disturbing” and “really emotional” for the client, but that “it’s really important that they go through it.” It would be ironic if this idea provided cover for the possibility that the therapist is simply hurting the client in the present moment, instead of doing what they think they’re doing, which is provoking the release of an invisible hurt.

We should consider that highlighting the psychic side of the therapeutic equation can obscure a lack of material evidence. We can also reflect upon the fact that this approach is conveniently familiar to the largely science-sceptical (or illiterate) subcultures of yoga and bodywork.

 

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I don’t know enough about the work of Myers to know how much he might be short-handing his themes for a lay audience here. Nor do I know whether he modulates these views elsewhere. The video doesn’t have an academic feel to it: he might be speaking only to a specialized audience he’s confident won’t take these misdirections to heart.

But let’s say he does actually believe in this three-part model of pain. Where might this belief be coming from, and why is it more important to him than decades of established neuroscience?

To speak of pain that “goes into” and “leaves the body” resonates not only with the psychotherapeutic literature that saturates our entire self-help zeitgeist, but with a very old metaphysics from which we can’t seem to release ourselves, no matter how firm our philosophical foam-rollers are. It’s a belief system that may even be more attractive to Myers’ followers than his specific claims about tissue health.

What does this metaphysics say? It says that the body is a vessel, built to contain the life-force, its tensions, and its distortions. (“Contain” being the operative term here.) It says that experience enters into the passive flesh, and can stay as long as it likes, until it is pulled back out of the flesh of those who are blessed to encounter magically attuned therapists. Pain as an experience becomes objectified and seen as a thing that has invaded.

In Myers’ model, pain is like the soul, but in shadow form. This anti-soul of pain enters the body, wreaks its havoc on the temporary home it holds in contempt, and then departs to find another home.

It is a dualistic view, to the core. This a paradox for someone like Myers, and everyone in body-mind work who tries to bind embodied realities to psychic realities. (“Body-mind” as a moniker only deepens the confusion.)

These beliefs are as old as time, and they aren’t going anywhere soon. The mechanistic pain theory of Descartes, and the old spirit-flesh split upon which it stands, is not only embedded in the very structure of the social and medical sciences, as well as the grammar of most human languages, but it also resonates too closely with lived experience for us to ever cast it out completely. The work of Drew Leder in The Absent Body is the best presentation I know of the conundrum of dualism in sensual experience, in which the flesh is felt to contain things, rather than express them.

In Leder, the spirit-flesh split is built upon the simple fact that our internal bodies are, in the end, unknown to us. Despite every yogic aspiration we may have, our interoceptive capacity has a hard limit. Where our mindfulness of the internal body ends, our dreams of the soul – along with our intuitive healing theories – begin.

The metaphysics of Myers may compel his students to seek ever deeper for embodied meaning, and to that extent they may have deep value. But they also limit the metaphors that illuminate that search. The nondual body, in which conscious life emerges from material life only to try to refashion it, is not a dumb vessel, or an empty book for experience or God to write in. The nondual body, which Myers and everyone else wants to see, treat, and love, is something his pain theory would miss, something so strange it’s almost inexpressible.

Bear with me:

The non-dual body doesn’t contain anything that’s not it. Its experience or movement doesn’t “enter in”, to animate this slab of meat. Its movement is inseparable from the meat, until the meat stops moving, like a ball stops rolling. Similarly: consciousness is an epiphenomenon of neural activity. Thought doesn’t “enter” the brain, but is secreted by it, like a juice the body itself — and bodies around it — will “drink”.

The memory of the non-dual body is not “stored”, as in a book. If experience wrote upon you, it wrote like a stylus on a wax tablet, and continual reading warms and reshapes that wax.

More than a book, the non-dual body is the reader of experience. It is experience, however, that trains the reading process. If we were to say that the non-dual body is like a book, it would be more like a collectively-written play, unfolding in real time, in which each character has habitual lines and reactions, but none of them knows where the plot will lead.

 

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I‘ll finish with a hard left turn.

The body of our sciences and humanities is not a collection of separable parts. It is, as Myers describes the human body, a single fabric, woven of many threads. For generations we have been aware of the independent action of each muscle: we know the language of religion when we hear it, or physics, or history, or sociology, or geometry, or chemistry, or ethics, or politics. But now, thanks to the dissections of deconstruction, we are slowly becoming aware of the hidden glue.

The conceptual split between flesh and spirit is the sticky fascia that knits our dreams together and makes them move as a fractured whole. Like bodily fascia, this metafacsia is a non-living detritus, the hardened junk of metabolizing uncertainty and fear. It gathers in the spaces of not-knowing, increases with age, and slowly chokes out the imagination.

It’s time to roll that shit out. Gently would be best. There’s probably no point in causing more pain.

 

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9 Comments

  1. Bravo for the call to awareness that goes beyond hackneyed beliefs and blind acceptance. I could not be more pleased by this or any daring departure from the fray.

    I have an arsenal of self help tools that began in the 70’s with a Ma Roller and so far ends with a soft rubber roller and balls called the M.E.L.T. method. If I had not spent most of my informative physical yoga years as a Feldenkrais student and later a Breema student, I may not have recognized the subtle power of less. I have long been a fan of the edge and still advocate that practice at an early point in this life under the guidance of a teacher who can help you temper it as I believe it builds both confidence and mental acuity. In truth, that edge need not be a physical practice but any practice where you go beyond your comfort zone. These days I do it by my behavior in general. I have only my experience and my subjective observations as proof that this is important.

    I did a weekend with Myers long ago at a massage school. He was just getting into the yoga world. His work was enlightening and I appreciated the information on fascia though I don’t remember the discussion of pain. I suspect his work must evolve to keep up with a more informed and hungry community. He struck me as a man who was keen on being the engineer of breaking ground. It will be interesting to see how the science shifts, as it will.

  2. the moment already came

    It’s been fascinating to watch how this conversation unfolded on all sides. Tom responded to the article you mention here:

    http://www.anatomytrains.com/news/2014/11/14/response-painful-controversy/

    His reply both clarifies and complicates, and I for one would love to hear your response to his response.

    • Thanks for posting this. I’m glad that Myers addressed the criticism, and clarified his scope of practice. I think many problems remain, because he essentially repeats himself.

      Admitting that one is not talking about neurology when one is talking about pain is an admission to using metaphorical language. But the video isn’t transparent about this, nor is the non-metaphorical way in which the entire AT discourse is presented, with its free utilization of biomed language, florid anatomical images, and cadaver tissue photographs. The work sits right on the threshold of saying “This is science”, when my Myers’ own admission, it’s not. If he prefaced by saying “This is my poetic theory about pain”, everything would be cool, except that some pain specialists would say: “Why confuse people with poetry when we actually know that there is no ‘storage’ of pain, or ‘leaving’ of pain?”

      I think Myers shows his epistemology clearly when he states the value of his personal experience first, and that he would continue to hold Ida Rolf’s definition of pain over that of current pain researchers. Further than that, he says “I don’t know where she got it.” This is amazing. What this says to me is “I will always value my intuition, and the intuition of those I’m devoted to, regardless of where it came from, above and beyond what’s generated by the peer-reviewed neuroscience community.” It says that knowledge comes from mystical experience. This might feel true, but how do we distinguish that feeling from hubris?

      He goes on to claim that Rolf’s definition of pain — “sensation accompanied by the motor intention to withdraw” — is solid because he hasn’t encountered a client’s pain unaccompanied by it, presumably as he’s treating them. Where are the controls for this transference/countertransference and confirmation bias mess? And what of the chronic pain client who isn’t withdrawing from anything, because there is no noxious stimulus, and who has learned to relax their eye-corners through the dull throb?

      To his credit, he acknowledges the full spectrum of relationships between pain and therapy. In the video, he categorically says that stored pain (a key refuted idea he doesn’t defend but rather repeats) must hurt when it “leaves”. So I guess he feels he can say one thing on camera and then walk it back, at least a little bit, in print. It gives me pause whenever a charismatic presenter whose followers hang on his every word feels free to make black-and-white statements in an instantly-influential medium like video. I don’t think is necessarily manipulative — perhaps it’s in the nature of the beast. The camera goes on and you know you have a few minutes only to make your mark: it would be easy to be seduced into overstating your case, or using language you know will impress, whether it’s accurate or not.

      It reminds me of Richard Dawkins confronting Deepak Chopra about the nonsensical idea of “quantum healing”. Chopra finally admits: “It’s a metaphor.” But the millions of people who bought his book didn’t know that, and probably still don’t.

  3. Rowan

    “consciousness is an epiphenomenon of neural activity. Thought doesn’t “enter” the brain, but is secreted by it, like a juice the body itself — and bodies around it — will “drink”.”

    The problematic thing about this, though, is that we have no direct experience of the brain (similar, as you mention, to most of the body’s internality).

    So to say that consciousness is a phenomenon of the brain seems like stepping far away from non-Cartesian embodiment, and back into the realm of theory – because ‘the brain,’ or ‘consciousness as coinciding with or produced by with the physical brain,’ is a concept, one that we don’t ever experience in consciousness (Marilynne Robinson’s book ‘Absence of Mind’ is good on this). Our experience of being a body does not include ‘the brain’ as such.

    And this seems to open up the possibility that the choice to say either, ‘I am not the body’ in Indian transcendental/Cartesian style, OR ELSE saying ‘I am the body’ in scientistic/materialist style, is a false dichotomy. ‘I am consciousness’ and ‘I am body’ can coexist and this doesn’t require a reductionist-materialist paradigm.

    Thanks for another thought-provoking piece!

    • Thanks Rowan. This in an old argument! The fact that we cannot introspect the brain is only problematic in the subjectivist realm of Descartes and his inheritors. He’s the one who decided consciousness alone could be verified by shutting himself in an attic and having people bring him his food! Once we get into the intersubjective science of material experimentation coupled with peer review, the ground shifts. We introspect brains by proxy, and watch consciousness come and go as the brain is injured and repaired. I have no qualms with “reductionism”, perhaps because I don’t feel that it reduces anything in scope or wonder.

  4. Thank you for writing, Matthew. I would recommend clients, patients, and health professionals look up the works of Ronald Melzack, V. Ramachandran, Lorimer Moseley, and Diane Jacobs to get a more accurate information on pain science.

    Myers’ wrote in his response, “I am well aware of the lack of research correlation between postural set and pain, but I am allowed to hold a contrarian view of this until all the evidence is in. I’m a posture ≠ pain denier.”

    Basically, what he’s saying is that he is ignoring the research and stands firm in his beliefs like Creationist Ken Hamm stand by his beliefs despite the evidence. There are a lot of data and strong evidence that finds a weak or lack of correlation between posture and pain.

    Like you said about Chopra, Myers explains pain metaphorically, but thousands of followers who are treating and working with clients and patients with pain don’t know the difference.

    Some current evidence on pain and movement:

    Evidence showing that pain is likely to cause “movement dysfunction,” not the other way around.

    http://www.ncbi.nlm.nih.gov/pubmed/25119510

    Pain causes a change of posture.

    http://www.jpain.org/article/S1526-5900%2811%2900485-8/abstract

    Rolfer and science writer Todd Hargrove summarize the evidence the “anterior pelvic tilt.” Citations included.

    http://www.bettermovement.org/2012/does-anterior-pelvic-tilt-cause-low-back-pain/

    I hope this helps. Thanks, Matthew.

  5. Great post, and replies. Thank you Matthew.

  6. This has nothing to do with Yoga .. He has not ‘aligned’ with it whatsoever .. Not training principles .. Spoken from someone who hasn’t had that experience over years ..an understanding of what happens during deep hands on work Definatley

  7. The guy who coined ‘the selfish gene’ going after the guy who coined ‘quantum healing’…. priceless. I’d say that Dawkins bullshit concept actually points towards nihilism and does far more damage than whatever Chopra has done. Chopra has actually helped a lot of people get out of reductionism and related isms, while Dawkins and company are happy with reduction, materialism, produce a worldview which is meaningless, but then being faced with a Nihilistic worldview Dawkins says ‘never mind, be nice anyway’… LOL.

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