tructural ntegration S ® I THE JOURNAL OF THE ROLF INSTITUTE DECEMBER 2016

TABLE OF CONTENTS

STRUCTURAL INTEGRATION: THE JOURNAL OF ® THE ROLF INSTITUTE FROM THE EDITOR-IN-CHIEF 2 December 2016 Vol. 44, No. 4 COLUMNS Ask the Faculty: Rolfing® Structural Integration and Healthcare 3 PUBLISHER The Rolf Institute of BIOTENSEGRITY AND SHAPE Structural Integration Biotensegrity: An Interview with Stephen Levin 6 5055 Chaparral Ct., Ste. 103 Brooke Thomas and Stephen Levin Boulder, CO 80301 USA A New Paradigm of Anatomy: An Interview with John Sharkey 10 (303) 449-5903 Brooke Thomas and John Sharkey (303) 449-5978 Fax Musings on Tensegrity and Biotensegrity 16 Michael Maskornick EDITORIAL BOARD Anne F. Hoff, Editor-in-Chief Manually-Evoked Tensegrity and Pandiculation, Part 1 19 Luiz Fernando Bertolucci with Angela Lobo Shonnie Carson, Lineage Editor Szaja Gottlieb, Research/Science Editor From Embryo to Adulthood: 24 Linda Loggins, Movement Editor The Human Body as a Performance of the Soul Heidi Massa, Latin America Editor Brooke Thomas and Jaap van der Wal Keren’Or Pézard, Arts Editor John Schewe, Faculty Liason ROLFING SI AND HEALTHCARE Matt Walker, Asia/Pacific Editor Fascia Pioneer: An Interview with Thomas Findley 28 Naomi Wynter-Vincent, Europe Editor Anne Hoff and Thomas Findley Diana Cary A Physician’s Perspective: An Interview with Wiley Patterson 34 Lynn Cohen Linda Loggins and Wiley Patterson Craig Ellis Lina Hack A Team Approach 37 Jeffrey Burch Dorothy Miller Meg Maurer Rolfing SI as Part of Healthcare: 3H Rehab – A Residential Program 39 Robert McWilliams for Rheumatic Patients Deanna Melnychuk Bibiana Badenes Max Leyf Treinen Putting the ‘Health’ Back into Healthcare 42 Linda Loggins LAYOUT AND GRAPHIC DESIGN CONTACTS 46 Susan Winter

Articles in Structural Integration: The Journal of The Rolf Institute® represent the views and opinions of the authors and do not necessarily represent the official positions or teachings of the Rolf Institute of Structural Integration. The Rolf Institute reserves the right, in its sole and absolute discretion, to accept or reject any article for publication in Structural Integration: The Journal of The Rolf Institute.

Structural Integration: The Journal of The Rolf Institute® (ISBN-13: 978-0997956917, ISBN-10: 0997956917, ISSN 1538-3784) is published by the Rolf Institute, 5055 Chaparral Ct., Ste. 103, Boulder, CO 80301.

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“Rolfing®,” “Rolf Movement®,” “Rolfer™,” and the Little Boy Logo are service marks of the Rolf Institute of Structural Integration. FROM THE EDITOR-IN-CHIEF

In this issue we juxtapose the theoretical and the practical with two themes. Our first group of articles looks at tensegrity in its latest format – biotensegrity – while our second theme looks at the interface between Rolfing ® Structural Integration (SI) and the healthcare system. For almost as long as Rolfing SI has been in existence, Buckminster Fuller’s unique explanation of discontinuous compression structures has been studied and offered as the rationale behind Dr. Rolf’s conceptualization of how the body really works in gravity and why Rolfing SI works as well. A good example of this is Ron Kirkby’s article “The Probable Reality Behind Structural Integration: How Gravity Supports the Body.” [Bulletin of Structural Integration, October 1975 (Vol. 5, Issue 1), pp. 5-15. Available at http://tinyurl.com/pbafhf4.] While tensegrity was an apt description with inanimate bodies, it had limitations when applied to living organisms. Thus, it eventually led to the concept of biotensegrity, tensegrity as applied to animate, living organisms. A useful reference on this sea change is the article “Paradigm Shift” by our Research/Science editor Szaja Gottlieb in the July 2015 issue (Vol. 43, Issue 2, pp. 66-68), which was a review of Graham Scarr’s groundbreaking book Biotensegrity. It is Graham, according to Gottlieb, who suggests we are looking at “nothing less than . . . a new discipline in the field of science.” We are fortunate to entertain a number of articles on this first theme. First, Rolfer™ Brooke Thomas graciously shares with us transcripts of interviews she did on her program The Liberated Body Podcast (www.liberatedbody.com/podcast/). We have her interviews with “the father of biotensegrity,” Stephen Levin, and with clinical anatomist and biotensegrity pioneer John Sharkey, both explicitly addressing biotensegrity. We also have her interview with Jaap van der Wal, who addresses form embryologically and, in a sense, spiritually. For considerations within our own Rolfing SI community, we have articles from Rolfers Michael Maskornick and Luiz Fernando Bertolucci. Maskornick tells us how contemplating tensegrity/biotensegrity, and building tensegrity models, informs his understanding and his Rolfing practice. Bertolucci shares how an examination of certain unique aspects of his way of working led to the development of Tensegrity Touch – a methodology of touch that invokes tensegrity in ways that make our hands-on contact more targeted and effective. Our second theme looks at Rolfing SI and Healthcare. Rolfers have traditionally operated outside of the healthcare system, going back to Ida Rolf who encouraged us to think of our work as ‘education’, famously stating, “gravity is the therapist.” Nonetheless, this has not stopped clients from associating our work with alternative medicine and seeking our services to help with pain and other issues that interface with the world of healthcare. In this issue, we hear from various members of our community who have operated within, or closely interacted with, the healthcare system. We share interviews with MD/Rolfers Thomas Findley and Wiley Patterson, and then hear from PT/Rolfer Bibiana Badenes, from certified medical technologist/MPH/Rolfer Linda Loggins, and from Rolfer Jeffrey Burch. You will find a multiplicity of viewpoints – as is common among Rolfers! There is clearly no one answer on whether Rolfers should be involved in healthcare, but it is a question each of us is forced to consider as we establish and pursue our practice of Rolfing SI.

Anne F. Hoff Editor-in-Chief

2 Structural Integration / December 2016 www.rolf.org COLUMNS

see the need to find answers that allow an Ask the Faculty attitude of ‘as well as’ instead of ‘either/or’. I have no satisfying answer to this challenge, Rolfing® Structural Integration and Healthcare but I am more optimistic about the future given the latest research results and a slight Q: Rolfers™ have traditionally operated outside of the traditional healthcare movement towards the acknowledgment system, yet more and more clients seek our assistance for issues that relate to of complementary medicine methods. The pain and various health conditions. Have you engaged or interfaced with the challenge for us as SI practitioners might healthcare system, and how have you done so while maintaining the integrity be how we answer the question of how to and identity of our work of Rolfing Structural Integration (SI)? relate ‘clinical aspects’ (which needs to be defined) and the tradition of Rolfing SI in a meaningful way. A: The healthcare system was vastly healthcare field in my local community. This different when I was certified thirty years pleases me as it’s a lot more fun to share Jörg Ahrend-Löns ago. During the intervening years, my what I know about Rolfing SI than to fill in Rolfing Instructor practice and the healthcare system have the appropriate boxes on those silly forms. developed and evolved into an unexpected A: What is the relationship between and oddly satisfying relationship. Sally Klemm structural integration and traditional health Advanced Rolfing Instructor care? To answer this question we confront During the mid-1980s, there was more time You can look at the question from our historical ambivalence and ambiguity and discretionary income available for A: different perspectives. One is a kind about our work: ambivalence about who ventures into modalities such as Rolfing of ‘administrative’ (insurance) or even we are as practitioners; ambiguity around SI and exploring human potential. At governmental (licensing) point of view. what it is that we do. What makes our that time, I found it easy to sidestep This has different implications in different work traditional? What makes our work taking on new clients through workman’s countries, even within the EU where non-traditional or distinctively different? compensation or auto accident claims healthcare systems are not interrelated who sought out Rolfing SI to relieve the It’s a puzzle: to the casual passerby, we – there are lots of different histories pain and discomfort of their injuries. But apply hands to soft and bony tissue. We of how healthcare systems developed inevitably former ‘cash’ clients would be claim to affect things in the domain of within Europe. One example is that in injured either at work or in an auto accident, physiotherapists, osteopaths, chiropractors, Germany we have the so-called Heilpraktiker and eventually I acquiesced to taking the and even orthopedists. Is this comparison license, which allows the practitioner extra time necessary to fill out and submit and apparent similarity apt? How do we to treat clients outside of the traditional the required forms and SOAP notes, to wish to be perceived? Do we want to be allopathic-oriented healthcare system. In bill according to diagnostic codes, etc., in categorized with physicians? France, there are very rigid regulations order for them to receive the treatment that almost prevent practitioners from When we have clients who also see medical they were entitled to according to their treating people unless you are a medical professionals, we notice an important insurance claim. doctor. (From my perspective, this is one conceptual difference. The medical field Initially, I was fairly shortsighted: I was of the reasons we still have almost no offers a paradigm oftreatment . Rolf steered more invested in assuring my clients got French Rolfers, even though France is part us away from the idea that we treat people, the help they sought without incurring of the EU. Additionally, in Germany there telling us we are not, in fact, therapists. additional cost, and that my services are ‘systemic’ hierarchic regulations; for She insisted we are educators. It’s accurate would be covered by their insurance, instance, even as a physical therapist (PT) to say ‘body educators’ – we coax forth than I was concerned with any long-term you are not allowed to diagnose and treat the body’s latent intelligence. This is not a ramifications. I didn’t particularly enjoy the clients without a prescription from an MD. trivial point. extra time involved doing paperwork or the You can imagine how delicate, difficult, and Medically trained practitioners don’t think time lag for payment, however it usually sometimes impossible it can be for Rolfers in terms of patients’ bodies needing better (but not always) worked out. to interface with the healthcare system. information. We don’t hear physicians or Another point is that Dr. Rolf’s method goes Unexpectedly, what did ensue from this physical therapists speaking about how to beyond the clinical frame of the healthcare interface with the healthcare system was improve the ingredients to motor control system. Clinical work focuses more and requests from these various clients to make as manifested in posture and movement. more on details and seems to have lost presentations on the efficacy of Rolfing SI People who come to see us have usually not the ability to look at people from a holistic at their various workplaces – which have heard medical professionals use words like point of view. included Shriner’s Children’s Hospital, coordination, conflicted motor pattern, pre- University of Hawaii School of Nursing, Sometimes I perceive myself as being movement, eccentricity/palintonicity, or Kapiolani Community College Massage caught between two opposing directions: self-regulation. During intake, clients tell us License Program, Institute of Clinical staying with our method and our tradition the names of their problem body parts. We Acupuncture, etc. What began as a reluctant on the one hand, or finding a meaningful rightly get the impression that traditional/ one-person endeavor ended up having a response to increasing demand from what medical models are mechanical models of the favorable and far-reaching impact of is outside – let’s call it ‘clinical’. As I have dysfunction: an ‘identify and fix the part to raising public awareness of our work in the the situation of being a PT and a Rolfer, I relieve the symptoms’ approach. This isn’t wrong; it’s the medical point of view. How

www.rolf.org Structural Integration / December 2016 3 COLUMNS might we characterize something different a system organizes, learns, and anchors this was a funny question. It is perhaps from a mechanical model? more intelligent motor activity. more meaningful to ask, “Are Rolfers able to fix things or not?” I experienced Rolf had the chance, almost a century The good news is that structural integrators that some were, and still are, able to do ago, to discern the difference between occupy a niche in which soft/bony tissue so. Louis Schultz once stated, “We are all mechanical and systems approaches. In the manipulation and positioning don’t have either balancers or fixers.” In my opinion, 1920s and 1930s, holistic forms of thinking to become a limiting focus. We work a Rolfing instructor helps students most if achieved popularity in the scientific world. within a field of inquiry that holds more he opens both avenues for them, then the Rolf conceived her work during a time in complex and holistic questions about why young Rolfer has a choice. If s/he learns which ‘systems views’ of biological activity a person does not spontaneously heal. To only one dimension of the work, s/he has gained influence. Systems models posit articulate this viewpoint, in words that are no choice and will face difficulties making that looking at parts can obscure a bigger accessible, is a challenge – but hardly an a living. picture. When we look at the big picture we insurmountable one. Words that do justice ask different questions; we start, as Rolf put to Rolf’s work are, moreover, less prone Occasionally I work with people who had it, from a different premise. to imitation. We have the chance to offer sessions with Ida Rolf. They report that they clients a new perspective, a refreshing felt her work had these two dimensions: Medicine plays a vital role. Parts need perspective. We offer a different model for She would take any opportunity to work attention and medical models have their those seeking new answers to a range of with people with serious problems who place. However, there is essential value nagging physical and psychological issues. were seeking help from manual medicine in practitioners who offer a model, and We have the opportunity to confront our – ask Jim Asher about the story of the a means, to help people function more field’s historical ambivalence and ambiguity woman and the iron lung! And Ida Rolf intelligently, especially if they find little about who we are and what we do. worked under the license of her son, useful or lasting remedy from traditional Richard Demmerle DC. fields. We have been educated to think Kevin Frank about body systems holistically. Rolf Movement® Instructor I learned from my first experience of this work: the reality of Rolfing SI is not so much A concise example can be gleaned from A: Perhaps it is an illusion to try and find what we intend it to be, it is much more an article I wrote for an earlier issue of a sort of objective answer for this question what the client experiences. And as soon this journal. A PT referred a man with – there are so many subjective dimensions as the client finds a way out of dysfunction trauma to his pelvis; he had undergone involved. I can only report my personal and pain, it will be easier to follow a process two surgeries to correct the source of his experience, more than forty years ago. I of global alignment and balance and pain. The PT, who had worked with this had ten sessions of Rolfing SI, later four free movement. individual continuously for several years, sessions of the old advanced series. My is skilled and intelligent. When I watched Rolfer did not say a word about what this Of course there is the question of licenses this new client move, it was obvious that work is about, or should be about. He did and insurance. We have to wait to see his attention was directed toward control the Ten Series with ninety-four people in what comes out of the involvement of of his anatomy. He was working diligently my circle of acquaintances (yes, ninety- Rolfing SI in healthcare, if something ever to manage the ‘parts’, to make the right four! – this was during the 1970s). Most happens. Let’s see what the Swiss are able things move in the correct shape. Missing of them appreciated the ten basic sessions to accomplish by making Rolfing SI a part was a broad spectrum of skills to organize a lot, but not so much the old advanced of the recognized complementary medicine or reboot normalized movement. Missing series. There was no philosophy of Rolfing scene. Swiss watches still seem to work were simple things like: a reasonable SI involved, no talk about alignment, no talk pretty well! sense of weight and how this weight about gravity, and no talk about symptoms. Peter Schwind translates into support; perception of spatial There was almost no talk using words, orientation that translates into support; but the touch of the practitioner talked to Advanced Rolfing Instructor capacity to allow automatic governance to me on several levels. I experienced two A: In Switzerland there are two orchestrate his movement; evidence that dimensions of the process: the serious organizations – EMR (Register of Empirical fascial touch was used to differentiate his dysfunction in my left knee was handled Medicine) and ASCA (Swiss Foundation for sensory and motor maps. The PT had done brilliantly, and something happened to Complementary Medicine) – that recognize diligent work – but within a paradigm in my organism as a whole – sort of a general certain therapies and certain therapists. which body parts are assessed as too weak ‘lightness’ and definitely a subtle correction The EMR and ASCA are each recognized or too strong, or incorrectly positioned. of the way I was used to moving. It was by a group of different complementary It’s a mechanical model: what we often a deep experience, and I am glad I wrote health insurances that refund recognized called a ‘body-as-soft-machine’ model. something down about it – as we know, therapies or therapists. ASCA is more Structural integrators offer an information our memory changes the content of our present in the French part of Switzerland model – a system model – that posits that experiences all the time. and approximately ten insurances work when a body behaves poorly, it’s often with them; EMR is present in the whole Later, when I came to the Rolf Institute® not the fault of bad parts. Rather, it’s the of Switzerland and around thirty-five in Boulder as a young Rolfing instructor, I result of blocked intelligence and faulty other insurances work with them. A Rolfer listened to the battles happening between information. Blocked intelligence and faulty needs to sign up and pay a yearly fee to some of us instructors. Are Rolfers allowed information are remedied through a process both organizations (around $600 total) if to fix things or not? Sitting there, I thought of differentiation and integration, in which he wants his sessions to be refunded by all

4 Structural Integration / December 2016 www.rolf.org COLUMNS complementary insurances. He can only lines of work, like chiropractors, osteopaths, client searches for any of the above, Google do that if he has done a certain number and related disciplines. By now thousands will hook on my keywords and show my of sessions already, if he has studied a of people have benefitted from Rolfing SI, links to the client. That is how I get a good minimum of 150 hours of anatomy in an but we have never been able to breach that 25% of my business here in the sunny south approved school, and if he can prove that magical area of ‘third-party payments’. land. Once the potential client sorts me out he is doing a minimum of three or four days We have accomplished some research to from the other links, and calls me, then it of continuing education per year. demonstrate that our ideas are valid, and becomes my job to either reel him in, or done some clinical research to show that send him on, depending if I think it is a This general scenario will probably change what we do helps some people, but it has good match for my work. in the future as a new métier is slowly not been enough to get the recognition of taking place in Switzerland: Therapist of I almost never get referrals from the the value of Rolfing SI. Complementary Medicine. There is already ‘medical’ community. That includes the a course in place that allows therapists of Rolf took an important position regarding docs, and chiropractors, the acupuncturists, all kinds to register to earn this designation. her work. She insisted that we did not fix the dentists, et al. Now and then a nurse Our Swiss Rolfing board, and in particular anything. She insisted that gravity was will refer, or an occupational therapist, or a our former president Marlene Sonderegger, the therapist. She carefully avoided ever Pilates, yoga, or other non-medical worker, have worked hard to have our curriculum claiming that Rolfing SI was any kind of but almost never from the upper echelon of accepted as a training in Structural practice of medicine. She insisted that medical practitioners. This is reinforced by Integration (Rolfing). Guild for Structural it was a process of manipulation and the new wave of ‘evidence-based’ practices, Integration practitioners are recognized education. She even went so far as to say aimed at actively discrediting work like as well, so to be more precise, structural that if a person were interested in relieving ours to the extent that they want to put us integration is recognized and Rolfing symptoms, that they had no business being out of competition for clients’ dollars. That Structural Integration is a brand. In our a Rolfer. is the same battle that Abraham Flexner Swiss Association, we have both Rolfers and prosecuted for the medical profession in Given a public stance like that, it is no Guild Practitioners. Further down the line, 1910 (the Flexner Report), successfully wonder that our profession has never schools for this new métier will be created. putting many of the ‘alternative medical made any headway into recognition by A few exist already. In such schools, there schools’ out of business. Make no mistake, the establishment, or serious competition are two years of common-core studies in these champions of evidence-based practice for the other professions that reach for which anatomy, physiology, psychology, are not your friends. the consumers’ dollars. We have relegated etc. are taught. Then there is another ourselves to a very particular corner of the Given this cultural context, my own drive year of study for the particular method therapeutic market in which we are not is to develop skills that are useful to my the therapist is working with (there is a medical, not therapeutic, but educational. community, and reliable for increasing minimum of hours, and Rolfing SI meets At this point, I have to say that no third- performance, raising adaptability, the criteria). This Swiss initiative has been party payers in North America pay for alleviating suffering, and bringing referrals recognized as a possible future project for education. In fact, when times are harder, as based on good results. I don’t care about recognition of complementary therapists in they have been recently, teachers are among proving that Rolfing SI works to some different European countries over the long the first to lose their jobs. amorphous scientific body who will term. We are not there yet. eventually approve of us and admit us into Most people who find Rolfing SI also find the lofty realm of third-party payments. In France Hatt-Arnold that they pay for it with what is called that realm, our practices will be constantly Rolfing Instructor discretionary income. That is, money not challenged, our fees regularly reduced, and Rolf Movement Instructor dedicated to essentials like food, gasoline, our claims denied, leaving the practitioner or rent. It is in this milieu that we exist. A: I have been practicing Rolfing SI for on the losing end. This situation is already We exist on referrals, and on the good more than forty-five years. During that time driving many doctors out of business as will of people we have worked with who I lived in Northern New Mexico, and for the they can’t cope with lowered fees and got benefit. We exist on a tiny amount of past six years in the heart of Los Angeles. I fumbling bureaucrats. have never advertised my services, and did advertising, and the very occasional sports not have a website until I came to LA. All testimonials about higher performance. I think that our school must prepare our of my business has come to me by word- Most of us do Rolfing practice to make a students with a solid education that will of-mouth referrals: that is the means where living, or part of a living. Very few of us enable them to work competently and one person I have served well tells friends practice as a hobby, or sideline. draw people to them who need them. Rather than struggle to gain acceptance and family, and this grows a reputation. I In this period of the history of Rolfing from other professionals who have no have also ridden the wave of awareness of SI, we have become part of a larger field interest in opening their doors to us, we Rolfing SI as a useful adjunct to other means of hands-on therapeutic practice. My should concentrate on proving to ourselves of healthcare. website (remember, new to my time in what works and what does not, and LA) hooks Google searches with keywords Rolfing SI’s fortunes have risen and fallen developing the work so that we can serve embedded in my front page, like ‘deep with changes in the culture. Starting with the communities that we live in. I think tissue’, ‘structural integration’, ‘Rolfing’, Ida Rolf herself, treating one person at a we are more related to folk healers than ‘myofascial release’, ‘visceral manipulation’, time, and then teaching small groups of medical practitioners, and we should strive ‘craniosacral therapy’. When a potential other interested professionals in parallel to be very good at that.

www.rolf.org Structural Integration / December 2016 5 BIOTENSEGRITY AND SHAPE

Six years ago I moved to LA and had the clients. Pediatricians suggest Rolfing SI for I myself never feel obligated to adapt the very unpleasant experience of building a scoliosis for instance, because they noticed principles of our work to a request that business from scratch. I discovered that remarkable improvement in patients after comes from rules written by the healthcare the high recognition that Rolfing SI enjoyed Rolfing sessions. Medical doctors who system. Clients come for sessions of their in the 1970s had given away to questions have come for Rolfing sessions themselves own volition, decision, and wish to improve like “Are they still doing that?” It took have no resistance to suggesting it to their wellbeing. me a year and a half to do a full weeks’ their patients. work – this in spite of having a pretty well- Pierpaola Volpones established personal reputation in the field. Rolfing Instructor From this perspective, I think that the Rolf Rolf Movement Instructor Institute needs to concentrate on producing graduates who can deliver the work across a spectrum of clients. We need to concentrate on the development of solid skills, and good understanding of structure. We need to also Biotensegrity teach our grads how to speak about the work, and how to listen to clients’ anecdotal An Interview with Stephen Levin, MD accounts of their state and make sense of it. By Brooke Thomas, Certified Rolfer™ and Stephen Levin, MD We need to teach our grads how to listen with their hands, and their hearts, because Editor’s Note: This interview was originally done for Brooke Thomas’s The Liberated Body when people are paying out of pocket, they Podcast. You can listen to this interview at www.liberatedbody.com/stephen-levin-lbp-035. also need to feel heard and recognized. Brooke Thomas: For those unacquainted, Jan Sultan can you give us a simple nutshell definition Advanced Rolfing Instructor of biotensegrity? A: I will address the two parts I see in this Stephen Levin: Tensegrity is a word question. The first is “more clients seek our derived from tension and integrity, [it] is assistance for issues that relate to pain and a Buckminster Fuller term to indicate a various health conditions.” The great majority continuous tension network. It’s actually of my clients come for Rolfing sessions more than that: it’s the compression because they have a ‘problem’ related to elements of the structure meshed within the a lack in their health, pain that bothers tension elements so that the compression them, discomfort more or less all day long. elements, the rods, the skeleton, do not Very few clients come to improve their press on one another. It was derived from posture. Almost no one comes for personal Kenneth Snelson’s sculpture [Needle Tower; development in these past decades. So, yes, see Resources at the end of the article for I constantly face clients’ requests to reduce a link to images], actually. Snelson was a Stephen Levin their pain. What they discover during the student of Fuller, but it was Snelson who Rolfing sessions is a broader field – that really made the first structure. He describes involves many aspects of their lives – that it as a closed structural system composed needs to be looked at and addressed. of three or more compression struts within This could range from lifestyle to specific a network of tension tendons. He says coordination and repetitive movement the compression rods float within this patterns to fixed attitudes in their behavior structure and they press outwardly against and worldview that reflect in rigidity in the tension member so it’s a self-contained their facial web. What I do is working the unit, and it’s a pre-stressed tension and fascial net. compression unit. Tensegrity as a word had Next, you ask if I have been “engaged or lost its meaning, so we put bio in front of it, interfaced with the healthcare system, and which is adding biology to it, and it’s really how have you done so while maintaining the more narrowly defined and more specific integrity and identity of our work?” Yes, I have than using tensegrity, which everybody interfaced with several medical doctors, uses for everything else. You can get away physiotherapists, and osteopaths, and their with things in tensegrity that you just can’t Brooke Thomas responses have been very different. Some get away with in biotensegrity, because doctors simply deny that Rolfing SI could life forms have their laws that they have be of any help, and have no recognition of to stick to. pre-stressed. Can you talk about that a the value of our work simply because it little bit? BT: The difference between the mechanics is not formalized by a degree recognized of a bicycle wheel as opposed to a wagon SL: Aside from the Snelson sculptures, the by the healthcare system. Other doctors wheel is a nice illustration of how we are closest you get to tensegrity in everyday are totally enthusiastic and had send

6 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE life is a bicycle wheel, where the hub is and red blood cells, pollen grains, when metatarsal, and the heel bone, the calcaneus, suspended in the middle of a tension you get down to the little things, but if you which is as soft as eggshells. So we stand network of spokes. All your spokes are start looking at bigger things, things like on our calcanei and of course we often have always under tension. In a wagon wheel, raspberries and similar fruits and berries, dense heads that put a lot of load on these each spoke bears the full weight of the puffer fish. In fact, most round spiky things structures. We’re built upside down. We wagon, of course divided by the number of are pretty obvious tensegrities when you don’t make sense in a Newtonian concept. wheels you got on the ground. Each spoke look at them. Tensegrities actually can be All biological structures also have flexible bears the full weight and you actually are recognized more from the mechanics of the joints, and we are omnidirectional. We vaulting from one compression pillar of structure than outward appearance. don’t break apart when we’re turned upside the spoke to another compression pillar of down and shaken. BT: That makes sense. On the opposite side the spoke. of the spectrum, bioengineers oftentimes BT: I like how you mention that we don’t A bicycle wheel works the opposite. All will say human bodies are like skyscrapers. need gravity to hold us together. When we the spokes are working all the time. When What are some of the many ways that we have people who go into space, or even just you set a bicycle wheel, you tighten all the are not like skyscrapers? diving in different pressures under water spokes, you pre-tension them, and then it and things like that, we don’t come apart. SL: Tensegrities are built up from smaller stays that way even when you ride on the units. In biology, the subunit, the cell of SL: It’s one of the characteristics of the bicycle. Your load is distributed through the tensegrity structure, is the icosahedron, tensegrity structure that it is independent the tension elements of the spokes. All the which is a polyhedron with twenty of these outside forces. It holds itself by spokes are pulling on the hub all the time. triangular faces. Triangles are the only internal forces. It’s by the opposite pulling of the spokes structures that are inherently stable with that the hub stays in place. It’s like if you BT: And the foam, the soap bubbles, is flexible hinges. [Tensegrity] structures were doing tug of war and you had equal a really nice example too because that’s can have any outward appearance, from sides and the rope wasn’t going anyplace – something we can interact with pretty spheres to towers with limbs sticking out. staying right in the middle because it’s regularly. It doesn’t make any difference. They’re all equally pulled on both sides. Just as the self-contained entities. They don’t require SL: We essentially are foams. spokes in that bike wheel are pre-stressed, gravity to hold them together. all the tissues in the body are pre-stressed. BT: You had mentioned the icosahedron, They are always under tension. So muscles Skyscrapers and towers need gravity to which is pretty important I think to the are never programmed lax: there’s always hold them together. The bottom bricks are concept of tensegrity. Can we break that muscle tone present. All the fascia and held in place by the bricks above them, down a little bit more? Why we should care connective tissue, in fact all collagen, have one on top of the other. When you build a about this structure? intrinsic tension within them. Even under skyscraper, the base has to be bigger and SL: When I started doing this, I tried to find deepest anesthesia, when you cut muscle stronger and stiffer than the top, and if some structure that looked like a cell and that it retracts and pulls apart. There’s always you tilt the tower over it not only will fall would build from a cell. The icosahedron is tone to muscle, and you can never say your over, but it will pull itself apart because of one of the Platonic solids, going way back. muscle is completely ‘off’. the intrinsic shear forces that develop. If It’s a fully triangulated structure. Again, you build biotensegrities, they really join BT: I think that’s a beautiful illustration. only triangles are inherently stable, so if together like bubbles in a foam and they Speaking of visuals, you say that tensegrity you’re going to have flexible hinges, you can share walls and structural continuity. structures are ubiquitous in nature if you have to be triangulated. It’s omnidirectional know what to look for. Can you give some If you go back to towers, I lived in the so that you can turn in any direction. It has examples of what we might be able to notice Washington, DC area, and the classic model the largest volume for surface area, so it’s if we do know what we’re looking for? might be the Washington Monument, which energetically efficient in the sense of using is 550 feet tall, thirty feet thick at the base, materials that are most economical. It can SL: There are no true man-made tensegrities and five feet thick at the summit. It’s built be close-packed to fill space or would fill because even a man-made tensegrity stone on stone on stone held together with spaces like cellular space filling. It joins structure itself uses linear materials, rigid mortar. The Washington Monument together. When it joins together, it’ll share the regular materials people build with. was almost toppled in an earthquake a structures. It’s like sharing the faces in the Tensegrities in themselves are nonlinear, couple of years ago. It got shaken up and bubble, as we pointed out. The individual and we’ll probably talk about that later. got cracked because it has no flexibility in icosahedrons can actually then function as They’re ubiquitous in nature; it’s just it. Trees on the other hand are broader at one unit structurally, but [the whole] also recognizing them. Most of the obvious ones the top. They have much more weight at has the ability to function as the individual look like the Buckminster Fuller geodesic the top than the bottom. They withstand unit. They become independent and domes, like the Disney Epcot Center. Those big winds, and they’re sort of built upside interdependent at the same time. It can can all be built as tensegrities. My favorite down from a Newtonian concept. have an external or internal skeleton. You one is the dandelion puffball because that can internalize the compression elements was a large structure that I recognized If you stop and think about animals – instead of keeping them in the outside shell, as being consistent with a tensegrity. The including ourselves – we have small and and that internal creation is a self-emerging concept has been around for a long time. light bones in our feet. We actually stand property that comes from the structure Icosahedrons were described in the mid- on two little sesamoid bones under the itself. It also has mechanical properties 1960s. I think it was in the lymphocytes first metatarsal, a little thing at the fifth that are nonlinear, viscoelastic, which is the www.rolf.org Structural Integration / December 2016 7 BIOTENSEGRITY AND SHAPE same as biologic materials, so why wouldn’t you touch it slow and broad, your fingers [instead] using body conditions, then you you use it? will sink in. And then getting your fingers get completely different results. out, if you pull real quick, it’ll keep you BT: Can you describe viscoelasticity a bit BT: That makes perfect sense. You have in there. It’s really cool to play with that more? pointed out that in the traditional paradigm quality with touch and to get a sense for of Newtonian biomechanics, “The forces SL: ‘Viscoelastic’ suggests the material how responsive it is. needed for a grandfather to lift his three- property has some qualities of a liquid, SL: I frequently use the example that when year-old grandchild would crush his spine, the viscous part, which is liquid, and some you pull on your lip or your earlobe, it’ll or touching a fish at the end of a fly rod qualities of a so-called solid part, the elastic first give easily and then it stiffens up. It’s would tear the angler from limb to limb.” I part. ‘Elastic’ just means that the form can not a linear stiffening up where you get think these are some good examples about return to its previous shape. Rubber-band an incremental point-by-point change. It how this Newtonian model doesn’t really elastic is not a really good elastic. When actually gets structurally stiffer in many hold up to how we actually use our bodies. you apply the term ‘viscoelastic’ to biologic ways. The harder you pull, the stiffer it gets. material, it’s really a misnomer. Biologic SL: Rather than go through the math with Silly Putty gets stiffer the harder you pull materials are not hard matter; they’re you – it’s difficult without a blackboard on it or the faster you pull on it. all condensed soft matter, or just simply – let me point out that the Newtonian soft matter. As a class of behavior, the If you look at things like fascia for instance, biomechanics calculation of spinal loading hard-materials side has been described as then you’re right: as you play with it, the and joint muscle loading are based viscoelastic, but it’s really a breed of its own. fascia does that. If you attack a body and on a 350-year-old model that assumes push on it hard, it’s going to resist you. 1) biologic material is hard matter, and we The best examples I can give you of this You’ll never get into its deeper layers. If just discussed that it is not, we now know are Silly Putty and the green slime that you just sort of lean on it and move into it it’s more like Silly Putty; 2) that muscles kids play with. Silly Putty is a polymer, it’s slowly, you’ll get into the deeper tissues of act as binaries [and] they’re on and off, but a mixture of things. Sometimes it’s rigid, it, and that’s very typical of these kinds of we’ve already said that muscles are always sometimes it’s soft. You can bounce it. You things. If you think of Silly Putty or those on, there’s always tone in muscles; 3) that can do all sorts of different things with slimy gel things, you’ll see that’s exactly the muscles act as agonists and antagonists, it, and it behaves differently the different the way they work. Look at something like when they mostly act synergistically; 4) that ways you load it – it depends on the rate of the heel pad, for instance. You run on your the muscular system is an open kinematic loading, the surface area, the temperature. heel pad, and every time you hit it hard it chain system, when we know that much, By temperature, I mean only a few degrees. protects you; when you walk on it, it gives if not all, of muscular skeletal mechanics We operate in a very few degrees. Steel, you a soft, gentler kind of response and is really closed kinematic chains (we move you need to really get it hot to change its more of a shock absorber; and if you touch one thing and something moves at the other shape. Biologic things have very slight it, you can just sort of sink your finger into end of this chain). You also understand temperature changes where they can do it. It’s the same material. It’s the rate of that muscles are internal forces and can’t different things. The Silly Putty and the loading that makes the difference. resist external forces without external biologic density can be malleable, brittle, help. They’re using the calculation as if the elastic, all these things at the same time. BT: You mentioned how delicate a structure internal muscles can resist gravitational our calcaneus is, and that this model of us Soft-matter physics is the science of forces, and they cannot. You can go through like skyscrapers just doesn’t hold up. If we gels, foams, emulsions. Some composite all this, and I don’t have to use calculations were loading our calcanei that way with all mixtures like cornstarch in water will or any math. I can just talk about this and the force of everything else piling down on show these kind of behaviors. The Oxford say, “Hey, they’re using the wrong model. top, they wouldn’t last us very long. University lab [The Oxford Centre for Soft You got to start over again.” and Biological Matter] actually has on SL: The calcaneus is really very soft bone. BT: Perfectly said. We dipped into this a its website, “Biology is soft matter come In surgery, you can actually just poke at teensy bit, but going back to it, biologic alive,” that’s a quote right off the website. it and it’ll break. One of our problems is systems are pretty invested in using the If you think of foam as behaving like Silly that when you take these things out of the least energy expenditure necessary. What Putty, as it probably does, we have all these body and let them dry out, they become are some of the ways we’ve developed to properties built into the viscoelasticity stiff and hard, and you’re not dealing with use the least energy needed? and the characters of biologic tissues. them under normal test conditions that the All the structures in biology behave the body uses. If you’re testing things at room SL: I’m old enough to been in the Army, same as icosahedrons do, which have this temperature, well the body doesn’t operate and the Army maxim was, “Never stand viscoelastic property, which really isn’t that, at room temperature. It operates at body when you can sit. Never sit when you can it’s soft-tissue mechanics. temperature. Take a thing like petroleum lie down. Never stay awake when you can jelly, you keep it at room temperature and be asleep” – and that applies to biologic BT: You mentioned cornstarch and water. it’s a thick jelly; you put it on your skin, it systems. A nonlinear stress-strain curve We use that at the Rolf Institute® just to just slides all over the place. You have to is initially flat. It just sort of flows along get a tangible sense for viscoelasticity, now think, how are these people testing and then starts getting steeper, stiffer, and it’s really fun if you mix up a tray of it these materials outside the body? If you’re and stronger. The biologic system always because if you touch it hard and fast, like not testing it at room temperature and wants to operate at the least-energy point, with really pointed fingers, it just firms up at the low part of the curve, because as you like a wall and kind of pushes you away. If

8 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE increase that strain and it gets stiffer, you and of course the chest wall is moving up a tensegrity concept. More than anything need much more energy. It’s interesting that and down sixteen times a minute through else, the Diplodocus had a tail that was over in the laboratory, most of the testing is done these flexible ribs, so there’s no way you 100 bones long and was held up in the air. It on the steep part of the curve and they sort can pass a load through the chest to the didn’t drag on the ground. It used to whip of ignore the bottom part because the math axial spine. it around. There’s no way that that could there is very difficult. have functioned unless it was in a tensegrity BT: Thank you for that description of structure. The muscles are adjacent to the BT: That’s interesting to know. Diving the float of the scapula and the float of bone; there’s no lever that you can possibly into one structure in particular here, the everything. You’ve been working in the make out of it, so it has to function as shoulder is one of the least successfully biotensegrity field for a long time and a tensegrity. modeled joint complexes using Newtonian you’ve contributed a lot of wisdom in this mechanics, and you have a great paper on field. Is there anything that you’re currently BT: My son went through a very intense this, which I’ll put in the notes. It’s titled really fascinated by in your own work? dinosaur period for a long time, so I’m “The Scapula is a Sesamoid Bone.” I love pretty well versed. Because the tails were so SL: Actually this year is my fortieth year that image. Can you briefly touch on what long on these skeletons they were finding, working in biotensegrity. My original a sesamoid bone is and how the scapula they just always assumed that the tail concept was sort of a eureka moment functions as one? dragged on the ground (and assembled forty years ago: I was sitting outside the the skeletons that way), until they finally SL: The sesamoid bones are those bones National Museum of Natural History realized they’d never found a fossil with considered outside the axial skeleton that in Washington, D.C. contemplating the a tail drag. don’t contribute to direct support of the skeletons of dinosaurs when I recognized body (of course they’re thinking of a body Snelson’s sculpture across the lawn. (The SL: Exactly. That was my professor. I was that has a column of bones), and the most Hirshhorn Museum with his sculpture trained by the head of the paleontology common one that everybody knows about is directly across from the National group over there, and he used to say, “In is the patella, the kneecap that sort of floats Museum of Natural History.) I put the two the sands of time there are footprints but outside the knee and is buried within the together and then started building from no tail tracks.” tendon of the quadriceps muscle. There are there. Since then, I have been working BT: Which means we have to think of these others. One you don’t think about very often on this concept and trying to figure out things totally differently than we have. is the hyoid bone in your neck where your how these two mesh together. The most Thank you so much for all of the amazing voice box is. That’s sort of sitting in space recent things I’ve been working on have work that you have been doing and for not supporting anything. Of course there been soft-matter physics and the closed- talking with us today. are supporting sesamoids, but not thought kinematic-chain mechanisms, which are of that way: the two little sesamoid bones how these structures move and how they SL: It has been my delight. Thank you underneath the first metatarsal. These bones behave under different forces, which very much. are about the size of small peas, and they completely gets you away from the Brooke Thomas is a Certified Rolfer who has crush easily. They are like peanut shells, hard-matter physics that is the staple of been practicing for over fifteen years. A self- they crush very easily, and they’re sitting present-day biomechanics. admitted body nerd, she teaches movement there, and you’d expect them to get all this BT: That was a really fortuitous day to see and hosts The Liberated Body Podcast as crushing force. They’re sitting in tendons, those two things together. a continuing-education resource for those in and those tendons act like leaf springs on a the manual and movement therapy fields. Visit car and actually keep you from striking the SL: The Hirshhorn Museum [had] opened www.liberatedbody.com for more episodes, bottom. If those little sesamoids got hit by a year before and I had gone down and or visit www.newhavenrolfing.com for more the first metatarsal, they’d be crushed – like walked around and couldn’t figure out information about Brooke and her practice. hammering against an anvil. how this structure [the sculpture] stood there. I just left it at that. A year later, sitting Dr. Stephen Levin originated the concept of I looked at the scapula, it sits there and across the Mall, I said, “Oh my god, the two biotensegrity more than forty years ago. He floats on the chest wall. There’s no direct of them [the sculpture and the dinosaur originally trained as an orthopedic and spine loading between the scapulae and the chest skeleton] match.” I went across and then surgeon and was formerly Clinical Associate wall, [they are] buried in muscles. The figured it out from there, and then it took Professor at Michigan State University and scapula fits the definition of a sesamoid. Of me a long time to figure out how to build Howard University. He studied general course, I take it a bit further, and I say that the tensegrity. I called Snelson and got hold systems theory with noted biologist Timothy in the biotensegrity model all bones float of Buckminster Fuller people and did all Allen, and now, retired from clinical practice, because that’s a definition of tensegrity, sorts of things to finally figure it all out and considers himself a ‘systems biologist’. He has and therefore all bones are sesamoid bones. get down to the icosahedron and then work been closely allied with others working in the BT: With the scapula, we’ll think about that back up from there. field of design science, emphasizing the work continuity with the clavicle, but that doesn’t of Buckminster Fuller and its applications. He BT: That’s wonderful. Those giant mean that it’s not floating just because it has has written numerous papers that contribute to dinosaurs couldn’t have existed with the that bone nearby. the understanding of how biological structures structural skyscraper model. function like tensegrity structures. SL: If you look at the clavicle, it’s also SL: Absolutely not. There’s no way that floating up there. It’s only hinged to the they could have functioned in any way but sternum by a little ligament there at its joint,

www.rolf.org Structural Integration / December 2016 9 BIOTENSEGRITY AND SHAPE Resources / References Stephen Levin: A New Paradigm of Anatomy http://biotensegrity.com. An Interview with John Sharkey The Levin Biotensegrithy Archive: http://biotensegrityarchive.org. By Brooke Thomas, Certified Rolfer™ and John Sharkey MSc, Clinical Anatomist The Buckminster Fuller Institute: http://bfi.org. Editor’s Note: This interview was originally done for Brooke Thomas’s The Liberated Body Podcast. It has been edited slightly for length. You can listen to the interview at www.liberatedbody. Kenneth Snelson’s Needle Tower com/john-sharkey-lbp-055/. sculpture: https://en.wikipedia.org/wiki/ Needle_Tower www.smithsonianmag. Brooke Thomas: Today, I’m talking com/smithsonian-institution/how-does- with John Sharkey who is a clinical hirshhorn-60-foot-needle-tower-stay- anatomist, exercise physiologist, and upright-in-stiff-wind-180953391/?no-ist (the European neuromuscular therapist. He’s latter includes a video of its installation). developed the world’s only master’s Articles: degree in neuromuscular therapy, which is accredited by the University of Chester “The Scapula Is a Sesamoid Bone”: (UK). He’s on the editorial boards of the www.biotensegrity.com/resources/ Journal of Bodywork and Movement Therapies, scapula-sesamoid-bone.pdf. International Journal of Osteopathy, and “Tensegrity: The New Biomechanics”: International Journal of Therapeutic Massage www.biotensegrity.com/resources/ and Bodywork. He’s also a member of the tensegrity--the-new-biomechanics.pdf. Olympic Council’s medical team and a founding member of the BIG, otherwise known as the Biotensegrity Interest Group. John Sharkey He has also authored or co-authored several books including the third edition of The Concise Book of Muscles. He and I are talking here in great depth about the old paradigm of anatomy and biomechanics and what the new paradigm holds. This is really critical stuff. I believe we’re on the brink of a new understanding of the living human body. We have a lot of fascinating people doing groundbreaking work in this field and it’s time to look at our old models; to look at where they come from and why they’re outdated. If you’re interested in things like living tissue versus formaldehyde-treated cadavers, biotensegrity versus biomechanics, Brooke Thomas continuity of form versus origin-insertion, and just how individual human anatomy clinical anatomists earn their stripes, so to is and what that changes about our often speak? dogmatic approaches to the body, then this interview should be a treat for you. Thank JS: First of all, I’m going to take you back you so much John, for talking with all of to the mid 70s and then into the late 70s and us today. early 80s. The health fitness industry hadn’t really started yet and I was into running. John Sharkey: It’s a real thrill to be here. I just didn’t know at the time that it was called ‘running’. I used to just run from one BT: I want to start off with some of your end of the beach to another with my brother, background. I introduced you so people and the game was really to get from one end have a sense of your bio, but the one thing I of the beach to the other, that’s it. Then that really want to pick out for this conversation later became known, thanks to Jim Fixx, is that you’re a clinical anatomist; I want as ‘jogging’, as ‘running’. I was also lucky people to have an understanding of what enough to meet a group of ladies who were that means. Could you describe the way looking for somebody [to] practice their

10 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE massage techniques on. I offered my body of specificity. Anatomists really feed on nerves and the blood vessels and perhaps and so I had one person on each foot and technicalities and on detail. then the viscera and the musculature. one on each hand, somebody massaging BT: [So] clinical anatomy is about where That really is a focus of parts and the my head, and somebody else on my body. and it’s about knowing the names of language of parts, while I was really I said, “What’s all this about?” That was structures that have been passed down interested in exploring the language my introduction to massage and bodywork through the ages. Really you’re very much of wholes. I wanted to appreciate the therapy, and over the years as I read more steeped initially in what I’m now calling, relationships and the continuity. In many articles and got to listen to some of the and many people are now calling, the ways you are not even given the opportunity leaders at the time, I became more aware old paradigm – this idea of parts, naming to do that, because as a student, you’re that there was a big disparity between the parts. [And] you are such a champion for usually at a table with five other students. medical fraternity and the massage people. the new paradigm as well. You’re running You can’t really dictate to them and say, In the United States there were people like the world’s first biotensegrity dissections. “Oh, hang on guys. Let’s not destroy this the structural integrators and so on, but You’ve been writing articles with really until I get to have a look at it.” In the it really hadn’t developed very well over compelling titles like “Fascia and the department of anatomy, my nickname was here in Europe yet. I made the decision that Fallacy of Biomechanics.” These are big Fascia Man because I had an interest in physiology and anatomy were going to be things. I’m curious, do you agree first of fascia, and in fact one of my colleagues who the foundation stones upon which I was all with these terms – old paradigm, new works with me on the biotensegrity-focused built. I went into formal studies and gained paradigm – and if so, how might you dissections (he went on to do his PhD and my undergraduate degrees and then went differentiate them? so he is now a doctor of anatomy) still calls on to do my postgraduate degrees in both me Fascia Man because he remembers the JS: Yes, I absolutely do, and I also realize that exercise physiology and in clinical anatomy. nickname. Every time I’m in the dissection I’m not alone. There are many individuals room, they introduce me as Fascia Man. It’s [So you posed the question,] “What exactly on this path, and that’s really what took me lived with me because it was so unusual does the clinical anatomist do?” You’re into the path of Dr. Stephen Levin, [who] for them – “Oh, you’re the guy who talks probably aware that my alma mater is was investigating this biotensegrity model. about continuity. You’re the guy who talks Dundee University in Scotland. In Dundee When you’re investigating and somebody about fascia.” University the department that we work in else is investigating, it takes you perhaps is called the Department of Anatomy and to a common ground. Over twenty, twenty- That’s what really intrigued me, and that’s Human Identification. Anatomy spawns five years ago, Dr. Levin [and I] met. We what led me to meet with Dr. Stephen quite a broad spectrum of speciality. For started to communicate and we began to Levin. I’m so lucky, Brooke, and this is a instance, one of my heroes is Professor Sue exchange thoughts and ideas; and of course big reflection of Dr. Levin’s spirit and of the Black who is the head of the department. Stephen has a number of years in life on kind of man he is. We established what’s Sue [was] involved in several legal claims me, and so he was well ahead of the curve. called the BIG group; the Biotensegrity against individuals who had committed [Editor’s note: Brooke Thomas’ interview Interest Group. We meet every year and crimes against children, [producing] with Stephen Levin appears on page 6.] there is no fee for these meetings; it’s just evidence to demonstrate that this was the a group of interested persons arriving Even if I’d never met Stephen and if I’d person who perpetrated that particular and sharing their information. People like never come across this term biotensegrity, crime. Also, she was involved in returning Robert Schleip and others have been at my own experiences were leading me [in bodies to families after [wars], for example these meetings. That’s just amazing that that direction]. In clinical anatomy what in Bosnia, and this was through human you get to meet and speak with some of typically happens is that [new students] identification. That’s one aspect of speciality these people and you don’t actually have are given a textbook, this could be Gray’s in anatomy. to pay for it. That’s really informed me over Dissector, and they open it up and it will the years. My speciality is clinical anatomy, and in immediately begin to tell them how to carry clinical anatomy, it’s really all about where. out the dissection. Every student follows BT: Could you define biotensegrity in the Where is the phrenic nerve? Where is the the guidelines in whatever textbook of way that you think of it. superior mesenteric artery? Not just about choice the university uses, I’m just using JS: Sure. I’m sure that many of your where but, basically, what is its path? What Gray’s Dissector as an example. They follow listeners will understand what tensegrity structures lie close to it? In the case of the the dissection descriptions and carry out means; ‘tensegrity’ of course is basically superior mesenteric artery, it begins at the those dissections the same way that the a compression of the words tension and distal part of the first lumbar vertebra. Then previous students a year earlier carried out integrity. This word was brought to us by people are interested in specifics, so they the dissection. The same way students a the engineer Buckminster Fuller, and so want to know that it is one centimeter lateral year earlier carried out the dissection, and this really relates to some of matter – the of the celiac trunk or something to that in fact the same way students from perhaps construction of buildings, of bridges – effect, and that’s because part of our job is the last several hundred years have carried which requires nuts and bolts and screws, to inform surgeons – e.g., where the nerves out these dissections. From that viewpoint, etc. This is also the language that’s used are, and also in what percentage of the the dissection has always been the same. in biomechanics. However, biotensegrity population would you find them perhaps What tends to happen is that in anatomy refers to living tissue. one centimeter lateral or one centimeter they want to get through the skin, through medial and so on. It’s to do with that type the subcutaneous, and get down to the People often use a particular toy from The structures that ‘really matter’ the most – the Manhattan Toy Company called Skwish™

www.rolf.org Structural Integration / December 2016 11 BIOTENSEGRITY AND SHAPE to explain the principles of tensegrity. What buggy and sticky and cause ‘adhesion’ (this with contraction in fascia is that it could you have basically are wooden struts with is another word I don’t like). start contracting today and may not stop an elasticated band that runs throughout contracting for the next two to three years. Dr. Jean-Claude Guimberteau will be joining the structure. The wooden struts don’t me this summer at the pre-conference BT: I think that language is wildly touch each other, they’re kept apart by the day for the British Fascia Symposium. In important, particularly when our models tensional aspect from the bands. While Guimberteau’s videos, he uses the word of how we understand the human body this can be used as a visual aid to discuss ‘sliding’. Place one hand on top of the are evolving; so language has to evolve tensegrity, it’s also an enemy to me because other and then move your hand back and alongside that too or we get stuck. the very materials that this little toy is forward, and you feel heat, a consequence made of are the wrong materials. We are JS: Let’s applaud that because I tend to find of the friction: this would not be a good way not made of wooden struts and we do not that people don’t place enough importance for mother nature to build living structure. have elasticated bands. For me, Brooke, on that. I believe that the image you have in In living architecture, tissues do not slide. words are hugely important and I fully your head when you come to a table to do What they do in fact is glide relative to understand that there will be people who some bodywork, and you’re about to make each other, and Guimberteau’s videos say, “John Sharkey is just making a big thing a decision on behalf of a client, I believe demonstrate that beautifully. If you look out of nothing.” that the words create images in your head, at his Strolling Under the Skin, it’s a perfect and those images inform you as to what Human tissue is not supposed to be example of gliding as opposed to sliding. it is you wish to achieve and how you’re stretched – and take this with a pinch of When we talk about living tissue versus achieving it. If you have a false image in salt because I’ll have to put it into context, non-biological tissue, it’s important to make your mind, I think that you’re going to but human tissue does not stretch. We can that distinction because people talk about have false expectations in terms of the see that for instance in skin. If somebody stretching in a Newtonian way. If we were therapeutic outcomes. has been heavier and then lost weight, we to take a look at various structures (again see stretch marks [on the skin] because BT: Agreed, and I think that happens with with my clinical anatomy hat on) in a the integrity of that structure has been dissections as well. If people start out with Newtonian tube – for instance, the heart or compromised. Now it’s not that I’m saying a drawing of a shiny red muscle against a the blood vessels – the tube would lengthen to people, “Don’t do what you have been white background as a separate piece, and and it would expand under pressure. With doing all along.” What I’m saying basically then are handed a scalpel and told, “Make all that pressure, the blood vessels in the is that, “What you think you have been it look like this,” they’re really not paying brain should also expand and squeeze the doing and what you are actually doing attention to what’s in front of them, they’re brain out through the eye sockets and the are possibly two different things.” I would just trying to make it look like the concept ears. This doesn’t happen because of what’s like to see a discussion regarding the they’re starting with. known as nonlinearity of the arterial walls. vocabulary, and perhaps changing this To me it’s an important discussion, and to JS: Exactly, and what we’re getting there is word ‘stretch’. In a discussion I was having me language is hugely important. I’d love a very antiseptic view of the human body. with a colleague, he was talking about to see the bodywork and movement therapy By the way, I don’t ever want to throw the stretchy material in the pelvis. That’s where worlds change the word ‘stretching’, or at baby out with the bath water. I love the the whole problem is, once the tissues in the least realize that that is not what you’re history of anatomy. The history of anatomy pelvis have stretched, they will not return trying to do. If anything, you’re trying to is quite dark because from the very earliest to their former states. restore physiological range of motion if [it] dissections via Alexandria (or back to the This is one of the things that is so important has been lost, but we certainly do not want ancient Egyptians) and coming into the in terms of bodywork and movement to take somebody’s physiological range and more modern era, the church was keeping a therapy, because there are many people increase it because most likely you’d get very close eye on scientists and anatomists. who spend hours stretching. Gymnasts into damaging ligaments and lengthening Leonardo da Vinci had to do his dissections are known to lie on their backs, place ligaments, and that’s going to lead to a in secret. So from that viewpoint, there is a their bottoms against a wall, let their legs lack of stability. Lack of stability will mean dark history, but it’s also a really interesting abduct, and then take either a magazine or that the body has to try to find stiffness history. For instance, the term ‘acetabulum’, a book and lie there and read for half an and tension from somewhere in order to any idea what that might mean? hour or an hour. The question you’ve got be able to support a joint, and that’s going BT: No, I don’t know. I hadn’t thought of to ask yourself is, how are they achieving to come from the more contractile tissues. that one. this range of motion, this new additional The muscles are experts at contracting, but range of motion? Now I don’t like the also we have various fascia in the human JS: [With] one half of the pelvis turned on terms ‘origins’ and ‘insertions’ in terms of body and they also contract, just not quite its side, [it] resembled a vinegar bowl, and biotensegrity, but I think that’s a language in the same way as muscle fiber. By the way, so the Greeks gave it the name acetabulum of convenience that we can use. It’s not that muscle fibers are fascia. – this would be the little bowl of vinegar we want to take the origin and insertion they would dip their breads into. The BT: I know. It’s so important. any further away. We’re trying to change terms used in anatomy for muscles are very those tissues that lie between the origins JS: Yes, and they’re not to be separated ordinary, simple words that really inform and insertions, perhaps maybe the more from the continuity that exists. They are us what the structure does, or where it is: contractile tissues, the fibers, or perhaps specialists along a continuum, and fascia tibialis anterior basically tells you where it those tissues that can become a little bit can also contract. The issue and the problem is, flexor digitorum longus tells you at least

12 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE that it flexes. That’s in traditional anatomy models, to provide us then with computer pliable tissue. What you have is continuity, by the way. graphics that will help us to explain these and speciality on the continuity. multidimensional dynamics. However, we are dealing with three- BT: You recently took on a project that dimensionality. The tensegrity icosahedron For instance, there are colleagues of ours involved probably quite a lot of building (a polyhedron with twenty faces), which who are working with NASA and helping bridges between this old paradigm and is what biotensegrity is based upon, is to build robots that can go to far-off places new paradigm: you co-authored the third really multidimensional. It’s definitely in space such as Mars, etc. They’re using edition of The Concise Book of Muscles. How fourth-dimensional and it may be tensegrity principles but also biotensegrity do you approach a task like that? It’s right multidimensional, but we will never principles. It is amazing to me that we are there in the title, ‘muscles’, and you’re a get to see that because the tensegrity still working off the idea that the body is fascia man. What was your approach? icosahedron is a three-dimensional vision a lever-based system. For that to be the JS: Well, I have a number of titles, I write on earth of something that is fourth- case, we would have to have screws going specifically for Lotus Publishing, and my dimensional. We don’t have the capacity through the joints. If we took the knee joint, publisher asked if I would take on this to be able to see it. We may be able to for instance, your femur and your tibia project. Now the problem of course is that provide some examples using computers. would have to overlap and there would the book is very much based upon origin- This structure is what we use to show how have to be a pin joint in place. There would insertion, and would be very much be based cellular activity might conduct itself. The have to actually be a screw. To me that’s one upon ‘this muscle produces this action’, but problem is that it’s presented on earth in a of the basic and easiest visuals. You take a my responsibility is to create change. Now three-dimensional manner. look at an x-ray and you see that there’s that I’m in my mid-fifties, the one thing that space between those bones. How can there In fact, again with my anatomist hat on, I realize, Brooke, is that change takes time. be space when you’re standing? Why are you have a right eye and you have a left You won’t achieve a lot of change, it might the bones not crushing each other? Why eye and they are set apart on your face. be huge within a particular context, and are they not compromising that space? The information that you take in will from that viewpoint I said, “I’m going to People have this notion that there must be cause the brain some problems because the take on this task.” I made a lot of changes a lot of fluid inside the knee joint because it brain basically would say, “The image I’m to the textbook. Because it is such a popular is a fluid-filled joint. Lick your hand. That getting from this side and the image I’m book, many medical students use [it], so I is pretty much how much fluid you have getting from that side are not correct. There was very aware of the responsibility that I in your knee joint. What is it that’s saving seems to be a disparity here.” So what the was taking on. From that viewpoint, I was and keeping the integrity of that joint space brain does is it tries to fill in the missing able to change quite a bit of the anatomy. in place? information. We actually see in 2D, but It’s amazing how many people think that at best we see in what’s known as pseudo That really is where the discussion needs there are only twelve cranial nerves in the 3D or 2.5D, because your brain is filling in to go. It needs to go into a new anatomy, human body. There are at least thirteen, the rest of the information. You have two it’s the twenty-first century, not the old and there is possibly a fourteenth. We need images, the brain is giving you what we call biomechanics. They’ve tried to explain more research to know whether the seventh depth. Think about that, that we can only how people in a gym can lift 200 kilograms, cranial nerve just simply subdivides and see in 2.5D, but the tensegrity icosahedron saying things like, “It’s intra-abdominal branches off, or if the branch is in fact a true operates in at least the fourth dimension pressure.” Then you have someone like cranial nerve on its own. The point is that if not the fifth dimension. By the way, for Serge Gracovetsky who provides evidence this type of detail is incredibly important those people who think that the fourth that to lift a weight any heavier than fifty for undergraduate and med students and dimension is time, you always have to have kilograms would require so much intra- I wanted to make sure that they had the time because something can’t exist unless abdominal pressure that a person would accurate information within the book. you have time, so time exists in all of the explode. We know that we can’t explain Then the other aspect was, I introduced a dimensions. I’m not talking about time, I’m how some of these long-distance migrating section that was co-authored by myself and more or less talking about something like a birds can travel 9,000 miles without cooking Dr. Levin to introduce the idea of Möbius strip, so that there’s no inside and themselves. In other words, the amount biotensegrity as the new anatomy for the no outside and there is just continuity – and of heat that they would generate from the twenty-first century. I suppose it’s a soft that is true of the human living architecture. muscular action of flapping their wings introduction, and then perhaps in the next would cook them. Or perhaps the example edition, I make some additional changes. BT: I had never thought about that that a kangaroo jumps simply because he Let’s say in the next ten to fifteen years, if I’m before, that we literally can’t comprehend stores energy in his tendon. Nobody is still alive, the sixth and seventh editions will continuity because we can’t really see it. discussing the role of bone: bone is soft look very different to the current edition. JS: This is why what I really want to try matter, it is not hard matter, all it is is a BT: Let’s talk a little bit about the to do with the scientific community, with continuation of the fascia. [Bone] happens biotensegrity dissections that you’re the bodywork community, is to ask people to be harder than ligament; ligaments tend running at Dundee University in Scotland. to consider the model of biotensegrity and to be tougher and a little bit harder than The first was last summer, and the second is recognize that what we are actually dealing tendons; tendons tend to be tougher and going to be at the end of June, beginning of with requires soft-matter physics. Soft- harder than the septal tissue that acts as a July this summer [2016]. The first thing I’d matter physics will give us the mathematical partitioner; and so on up to subcutaneous like to address, and then we can talk about tissue, which is a much softer, malleable, what happens there more broadly, is the

www.rolf.org Structural Integration / December 2016 13 BIOTENSEGRITY AND SHAPE cadavers are treated with something called system in the model, and they’re made bone. It just went under a slip of connective Thiel rather than formaldehyde. Why are of the wrong materials, so this is a really tissue and one muscle became the other. In you doing that and what is that? great opportunity for me to be able to tell the textbooks you see a tendon going to a people these are models that help us to put portion of the bone and attaching to it. The JS: Over the years I realized that working forward some type of image and to be able early anatomists got some things right, with cadaveric specimens that are treated to talk about continuity. For instance, we they could see that the talar was a sesamoid with formalin and formaldehyde changes might talk about the wooden struts being bone, a bone that was floating in connective the texture, changes the color, everything discontinuous and the elasticated tissues tissue. In the biotensegrity model, what we looks like a fawn color. In fact, you could being continuous, but in a biotensegrity, can demonstrate in the dissection is that have a student call me over to a table and that’s just not the case. In biotensegrity, every bone is floating in the connective say, “John, what’s this structure?” I might the bones are simply a continuation of the tissue, so every bone in the human body is say, “Gosh, I don’t know.” You really would fascia, so there is no discontinuous element. a sesamoid bone. not know what the structure was because That is a really important piece to get across. it looks like all the other little structures Because of our particular approach to that are there. What you would have to BT: It’s hugely important. I went to art the dissection, we will perhaps take the do is follow that structure along its course school, so I’m imagining how amazing it skin off as one autonomous structure. We and bring it back to its origin in order to be would be if somebody could make a toy would take the subcutaneous fat as one able to say, “That’s actually such and such a that was woven, where you could actually autonomous structure so that it at least nerve” based upon where it has originated see the continuity of the form instead of gives people the impression of continuity, from and the path that it has taken. From wood and then elastic bands, but anyway of connectiveness, and that’s what the a textural viewpoint as well, all the tissues that’s my aside. That’s my personal fantasy. dissection also brings to people. It brings change color. them a very strong visual image that shows JS: Let’s just repeat that really quick the continuity, and that there is no such Here’s a point I try to make: once you make an because I think that that is such an important thing as a biceps brachii or a rectus capitis incision to skin, and you allow atmospheric point. [Compared to a tensegrity model], in posterior minor. These are man-made terms air to touch what is beneath the skin, you the human body there is no beginning, because some person back in probably the will begin to see changes taking place. From there is no end, there is no front, no back. thirteenth century put names on muscles, that viewpoint, if somebody takes a piece There is an inside and an outside in terms and they decided to make an incision on of tissue out of the human body, and they of atmospheric air, but when we get down the tendinous inscription at either end and carry out some type of investigation on that to the micro and nuclear level, we’re dealing then take that up and call it a name. You tissue, what you’re actually witnessing are with a different dimensional space. In fact, ended up with your vastus medialis or your emergent properties. We go back again to if somebody was to hold their thumb and vastus lateralis. For those individuals who the amazing historical pioneering work first finger apart, and let’s say they took come to my Facebook page, I put a post up of Dr. Guimberteau because Jean-Claude the fingers apart by an inch, that inch is just a couple of weeks back highlighting the could do what no university would allow infinite. We can say it’s an inch, but it in fact fact that we’ve discovered a new muscle in a PhD student to do. That is, he was able to is infinite – and that’s science. quadriceps. I’m not sure what we’re going get permission from his patients to place a BT: Aliveness changes so much, which is to call the ‘quadriceps’ anymore. camera under their skin. For the first time why Guimberteau’s films are a huge leap in history, we have recorded images of our BT: Wow, interesting. This focus on forward in our understanding of the living connective tissue in living tissue, and it just individuality releases us from so much of human form. I’m curious, when you ran has blown people away. It certainly blew me the dogma that gets passed around, not the dissection last summer, were there any away. This is the type of visual evidence that just in anatomy but also in movement. That surprises or any big aha moments for you I needed to be able to demonstrate (which everyone has this attaching here to here and in doing a biotensegrity-focused dissection helps me to be able to support why I say it does this action, so everyone should be with that Thiel-treated tissue? that you cannot stretch or should not be able to accomplish x, y, z. stretching tissues) that tissues glide relative JS: First of all, there are always aha JS: Absolutely, there’s no doubt about that. to each other but they do not slide relative moments. When you pick up any anatomy It doesn’t necessarily mean that somebody to each other. In fact, in Dundee in the textbook, [it will say a] muscle comes is going to be restricted. They may need summer, we are going to be bringing in an from here to here. The truth of the matter some adaptation. What’s really interesting endoscope and we’re going to be actually is that the norm in human anatomy is is I’ll often have students take out a whole using the endoscope on the Thiel cadavers. individuality. The norm is not that we are range of femurs and pelvises and give them all the same; the norm is that we are all With the Thiel soft-fix technique, the some cloth measuring tapes. They will different. Every single dissection on every cadavers hold on to their original colors, measure the diaphysis and the epiphysis, single donor brings forth just amazing I’m able to keep fluids moving in the arterial they will measure the neck, they’ll measure differences. There were several that we and veinal system, and I’m able to keep the the head, they can measure the depth of found. Wilbour Kelsick, a chiropractor lungs inflating and deflating. It’s a very real the acetabulum, the hip joint . . . and when based in Canada, called me over to the experience, as close to the surgeons as you they come back they will find that none of table because they were looking at the possibly can get, [although] of course there the measurements are similar in any of the biceps femoris and its attachment. Basically is no life in the tissue. Bear in mind that bones that they were given. For me at least, it became the gastrocnemius; there was when we use a tensegrity model again there it translates into the fact that there is no no real direct attachment down onto the is no breath in the model, there’s no nervous one squat that suits all or fits all. You really

14 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE have to work with people as individuals, and over and above. This changes the JS: I love sport and I want to play in and when you can see that in the anatomy way in which orthopedic surgeons will sport. If people love the gym and want department, it really drives that point approach surgery. to lift incredibly heavy weights and do home that we shouldn’t be expecting that leg extensions, I don’t mind as long as From a movement and bodywork everybody can do the same thing the they’ve been informed [and] understand viewpoint, biotensegrity is an amazing same way. what the ramifications are. What I am model for demonstrating to individuals concerned about is children, and children BT: Wonderful. With this shift that we’re that if you have a pain and problem in your involved in sporting activities and in very making, this evolving into a new paradigm shoulder, I would say that a good 85% of the strenuous activities. That will have long- of understanding the body, what is it time if not 90% of the time, your problem is term ramifications as they become adults. leading us towards? What are some changes not your shoulder. Your shoulder is making For people who think that it is a great idea in approach or intervention that might be a noise, it’s screaming and shouting for to be able to raise your leg, your lower limb, born of understanding a more biotensegrity attention, but it is going to be a problem in a fashion that mimics kicking an imperial model of the body? that is perhaps lower down the kinetic guard who’s on an imaginary horse in some chain. I don’t want to jump into conclusions, JS: First of all in terms of anatomy, we paddy field in China, if that’s what you but bear in mind that the real motors for tend to look at the connective tissues from wish to do because you’re involved in the movement up in the shoulder come from both an embryology viewpoint and from martial arts and you love that, then knock the lower limbs. Your shoulder musculature a phylogeny viewpoint. In other words, if yourself out. Just bear in mind that having is really about dexterity, it’s really about fine we take a look at the human body, there’s that type of range of motion could bring tuning and doing rotations, twists. People nothing perfect about our anatomy or our with it some issues later in your life. So we like to train their upper limb, show off neurology. If I were to make the human need to make sure that we’re giving people their bis and tris. I wish they could really eyeball, I think I would make it differently the right information. understand the consequences, because if to what we currently have. If we were to you think of it in terms of kinetic chains and BT: I am so grateful for all the work that take a look at the path of certain nerves, links, [they develop] this big massive link you’re doing, really shining light on this particularly cranial nerves, you might be that has no relationship to the entire chain, new paradigm and being able to build the forgiven to think that cranial nerves would and now it’s capable of perhaps producing bridge. Thank you so much, John. come out of the skull close to where their forces that are out of sync with the entire terminal destiny is, and that’s just not Brooke Thomas is a Certified Rolfer who has structure, and what are the consequences true. These nerves take torturous routes, been practicing for over fifteen years. A self- of that? circuitous routes, to get to where they need admitted body nerd, she teaches movement to go, and you think, “Hang on a second, Our shape, our strengths, would have and hosts The Liberated Body Podcast as what does that mean?” been dictated by the fact we would have a continuing-education resource for those in had to climb a tree, or climb the face of the manual and movement therapy fields. Visit What that means, basically, is that as these a cliff in order to get to an apple tree, or www.liberatedbody.com for more episodes, nerves are going from the brain to their we wanted to go down on the beach and or visit www.newhavenrolfing.com for more terminal structures, they will have many climb over the rocks. We have to have that information about Brooke and her practice. branches off the mother nerve. Remember type of dexterity. We didn’t have a fitness these all have continuity with the connective John Sharkey is a clinical anatomist, exercise center with a leg-extension machine that tissue. In surgeries it is referred to as the physiologist, and European Neuromuscular we could go into and place weights on the ‘passenger’. It could be for instance, the Therapist. He has developed the world’s only weight stack and then sit into this machine, uterus or it could be some other structure master’s degree in neuromuscular therapy, really disassociating the upper body with that we’re looking at, the nerve structure. which is accredited by the University of the lower body, and then focusing our They are simply the passengers that are Chester (UK). He is on the editorial board for attention and isolating the quadriceps, being supported by the connective tissue. the Journal of Bodywork and Movement and then asking the quadriceps against If your focus is on doing something with Therapies, The International Journal of resistance to repeatedly contract. What this just the passenger and you think you can Osteopathy, and The International Journal is basically doing is teaching the body new just stitch the passenger against something of Therapeutic Massage and Bodywork. neuromuscular engrams. It’s teaching the that’ll hold it in place, that is completely He is also a member of the Olympic Council’s musculature, this is how you contract, this wrong. Believe it or not, that is what medical team and a founding member of the is how you operate, and it’s just losing the is happening in many surgeries at the BIG, otherwise known as the Biotensegrity connection between the entire body – which moment, where a surgeon will take up lax Interest Group. He has authored several books would be full-chain kinetic exercise. tissue and stitch it perhaps to a particular including the third edition of The Concise ligament. In nature, that tissue was never BT: You’re painting a really remarkable Book of Muscles. attached to that particular ligament, but picture of just how much can change they think that they’re offering integrity as we understand continuity better, where in fact what they need to do is to really big differences in how we would go in and recognize where the true insults approach surgery, movement, manual in the soft tissue are and repair only those therapy, and just how we would live in our soft-tissue insults. It really means that we bodies generally. need to be more respectful to the wrapping, to the tissue that roams through and around

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The spherical model (second from the Musings on Tensegrity top) was made from struts with a 120° arc. Continuing my exploration, I found I could make an ‘inverted’ sphere with the and Biotensegrity convex surface facing toward the center of the sphere. Hence the top (not really By Michael Maskornick, Certified Advanced Rolfer™ spherical) model. In order for this ‘inverted’ model to function as a tensegrity object, the ® I trained at the Rolf Institute shortly after arc of the struts had to be less than 60° to the publication of Ron Kirkby’s (1975) avoid contact between the struts. In simple article discussing the idea that tensegrity terms: for a normal tensegrity sphere, the can provide a sensible explanation for how compression arcs (struts) must be more changes in the fascial web exert a broad than a 120° arc of a circle. Larger than that influence throughout the structure of the range the struts will contact each other, human body and a justification for calling negating tensegrity. On the other end of our manipulative strategies ‘structural this model, an inverted tensegrity sphere integration’. For a short time after that I must have struts greater than -60° degree became a model builder, creating a modest arc (i.e. between 0° and -60°), obviously collection of tensegrity spheres, prisms, closer to a straight strut than the previous and towers. My interest was rekindled model. Within this range the models on reading Sjaza Gottlieb’s (2015) article demonstrate two important characteristics in this journal, “Biotensegrity: Paradigm of tensegrity structures: dissipation of stress Shift” that reviewed Graham Scarr’s (2014) throughout the integrated structure and seminal work, Biotensegrity: The Structural nonlinear adaption of the overall structure Basis of Life. Since I already had experience to distribute those stresses. I don’t have any working with string and dowels, I began to great insights about this, but I did notice wonder about using curved struts instead that as I was making the inverted sphere, of dowels in their construction. up to a point of 75% completion the inverted Playing with Models sphere could revert to a normal sphere. This may imply that in physiological structures Let’s start with Figure 1. This is a picture this back-and-forth play between the two of the tensegrity models that reside in my forms can continue up until final closure office. The two wood and thread models prohibits such exchanges. Figure 2 shows are thirty-year-old structures that represent the arcs that I am discussing. my introduction to tensegrity. The arced plastic and string models are less than My interest in creating these models was three months old, inspired by my reading inspired by Kirkby’s article using the of Scarr’s book. application of tensegrity to biological structures. I quickly noticed, however, my As I read the book and looked at the figures, tendency to build more complex structures, I realized that looking at two-dimensional ultimately making the larger dowel/thread representations did not really help me model in Figure 1 (ten dowels, forty strings, understand the three-dimensional reality two reversing layers), essentially drawing of these models. Having already lived my attention toward solid geometry and with models containing linear compression away from organic structures.1 There is components (struts), I set out to construct a message here. In order to create these models using arced struts. The first thing geometrical shapes, the relationships I learned was that these curved models represented in the model become more are much harder to make and stabilize. bound by the mathematics of geometry Maybe if I were a fly fisherman who made and less like the relationships in living his own gnats and flies, I would have a tissue (nonlinearity). I believe that this workshop geared to the project, but not holds true for both tensegrity and fractal so. As I became more skilled, I found that math. In living matter there exists a random making a functional tensegrity sphere variability that interferes with higher levels required struts with an arc between 120° of continuity and orderliness, making these and 1°. Arced struts larger than 120° cause models less applicable. So while the larger, the struts to touch each other on minor more complex dowel-and-string models compression, thus eliminating the model are attractive and engaging, they draw our from the tensegrity definition and reducing attention away from living organic forms. the model to a mixed-breed tensegrity/ stacked-block contraption. Figure 1: Tensegrity models. I encourage anyone reading this to try to construct these models as that is far more

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managed by muscle tissue, ligaments, and tendons. The structures, while orderly, are often crisscrossed with fascial planes that serve to tie the whole of the volume together and act as support for the general 180 deg 90 deg 60 deg 0 deg -60 deg shape. So, at best, we can use the tensegrity model as a concept, not a fact. It is important to remember that this topic is highly abstract and thus has the risk of confusing our awareness and perception of touch and take us away from the ‘silent level’ of Direction to center of tensegrity sphere awareness (again Korzybski; more below). It is also human nature to fall in love with Figure 2: Different degrees of arc in a tensegrity sphere. the models and concepts that we create and to make every effort to alter our perception instructive than simply reading some text Working with Biotensegrity of reality to fit our theories. However, if we or looking at two-dimensional photos or approach our physical contact with this in drawings. Remember that this is basically the After reading Scarr’s book, I began to mind, the volume may begin to feel like a study of solid geometry and not physiology. reconsider my way of working, taking into complex, integrated organism, and we can consideration that the macro structures treat it accordingly without being locked Biology and Tensegrity of the body are built on a hierarchy of into the tensegrity model. Having said all micro structural biotensegrity elements that, I have lived with these models for Two major characteristics of tensegrity and are still governed by the mechanics thirty-five years, and I still use them to models are how they retain shape and of tensegrity. Just thinking this way has explain the relationship between tensegrity maintain tone under a wide range of external changed my focus and awareness regarding and structural integration. strains. First, if you compress a tensegrity session design. (Remember Korzybski: sphere, it begins to resist compression “What you think governs what you see Biotensegrity while at the same time expanding slightly and what you ignore.”3) I don’t think this and the Cranium in all three dimensions without contact has been a global change in my thinking or between adjacent struts until its limits are If the cranium is considered a biotensegrity perception, but it has influenced how I think reached. Second, if you begin expanding the sphere (Scarr 2014, Ch. 8), it is no longer about flexion, extension, muscular pull, structure, it resists as a whole, reshaping adequate or appropriate to just consider tendons, aponeuroses, and how stress and also in three dimensions until its limits are strains as localized along sutural lines strain are distributed throughout the body. reached. Both compression and expansion and junctions (lesions). The dura must be It has caused me to think about the source demonstrate how these spheres disperse considered a tensional element of the skull of the fluidity and resilience that I perceive. strain throughout the structure without that functions to retain the form and fluidity concentrating it on any single area. Third The likelihood that elements not directly of the whole. This is just another way of saying and fourth, if you twist and bend tensegrity related to the structure under strain will that the three-dimensional shape, fluidity, tubes (bi-helical structures), they retain and have a significant impact on the greater and resilience of the cranium is governed expand their inner dimension and they structure now requires more consideration. as a whole by the dynamic interplay of resist crimping and folding (Scarr 2014, 53- The three-dimensionality under my dura, tentorium, falx, bone, cerebrospinal 54). From these four observations it is easy hands is now perceived as more complex. fluid (CSF), and brain. Injuries and lesions to draw conclusions as to the source of the Stretching, molding, compression and still exist and will still be responsible for durability and resilience of cells and tissues, expansion, as well as indirect manipulation distortions and restricted movement, but surviving forces that might be expected to and unwinding, require a much broader this new perspective expands the scope destroy them. It is important to note that perspective taking into account the slow of treatment and adjustment. The overall the responsiveness and resilience of the accommodation of membranes and fascial motion of the elements of the cranium as whole structure is retained up to the limits sheaths from distant locations. This, then, well as the responsiveness and fluidity of but gives little information about fracture requires a new perspective on the timing the tissues must be considered in evaluating or collapse during failure. between sessions. the health of the system. Strains can reside within the borders of the bones or within The tensegrity model allows the macro and Before moving on I want to express some the volume of the brain itself (Upledger and micro worlds to integrate. Collections of of my hesitation regarding biotensegrity. Vredevoogt 1983, 295). These strains can be micro tensegrity units can be grouped into a In a living organism there are no straight maintained by the tension created by the hierarchical macro structure that retains the lines, nor are there tightly wired cables. complex relationships among the dura, falx, 2 functionality of tensegrity. This allows us Anything that might be considered a strut and tentorium (Upledger 1990, Ch. 2 and to talk about integration over a hierarchical is irregular in shape and slightly flexible. 3). The density of the tissues of the brain is size that covers many powers of ten, and Instead of cables there are wide sheets of now to be considered a functional part of we can relate the behavior of the macro- connective tissue, often with semi-rigid the cranial vault. structure (bone, fascia, muscle) to that of the tissues imbedded within (more like a drum micro-structure (cells, tubules, extracellular head than a cable). The whole structure is Following up on my considerations at the matter). That is pretty exciting. end of the previous section, it is important

www.rolf.org Structural Integration / December 2016 17 BIOTENSEGRITY AND SHAPE when working with the cranium to approach between the eleventh and twelfth ribs and dimensional aspects of the structure add the process as three dimensional, not just the pelvic ilia. enough complexity to require additional working on the two-dimensional surface of thought to the original model of a tensegrity a sphere as is the case when working with The Little Boy Logo sphere to explain our work. sutural lesions. The Little Boy Logo has always brought to Michael Maskornick, Certified Advanced mind the ordering of the body presented in Rolfer, was introduced to Rolfing SI in 1974 Implications for Reichian therapy, where each of the tension by Leland Johnson and Jan Sultan. One of Structural Integration bands might represent a transition between the first practitioners who never met Dr. Rolf, adjacent tensegrity spheres. Structural As I was writing this I remembered some of Michael trained in 1978 , moved to Bellingham, integration has presented these bands as the paradoxes in the writings of Dr. Rolf that Washington, set up his low-key practice, and horizontal planes that separate different we were challenged by during our training. has worked and lived in the Pacific Northwest visceral spaces. I think we can also interpret ever since. Gravity Is the Therapist – these horizontals as the space where one The Skyhook biotensegrity sphere relates to the adjacent Endnotes As gravity compresses the biotensegrity one without necessarily integrating. These breaks in pattern offer the possibility of 1. You can see here the flattening of the tower of our spinal structure, the column two-dimensional picture, minimizing the first contracts but then expands in all distortion and collapse without complete disruption of the biological form. It fluid dynamics and vitality of the three- directions, one of which creates lift. Similarly, dimensional sphere. It also limits your the pull of any muscle on the spine activates also offers reintegration by establishing congruent relationships between the ability to see the complexity of the volume a complex expansion of the whole column. I defined by the sphere. would now suggest: biology and evolution adjacent segments. are the architects; gravity is the therapist; and Levels of Abstraction 2. The ‘Little Boy Logo’ is an example where we no longer require an imaginary skyhook and the Silent Level each block is considered as a unit that then attached to our head to keep us upright. As integrates onto the body as a whole, each long as the membranes remain competent, The ‘silent level’ of our work represents the exhibiting some level of integration. level of direct experience below the levels of the spine retains fluidity of movement and 3. Do a web search on Korzybski or general abstraction and naming (Feitis 1979, 45-47).4 a wide range of responsiveness, which then semantics for a sense of this complex theory, This level was strongly emphasized in early feels like floating and lift. especially hierarchical levels of abstraction. trainings. It is the level that is compromised Contraction of the when we think we know everything there 4. This level is associated with the first Psoas Extends the Spine is to know about structure and living level (and subsequently the fifth level) We were challenged to explain the statement processes and we use language to define of abstraction in Rolf’s discussion of “when the psoas contracts, the spine our protocol process. In other words, our Abelard. Rolf’s scheme of these five levels lengthens.” Building on the model for lift language pulls us away from our direct is: 1. Sensing, 2. Classifying, 3. Relating, under the force of gravity, we can consider experience. The silent level is the level 4. Postulating, and 5. Unifying. associated with deep meditation and the the spine a helical tube that retains its Bibliography inner dimension while flexing or rotating. consequent awareness that emerges. In order not to crimp under flexion, the “Compound Essence of Time” Feitis, R., ed. 1979. Ida Rolf Talks About spine must lift and extend. Only when Rolfing and Physical Reality. New York, NY: the relationships among the supporting In a discussion with an osteopath about Harper Collins. how Rolfing® SI doesn’t seem to affect structures begin to fail do we see collapse Gottlieb, S. 2015 July. “Biotensegrity: onto the disks with subsequent pathologies. everyone equally, he pointed out that Rolfing SI was missing some concept of Paradigm Shift.” Structural Integration: The ® Interplay Between time; i.e., how long it takes for a session to Journal of the Rolf Institute 43(2):66-68. Flexors and Extensors have an impact. (Feitis 1979, 48).] Thinking Kirkby, R. 1975 Oct. “The Probable Reality in terms of a tensegrity model, we can Similarly, movement of the joints is much Behind Structural Integration.” The Bulletin consider the widespread interactions more complex than coordination between of Structural Integration 5(1):5-15. Available among fascial membranes and layers and flexion and extension (Scarr 2014, 60, at http://pedroprado.com.br/cgi-bin/cont_ the adaptations that occur as the layers shift. 63-68). Joints may be considered to be ipr.cgi?cmd=show1artigo&ling=eng& It makes sense that this is a process that is biotensegrity spheres integrated with id=151. dependent on the fluidity and resilience of biotensegrity towers. Movement is the the membranous layers. Scarr, G. 2014. Biotensegrity: The Structural interplay among supports, tension, and Basis of Life. Pencaitland, Scotland: action. Looking through this lens at the Conclusion Handspring Publishing Ltd. elbow, knee, hip, or shoulder, you can see that the movement of the joints requires In summary, tensegrity is a theory that Upledger, J.E. and J.D. Vredevoogt 1983. much more complexity than a simple pull/ fits into a relational (nonlinear) model of Craniosacral Therapy. Seattle, WA: Eastland release model to maintain the space and biological structure (hence biotensegrity) Press. that keeps us thinking about how the fluidity within the joint capsule. This helps Upledger, J.E. 1990. Somatoemotional Release human structure has evolved as a response explain what Rolf called ‘lift’ and we now and Beyond. Palm Beach Gardens, FL: to the vertical line of gravity. The three- call ‘palintonicity’ in relation to the space Upledger Institute Press.

18 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE Tensegrity Manually-Evoked Tensegrity Induced by Touch So we were investigating a way of touching and Pandiculation, Part 1 that gave the sensation of shearing tissue and eventually repositioning muscles in Building a Style of Touch relation to something else, but what else? We did not know at that point. The ‘surgical’ By Luiz Fernando Bertolucci, MD, Certified Advanced Rolfer™, Rolf Movement® and ‘muscle repositioning’ concepts seemed ® Practitioner, Rolf Institute of Structural Integration Faculty, with Angela Lobo, sound, but they didn’t explain the quality of Certified Advanced Rolfer, Rolf Movement Practitioner, RISI Faculty firmness felt under the practitioner’s hands. We considered various concepts to describe Foreword the practitioner the clear sense of internal this relationship. At some point, we noticed gliding happening under his hands, and that the firmness under the hands arose This article describes the development, 2) a sense of the touch meeting firmness. initially serendipitous, of a style of when the touch related to the client’s whole- These were the first of various features body weight. fascial manipulation currently referred progressively identified as components of to as Tensegrity Touch. Its outset was the my style of touch. Palpating a relaxed body on your table, it observation from various Rolfer colleagues is difficult to sense its whole weight as the who noticed “something different” in the One day during a session, I suddenly segments are free to move in relation to each my (Bertolucci’s) manipulation maneuvers. recalled Dr. Rossi’s words. Sensing internal other; in other words, there is slack in the tissue gliding, I related his words “operating Operating from the system. Just as holding a piece of meat on from the outside” to the surgical concept of a cutting board stabilizes it and helps with Outside: Blunt Dissection blunt dissection: a way to separate tissues cutting, in fascial manipulation, firmness in during an operation using a blunt tool, This all started back in the late 1980s, the client’s body seem to optimize its effects. commonly the fingers. There seemed to be during my residency in physical medicine a very precise way to steer one’s touch to the Our finding is that combining a shearing and rehabilitation. I had planned to study gliding surfaces (planes of cleavage) among with pressure, delivered in specific ways, Rolfing® Structural Integration (SI), and by myofascial compartments. This led to the engages the three-dimensionality of the way of illustration to my mentor, I touched nickname of our first workshop: Surgical client´s body, linking or integrating body his forearm in a way that I described as Rolfing SI. segments so as to unify them in a single unit. “freeing the myofascial compartments Thus, the manual input evokes tensegrity from each other.” A wise and open-minded The main element in achieving this blunt- in the system. Tensegrity evoked by touch orthopedic surgeon, Dr. Rossi added, “You dissection effect seemed to be shearing can be seen (see Video1, listed in Video mean that applying Rolfing SI you operate the skin on top of underlying tissues to References at the end of the article) and also from the outside?” I laughed as if I had heard the end of its mobility in a particular palpated when small sonar-like oscillations a joke. Years later this would come back to direction. (We now call it ‘milking’ tissue are imparted to the client’s body under me, as I will describe below. from one hand to the other.) We surmise the condition of fascial loading. With this this possible biomechanical explanation: I graduated as a Rolfer in 1990 and started shearing loading, body segments move in shearing tissues further loads the fascial my practice in São Paulo. Impressed with phase and in the same direction throughout system (beyond its basal prestressed the first results of applying Rolfing SI the body. With ordinary oscillations (a status) to the end of its elastic phase (when to the same clients to whom I was used slack system), the movement begins where the practitioner feels a sudden stop), thus to prescribing physiotherapy, I plunged the body first receives input and moves reaching the viscous phase of the tissue in into further study – initially extracellular in waves in various directions through which plastic changes can take place. Such matrix (ECM) physiology, aiming to better segments sequentially (see Figure 1). manual loading would tense the matrix understand what could be happening links in the superficial fascia (SF) and be With tensegrity evoked, the practitioner can under a manual therapist’s hands. transmitted to the remaining matrix ‘net’. sense the client’s whole body weight (its A Different Way to Touch? As such, the SF could be considered a center of gravity) as the segmental centers ‘handle’ to access the fascial system. It is of gravity are linked. This provides the Around four years later, I started hearing thus as if the practitioner is creating a knife sense of a firm and steady platform that from Rolfer colleagues that my touch felt that can reach virtually any location, and gives a counter-force to the practitioner’s “somehow different.” As I heard this more the handle of the knife is the loaded tissue input, and we assume this improves the and more often, I gathered a group of in the touch interface. ‘blunt-dissection’ effect. The key to evoking Rolfers and began an empirical research tensegrity is the way shearing and pressure project to investigate whether there was An abrupt snap (possibly between are combined. Shearing alone drags tissues indeed anything significantly different myofascial compartments) is sometimes from superficial to deeper structures and at in the techniques I applied from those noticed during a maneuver, followed by some point moves the latter in the direction traditionally employed in Rolfing SI. significant clinical improvement. Might of the shearing. Pressure alone squeezes the manipulation be affectingrelative muscle tissues and dissipates the forces randomly. We initially noticed two singular position (Maas and Sandercock 2010)? This features to my way of working: 1) a way When shearing is combined with pressure led to another transitory naming attempt, with appropriate timing, quantity, and of engaging tissue from the skin that gave Muscle Repositioning.

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Figure 1: The effect of sonar-like oscillations under fascial loading (tensegrity) and under fascial slack. The white arrows show the vector of sonar- like oscillations manually imparted to the thorax. In (A), with previous manual loading of fascial system, the segments are integrated and move synchronously (in phase) in the same direction. In (B), without previous loading (slack system), segments are not integrated and move out of phase, in various directions. See also Video1. Illustration by Angela Lobo.

direction, it is possible to ‘corner’ deeper structures (especially bones) in relation to the previously loaded (sheared) tissue so that they are not dragged but rather stay still. There is thus a steady platform so that 1) tissues are not squeezed and 2) the force seemingly flows from the touch interface and concentrates wherever internal mobility among compartments is restricted. Adding minute torque, a third component of the touch, will ‘challenge’ the system and coax tissue differentiation (Figure 2). In this way, the shearing (blunt- Figure 2: The combination of forces: (A) shear alone rolls compartments and drags dissection) effectsnaturally occur where they bones along; (B) pressure alone squeezes tissues and forces are dissipated; (C) are most needed, i.e., in areas with ECM the appropriate combination of shear and pressure (white arrows) creates internal densification and/or fibrosis, even in areas reaction forces that assemble the system and evoke a tensegrity response. Additional distant to the region of touch (Figure 3). torque, represented by the black arrow, coaxes the differentiation of restricted tissue. It is our understanding that manually Illustration by Angela Lobo. evoking tensegrity emulates the inter- compartmental movements/relationships present in the client’s ordinary functioning. The firm platform created by tensegrity cause tissue restrictions to emerge in the direction of the practitioner’s hands, making palpatory diagnosis easier and more reliable, as such restrictions may have a functional significance. Practitioner and Client Form a Single Tensegrity System Figure 3: Two possible outcomes of differentiation between two myofascial Further explorations showed that tensegrity compartments. With tensegrity, the interplay of internal forces between tension and in the therapist’s body favour its emergence compression elements may be such that shear vectors naturally concentrate/focus in in the client, i.e., ideally, client and the areas of reduced mobility, which can differentiate (free) tissue restrictions even at a distance from the contact. Illustration by Angela Lobo.

20 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE therapist form one single tensegrity system. Under such a condition, the practitioner can relate his own center of gravity to that of the client’s and, with proper positioning, rely mainly on his own weight to help free less mobile tissue (as opposed to the therapist adding muscle force), in a natural and effortless way (Figure 4). Curiously, the act of evoking tensegrity, ‘milking’ tissue from one hand to the other and loading the client’s system, seems to simultaneously load the practitioner’s system, evoking tensegrity in his own body. (We also use simple qi gong exercises to encourage self-awareness of tensegrity in the practitioner.) Unified in a single tensegrity Figure 4: When practitioner and client form a single tensegrity system, any manual system, both client and practitioner often input will immediately transmit to the client’s whole body, providing a sense of firmness subjectively recognize an appropriateness and security that favours therapeutic effects. Appropriate positioning also allows the or ‘rightness’ to the condition (see the therapist to use his own weight – as opposed to muscle force – to help free tissue. section on beneception below). We believe Illustration by Angela Lobo. forms of bodily, nonverbal communication may be present, which will be subject of the Spontaneous Motor Activity (see Video 2). Indeed, we have already second part of this article in a future issue. observed a myriad of motor patterns, such At a certain point in clinical practice a as twitches, clonic to-and-fro movements, Monitoring the curious phenomenon showed up: the slow undulating movements, and isometric Degree of Tensegrity practitioner sensing a push of the client’s co-contraction in yoga-like positions, head against his hands when working among others. Slow eyeball movements On starting a maneuver, it is common on the occiput. This action eventually that not all the client’s body segments are were also observed, often in conjunction became strong enough that the muscles’ with altered consciousness (see Video 3). integrated at once. For example, the thorax action could be seen and palpated. Such and pelvis may be integrated as a unit, but observation led us to undertake EMG The question naturally arose as to which without the head. So, one can talk about studies, where we detected an association physiological mechanisms were underlying degrees of tensegrity. between manually eliciting tensegrity and those spontaneous responses. Taken We use the oscillations described above the arousal of spontaneous motor activity together with another clinical observation to monitor the degree of tensegrity in the in the client’s body, namely, tonic activity described below, they suggest the client’s body, observing which segments of the spinal erectors. Working on either involvement of autonomous homeostatic- move in synchrony with the oscillations. the occiput (Bertolucci 2008) or the thorax maintenance functions. Moreover, the small and precise oscillations (Bertolucci 2010a), we detected tonic muscle activity in the cervical erectors. Pandiculation: allow both the practitioner and client to feel a Possible Link which segments are integrated at any given The spontaneous motor activity took point of a maneuver. As the client can also some time to start (around two minutes), A client complaining of neck pain had a feel the degree of tensegrity, this aspect of progressively rose to a peak, then suddenly first session. Returning for his next session, touch can be a resource to foster the client’s fell, at which time significant tissue release he mentioned the pain had gone. At some embodiment and also to strengthen the could be felt under the practitioner’s point he added, “I forgot to tell you that client-therapist relationship. Client’s and hands – and the client often referred to a after our first session, I slept very well and practitioner’s subjective experiences have relief or a release. To our knowledge, such the next morning, I deliciously stretched, also been shown to be useful in teaching a phenomenon has not been described which I have been doing every morning this style of manipulation (Bertolucci 2010b) in the literature before. Additionally, we ever since. I then realized that at some point in my life I stopped doing the ‘morning It is also our observation that the degree of detected synchronous cervical and lumbar stretch’, I don’t know why…” [Italics are tensegrity tends to rise during the course erector activity, suggesting that the motor ours, explanations below.] of a maneuver, i.e., a progressively greater responses involve systemic mechanisms. number of segments move in synchrony We suppose that the progressive tonic The association to the patterns of during the oscillations. We hypothesize activity underlies the (also progressive) involuntary movements we were already that manually eliciting tensegrity evokes degree of tensegrity observed during a witnessing was obvious: they often very the spontaneous participation of the client’s maneuver, as mentioned above. much resembled (and were experienced system, leading to a progressively higher In some cases, the intensity of the motor as) the behavior of pandiculation, the degree of tensegrity along a maneuver, as responses became big enough to evoke instinctive behavior of morning stretching described below. involuntary movements, which sometimes and yawning. Would this client be ‘treating continued even after manual contact ended himself’ through resuming his habit of pandiculation? Curiously, the word he used

www.rolf.org Structural Integration / December 2016 21 BIOTENSEGRITY AND SHAPE in Portuguese was “espreguiçar” – a verb fascia – as well as the Ruffini corpuscles, For instance, when thirsty (nociception), meaning ‘to take the laziness out’. related as they are to shearing forces the organism will search for water and (Schleip 2003); Pacinian corpuscles could be rewarded with pleasure (beneception) Pandiculation seems to be an appropriate also be stimulated during the oscillations. when drinking it (Esch and Stefano 2004). model to understand the possible Receptors conveying interoceptive afferents Similarly, it is uncomfortable to feel rigidity physiological mechanisms underlying the (which monitor the physiological state of movement and pleasurable when free involuntary motor phenomena observed. of tissue, associated with maintenance movement is restored. Our current understanding is that there of homeostasis) may also be involved. In is a whole class of autoregulatory motor Interestingly, referred sensations triggered fact, clients often experience interoceptive behaviors that work to restore and by Tensegrity Touch seem to convey some sensations during Tensegrity Touch maintain the movement capabilities of sort of biological meaning. We often hear maneuvers, such as dullness, burning animals. These could be considered akin from clients phrases like “ I feel parts being pain, itching, changes in temperature. to the morphogenetic movements seen in put in place”; “This touch is fixing such and Such interoceptive sensations often have fetal development – in the sense that such”; “This is the place where the problem a hedonic value based on pleasantness bodily movements are also determinants is . . but it is not over yet; I feel some pain, but or unpleasantness (Craig 2002; 2003) and of morphology, given that they signal ECM you can proceed because it is a good pain”; may also work as a therapeutic resource in modelling (and re-modelling) as discussed and so on. This kind of testimonial suggests clinical practice, as mentioned below in the below. Pandiculation can be considered that we have a system of recognizing section on beneception. prototypical of such type of behavior. the appropriate arrangement or relative The effects would probably encompass It is also worth mentioning the positioning of parts/compartments both structural (e.g., myofascial) and possible involvement of non-neural, within our bodies. Perhaps patterns of neurological (e.g., tonic-postural function) mechanoresponsive mechanisms such pandiculation arise from this interoceptive effects (Bertolucci 2011). as morphological communication, in sensitivity? Indeed, interoceptive afferents which morphology, physical forces, and have already been related to pandiculation Indeed, the phylogeny and ontogeny of displacements act as a non-neural channel behavior (Walusinsky 2006), as have pandiculation reveal its likely role in the of information (Rieffel et al, 2010), related temporary positional stress or immobility development and maintenance of motor as they are to tensegrity. This effect will be (Fraser 1989b) – that is, certains positions function. Fetal ultrasound studies on sheep dealt with in Part 2 of this article in a future will create non-functional ECM links in (Fraser 1989a) revealed fetal pandiculation issue of this Journal. certain areas that produce interoceptive as a mechanism that influences functional afferents to the CNS, giving rise to the determination of the moving parts of the Whatever the mechanisms involved, the appropriate motor patterns to ‘free’ them. musculoskeletal system and contributes to involuntary tonic muscle activity of the Maybe in Tensegrity Touch our way of articular development and maintenance. pandiculation-like responses apparently evoking tensegrity somehow emulates the Similar functions were also described in aims – like the fascial manual input – to free afferents that evoke pandiculation? poultry, dogs, cats, and horses, among structural restrictions (especially matrix other animals (Fraser 1989a). In ostriches, densifications and fibrosis). This is what Tensegrity in Pandiculation a similar ‘maintenance’ pandiculation has pandiculation itself seems to accomplish. and Somatic Disciplines been described (Sauer and Sauer 1967). This means that during a Tensegrity Touch maneuver the practitioner initially has We now recognize tensegrity in virtually all Pandiculation is described as a series of an active role, blending manual forces life forms from micro to macro in scale. It coordinated actions that unfold sequentially, so as to evoke tensegrity and, hence, is a way to build light, adaptable structures building up soft-tissue contractile tension the pandiculation-like reflexes. Those, – and also possibly a way to help control to a peak, at which point the joints of the in turn, progressively ‘take over’ the movement other than through neural limbs and trunk are maximally extended or, job of freeing such restrictions. In this mechanisms, as noted above. Tensegrity alternatively, the trunk is arched in flexion sense, the practitioner works from outside is present in the evolutionary behavior of (Fraser 1989b). This is remarkably similar in, while the client works from inside pandiculation, and also in classic somatic to the phenotype of the spontaneous motor out – spontaneously – by means of the disciplines such as yoga and martial arts activity we have been observing arising pandiculation-like reflexes. The clinical – where whole body actions and inter- from Tensegrity Touch interventions. efficacy of Tensegrity Touch may be related segmental relationships are acknowledged. Pandiculation-Like to the summation of these effects. Interestingly, some yoga poses are named after animal pandiculation behaviors, Reflexes? Beneception, Nociception, and martial arts movements also were It seems reasonable to postulate that and Homeostasis often inspired by animal movements manually-induced tensegrity stimulates that exhibited tensegrity. Tensegrity A homeostatic behavior is any action that receptors so as to create afferents that, once and pandiculation are also found in brings an animal back into homeostasis when processed in various levels of the central more recent somatic modalities such as an imbalance has occured. Interoceptive nervous system (CNS), reflexly provoke Eutonia, Continuum, Fascial Fitness, afferents inform the CNS so the required involuntary pandiculation-like responses. among others, each of which has its own action can be planned and executed. Which receptors could be involved? As way to encourage pandiculation and The biological signaling in this process touch is mechanical stimulus, it is likely pandiculation-like movements. involves nociception and beneception that mechanoreceptors are stimulated, (pain, pleasure, and related experiences). especially interstitial receptors – rich in

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Yawning and pandiculating in the presence Luiz Fernando Bertolucci, MD, BSc is a biologist Esch, T and G.B. Stefano 2004. “The of another person is considered rude in and physiatrist (rehabilitation medicine). He has neurobiology of pleasure, reward processes, most cultures (Walusinsky et al. 2010). been applying Rolfing SI in the treatment of addiction and their health implications.” Do we have an embedded self-regulation musculoskeletal disorders since his certification Neuroendocrinology Letters 25(4):235-251. resource (pandiculation) which education in 1990. In this period he also developed Fraser, A.F. 1989a. “Pandiculation: the suppresses? If so, this may be one reason Tensegrity Touch, and has been studying and comparative phenomenon of systematic that musculoskeletal disorders are so researching its mechanisms of action. He is stretching.” Applied Animal Behaviour Science common in our society. particularly interested in spontaneous self- 23(3):263-268. healing movements. He is on the Rolf Institute Conclusion (RISI) Foundations of Rolfing SI Faculty and Fraser, A.F. 1989b. “The phenomenon of ECM is under constant remodeling, Fascial Anatomy Faculty. He teaches for the pandiculation in the kinetic behaviour of reflecting our motor history. In this process, ABR (Brazilian Rolfing Association) and in the sheep fetus.” Applied Animal Behaviour mechanical stimuli are determinant: good health institutions in Brazil and abroad. Science 24(2):169-182. movement patterns reflect in healthy ECM Angela Lobo has degrees in physical education Maas, H. and T.G. Sandercock 2010. and vice versa. For instance, normally and physiotherapy. She has been a Rolfer “Force Transmission between Synergistic gliding tissues tend to densify and since 2004 and a part of the Tensegrity Touch Skeletal Muscles through Connective adhere when there is no movement and/ Research Group since 2005. She is on the Tissue Linkages.” Journal of Biomedicine and or inflammation. This means that non- Foundations of Rolfing SI Faculty and teaches Biotechnology 2010(1):575672. functional ECM molecular links are part of anatomy, physiology, and myofascial release for Sauer, E.G. and E.M. Sauer 1967. “Yawning life, as there are periods of stillness (sleep), the ABR since 2009. She practices Rolfing SI and other maintenance activities in the as well as vagaries like trauma and diseases and physiotherapy. that progressively diminish movement South African Ostrich.” The Auk 84(4):571- capabilities. Maybe pandiculation is Bibliography 587. a natural mechanism to re-regulate? Bertolucci, L.F. 2008. “Muscle Repositioning: Rieffel, J.A., F.J. Valero-Cuevas, Pandiculation patterns feature reaching to A new verifiable approach to neuro- and H. Lipson 2010. “Morphological maximum body dimensions (Walusinsky myofascial release?” Journal of Bodywork and communication: exploiting coupled 2006) – shapes of movement that seem to Movement Therapies 12(3):213-224. dynamics in a complex mechanical structure ‘refresh’ tensegrity through various body to achieve locomotion.” Journal of the Royal configurations. These intense stretching Bertolucci, L.F. and E.H. Kozasa 2010a. Society Interface 7(45):613–621. actions possibly free non-functional ECM “Sustained Manual Loading of the Fascial bonds, restoring body architecture and System Can Evoke Tonic Reactions: Schleip, R. 2003. “Fascial plasticity – a at the same time stimulating tensegrity Preliminary Results.” International Journal of new neurobiological explanation: Part 1.” so that optimal movement patterns are Therapeutic Massage and Bodywork 3(1):12-14. Journal of Bodywork and Movement Therapies perpetuated. Additionally, pandiculation 7(1):11-19. Bertolucci, L.F. 2010b. “Muscle resets postural muscle tonus to produce Repositioning: Combining Subjective and Walusinski, O. 2006. “Yawning: unsuspected integrated movement, which in turn Objective Feedbacks in the Teaching and avenue for a better understanding of arousal is a further source of good mechanical Practice of a Reflex-Based Myofascial and interoception.” Medical Hypotheses signals. In this sense, we could speculate Release Technique.” International Journal of 67(1):6-14. that pandiculation is a form of neuro- Therapeutic Massage and Bodywork 3(1):26-35. myofascial hygiene that is constantly Walusinski, O., R. Meenakshisundaram, restoring tensegrity. Bertolucci, L.F. 2011. “Pandiculation: P. Thirumalaikolundusubramanian, nature’s way of maintaining the functional S. Diwakar, and G. Dhanalakshmi If this is true, might we encourage integrity of the myofascial system?” 2010. “Yawning: Comparative Study pandiculation – and hence tensegrity Journal of Bodywork and Movement Therapies of Knowledge and Beliefs, Popular re-sets – to enhance general health? This 15(3):268-280. and Medical.” The Mystery of Yawning would require reassessment of cultural in Physiology and Disease. Available at taboos against yawning and pandiculation, Chang, D.S., F. Burger, H.H. Bülthoff and www.baillement.com/recherche/beliefs_ as well as further investigation of S. de la Rosa S 2015. “The Perception of knowledge.pdf. therapeutic approaches that could Cooperativeness Without Any Visual or stimulate it. Tensegrity Touch seems to Auditory Communication.” Iperception Video References be one way to stimulate tensegrity and 6(6):2041669515619508. pandiculation through fascial touch in the Video 1: http://tinyurl.com/ Rolfing SI domain. Craig, A.D. 2002. “How do you feel? tensegritytouch1 Interoception: the sense of the physiological Video 2: http://tinyurl.com/ Part 2 of this article will describe additional condition of the body.” Nature Reviews tensegritytouch2 Tensegrity Touch features as well as discuss Neuroscience 3(8):655-666. their mechanisms of action. Video 3: http://tinyurl.com/ Craig, A.D. 2003. “Interoception: the sense tensegritytouch3 Acknowledgements: Thanks to Angela Lobo, of the physiological condition of the body.” and Soraia Pacchioni for the theoretical and Current Opinion in Neurobiology 13(4):500- Additional videos and articles are at the blog practical contributions, and to Anne Hoff for 505. http://musclerepositioning.blogspot.com.br. editing the text.

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locomotor system or locomotor apparatus. From Embryo to Adulthood Proprioception. In that domain of what is our perception of body, the questions The Human Body as a Performance of the Soul started – like, “What is anatomy actually telling me about my body?” More and By Brooke Thomas, Certified Rolfer™ and Jaap van der Wal, MD, PhD more I became aware of the fact that the body that I am, the body that I experience, Editor’s Note: This interview was originally done for Brooke Thomas’s The Liberated Body is quite another reality than the body that Podcast. You can listen to this interview at www.liberatedbody.com/jaap-van-der-wal-lbp-057/. I studied and learned and dissected. There apparently are two bodies in me, or two Brooke Thomas: My conversation today body qualities. That brought me in contact is with an embryologist and anatomist, one with phenomenology – the philosophy of my longtime personal heroes, Jaap van where you do not start by observing der Wal. He’s been a professor at various the world or becoming an onlooker and universities in the Netherlands and has beholding your body as something like also been a researcher. His work stands an object, but where you primarily start to out, however, because he approaches these experience the reality or feel it or take for things quite differently. He describes himself true what your senses are telling you. as a phenomenological embryologist who is looking for the soul via the embryo. He The body that you live, the body that you now teaches about this all over the world are, is quite another reality than the body through his Embryo in Motion project. that I had to teach students and that we Thank you so much Jaap, for talking with met in the dissection room. There, my all of us today. questions came: What actually is the body of science? Is that a reduced reality? Is Jaap van der Wal: You’re welcome. Jaap van der Wal that a whole reality? What is lacking in it? That brought me to embryology, with the BT: To begin, could you describe what your question, Where is this body coming from work is about? and how do we live with this body when JV: My usual opening sentence is that we are an embryo? What are we actually I’m an embryologist and an anatomist, doing as an embryo? There I found, so to but that I am searching for spirit in the say, that it’s not first the body that is formed, human being. That is my mission; to help and then we start to live in it or start to people to see and to become aware that be aware of it. I think that from the very there’s something more at stake than just beginning on, you can see that your body is the matter dimension or body dimension. a performance, that your body is a process, There’s something which you could call a lifelong performance. Literally, you are spirit. Something in this reality which is a performer, you perform your body, you more than just the matter dimension that shape your body. And the entity that is we are so used to. That is my mission [I shaping that is me, and ‘me’ is not only take] all over the world. I use the embryo this body, apparently also something else because the embryo is the perfect domain in that body that is the shaper, the realizer Brooke Thomas to ask questions like, “What are we doing? of this form the body. Like Descartes said, What is a body? Is the body something that there are two realities, and the body is the curious how you got on this path as an is producing us or is the body something form, the realized reality, and in me as I am embryologist? we are producing? What is our body living this body, there’s also something else, actually? Where do we come from? Is my JV: I didn’t start as an embryologist with my awareness, my consciousness, my soul, consciousness coming from my body or is these questions. When I was still a medical that apparently is the former, the shaper, my body maybe produced or formed or student, I came in contact with what in the performer of that reality. That’s a lot of shaped by me, by myself?” The relationship those days was the Institute for Anatomy words, but that’s how I see it. or the dialogue between spirit and matter, and Embryology. In those days, the two BT: I think one of the ways that we or soul and body, that’s my theme and I disciplines were – in Holland at least – in culturally reduce the body is that we decide try to help people see it in a scientific way. one institute. I got a job there before actually that our brain is running the show. You say Not by believing in spirit and soul, but that starting as a doctor, I never practiced as a that the embryo challenges the idea that we you can scientifically, with a good scientific medical doctor. I became teacher, I became are our brain. procedure and methodology, see such a researcher. I was fascinated by the body, things or such qualities. by anatomy. Later on, also by embryology JV: Literally, because for more than because that was in the same department. eight weeks when you are officially in the BT: It’s so beautiful, and I think the work embryonic stage, you do not have a brain, you’re doing is so different from much My main work in the beginning was at least not in the way we have now as of how the body is spoken about. I’m anatomy, specialized in locomotion – the adult beings, a brain functioning, an organ

24 Structural Integration / December 2016 www.rolf.org BIOTENSEGRITY AND SHAPE functioning. The first weeks you do not you wake up with a new body, or every JV: Actually, the dogma of ‘the brain as have a brain at all. How do you exist when moment you have a new body. I think it active principle’ is the sister or brother of the you’re an embryo? It became more and gets to this point you’re making about your dogma of ‘the genes as active principles’. more clear to me that the way you exist as body being a performance. I have never in a human embryo or in embryo is, apparently, the same way as you any embryo seen genes being an active JV: Yeah. That is the main error in modern exist in your body in the non-brain part, in principle. They do not cause anything. biology. The embryo taught me again and the non-conscious part of your body. There’s Genes are the most inactive principles again, we are not a spatial structure. We so much presence and awareness in your in the living organism. They only serve are a time body. Every living organism is body that is not conscious, or let’s say not heredity, they only store information, that’s a performance in time. You are a process, the brain consciousness. all. They do not cause anything. During the not a machine built up from particles. development of the embryo, genes do not Actually, [I wondered] if I could find in the The anatomist is wrong. I’m also an cause your properties, they do not cause the embryo also something like soul, awareness, anatomist and I had to teach it, that your faults or shapes in your body. You need consciousness – could I see it there at work? body is composed from parts. No, it is not them, to perform that, but during your That might explain how in my body, say composed from parts. It’s not built up from development, your genes are differentiated, below the level of my neck, soul or spirit is cells. The embryo shows loud and clear that your genes have these different states of also working and performing in the body. you are organizing your body into parts, activity. The thing with the gene is that it’s That’s what I learned from the embryo, that and it is a process in time. A lifelong process nearly like a brain. Brain and genes have your body is not producing a brain and that you never stop. So you cannot say that a common notion: they are almost purely your brain producing you. It’s the reverse. at a given moment you are ready, or that as form. The brain is form, a structure. The You are producing – from day one, to day an embryo you are not yet a human being. gene comes to form and structure. The most last, to day X – you are performing your All the phases of your life, from day one on, lifeless molecule that was ever produced by body. It’s the primary thing you do. Every belong, are part of the whole performance living beings is the DNA. The DNA is not a morning, you wake up with a new body. It’s in time which your body is. The embryo molecule of life, it’s a molecule of heredity. It not a machine. A machine is built up from in you never stops, because your body is the most structuralized molecule that has parts. A computer is built up from bytes remains a process – lifelong, every day, ever been produced by living organisms. It and chips, and it starts to function. But every hour. There are organs which are is produced by living organisms, like a brain that’s not what you do. You are constantly every minute changed in their anatomy is produced by a living organism, and not performing, shaping your body. You do not and their form and shape. So process is the the reverse. have a computer in your head. It’s an organ word, we are not a machine. that might function as a computer – which How come people nowadays start to think BT: It really gets to our difficultly, I think, by the way is a very poor comparison, that we are robots, that we are products of with the present tense, understanding it’s a very poor model – but it’s not a our genes? That comes when you change things unfolding in time. computer, it’s an organ that can function as the brain, when you change the genome, a computer, and you have to perform that JV: Yes. The problem is that, of course, we then the organism has to follow. That is organ from day one until day last. also are a machine, but in the sense that why genes and brains for me are necessary our anatomy, let’s say our ‘machinery’, is but not sufficient conditions. But they are That’s actually your primary behavior: your formed. But it is a constant process in time: very necessary – to give your soul and body body is a behavior and your brain is just you have to shape and reshape it [all the shape you need a given gene structure or an organ of it that is dealing in or mostly time]. Even when computers come – and brain structure. So when you change that, involved in consciousness and awareness. they are coming, the robots [that] will look of course the organism starts to behave in a It’s not my brain that is moving my arms: I like a human being, act like a human being, different way. But that does not prove that move my arm, I speak here. And for that, I talk like a human being, even think and do the genes or the brains cause your body or need a brain, I need a guttural fold, I need things faster – the only simple thing that your consciousness, respectively. a larynx, and I need arms and legs and every human being, every little child, can muscles. I move, I’m not moved by one My wife had a tumor in her brain, and her do, that will never be in the capacity of organ that is the leader of all the others, personality changed completely. It took that robot to do, is performing your body. that’s not what I see. I see the embryo, I see a many, many years before we discovered it. Robots are spatial structures. They are child, I see an adult constantly performing, What was the first thing my colleague said? machines. They are computers, and they shaping, primarily acting his body. Actually, “Jaap, now you are [surely] convinced that produce action. We are primarily actions your body is an act, is a performance. You the brain is just an organ producing your in time. Our body is our primary act, our repeat that physiologically, psychologically, personality, your psyche, because look at primary behavior, our primary appearance. but it’s not done by the brain. The brain your wife, if you have a damaged brain, That can never be shared by a clever, smart, is just one organ that is specialized in you get a damaged personality.” Yes, yes, or super machine – ever. Don’t consider a awareness or in control. Maybe it’s the yes, but that does not prove that in normal robot ever as a human being. leader of the orchestra, but it’s not the conditions, when I live my body, that my orchestra. The orchestra is your body, and BT: One of the other things that we love brain is producing my consciousness or that is playing the symphony. to point to, I think, right now, are genes as my psychology. But of course if you change what causes what happens in a body. You my brain, I have to perform my body, my BT: That’s so gorgeous. I want to emphasize reject that completely. I’d love to hear more consciousness, my soul, in a different way. one thing you said because I think it gets about that. lost for a lot of us. You said that every day

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That is the problem with modern science. forth by Rudolf Steiner of Anthroposophy, cosmos, too much spirit, too much body, They think that the experiment proves that Randolph Stone from Polarity Therapy, too much death of matter and death of you are right. No. I am a scientist. I have Andrew Taylor Still from osteopathy. time, space and time. Maybe life is not the been an associate professor in anatomy They all three say that spirit and matter, opposition or polarity of death, but life is and embryology for forty years. I know if they exist, they must be one – because the breeze in between two polarities that what I’m saying now. I say that science is it is a polarity, one reality is the complete might both have an aspect of one-sidedness not like they want us to believe. They want inversion of the other and they cannot exist or polarity and in their one-sidedness they us to believe that science is a new way to without each other. The Cartesian people are poles of death. Life is realized in the know everything, that scientists gather always separate spirit and matter as if they breeze in between these two polarities. Or objective neutral facts, and that out of these are entities you can separate. You can never is that too vague? objective facts, they just come to inevitable separate consciousness from your body. If BT: No. I think I’d like more detail with a conclusions. That is false. The truth is that you do that, you are unconscious. They are couple of concepts of yours, having read every scientist, including me, every scientist two realities always together. (That’s why your article where first you talked about has in his mind, or her mind, a frame of I call myself not a dualist, but a polarity how you “learned from the embryo, motion thoughts, a hypothesis, an idea, and they thinker or a non-dualistic monist.) That is primary, form is secondary” (van der Wal, are looking for the facts that are in harmony maybe is the problem, that we separate 2012). Forms come out of motion and not with that idea. That is what the experiment the two domains, and now we gradually the reverse. Also, that the embryo is not in does. The experiment proves that the facts evolve one of the domains to be so big the past, it still exists in our human adult that you have manipulated are in harmony and so great that we think we can explain organism. So form coming out of motion: with your theory, but not the reverse. That’s nearly everything with that and that we, so could you say a little bit more about that? the problem with modern science. If you to say, do not need the other dimension as I think that might illustrate this life/death think that we are brains, you can prove it an explanation or a cause. principle some. by millions of experiments. If you think that That is what I’m saying as a phenomenologist. the genes are causing our properties, you JV: Actually, motion or movement as the I’m not interested in causes, I’m interested can prove that by many experiments. But it’s primary dimension is related to the other in questions like: What does it mean? Is never realized in the living situation. In my issue that I mentioned: time. That all bodies there finality? Is there something going on? primary reality, genes are not active because and organisms appear in time. Time and Is there an aim of evolution or is it just all they are not causing me. Genes do not have motion are related. Space, pure space, so blind causality? That is the topic I’m talking properties. Genes cannot be illnesses. Brains to say, is death, as Goethe said. Motion is about. Causality is restricted to the body. cannot think. Brains cannot move. They are space in time, time in space. For me, we Finality involves mind, spirit, and future. necessary but not sufficient conditions for an are therefore not only anatomy, but we I think that modern materialism has no organism to be ill, to move, to perform. are motions, processes producing forms. future. It’s only the past of our genes and The important thing is that when you BT: Going back to the embryo illustrates our brains that is ruling our society. I’m produce a shape, a form, that is an act. Our this. The question I’ll often ask myself, very worried about a future that will be locomotion is not motion, our locomotion just as a part of my spiritual practice, is, realized by such a society that only believes is posturing: it’s a very rapid change of What is making the embryo? If we can say in brains, genes, and bodies. position, of posture of your body. It’s a the embryo is making itself, what is the BT: Sometimes with clients, I try to very fluid anatomy, but posturing. Maybe intelligence that allows that to happen? It’s explain that everything is connected. If you posture not only in an anatomical way, not a brain, because as you said, it doesn’t your elbow is bothering you, your elbow is you can do it in a psychological way [too]. start out with a brain, and it’s not the genes not in a separate room. It’s actually really Look at the structure of your mind, how you just going along a program. simple, that we’re connected. I think what think, how you feel, your ideas, your views. JV: The only answer is that apparently, in you’re saying about consciousness and the It all has a kind of morphology. Everywhere, me and in every one of us, there is what embryo, if you’re alive then you’re alive motion is the primary thing. Therefore, that Descartes called a res cogitans. There is in a certain way, but we don’t understand is essential for living nature, that it is in something that is not just matter, it’s not what aliveness is, or that it’s happening all motion, and that the act of motion produces the material dimension you can measure. the time. facts, and facts can be space, can be body, There’s something else realizing itself in can be thoughts, can be acts. So it’s not that JV: Another thing I learned from the us. Call it your soul, call it your self, call it we first have a body and the body starts to embryo is that the polarity is not life versus your mind, call it your spirit. move. No. The body is in motion from the death. We nowadays think that death – very beginning onward, producing bodies, I’m not a dualist. Descartes was a dualist, inorganic dead matter – is a primary thing, I producing brains, producing genes and so but he did not separate the two. Descartes don’t think so. I think that this cosmos, this on. That’s what I learned from the embryo. discriminated between, let’s say, soul reality, is life. So life is actually something and body, between spirit and matter. He primary, and death is secondary. It might be BT: When I interviewed her, Joanne Avison discriminated the two, he did not separate that the polarity of spirit and matter are, so said that you used to always tell people “ask them. After Descartes, philosophers started to say, two aspects of death, and that when the embryo” when you’re trying to learn to separate the two, and then they chose, as the two aspects of death are one, you have something about the human body. That’s scientists, the one and neglected the other. I life. Life, living is always in between. The been a very helpful anchor for me, am a non-dualist monist. I think that body breath of life is always in between the two and spirit are always one. That ideal was put dimensions of too much chaos, too much

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JV: Yeah. One of my great inspirations I present in the world differently, my fascia when you do your jumps in the stadium.” was Erich Blechschmidt, the German is different. How do you see fascia weaving People always think, “I have to concentrate embryologist. He said, for example, don’t into this conversation, no pun intended? in order to perform.” No – I have to consider soul or psyche as something ‘de-centrate’, so to say, to get rid of my JV: When I met fascia for the first time, the that is added later to the body: you are head. In my innerness, that is where I know first association I made was with the meso. a psychosomatic being from the very exactly how it works, what to do. And Blechschmidt was the first and, as far as I beginning. The first thing you have to do there’s a lot of mind and knowledge and know, the only embryologist who said, let is behave in your forms, in your anatomy. awareness in my body, in my muscles, in us stop talking about these germ layers He then said that the soul is pre-exercised my stomach, in my liver, whatever. ectoderm, endoderm, and mesoderm. in the body. Your body is an act, your body He said it is too anatomical to talk about Soul is not only in the brain; in your brain is behavior, and there you pre-exercise acts three layers. We do not have three layers. you get the possibility to become aware that you later can perform physiologically. We have two body walls, the ectodermal of your body, aware of your soul. I think That makes the embryo and the body so body wall, the endodermal body wall, and that our brain is the organ where we can interesting. If you want to understand there’s an in between. There is an innerness have the most distance between ourselves human behavior, let’s say in a psychological and the innerness is represented by the as participants in the body and ourselves way, you also have to look at [the person’s] primitive fascia. The meso is therefore not as observers of ourselves. There’s the old physiology, anatomy, and morphology, a mesoderm, it is a meso quality, it is the duality again, that is the duality of being because there he is also exposing human connective tissue. That is where, so to say, an observer and being a participant. The behavior. The way we shape our body is the body processes start and are realized, participant is the body that you are, and a kind of free exercise of what we later the body processes that have to do with the observer is the body that you have, on are capable of doing physiologically, your innerness. I have two body walls to and both realities are there. Scientists and psychologically. That for me was an deal with the world, to act with the world, neurophysiologists try to convince us that eye opener. to perceive the world, and to digest the there is only one reality, the reality of the Since then, I see that anatomy forms and world. In between the two layers, there is observer, and then you have to think that shapes can also tell about psychology and my actual innerness. all your soul processes are taking place in about behavior, maybe about meaning and the brain. We are processes in the body and Then I started to think, isn’t that what about what we are doing. What is expressed there’s another reality that we get lost from Andrew Taylor Still is also talking about? when I make a fist? As an anatomist and as if we go on thinking we are walking brains That your fascia, your connective tissue, a scientist, I’m only interested in the genes or whatever. is much more than only your connective and the nerves and the muscles in the brain tissue, your skeleton, it is also your blood, BT: It’s so interesting that we’re at a time that causes the fist. But the most important and it is your locomotor system. Fascia as in our culture where we’re always looking thing in me making a fist is that I want to the organ, the world of your innerness, not for the one ‘important thing’. express something with it! I’m expressing your insides but your innerness. There something with this body, with this form, JV: We are addicted to causality. Why? where you weave, where you dwell, in with this fist, and that is phenomenology. Because if you find a cause, of your motion between your body. Over this enormous Phenomenology tries to understand the for example, then you can manipulate. matrix of blood and connective tissue, forms as expression. What is our body That is the only motive. We are addicted including sense organs and nervous tissue, telling about us? It is not just that you first nowadays to genes, brains, and body you can organize your inner world, your have a body coming out of evolution, then because if you can find out what causes our inner metabolism, your innerness, in a it started to be human. Maybe evolution is disease or causes our behavior, then you morphological, physiological, psychological an act of trial and error, a process of trying can manipulate it. That’s what we love. Of way. Why isn’t the meso considered as the to become a human being. Maybe evolution course, that is very helpful – it saved the life domain of soul or my innerness or my is our embryonic development also, but on of my wife, so to say. I know how important psyche? That’s just a general notion that a larger scale. Forms as behavior are telling that can be that you can manipulate and I’ve tried to work out during the last years. me the meaning of these forms, telling me influence things. But it’s not the only reality. what we are doing, what we are, what we BT: I feel like that illustrates to a certain BT: Right. We lose something when that are going to do, and what we are meant for. degree this idea that the embryo is not becomes the only thing, the only focus. You Maybe that sounds too religious, but okay. past tense that it’s still unfolding in our have a very potent phrase that I read, where adult organism. BT: I’m wondering if I can drop the concept you said, “the body does not have a soul, the of fascia in here. I saw you speak at the most JV: It also is related to my view that it is not body is a soul”. To close, I just wanted to ask recent Fascia Research Congress, and I’ve in the ectoderm alone, it is not in my brain, if there was any part of that you wanted to read your work in the compendium book my nervous tissue alone, that I live or where dive into a little more. on fascia that Robert Schleip [helped] put I am conscious. There is also consciousness, JV: I think that many people think that you together. I know this is something you’re on a lower level of consciousness, there is have a soul. I think that is related to the fact well versed in. One of the things that I think awareness in my heart, in my liver, and that many people experience themselves as about with fascia is that it’s very faithful in my muscles. I worked for many years two entities. On the one hand there is the to your actions and your emotions. If I’m with athletes who had to perform and they body and they talk about my adrenaline depressed, I tend to tighten up around my said, “Jaap, you never perform with your or my brain or my hippocampus is doing chest. When I sort some of those things out, head. You have to get rid of your head this or doing that. And on the other hand,

www.rolf.org Structural Integration / December 2016 27 ROLFING SI AND HEALTHCARE they have their consciousness or they have their soul. They live it as two separate Fascia Pioneer domains. Are we souls? With that I mean that soul and body are not separate entities An Interview with Tom Findley or separate domains, it is one. There are only two polarity dimensions, let’s say By Anne Hoff, Certified Advanced Rolfer™ and Thomas Findley, MD, PhD, dimensions of space and time for example, Certified Advanced Rolfer but it’s one. Therefore, it is not a body producing a soul, it’s a soul producing a Anne Hoff: We’ve been wanting to body. It is constantly a dialogue between interview you for the Journal for quite some the dimensions. We do not have a body. We time, so I’m thrilled this is taking place. Let’s are a body. And when you are a body, you start with your background. You became are a soul that is that body. It’s playing with a medical doctor in 1977, got a PhD in words but I want to express with that that physical medicine and rehabilition in 1983, we are one and not two. We are of course did your basic training with the Guild for a duality, but we are a non-dual duality or Structural Integration in 1991, and did your a non-dual polarity. That is important for Advanced Training with the Rolf Institute® me, that you think in twofoldness, and not in 1998. Plus training in acupuncture and in duality as separate entities. homeopathy during medical school. Was there an organic progression in all of this? BT: Thank you so much. I honestly believe that if your work could be more digested Tom Findley: I was exposed to Rolfing® by culture, the world would change. I’m [Structural Integration (SI)] back in college, very grateful for the work that you’re doing. in 1969. Sharon Wheeler was the sister of Thomas Findley one of my college friends, Richard Wheeler Bibliography – she was one of the first Rolfers. I got my van der Wal, J. 2012. “The Embryo in Us ten sessions in Berkeley between college – A Phenomenological Search for Soul and medical school and Consciousness in the Prenatal Body.” AH: So even in medical school you knew Available at www.portlandanthroposophy. about Rolfing SI. Did you think way back org/the-embryo-in-us-article. then that at some point you might want to Brooke Thomas is a Certified Rolfer who has do the training? been practicing for over fifteen years. A self- TF: So, in medical school I did an elective admitted body nerd, she teaches movement with Frank Wenger MD, the director of the and hosts The Liberated Body Podcast as department of physical medicine at the a continuing-education resource for those in Washington Hospital Center who became the manual and movement therapy fields. Visit my mentor, and convinced him to quit his www.liberatedbody.com for more episodes, job and become a Rolfer, and he convinced or visit www.newhavenrolfing.com for more me to go into physical medicine and Anne Hoff information about Brooke and her practice. rehabilitation. We have always considered it a fair trade. Jaap van der Wal is a physician and scholar AH: What did you research when you were whose contribution to the field of embryology AH: Was fascia a big part of your training three years old? has included describing the bridge of science in physical medicine, or was it something TF: My mother tells me I stood next to a and spirituality. He is self-described as an you had to learn about on your own? embryologist on the search for spirit. His window where the sun was coming in in current focus is his work on Embryo in Motion TF: No, so when I did my residency and got the winter, and I held up a can of honey, (www.embryo.nl). my PhD, we knew about bones and muscles and I stood there for forty-five minutes. and strokes, and how to rehabilitate those Finally she said, “Tommy, what are you things. And then I got to connective tissue doing?” And I said “I doing exerment and – duh, we don’t know anything. You [experiment].” know, heat a rat tail you can stretch it, that’s AH: Okay, so the research bug was there all we knew. So there’s a big gap here. So young, but you also knew you wanted to that was back in, oh, 1980, I knew there do some kind of clinical practice? was a big gap. TF: Correct. By studying to get my PhD AH: All along were you both a clinician simultaneously with my residency, I and a researcher? learned to go back and forth between the TF: I’ve been doing research since I was clinical and the research in the middle of my three years old. residency. And I just continued to do that.

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AH: That’s fairly unusual, isn’t it? TF: They were doing mixtures of Ten all sorts of things. She came back after the Series, nonformulistic stuff. Actually there’s Rolfing sessions and she looked better, TF: Yeah, it is. Most MD/PhDs get their some papers that came out of that, how our and her scoliosis was worse. She was more PhD as part of the MD, and then they go patients did. Our patients did quite well. balanced in her body but the curvature was into residency and don’t do any research, worse. So we sent her to a surgeon who and then they get out and only about 15% AH: So you’ve had opportunities, where straightened her out. wind up doing research. Most MD/PhDs are you’ve been established and respected in just straight clinical because they never got the medical system, to bring in structural AH: So the scoliosis was progressing in the any practice going back and forth. integration, and there’s been uptake on way it would and the Rolfing SI was just the medical end. But it sounds like a kind of masking that on the surface. AH: And then you’ve also been an educator, mixture of interest, or not, on the structural you were a medical school professor. So TF: Correct. integration end. you’ve had these multiple streams of AH: Do you think there are situations involvement . . . So you were exposed TF: I wouldn’t call it a mixture, I’d call it where Rolfing sessions can help with to Rolfing SI, and a certain number of not. scoliosis? years into your work you went off and AH: So the Guild was willing to come out trained – why? TF: Of course. and train, but other than that there hasn’t TF: Well, I tried the training back in ’86-’87 been interest from structural integrators to AH: How would you decide when it could maybe – that’s when I was research director come and work in the field? and when it couldn’t? of the Rolf Institute® – and I lasted about TF: No. TF: It sort of depends on how fast it’s three days in the auditing. I [decided], “No developing and how loose the tissues way, I’m not sitting on my hands for eight AH: I remember years ago when you were are. If somebody is loosey goosey in their weeks.” So I didn’t train then. But Frank at the VA (Veterans’ Administration) you adolescent growth spurt, it’s not going to Wenger had invited Ida Rolf to come work were looking for Rolfers to come work as help. on some of his patients at Georgetown interns in a mentorship with spinal cord University, we also had Richard Wheeler injuries. So you did not get people coming AH: But if they are tight and bound up in come; they did well with Rolfing SI. It was out, or not many? ways where Rolfing sessions could help pretty clear that Rolfing [SI] had something facilitate fascial lengthening in some places, TF: No, I didn’t. to play in physical medicine. it could help maybe? AH: Why do you think that is? So when I was at Kessler Institute for TF: Right. Rehabilitation, here in New Jersey, people TF: I don’t know. I think they’re independent AH: When you worked at the VA did you started listening to me when I had some cusses. pretty crazy ideas. I said, “I think this would find anyone interested in Rolfing SI? AH: That’s true of the Rolfing world. Was be very useful to have here. Can we put on TF: Oh yeah, we established structural that disappointing to you? a training here?” I asked the Rolf Institute integration as a skillset, and practitioners and they were not interested. So I asked the TF: A little. of structural integration can be credentialed Guild [for Structural Integration and they and work in the VA [hospital] where I used AH: Say more about working in a medical were]. We found nine physical therapists to work. I couldn’t do it all myself so I setting, this rehabilitative setting. What (PTs) and myself, and I put down my $5,000 wanted to be able to bring in an assistant, did you find when you brought structural check and told the hospital, “I’ll pay for but you can’t work on people unless you are integration into the mix of what you could my own training, can you pick up the cost licensed and credentialed in the hospital. already do as a medical doctor there. How for the therapists?” They did, and so in So I said, “We need to be able to credential did you know when to bring Rolfing SI into 1991 the instructors flew in and we trained practitioners of structural integration.” I patient care? I think many Rolfers are overly Thursday, Friday, Saturday, Sunday, went put together a packet, took it to the medical eager to think our work can help with many back to our regular jobs Monday, Tuesday, staff, and to everybody’s amazement, they things, but as a trained medical doctor Wednesday . . . And we did that two weeks approved it. on, two weeks off. you are probably more discriminating about that. AH: What kind of credentialing was AH: What was the result of the training? required? TF: Mostly that was in my private practice. TF: The physical therapists wound up People would come to me wanting Rolfing TF: I think that was before IASI . . . I think actually doing [structural integration] at SI because they’d been to see a bunch of it just said “graduation from a school of Kessler, and I went back to my full-time doctors. So my first question to myself structural integration.” research job because they didn’t really want was, “What did everybody else miss?,” AH: So somebody could come in with me doing anything else. And so Kessler before I even decide if I’m going to work structural integration training, and without had a [structural integrator] on staff for on them. And early on I had a family with being a PT or a doctor, and work at the place fifteen years. a young girl with scoliosis who wanted to you were at with the VA. Did this apply to [get Rolfing sessions] and I said, “No, I’m AH: Were they doing Ten Series, other VA hospitals or centers? nonformulistic work? And how was that not going to do it,” and they insisted and working in the health-care system, in went to somebody else. I said, “Okay, but TF: No, you’ve seen one VA, you’ve seen rehabilitative medicine? let me monitor it.” So we did x-rays and one VA.

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AH: So everything is done at the micro level actually got him to organize the first Fascia AH: So with more people doing that sort of each location. Research Congress. of assessment we’d have a better body of evidence of what we could and couldn’t do. TF: That’s right. AH: It seems difficult if it has to be done by What do you see as the pitfalls of Rolfers each VA rather than system-wide. AH: I’ve wondered, with so many vets engaging more with the healthcare system. coming back from these combat zones with TF: True. There’s been a lot of difficulty TF: They may find out what they do is very severe physical damage, could Rolfing getting acupuncturists into the VA for that worthless. But that’s true of mammary SI help them. reason. But once I had structural integration artery transplant, of lots of different approved, [I said to the] people [who] had TF: They even agreed to pay for Rolfing SI procedures that eventually turn out to be been trying to approve acupuncture for five on the outside for veterans here, and I could no better than placebo. years, “Let’s just do a text search and change not find a Rolfer who was willing to do it ‘structural integration’ to ‘acupuncture’ [in AH: So what is your impression of the for what the VA would pay. my proposal package] and resubmit it.” effectiveness of structural integration? Do AH: So they weren’t paying near what And it flew right through the medical staff. you think it’s effective? market was for Rolfers? AH: If a Rolfer somewhere were interested TF: Highly. TF: Right, but for the experience, come on in volunteering some time at a local VA, AH: Do you think it’s only effective in folks, these are our veterans. No one wanted who would they approach? certain situations? to touch it. TF: Probably the Chair of Physical TF: Well, you’re gonna help somebody’s AH: It seems there could be practitioners Medicine and Rehabilitation. They would posture, you may not change the disease who would come in and work at a reduced have to have a license in some state – any course. rate if it were organized broadly, like the state, because the VA is federal. You could way we have children’s clinics. have a license in Colorado and practice in AH: Well, Ida Rolf never said Rolfing SI New Jersey. was aimed at that. TF: The VA has every year a meeting of all their administrators. One year my hospital AH: So you were very receptive in your TF: You’ll find practitioners who are more director was in charge of that meeting. He role at the VA and other medical centers into that. Trying to treat diseases with stuff. wanted to demonstrate different kinds of to alternative therapies. Is there a general AH: And certainly a lot of clients today are alternative medicines that are offered in receptivity or a general skepticism, or is not coming in saying, “Align my body in the VA. So they flew in five Rolfers to work it really a mixture depending on who the gravity,” they’re coming in saying, “Fix my on administrators who were attending this individual is? knee.” Do you think there’s also some risk of meeting. They were booked the whole time, TF: It depends. Overall there’s quite a lot of Rolfing SI losing its identity if we get more they delivered all these sessions. And did receptivity because there’s a lot of veterans involved in healthcare? Ida Rolf started out anybody from the Rolf community pick who want this. There are individual teaching osteopaths and chiropractors but up on it? No. physicians who are quite skeptical. they wanted to borrow pieces of the work AH: That’s a shame. rather than do Rolfing SI. AH: Now there are a lot of Rolfers who TF: I agree. don’t want to touch the healthcare system TF: There’s nothing wrong with borrowing with a ten-foot pole. How do you feel about pieces of the work. AH: It seems like it would take the that? Rolf Institute or a group of structural AH: If that happened, wouldn’t the work integrators really stepping up to the plate, TF: [They’re] cutting off their nose to spite as a whole get lost? and somebody on the inside at the VA, to their face. TF: No. Ida Rolf borrowed a lot of pieces make it happen. AH: We Rolfers mostly love our from osteopathic medicine. That’s okay. TF: That’s right, and I’m no longer on the independence, but it means there’s many AH: I guess the question is would Rolfing inside. I’m retired. But the rehab docs at people who don’t have access to our work become just another type of myofascial my VA are very interested in Rolfing [SI] or even know it exists. release rather than a holistic system? and they would be delighted to reorganize TF: It also means you don’t get any feedback the program. TF: Rolfing [SI] is already a variant of on how good you are – measurement of myofascial release and I think it’s lost the AH: Is there any way that it could be done clinical outcomes. Maybe you’re good and opportunity to be in the forefront. other places too? Maybe in New York, New maybe you’re fooling yourselves. Jersey, there weren’t enough Rolfers. It AH: Do you see that changing at all with AH: So when you were practicing both might be more viable in Denver. the interest coming about in fascia research, privately and in hospitals, were you doing do you see the Institute trying to step into TF: There are a lot of Rolfers in New York a lot of assessments to gauge your results? the role we might be missing? and New Jersey. Jason Di Filippis came TF: I was bringing people into my lab out of school and came to work with me at TF: Well research is a highly structured at the VA to measure their balance. I was the VA. David Wronski came forward and speciality, if you are not trained in it you measuring nerve conduction velocity in my came to work with me at the VA, he was can’t do it. People seem to think research is private practice . . . interested in doing the Rolfing work but I easy and it’s not.

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AH: So you came out of a lot of training to TF: Yeah. And I’m still actively researching I studied it. I also missed the point where do research, and then there’s Rolfer Robert how exercise affects the spread of cancer. he said that, to his surprise, fibrotic limbs Schleip who did an incredible amount of softened, skin scars softened. AH: I was reading a bit about that – how training to be able to do research. There’s the tension within the fascia may have AH: So do you have any papers on this also people like Rolfer Karen Price who something to do with tumor metastasis. yourself? participated in a research study at Stanford, Typically Rolfers have been told to be or Russell Stolzoff up in Bellingham TF: That’s my research. We are collecting cautious in work with cancer patients, the helped a researcher with a project with data on young men lifting weights in two theory I remember when I was in school soccer players. Do you think that’s a way different ways and we are doing ultrasound was that working fascia might facilitate the to get more research done on Rolfing SI, measures of the muscle dimensions and spread of cancer. short of us having to go out and become calculating the forces and so on. That’s what researchers ourselves? TF: That depends on the cancer. I’m focusing on in collecting data – how is the muscle really different when you TF: I think that’s the only way. That AH: How would one know whether to contract in different ways? The other thing even if you get a PhD you still have to do work with a cancer patient or not? is that muscle is a filter, so that cancer cells collaborative research. TF: There are almost no metastases in as they travel in your blood get caught in AH: Does that need more Rolfers again muscle or in fascia. The chances of your the muscles. If you contract muscles in the stepping forward and finding researchers fingers running across a metastasis are right way it will pop those cells open so and saying “I’d like to help,” or do we wait pretty small. they don’t make it out the other side of the for researchers to come to us? muscle. So not only does it soften tissue, it AH: So is the idea that if you are getting also kills the circulating cancer cells. TF: You need to find the researchers and be the environment softer and more organized willing to work for research wages. you are supporting the body’s ability to AH: Is this how you are working out fight the cancer, or is there something more yourself these days? AH: How would you recommend finding specific going on? researchers who would be interested in TF: You betcha! And I have no circulating engaging in a study? TF: More specific than that. Stiffening of tumor cells. fascia around the tumor is associated with TF: Contact the key speakers from the AH: That’s fantastic, Tom. Back to Rolfing worse outcome for breast cancer. Whether Fascia Research Congress. Like Fred SI, what else have you learned about loosening has a healthy outcome, we don’t Grinnell had been seeing a Rolfer for thirty specific ways we should use our hands know that. years and he never knew that Rolfing SI that we might not be widely aware of? related to his work. He didn’t put the two AH: What about your research into exercise You wrote a paper on hyaluronic acid that together. He showed the business card of and cancer? seemed to suggest a particular vector of his Rolfer at his talk in 2007 – how many touch and also an oscillation. TF: There’s a certain kind of exercise that Rolfers followed up on that? Nobody. seems to loosen tissues: you don’t become TF: Correct. And it’s not just what’s under AH: We get ensconced in our offices just muscle-bound, you become more flexible your fingers but what’s next to them. When doing our work. It’s easy to have a busy as well as stronger. It’s loading the muscle you push on the tissue you are pushing the and full life doing that without considering when it’s very short. Most exercises are hyaluronic acid sideways, so it’s actually what else we could be doing. done mid-range. In this alternative style going to separate the layers just to the side you load it so that at the end of the range it of your fingers. So when you are gliding TF: Really, it’s going to be the new has the maximum load. So instead of doing your fingers down, you need to think about graduates. That’s true everywhere. You a biceps curl where at the end of the range what’s at the edge of that glide. take the new graduates and give them a you don’t work very hard, [here you do]; post-doctoral fellowship and work their AH: The lateral edge, or front and back? at the end of the range when the muscle is knuckles to the bone and they come out the shortest the gravity is pulling the most. TF: Both of them. doing things better. You do like a triceps kickback instead of AH: What about the oscillation? AH: Are you still involved with the an overhead press, for example. Most of Research Committee at the Rolf Institute, or the exercises in the gym are not that way, TF: These mechanical massagers are not with the Ida P. Rolf Research Foundation, or but they can all be adapted. [This was a bad idea. are you completely retired now? developed] in a 1948 paper by Dr. Delorme AH: Should we try oscillating our fingers as and it got forgotten. He called it Progressive TF: I’m still involved with the Foundation we move through the tissue as well? Resistive Exercise. So people remembered to the extent that I can, but I’m out on you lift 50% of the weight ten times, then TF: That’s Stecco’s technique. Antonio disability. My efforts are limited. you do 75%, then you do 100%. What they Stecco has his whole technique based on AH: But you’ve been doing a whole lot missed was his earlier paper that said you oscillation. these past few years, with the Fascia do it in a way that the muscle is loaded AH: Is that something Rolfers should be Research Congresses, and as one of the when it’s the shortest. He didn’t repeat trying? editors of Fascia: The Tensional Network of that in his subsequent papers. People have the Human Body. Is that the book that you cited the papers hundreds of times but they TF: Yeah. consider “the first textbook on fascia”? missed the first point. I missed it too when

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AH: It seems like there should be a feedback AH: So what’s next for you Tom? Somebody these dysfunctions. The links between fascia loop where if you are coming up with these is writing a biography of you. Is this going and cancer were proposed more than 100 years ideas through your research, Rolfers bring to be a book? What’s it going to cover? ago by A.T. Still, the founder of osteopathic that back into what we do if it will make Research, clinical practice, Rolfing SI? medicine. Dr. Findley is the recipient of it more effective. Did you find ways you the prestigious 2009 Northup Award from TF: Yes, my whole life. would adjust how you used your hands the American Osteopathic Association for his based on your research and get better AH: And then you are training a young paper “Three-Dimensional Mathematical Model outcomes, or easier outcomes? physician who’s going to step into your for Deformation of Human Fasciae in Manual clinical shoes, and he plans to study at the Therapy.” TF: Yes, but not in that way. I deliberately Rolf Institute at some point. modulate my muscles when I’m working Anne Hoff now has twenty years as a Rolfing on my clients so as to achieve modulation TF: Yes, he’s got good hands. I’ve seen practitioner. She has a private practice in in their muscles. If I want a certain set of him work. Seattle and Port Orchard, Washington. She muscles in them to relax, I have to make is also a teacher of the Diamond Approach® to AH: That must be very satisfying that you sure those relax in me. inner work. are not leaving the ship unmanned, so to AH: Is this a mirror neuron thing? speak. What else would you like to see as Selected Research your legacy? TF: I don’t know how it works, but it works Bibliography nicely, it speeds things up, and I feel a whole TF: Grandchildren! I put my order in but Chaitow, L., T. Findley, P. Huijing, and R. lot better at the end of a session. the kitchen isn’t forthcoming. Schleip (Eds) 2012. Fascia: The Tensional AH: I was looking at another of your AH: And this trip to Germany you are about Network of the Human Body. London: papers, “Three-dimensional mathematical to leave on? ? [Editor’s note: in August 2016, Elsevier Urban & Fischer. model for deformation of human fasciae in after this interview.] Chaudhry, H., B. Bukiet, E.Z. Anderson, manual therapy.” That one seems to suggest TF: Robert [Schleip] has his fascia research J. Burch, and T. Findley 2016. “Muscle that pressure is not doing anything. school. I’m teaching there. strength and stiffness in resistance exercise: TF: It says pressure on the fascia lata and Force transmission in tissues.” Journal of AH: Thanks so much for your time today, the soles of the foot is not mechanically Bodywork and Movement Therapies Aug 9, Tom, and for all you have been doing over moving the fascia. Around the nose, yes. 2016. the years. Those intermediate tissues of course, yes. Chaudhry, H., B. Bukiet, Z. Ji, A. Stecco, The really tough stuff, you’ve got to put TF: Thank you. and T. Findley 2014. “The Deformations all of your weight on the tip of your elbow Tom Findley is Professor of Physical Medicine Experienced in the Human Skin, Adipose to move them. It doesn’t mean you can’t and Rehabilitation at Rutgers University, New Tissue and Fascia in Manual Medicine.” move fluid down the layers, but you are not Jersey Medical School. He received his MD The Journal of the American Osteopathic pushing hard enough to deform it directly. from Georgetown University and completed Association 114(10):780-787. AH: So it’s an adjustment of the old idea his residency training in Physical Medicine and Chaudhry, H., B. Bukiet, M. Roman, A. that we are ‘melting’ fascia and it’s more a Rehabilitation at the University of Minnesota Stecco, and T. Findley 2013. “Squeeze film fluid process? under the guidance of F.J. Kottke, a pioneer in the lubrication for non-Newtonian fluids with field. He went on to earn a PhD at Minnesota TF: Yes, but I think you are melting some application to manual medicine.” Journal in physical medicine, and received state-of- of the fascia. Some of the older Rolfers don’t of Biorheology 50(3): 191-202. Available at the-art training in physical therapy, exercise work on the fascia lata anymore, they say www.academia.edu/13883926/Squeeze_ physiology, psychology, and anthropology. we can’t move it. That’s probably right. film_lubrication_for_non-Newtonian_ He has extensive training in complementary fluids_with_application_to_manual_ AH: Based on your research and your medicine and until his retirement in 2016 was medicine. clinical practice, what’s your own best an active clinician (Certified Advanced Rolfer) understanding at this point of how as well as a researcher at the VA Medical Center Chaudhry, H., M. Roman, A. Stecco, and structural integration works? East Orange New Jersey, which is a member of T. Findley 2012 Apr. “Mathematical Model the Planetree Network of hospitals incorporating of Fiber Orientation in Anisotropic Fascia TF: [Long silence.] Got that? Meaning, I integrative medicine. Layers at Large Displacements.” Journal don’t have a clue. of Bodywork and Movement Therapies He is the founder of the Fascia Research AH: So are we at the same place we were 16(2):158-164. Congress, and served as CEO and executive forty years ago: we’re doing something, director from its inception in 2007 through Chaudhry, H., Z. Ji, N. Shenoy, and T. we’re pretty sure it’s doing something, 2013. As a physiatrist he treats many disorders Findley 2009. “Viscoelastic Stresses on but we can’t explain what we are doing? of the musculoskeletal system. As a scientist Anisotropic Annulus Fibrosus of Lumbar But maybe we are at least beginning to do he strives to understand their pathophysiology Disk under Compression, Rotation and some research that helps clarify what it’s not in order to develop focused treatments and Flexion in Manual Treatment.” Journal doing and might point to something that prophylactic regimens. Fascia, part of the of Bodywork and Movement Therapies will explain more in the future. connective tissues that permeate the human 13(2):182-191. TF: Yeah, yeah. body, may be the unifying structure and concept that is essential to elucidate the mechanisms of

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Chaudhry, H., B. Bukiet, and T. Findley Findley, T. n.d. “Designing Clinical 2008 Dec. “Mathematical Analysis of Research” – a series of 12 articles. Available Applied Loads on Skeletal Muscles in at http://rolfresearchfoundation.org/ Osteopathic Manual Treatment.” The Journal resources/fascia-research-resources of the American Osteopathic Association Kwong, E. and T. Findley 2014. “Fascia – 108(12):680-688. Current knowledge and future directions Chaudhry, H.R., R. Schleip, Z. Ji, B. Bukiet, in physiatry: Narrative review.” Journal M. Maney, and T.W. Findley 2008. “Three- of Rehabilitation Research and Development Dimensional Mathematical Model for the 51(6): 875-884. Available at www.rehab. Deformation of Human Fasciae in Manual research.va.gov/jour/2014/516/pdf/JRRD- Therapy.” The Journal of the American 2013-10-0220.pdf. Osteopathic Association 108 (8):379-390. Langevin, H.M., P. Keely, J. Mao, L.M. Chaudhry, H., C. Huang, R. Schleip, Hodge, R. Schleip, G. Deng, B. Hinz, M.A. Z. Ji, B. Bukiet, and T. Findley 2007. Swartz, B.A. de Valois, S. Zick, and T.W. “Viscoelastic Behavior of Human Fasciae Findley 2016. “Connecting (T)issues: How Under Extension in Manual Therapy.” Research in Fascia Biology Can Impact Journal of Bodywork and Movement Therapies Integrative Oncology.” Cancer Research Oct. 11(2):159-167. 11, 2016. Findley, T. 2016. “The Fascial Organ.” In Roman, M., H. Chaudhry, B. Bukiet, A. Stecco, M. Hutson and A. Ward’s Oxford Textbook and T. Findley 2013 Aug. “Mathematical of Musculoskeletal Medicine, 2nd Ed. Oxford: Analysis of Flow of Hyaluronan around Oxford University Press. Fascia in Rolfing, Massage and Fascial Manipulation Techniques.” The Journal of the Findley, T. 2015. “Link Between Manual American Osteopathic Association 113(8):600- Therapy, Movement, Fascia, & Cancer.” 610. Available at https://scholar.google.com/ Keynote speech, Joint Conference: scholar?q=Mathematical+Analysis+of+Flo Acupuncture, Oncology, and Fascia. w+of+Hyaluronan+around+Fascia+in+Rol Available to view at www.youtube.com/ fing,+Massage+and+Fascial+Manipulation watch?v=TPCuHQ9Vbw4&feature=you +Techniques&hl=en&as_sdt=0&as_vis=1& tu.be. oi=scholart&sa=X&ved=0ahUKEwj2j-TN- Findley, T., H. Chaudhry, and S. Dhar 2015. urPAhXqylQKHXFTCGIQgQMIHDAA. “Transmission of muscle force to fascia during Sanjana, F., H. Chaudhry, and T. exercise.” Journal of Bodywork and Movement Findley 2016. “Effect of Melt Method on Therapies 19(1): 119-123. Available at Thoracolumbar Connective Tissue: The Full www.researchgate.net/profile/Thomas_ Study.” Journal of Bodywork and Movement Findley/publication/265338970_ Therapies Jun 2, 2016. Transmission_of_muscle_force_ to_fascia_during_exercise/ links/569a333508aea14769482144.pdf Findley, T.W. and M. Shalwala 2013 Jul. “Fascia Research Congress Evidence from the 100 year perspective of Andrew Taylor Still.” Journal of Bodywork and Movement Therapies 17(3):356-364. Available at www.bodyworkmovementtherapies.com/ article/S1360-8592(13)00082-X/pdf. Findley, T., H. Chaudhry, A. Stecco, and M. Roman 2012. “Fascia research – a narrative review.” Journal of Bodywork and Movement Therapies 16(1):67-75. Findley, T.W. 2011. “Fascia research from clinician/scientist’s perspective.” (Editorial) International Journal of Therapeutic Massage and Bodywork 4(4):1-6.

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while, I realized that that wasn’t going to A Physician’s Perspective happen because Rolfing [SI] is a different paradigm. I finally got to the point where An Interview with Wiley Patterson I quit trying to get other people in other practice philosophies to approve of what By Linda Loggins, MPH, Certified Advanced Rolfer™, Rolf Movement® I was doing. Practitioner, and Wiley Patterson, MD, Certified Advanced Rolfer, Rolf Movement Practitioner LL: How then do you describe yourself and what you do to prospective clients? Introduction by Linda Loggins: Through WP: Most of my new clients are well- mutual colleagues from Texas, I met Wiley informed about me and about Rolfing [SI] Patterson in Boulder in the 1990s. Wiley and I when they contact me because someone have interacted at regional meetings, structural whom they trust has told them “Rolfing integration workshops, and occasional social [SI] delivers the goods!” They have been gatherings. I consider him a friend and colleague. ‘pre-sold’, so to speak. For those clients Wiley graduated from Universidad Autónoma who aren’t as knowledgeable, I explain de Guadalajara medical school in December that Rolfing [SI] improves the function 1978. He went through his initial ten-session and order of their physical structure. I also ® series of Rolfing Structural Integration (SI) explain that I don’t expect them to truly in the summer of 1985, and graduated from understand what structural integration is ® the Rolf Institute of Structural Integration until they have received it in their physical in November 1992. Wiley did his Advanced bodies. I tell them the only risk to them is Training in the spring of 1999, and his Rolf the time and expense of a first session, but Movement Certification Training in Brazil in Wiley Patterson afterwards, they will be able to determine 2008. At the suggestion of Anne Hoff, Editor-in- if what they received was valuable to them. Chief, I sought out an opportunity to talk with My responsibility is to deliver a successful, Wiley for this issue of Structural Integration: authentic experience to them so that they ® The Journal of the Rolf Institute . What will be willing to continue exploring their follows is a recent interview I did with Wiley potential by receiving more of the work. to investigate his perspective on healthcare, and Rolfing SI, from the standpoint of a physician I had no idea what Rolfing [SI] was until and a Rolfer. I felt it in my own body – and neither did you – but when I experienced it, the Linda Loggins: How important do you conversation broadened enormously! think it is for Rolfers to have credibility in That’s why I quit trying to convince other the medical community, and what do you physicians of the validity of the work, think is the biggest obstacle in obtaining it? because unless they were willing to get up Wiley Patterson: I think it is minimally on a Rolfing table, and experience it for important for us to position ourselves themselves, there wasn’t any valid way for relative to the medical community. I think me to talk about it with them. that Rolfers are trained in a ‘healing’ Linda Loggins LL: Because they couldn’t quantify it? modality and the medical community is trained in a ‘treatment’ modality – bodywork is more mainstream and don’t WP: Exactly. They don’t have an x-ray plate I think the mindset of each group is feel threatened by it. They actually welcome to look at, or an intellectual file to put it in, extremely different. My experience with it and recognize it as being valuable. and all it does is confuse them. That’s what I most physicians is that they are not that think is the essential problem. Rolfers have interested in what we can do. It threatens LL: Do you feel that it is important for gotten better and better about describing the their self-perceived monopoly, and most Rolfers to connect with other healthcare work as enhancing presence, organization, physicians don’t understand healing well professionals in order to gain legitimacy, or and awareness in an individual, because at all. do you sense a reluctance to do so, because we’ve all experienced that for ourselves, of a lack of knowledge of what structural but for others who haven’t had the same LL: You certainly can speak on behalf integration is? experience, they don’t have anything of physicians – that is a very interesting objective to which to relate. Healthcare comment. WP: I think Rolfers gain legitimacy because of the power of Rolfing [SI] itself. People professionals can’t do it, prospective WP: In speaking with physicians over many who don’t understand the work can’t help clients can’t do it, and insurance companies years, most aren’t interested in Rolfing [SI]. to legitimize it. Those people who train to certainly can’t relate to it! They actually quit listening very quickly. become Rolfers understand what the work LL: You were already a physician when However, I’ve met a few who are interested, can do, and that is enough. I’ve certainly you made the decision to go through the either those who have a mentality that agonized in the past over whether my work training to become a Rolfer, weren’t you? allows for other possibilities, or those who as a Rolfer would be well-received and held have grown up in other countries where as legitimate by other people, but after a

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WP: Yes. The first time that I heard about and they believe that modality X will reimbursement, in order to save money for Rolfing [SI], it made sense to me. give it to them. If you deviate from their the insurance companies. Rolfing [SI] is a expectations, they aren’t going to want healing art, and the imposition of legislation LL: You must have already been thinking to work with you. A lot of it depends on is counter to what’s most important, which ‘outside the box’ as a physician, when you whether they can place their trust in you to is “What does this client need today?” heard about structural integration, or you deliver what they ask for upfront. wouldn’t have been receptive to the idea of LL: Let me now bring up the topic of the work, correct? Some of the people who come to me to “fix insurance companies. Most people when their shoulder” convert into Rolfing clients they graduate from Rolfing training and WP: That’s true. because I give them what they ask for, i.e., begin a Rolfing practice are faced with LL: How do you feel about the term I fix their shoulder, but do it in such a way the dilemma as to whether or not they ‘structural integration’ as opposed to that expands their awareness of the rest of will solicit payments from insurance ‘Rolfing’ [SI]? their structure. That becomes the starting companies for client sessions. How do you point for us to begin a discussion about feel about that? Speak about the advantages WP: I think ‘structural integration’ is a more Rolfing [SI] and what it might be able to do or disadvantages. accurate term to describe what the work for them. Conversely, I have patients who is about, but I still use the term ‘Rolfing’ WP: The temptation is to believe that you come to me for things like sore throats, who [SI] a lot. will get your practice established more aren’t receptive to alternative therapies, and quickly by ending up with more clients. LL: We both know the history of Rolfing only want antibiotics. If I try to offer them You may if you do it correctly, but you SI, in that Dr. Rolf first presented her something else, that is the quickest way to will have to work for less reimbursement work to the medical community, but ran lose them as a patient. per session, and you will have to allow into resistance. She ultimately decided to I use a technique called ‘motivational the insurance companies to dictate the change her focus and began to present her interviewing’ (Miller and Rollnick 1991) course of treatment. Most Rolfers with an work to those individuals who became the when I speak to patients/clients. Sometimes established practice deal with clients on a first Rolfers, who were outside the medical I’m able to expand their line of inquiry by direct-payment basis, which allows them establishment at that time. If I understand asking them what is it that they want, and to work in an autonomous fashion, which you correctly, you haven’t seen much then talk about all the things that they’ve is the most secure kind of practice to have. difference in the attitudes of physicians tried in the past to achieve that outcome, No one can take it away from you. If you from back then until now. whether or not their efforts were successful. depend upon word-of-mouth referrals WP: That’s exactly right. Physicians are I then talk about the possibilities or options from satisfied clients, no one unhappy sometimes interested to hear about the available to them, and determine to which client can take your practice away from theory behind the work, to get into an ones they are receptive. If bodywork is you. You sleep better at night! There is that intellectual discussion, but not much an option that they will consider, then we initial insecurity that comes with starting interested in exploring what it can do for pursue it. If not, then I drop the subject. out, when you wonder where clients will individuals. The same is true with my come from, but as your outcomes improve LL: Change of subject – what do you think efforts in presenting the work in more and you become established, you build a about recent efforts to limit a Rolfer’s scope mainstream settings, such as to patients network that will produce referrals and of practice through legislation proposed in my practice. If patients aren’t ready to help sustain the practice. by other healthcare professionals? You experience the work for themselves, they probably don’t feel threatened by alternative Personally, I don’t want to have anything don’t like it, nor do they want it. It speaks to therapies, unlike some of your medical to do with insurance companies! I would the heart of the doctor/patient relationship. colleagues; do you believe this to be a real end up losing more than I could possibly If a patient comes into my office expecting threat to others in the Rolfing community? gain at this stage of my Rolfing career pills, and I rub their arm, they get unhappy by accepting third-party payments. Not very quickly. Some patients are inherently WP: Any time anyone outside the Rolfing only that, but insurance reimbursement open to it, just because of their nature, community tries to tell Rolfers how to ends up affecting the practitioner/client but I believe that a large percentage of the practice, there are going to be problems. relationship. Time ends up being spent population doesn’t want to get [Rolfing Only Rolfers understand how to perform discussing copayments, upfront costs, sessions]. I think it’s a decision made on an the work. There is always bureaucratic etc. Clients end up focusing on the money unconscious level, that they somehow sense nonsense because people enjoy being aspect, rather than the desired outcome. that it isn’t right for them. powerful, and it needs to be addressed From a cost-effective standpoint, the cost periodically. I like the example of what LL: In terms of your patients/clients, do of extracting insurance payments can end happened here in Texas, that Rolfing [SI] most of the people you encounter in your up costing more than the reimbursement has been excluded from the massage laws practice come to you first as a physician, amount. My secretary can end up spending adopted by the state of Texas. It makes it and then experience you as a Rolfer, or four hours of work on one one-hour claim! easier for us to do our work, because no one vice versa? It can turn out to be a real nightmare. has the right to tell us what we do. Imagine WP: That’s an excellent question, and I if insurance companies began to tell us LL: As a physician, you are regulated in want to speak to it in terms of marketing what to do, just like they have done with your practice by the Texas Medical Board. strategies. People come to me expecting physicians – self-serving statistical analyses Do any of the rules that they dictate affect something in terms of a particular outcome, now dictate scope of treatment based on your practice as a Rolfer?

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WP: There are no restrictions in Texas that of continuing education for structural gain awareness, but it is a very formidable affect my ability to practice as a Rolfer. integrators. way to achieve it. However, there is a Rule 200 in the Texas WP: I think Rolfing [SI] is a phenomenal LL: Any last thoughts? Medical Board Rules and Regulations that modality. Ida Rolf was clearly a genius, speaks to alternative medical practices. WP: There’s no question that Rolfing [SI] and she has left a sizeable legacy to us. The rule states that patients have the right has made me a better physician. I learned There are similar parallels with osteopathic to seek treatment outside of established from my Rolfing training how to perceive, manipulative work. A.T. Still was also a medical protocols, such as when they turn and through the years in my practice, I’ve genius, and he left a sizeable legacy as to alternative therapies after conventional learned how to trust my intuition, how well. Both types of work take a lot of time medicine has not helped. Physicians to objectify what is real and free myself to master, and either one is worth a lifetime are also authorized to ‘step outside’ of from prejudices and preconceived biases. of study. Rolfing [SI] will survive as long normal protocols when treating patients, if I am still improving in my ability to see as there are individuals who dedicate deemed necessary. the original deviation from health and the themselves to understanding its power simplest way to help clients find their way LL: What kinds of changes have you seen and its scope. back to their best possible current level of in medicine since you began to practice as The study group that I organized helps health. a physician? give Texas Rolfers an opportunity to I’ve also noticed that among my highly WP: When I started practicing as a dialogue about our work, while enabling competent Rolfing colleagues, their level physician, there were no such things us to come together and foster community, of critical thinking is equal to most highly as MRI machines. There weren’t as which I believe is helpful. Rolfing [SI] competent physicians that I know, in many laboratory tests to order, either, can be a lonely profession. Study groups assessing a problem that they encounter. to help formulate the correct diagnosis can also provide continuing education in The work demands it of us. I’ve learned for a patient. Physicians had to be better an alternative format, besides three-day about anatomical functioning in a way diagnosticians, more ‘hands-on’ in terms of workshops and formal instruction. We have that most physicians don’t understand. I’m using physical examination to evaluate their had anatomy discussions over the past three surprised by how many conditions can be patients. Nowadays, although scientific years, as well as in-depth discussions on resolved from physical manipulation. It understanding has gotten much more Rolfing themes and concepts. The format has opened my eyes to the real causes of sophisticated in some areas, I see physicians has allowed veteran Rolfers of forty-plus illness. I consider myself very fortunate much more dependent on imaging studies years of experience to dialogue with brand- to have been able to carry on the legacy of and test results to help determine the new Rolfers just out of school. I cannot Dr. Rolf, and I will continue to disseminate correct diagnosis. There is also a broader over-estimate the value of what I have the knowledge of her work to those who pharmacopeia to prescribe from, so that personally received from the discussions. trust me with their health. more often than not, prescriptions are used On more than one occasion, the atmosphere to treat patients by suppressing symptoms – in the room was so profound that I could Wiley Patterson graduated from medical school which I think has become the primary goal, only express gratitude for what I was in 1978 and became a Rolfer in 1992. He enjoys rather than seeking to heal them. experiencing at that moment. I could have sailing, aikido and time with family and friends. never gained the insights that I’ve received Medicine is much more regulated by Linda Loggins is a medical technologist certified from the study group on my own, for the insurance companies and by government, by the American Society of Clinical Pathology synergy of the group was responsible for it. which I believe is a conflict of interest with a (ASCP) and a Board Certified Structural physician’s role as a healer. When insurance LL: Speaking of brand-new Rolfers, do you Integrator. She graduated from the Rolf Institute companies dictate the rights that patients have any advice for those just out of school, in 1993, became a Certified Advanced Rolfer have or don’t have, and dictate what is or those considering a career in Rolfing SI? in 2002, and completed her Rolf Movement appropriate behavior for a physician, you certification in 2006. She graduated with a WP: In order to master the work, I believe are talking about bureaucratic control master’s degree in public health in 2014. She that you must be very intentional in how where physicians will obey the ‘letter of walked the Komen Breast Cancer three-day you go about doing so. I don’t think that the law’, rather than the ‘spirit of the law’ sixty-mile walk for the third time this year. it happens by chance. Early on in my on which regulations are based. She especially enjoys being a grandmother career, I picked out people that I admired to a wonderful two-and-a-half-year-old boy Computerization will continue to because of the results that they were able named Trevor. change the practice of medicine in ways to achieve with their clients, and I sought inconceivable today. MRI machines, out opportunities to listen to them and try Bibliography improved demographic understanding to understand the perspective that each one through meta-analyses, and computer of them had toward Rolfing [SI]. Miller, R. and Rollnick, S. 1991. Motivational generated pharmaceutical designs are Interviewing. New York, NY: Guilford. For those people expressing an interest in current examples. becoming a Rolfer, all I do is encourage LL: What do you see as the future of Rolfing them. Even though it’s a very unusual SI? You have obviously been thinking about path to take, it leads those who follow it to investing in the future, for you have been self-fulfillment and awareness that most instrumental in setting up a monthly study people on this planet never achieve. It’s group in Austin, Texas for the purpose certainly not the only way for people to

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Dentists: Many clients have dental A Team Approach and/or oral situations that are limiting their ability to be well organized and By Jeffrey Burch, Certified Advanced Rolfer™ healthy in their bodies. I refer to several specialties including: general dentistry, Over the decades, I have developed an Chiropractors: This group has reported TMJ specialists, obstructive sleep apnea extensive referral network. Many of my that after their patients receive structural appliance specialists, orthodontists, clients can benefit from other services integration work from me, they are easier endodontists, and oral surgeons. in addition to what I can offer. Other to adjust and the adjustments are more practitioners have their areas of expertise likely to hold. I find that in some situations, Emergency Room or Urgent Care: Clients and often recognize that at any given time, if a chiropractor relieves pressure on a have arrived at my office with a range of their clients may need additional services, nerve in a client of mine, it is easier for conditions that warrant prompt medical including what I can provide. me to do my work. There is considerable attention including: injuries from a bicycle diversity of practice among chiropractors. crash on the way to my office, bones that I refer to some practitioners who also I refer to those whose work I know well, have been broken for several days, acute refer to me; there are others I refer to or who have stellar reputations in the appendicitis, dizziness and confusion that extensively who have never made a community. I often refer to upper cervical turned out to be a brain tumor(!), pleurisy, referral to me. I enjoy receiving referrals, specialists, and also to certain chiropractors urinary tract infections, and kidney stones. but referring my clients to others is never who are well trained in more methods in When in doubt about proceeding with dependent on reciprocity, it is all about the addition to high-velocity low-amplitude treatment, refer clients to an urgent care well-being of the client. After practicing (HVLA) thrust. facility or their primary care physician. Err in the same locality for decades, most of on the side of caution. my new clients now come from referrals Compounding Pharmacists: Pain and from former clients, with some from other sleep deprivation form an ugly feedback Functional Neurologists: These physician health-care providers – notably a few loop. Pain disturbs sleep, and disturbed specialists make detailed analyses of central MDs with alternative orientation. This sleep leads to bodily discomfort. Some nervous system function and provide referral network has developed organically clients with chronic pain have very clients with activities and exercises to over time. Some practitioners in the disturbed sleep patterns. As practitioners, wake up and connect parts of the brain network are ones I have seen for my own we want to organize their bodies so they that have been functioning suboptimally. health-care needs. Clients or colleagues can be more comfortable, but often an Functional neurologists have helped many recommended others. important stepping-stone toward healing clients with sensory integration challenges, is adequate nighttime pain control so they balance problems, learning difficulties, and Another local structural integrator (who is a can get adequate sleep. Some compounding much more. good friend) took many other practitioners pharmacists are well educated about to lunch to educate them about his work, Massage Therapists: Clients occasionally compounded topical analgesics. These are and to learn about their particular expertise. ask me for referrals to massage therapists, prescriptions where a mix of several non- He found this successful in building his and I am happy to refer them to people I opioid medications is put into a cream, practice. I have not done this, but would know who do quality work. thus able to be applied to painful areas. consider doing so if I were in a position to Significant pain reduction can be achieved Mental Health Professionals: Some clients build a new practice. with several advantages to the client. tell me about, or manifest, emotional When sharing information with other Because the medication is absorbed through challenges, either situational or long term. practitioners, I sometimes send along notes the skin, the blood concentration of the Some ask me for referrals to mental health with clients. Physicians regularly send me drugs remains low, so there is less potential professionals. For others, I gently work the radiology reports, and occasionally surgical for liver, kidney, and stomach damage topic into the conversation, and if they are reports. Fax transmissions are useful for compared to oral administration. Also, the receptive I offer referrals to professionals these exchanges, for rarely is there time addictive tendency of opioid medication is I trust and whose skills may match the for collaboration by phone. In all sharing avoided. While a physician’s prescription client’s needs. of client information, HIPPA regulations is necessary for these drug preparations, Naturopaths: Many naturopaths are skilled concerning confidentiality must be strictly the client having a discussion with a at diagnosing and treating pesky digestive- observed, and this largely excludes the use pharmacist well versed in topical analgesics system problems. Other naturopaths are of email. is sometimes a good starting place. skilled homeopaths. Most are able to Client needs which necessitate a referral Cranial Therapists – Pediatric/Neonatal: offer good nutritional counseling. Other to another practitioner may come to light I am trained in three different directions naturopaths develop skills in a wide at any time: when completing an intake of cranial manipulation, including range of specialties. I have gotten to know questionnaire, during the first session, training in pediatric and neonatal cranial the strengths of many naturopaths and during later sessions, at the end of a series manipulation. However, I get few newborns refer accordingly. of work, or any amount of time after our in my practice, so if I encounter a complex Obstetricians/Gynecologists: Some work is concluded. or difficult situation, I refer to other women tell me about reproductive system practitioners who work with babies on a In alphabetical order, here are some of the symptoms that should be looked at by daily basis. frequent referrals that I make: a doctor. Occasionally I see situations

www.rolf.org Structural Integration / December 2016 37 ROLFING SI AND HEALTHCARE working viscerally that lead my thinking in body to podiatrists. I am particularly prolotherapy (PRP), stem-cell therapy, and this direction. For example, a client came to enthusiastic about the work of Portland, other cutting-edge methods. If a client’s me with a mild foot injury, which had not Oregon podiatrist Ray McClanahan, joint or spine-related problem is not healed after two years. Exploring this, it was whose website is www.nwfootankle.com. resolving with my work, or if the symptoms discovered that she had a very large uterine He has a very insightful understanding are becoming more severe, I may refer the fibroid tumor lying on top of her iliac of the toes and the role they play in the client to selected sports medicine doctors vasculature on the side of the problematic structure and well-being of the whole whom I know to be ace diagnosticians. foot. If she lay supine, she promptly had person. I highly recommend visiting his One specific situation is where there is more foot pain. I had her lie in that position information-rich website. demonstrable ligament laxity that does and let the foot pain start. I then manually not resolve by loosening related fibrosities; Primary Care Physicians: Clients frequently shifted the fibroid off the vasculature and then I refer the client to a sports medicine mention health-care needs that should be the pain abated. She had been debating for doctor or other specialist to be evaluated addressed by a physician. This may be as some time whether to have a hysterectomy. for possible prolotherapy or PRP. simple as not having had a regular physical After this demonstration, she made the in several years, or can be a wide range of decision to have the hysterectomy. This Conclusion other health concerns. Sometimes I observe excision included an 800-gram fibroid. things and believe that a client would Once upon a time, long, long ago, when I When the pressure on the vasculature to benefit from getting medical advice, for was young and naïve, I had an idea that I her left leg was relieved, her foot healed. example, an asymmetrically shaped mole could learn everything. Since then, I have Optometrists: Clients sometimes arrive that appears to be increasing in size. In learned more about the dimensions of a with very out-of-date vision prescriptions those situations, I strongly urge the client human lifetime. Just to learn everything for their eyeglasses, which are causing to seek medical attention. there is to know about structural integration them eye strain and often neck strain. has turned out to be more than a one- Sleep Doctors: Sleep disorders are I have particularly noticed that if the lifetime project. epidemic. It is estimated that one-third of astigmatic axes have shifted in a client’s the population meets full diagnostic criteria I am a member of the Pain Society of Oregon eyes, he may be holding his head in a for some kind of sleep disorder. Beyond and the Western Pain Society. In these richly tilted position to compensate for it. Other that third of the population, there are more multidisciplinary groups, we educate each clients need specialized eyeglasses for people who just don’t sleep well. I explore other at our monthly meetings and annual particular occupational situations. For sleep issues with all clients and, when conferences about both the outline and example, an optometrist explained to me useful, I educate them about sleep hygiene. leading edge of each of our practices. Thus why most computer users should not wear For more serious issues, I refer clients we can each recognize the signs of more progressive lenses while at the computer, to physicians trained in sleep disorders. kinds of issues and make appropriate but should instead have a dedicated pair Among sleep disorders, sleep disordered referrals. I encourage those working in of computer glasses. Progressive lenses breathing in its various forms [central other geographic regions to find or found provide a narrow band of vision useful at a apnea, obstructive apnea, and upper airway similar organizations. computer that requires the neck to be held resistance syndrome (UARS)] is common in in significant extension. I recommend to Jeffrey Burch was born in Eugene, Oregon the population as a whole and quite over- clients that they seek additional help from in 1949, and grew up there except for part represented in the client population with vision specialists if eyestrain or headaches of his teens in Munich, Germany. He was which I work, which is chronic-pain clients. are a problem for them. educated at the University of Oregon, Portland In the general population, the incidence of State University, and the University of Orthopedic Surgeons: Some clients have obstructive sleep apnea alone is estimated Pavia, Italy, earning bachelor’s degrees in arthritic changes in joints, which can benefit at 20% of the population. With sleep apnea biology and psychology and a master’s degree from surgical approaches. One indicator for in its various forms, the combination of in counseling. Jeffrey received his Rolfing an evaluation of this type is when our work frequent partial waking and critically certification in 1977 and his advanced Rolfing increases range of motion, but the joint pain low oxygenation during the night is quite certification in 1990. He trained extensively does not decrease or even increases. For the damaging to all tissues, and particularly in cranial manipulation with French etiopath hip joint, the FABER test is also an indicator to the nervous system. I specifically probe Alain Gehin, and in craniosacral therapy for an orthopedic exam. these issues with all clients, and it is a rare with the Upledger institute. Jeffrey trained to week during which I do not ferret out Physical Therapists: I have no specific the instructor level in visceral manipulation at least one case of sleep apnea. Usually training in therapeutic exercise or under Jean-Pierre Barral and his associates. He the client was either not aware of it, or stretching. Over the years, I have picked has made substantial innovations in visceral was discounting its importance. Proper up a little of this and can offer clients some manipulation particularly for the thorax. Jeffrey diagnosis and treatment of these disorders basic techniques. For any more challenging has also developed groundbreaking new joint- by a sleep doctor improves tissue health, or complex situations, I refer to selected mobilization techniques. He first practiced in which allows my work to be more effective. physical therapists whose work I trust. London, England, and later in Anchorage Sports Medicine Physicians: Physicians (Alaska), Seattle (Washington), and Honolulu Podiatrists: Podiatrists are licensed to specializing in sports medicine are good at (Hawaii) before returning to his native Oregon practice medicine in the foot, ankle, diagnosing musculoskeletal complaints, in 1989, where he continues to practice and to and lower leg up to the knee. I refer both axial and appendicular. They are teach continuing education courses. medical problems in this part of the often trained in prolotherapy, platelet-rich

38 Structural Integration / December 2016 www.rolf.org ROLFING SI AND HEALTHCARE ® With a maximum number of thirty people Rolfing SI as Part of Healthcare in the program at one time, we divide them into groups, depending on their 3H Rehab – A Residential Program for Rheumatic Patients limitations, pain level, age, surgeries, heart problems, and other associated illnesses. By Bibiana Badenes, Certified Advanced Rolfer, Rolf Movement® Practitioner We usually divide them into four groups so we can do individual and group work. The Introduction years to discover this. I began to explore treatments are held in the morning, from the evolution of the program with a Rolfing 8:30 am to 2:00 pm; the afternoon consists Twenty years ago I became a Rolfer. vision. The result became the 3H Rehab of more education and fun activities, such Rolfing Structural Integration (SI) training program: Hands, Head, Heart. as flamenco or cooking clases! (We have changed my way of looking at a person, a the priviledge of living in a region of great Rolfing education changed my client, a patient – seeing the whole person gastronomy and cultural activities.) not just the parts, and also understanding understanding of how to work with the relationship of the parts. This also individual clients. This was how I really How the Program Evolved led me to a new sense of myself and wanted to work. Rather than focusing on To evolve and design the program, I has been extremely important in my the patient’s symptoms, part of our goal was asked myself many questions: How to life. Consequently, a transformation also to engage the patient in understanding his/ discover, even with limitations, that health happened in my work. Looking back I see her physical condition and learning all that is possible? How can we teach prevention clearly now that many of the things that I was possible about that condition. This goal and maintenance? (I begin to understand have accomplished would have not been became the core of my approach to organize that many of the things that we do as possible without it. a multidisciplinary team. Rolfing practitioners could really be applied In 1998 I was invited to run part of the Who We Are and What We Do to the patient’s needs.) How does one physiotherapy program for a Swedish change the system while still in the system? The healthcare team now consists of three to organization in Spain. The program, located How do we get results and be economically five additional physical therapists (trained in in a non-hospital environment, was to feasible? How could I do something that myofascial release and postural alignment, provide rehabilitation for Swedish patients I would be satisfied with using a holistic aquatic exercises, and relaxation), one with rheumatic conditions. For adults, a approach? – that one put a great deal of massage therapist, a Pilates and tai chi four-week residential program, and for pressure on me, and I could not change instructor, a nurse, an ergonomic therapist, children, a three-week program were offered everything as it was necessary to do before- a physician, other support movement in my hometown of Benicassim, Spain, and-after assessments and evaluations. practitioners like 5Rhythms™, and myself. located along the Mediterranean Sea. For me When I studied Rolfing SI, we were told it was a dream come true. We would have The physician assesses the health condition we should not work on rheumatic patients: one group of patients for one month! I could of each patient at the beginning (I am with that we should not work deeply on them. do anything that I wanted incorporating him) and end of the program. We use a Initially I kept that in mind when they movement and manual therapy. pain analogic scale; joint measurements told me to run the program. I was afraid are taken; and spinal measurements One of my first tasks was to research to work with them in the way I worked are recorded for those presenting with programs done in other places. I had with my clients as a Rolfer – I probably ankylosing spondylitis. The patients worked as a physiotherapist in the Centre did not know what ‘deep’ really meant and complete a questionnaire regarding their Termalismo in Benicassim, and I checked confused ‘deep’ and ‘hard’ as I see many pain scale, joint mobility, and morning out other cities in Spain – Ternerife and MFR practitioners still do. Over the years, stiffness at the start of each day and at the Malaga – where similar programs were I have come to realize that you can go really end of the program. This helps the doctors being offered. In the first year we did deep without damaging tissues. evaluate their progress and guides the movement exercises, such as streching, treatments they are given. general active movement for joints, Education and Prevention massage, and hydrotherapy, and I did small Patients receive daily treatments at four When working with rheumatism, we went myofascial interventions. At this point I did stations including: 1) hydrotherapy; back and forth between the symptoms not use Rolfing SI per se; I was cautious as I 2) movement exercises, body awareness and working with and understanding did not wish to damage their tissues. exercises, kinesiotherapy (therapeutic active prevention – gaining an understanding of and passive movements); 3) massage and When I started the program, I created a what is the potential of each person. When myofascial release (MFR); 4) ergotherapy conventional physiotherapy program; but patients are not in an acute phase of the (beause the hands of rheumatic patients through the years, I came to realize that illness, it is possible to work on prevention are adversely affected, this work helps to working only with symptoms was not and education. This is different from a restore and improve hand function). Some enough. The residential program gave us hospital program, where the work is with treatments are provided in groups and the opportunity to provide clients with acute symptoms. others are given individually. The activities more education and self-care. However, Through the years I have realized that depend on the needs of each person; there there was still something in me that was although we must deal with the presenting is not a single standard program provided not satisfied. I was not working as in my symptoms, what is most important is to for all participants. training as a Rolfer, and it took me a few emphasize education when the person is

www.rolf.org Structural Integration / December 2016 39 ROLFING SI AND HEALTHCARE not in an acute crisis. Our patients improve Other Therapies Offered of skin infections (fungal, psoriasis, viral). vastly when we integrate a more mindful So we have to be very careful with our touch approach. We achieve our best results Hydrotherapy and land exercises are and manipulations. working with prevention, noting where included, starting with mobility exercises the compensations occur and where we and progressing slowly into cardiovascular The Art of 3H and resistance exercises. Integral Aquatic anticipate the next problem area. Taking It is an art to work with the patients – Therapy works with the fascial and joint care of oneself is not just taking medicine or discovering what kind of touch one can restrictions of the client within the lower- doing exercises. Self-care with rheumatoid apply. Movement education and body gravity environment of a heated swimming arthritis is about understanding yourself awareness are important aspects of the pool. In this method, the client is supported as a person. exercise therapy so patients can adequately by the water and held by the therapist’s adapt and maintain new movement and I believe it is extremely important that all arms and some floats while being moved alignment patterns. Patients can change therapy is delivered to the individual needs in ways that are not easily accessible on a the way they perceive and understand of each patient. Often these patients have table. This work achieves fascial release and their bodies through movement awareness, other health complications that need to be activation of the parasympathetic nervous allowing them the potential of further addressed or taken into consideration with system. Since the patients have so many progress when they go home. a complementary health professional. I limitations, water is a key point within started to incorporate the Rolfing vision into the program. Many patients have afflictions or deformities the program since many problems I saw of their feet and easily lose proprioception, We also do kinesiotherapy (movement in were related to the person’s structure – the so work to recover the body schema is general outside of water) and ergotherapy. uneven distribution of stress in the body – very important. We teach patients foot Not much time is spent on bicycles or gym and not only to the rheumatism itself. Thus, exercises that will lead to a greater sense exercises as these are activities that can I adapted the Rolfing principles to work of connection to the way they walk. We be done at home. Howver, a great deal of with rheumatoid arthritis clients. give them tools that they can use at home, attention is paid to the hands since this such as tennis balls or balls of different The sessions use SI strategies to accomplish affects almost everyone. We ask questions sizes to help them regain proprioception the goals of balance and alignment. like: What are the hands? What do they and mobilization. Tai chi is also offered The work is not based on a ten-session mean in context? Hands are our way of to provide structural support as well as model; rather it is based on SI’s unique expressing. Deformity in the hands affects spatial, emotional, and mental adaptability. understanding of the human body and the way one moves, and sooner or later Education also includes daily care routines structure. The clients receive twenty-five- a problem will develop in the shoulder, for different body parts according to the minute hands-on treatment sessions, two or a limp, or a stiff back will come from patient’s needs. to three times per week. For example, in not having controlled balance. While manual therapy I position the tissue in the medical system attributes many of We want to support and educate each a way to challenge the joint and tissue the symptoms of rheumatoid patients person to live in his or her own body. restrictions while applying gentle and firm to their rheumatism, my experience and Rheumatioid patients become oriented pressure. I listen to the body and wait for observation is that many of them relate to around pain. When they are fine, they the person´s nervous system to respond compensations developed over the years. are not really enjoying their bodies. We so that motion restrictions are diffused as Discovering those compensations helps to want to give the message, “Come back the client’s awareness grows. I listen to the work with symptom prevention. to the body. Come back to your own tissues, listen to the nervous system. perception. Come back and feel you Most of the patients are emotionally or are alive. “ Understanding Rolfing principles of psychologically affected by their illness. connective-tissue work and working the With the loss of the ability to express with The structure of the 3H Rehab program body from the sleeve to the core made us the hands and the capacity to move with offers rheumatoid arthritis patients time focus on the feet and hands due to their ease, life becomes very limiting – especially to recognize – and learn to respect – their sensory potency, functional importance since they live in a country where the capabilities based on their condition in daily activities, and continuity with winters are cold with snow and ice. Because on any given day, neither forcing an the core of the body. This is so important rheumatic clients tend to have emotional unrealistic expectation of performance nor for rheumatic patients. We use MFR as a up and downs, they are inclined to isolate being hindered by physical limitations complement to Rolfing SI, particularly as socially as well. of the previous day. In my opinion, this preparatory work: softening the tissue and acknowledgment and acceptance of being Many patients receive cortisone shots and creating body awareness. When possible, I in the present is very important for fascial many are under heavy medication, so the work using Rolfing strategies for the patient release and their well-being. to have a better relationship in gravity. tissues are very much affected. The most We also use Swedish massage, lymphatic significant side effect of cortisone use is Inspiration drainage, and other massage techniques. atrophy (thinning) of the skin, making it extremely fragile. When used over How do we get the patients involved in All the team of physiotherapists have being their own process? How can they become trained by me in MFR. The principles and large areas, cortisone is absorbed into the body and causes bone demineralization engaged? As practitioners we know that vision of Rolfing SI complement the other this is an art. We know that we can start therapies offered in the 3H Rehab program. (osteoporosis). Further, with their immune system suppressed, patients see a worsening the process of changing them. We have to

40 Structural Integration / December 2016 www.rolf.org ROLFING SI AND HEALTHCARE be an inspiration. That became my goal: to nutrition and rest; they need to recognize Our thoughts, our emotions, our postures, be an inspiration. when a joint is inflammed, and massage the and our movements are the history of our child daily and do mobilization exercises. lives, and they take a toll over the years. Because rheumatoid arthritis is a chronic How they work with their child and teach The model of 3H Rehab is not just a holiday disease, without inspiration they will their child daily to care for him/herself program: it is the beginning of a new tend to not do anything, to view their will improve the child’s future. If they outlook towards health, well-being, and time with us as a holiday with good food, simply drop off their child every day for a mindfulness. good climate, and good company. But if physiotherapy treatment, there is no follow- we give them too much information, they Bibiana Badenes is a physical therapist through care and it becomes expensive may feel overwhelmed, that they have to (graduated from the University of Valencia and not as effective. When we involve and change their whole life. My team must be in 1988) and a Certified Advanced Rolfer work with parents, we really see progress an inspiration for our patients to get them and Rolf Movement Practitioner. She directs in their children. involved with the process of recuperation. Kinesis Center for Physical Therapy and We co-create a team, patients and therapists. Summary Harmony through Movement (www.kinesis.es) I tell the patients that we are not working and works with a wide variety of patients and on them, I do not work on them or do Many of the characteristic symptoms of different conditions, from athletes to children only a physical intervention, it has to be a rheumatoid patients are very difficult to the elderly. She developed one of the most collaboration. This is sometimes difficult to treat. Because it is a chronic systemic comprehensive residential treatment programs because many of them are not ready for disease, it is not something you have but available in the world today for rheumatoid that. So this is something we have to then it goes away. It is always there. Yet arthritis, where she has worked with more than encourage as a team. It’s very important that working with symptoms is not enough. 2,000 patients. Her website is http://www. the whole team understands this concept. What I have learned through these eighteen bibianabadenes.com. years is that I am really interested in the All the treatment programs I have seen whole person. By creating a better order At the leading edge of body-mind treatments in hospitals or in centers look the same: through our work, our clients have a and education in southern Europe, Bibiana is exercise, pools, and massages. Yet there is a different awareness of their bodies and thus co-creator of the innovative Terapia Integral key ingredient for success: awareness. It has functional movement and daily movement Acuatic as well as Myofascial Release Trainings, been so important that we as practitioners options can improve. It really makes and teaches both internationally. For more than understand what awareness means. We a difference. a decade she has collaborated with Spanish want the patients to live in their bodies. This and Swedish businesses to offer a range of is something that is missing many times in Through my experience, I have learned powerful rehabilitative seminars in the area rheumatism treatment. that the principles of SI can be developed, of stress management, burnout, and personal modified, and continually evolved empowerment. A pioneer in building bridges of The question to our patients is, “Aside from for different structural dysfunctions contact among distinct therapeutic disciplines, the fact that you are an ‘ill’ person, can including rheumatic disorders. SI can be she created the Bodywisdom Spain conference you be healthier while being ill?” When used effectively within a team of other to promote inter-disciplinary dialogue through a person is ill and in an atmosphere of health professionals to provide life-giving health that is accessible to everyone. illness, he becomes more ill. So working opportunities for patients of different ages in a non-hospital environment is also a with rheumatism. SI is a powerful method key point, in my opinion, to bring out the to implement in more holistic programs, best in the patients. Our location helps. and a structural integrator is well-prepared The clients stay in hotels with the sea to coordinate such programs: he has the and mountains surrounding them. Then ability not only to see, work holistically, in this environment we work to nurture and create better structure and a more awareness. We want to give the rheumatic functional body; he also has an orientation patient the possibility to choose what kind of engaging and educating patients in of movement they need, what kind of self-care, which can help patients prevent manual therapy they need, and what kind future problems so they can enjoy a higher of enjoyment they want. They can only get quality of life. this understanding through awareness. While my particular program is with Special Work with Children rheumatic patients, I believe this kind of understanding can be applied to Once a year, we have a group of children. any program for well-being: for back- Working with them is a very different pain disorders, personal growth, and experience because we are working with preventative programs for children at the children and their parents. We do school. As practitioners, we have the goal the same four stations, and we bring the of discovering the potential in our clients parents to each of the stations. We need the and patients, finding a way to create vitality, parents to understand why we emphasize equilibrium, and well-being. I have no a particular treatment/exercise so they help doubt that prevention is the best medicine or encourage their child to do it. Parents if we carry it out in a way that we enjoy. have to learn about the disease, about

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possibility of doing the same in our chosen Putting the ‘Health’ field of endeavor, the realm of healthcare. Integrative Medicine – Back into Healthcare More Than the Sum of Its Parts By Linda Loggins, MPH, Certified Advanced Rolfer™, Rolf Movement® Practitioner The term integrative medicine is often used to refer to “blending the best of conventional So many therapists are striking at believe it illustrates what is lacking in much (allopathic) and complementary and the pattern of disease, instead of of what passes for healthcare in this country. alternative medicine (CAM)” (Bell et al. supporting the pattern of health. One day, around 4:00 pm, I was sent to 2002). Combining the two systems seems One of the things that you as Rolfers obtain a blood specimen on a middle-aged like a good idea, one that seems to promise must always emphasize is that you female patient. The test to be performed an improved package of medical care for the are not practitioners curing disease; was a two-hour postprandial glucose level consumer (Bell et al. 2002). The challenges you are practitioners invoking to check if the patient’s blood sugar had to achieving this are a number of complex health. Invocation is possible by an ‘spiked’ after eating lunch (this test is a practical and conceptual issues within the understanding of what the pattern is, good way to gauge if a diabetic’s insulin or field of medicine. Bell et al. (2002) suggest the structural pattern of health. As oral medication is controlling the glucose that by adopting a worldview from complex you bring a man’s structure to conform level in the blood over time, by preventing systems theory, in which the whole equals to that pattern of health, you achieve marked fluctuations after eating). Much more than the sum of its parts, a new health. You invoke health. to my surprise, when I walked into the perspective for medicine and healthcare patient’s room, she was sitting up in bed, research emerges. Does this concept sound Dr. Ida P. Rolf eating a candy bar! I thought to myself, familiar, Rolfers? “Well, so much for the test results! This Within the field of mainstream medicine, won’t be able to measure anything that her Health is a state of complete physical, if you were to present this idea to most doctor wants to know.” mental and social well-being, and practitioners, the assumption implicit not merely the absence of disease or I introduced myself and explained the in ‘merging’ mainstream and CAM infirmity. purpose of my visit. She made a totally approaches is that the politically dominant unsolicited comment that she was in the ‘larger unit’ (conventional medicine in the Constitution of the hospital because her blood sugar was Western world) carries the values, culture, World Health Organization “messed up” again. She just wanted her and conceptual framework into which it (WHO) doctor to fix whatever was wrong so that expects the ‘smaller unit’ (i.e., CAM) to she could keep eating her candy! At that assimilate (Bell et al. 2002). It assumes that point, I couldn’t decide whether I was more “each CAM intervention, once tested and Health care – a set of actions by a person frustrated with this patient, because she proven effective, can be incorporated into or persons to maintain or improve the seemed to have no clue as to the long-term conventional care as now practiced” (Bell health of a patient/customer. consequences of uncontrolled diabetes, or et al. 2002). Healthcare – a system, industry, or field her doctor, who was obviously enabling Unfortunately, much of the conventional that facilitates the logistics and delivery the patient to continue behaviors that practice of physicians, especially for the of health care for patients/consumers. were injurious to her health. I remember treatment of patients with chronic diseases, thinking afterwards that there must be a focuses on a specific disease process, rather Deane Waldman, M.D., M.B.A. better way. From that day on I began to than on healing the individual person ‘look outside the box’ that is traditional (Bell et al. 2002). Dissatisfaction with how medicine, and search for alternatives that physicians provide conventional care and Years ago, when I first began my career as might be better able to support people in rely on pharmaceutical medicine continues a healthcare professional, I was working as staying healthy, rather than simply treating to grow among consumers and physicians a medical technologist at a small hospital disease. Eventually, I found out about alike (Bell et al. 2002). Integrative medicine in the Dallas-Fort Worth area. I was Rolfing® Structural Integration. responsible for performing laboratory emphasizes the goals of wellness and testing as well as collecting blood specimens Everyday, we speak to our clients about the healing of the whole person, with the from patients by phlebotomy. I had the benefits of Rolfing SI and how it has changed patient and the integrative practitioner as naïve belief that all people who worked not just our physical bodies, but also how partners in developing and implementing in healthcare were doing so because they we view ourselves and the world around us. a comprehensive treatment plan. Healing wanted to help people regain their health. Each of us has stories about people being is believed to originate within the patient Needless to say, I think it took about six transformed by structural integration, and rather than from the physician (Bell et months for my ‘eyes to be opened’, and I we are grateful at being able to continue al. 2002). The philosophy of integrative realized the fallacy of my belief. the legacy of Dr. Rolf into the future. As we medicine is compatible with the WHO continue to contribute toward establishing definition of health that equates health with One encounter with a patient has stood out integration and wholeness in the lives of well-being (Bell et al. 2002). Again, I ask, among my memories from that job, and I our clients, we should also consider the does this sound familiar?

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The problems that the systems of CAM Conventional medicine, on the other hand, process in the body? What outcomes that emphasize healing the person has confined itself largely to the belief that matter to the individual patient, and what as a whole (e.g., traditional Chinese the physical manifestations are the disease differential weight do other stakeholders medicine, Ayurvedic medicine, and classic and the primary domain for medical such as physicians, third-party payers, homeopathy) encounter with Western intervention. Differences between the views or hospital administrators place on the science are that 1) no commonly used, of conventional medicine, various CAM outcomes that the patient desires? Who scientific methods are easily applied to systems, and integrative medicine on the chooses the outcome goals in the end, them for study; 2) there are no obvious nature of disease can lead to divergent and how do researchers measure success? ways to incorporate them into conventional treatment plans and even to different goals Implicit in the worldview of integrative practice; and 3) there is no Western for healing. medicine, consistent with the patient- conceptual framework into which they fit centered approach to healthcare, is the (Bell et al. 2002). Because of this, clinicians Identifying and Weighing belief that the patient is the most important and researchers often break off parts of Health Outcomes stakeholder and that the rest of the system these CAM systems from their original There is limited data to support the healing- must give higher priority to the patient’s context and fit these smaller pieces into oriented integrative medical approach as needs and values than it does now within the dominant model of conventional care having an advantage over other medical conventional care (Bell et al. 2002). and medical research (Bell et al. 2002). worldviews. The classic view of the quality As an example, acupuncture has been Conclusions of healthcare can generally be divided into and Implications studied for its efficacy with various Western three components: 1) structure (providers’ disorders, but traditionally, Chinese competency, equipment, etc.); 2) process Integrative medicine is a system of care that medicine uses a program of diet, botanicals, (what was done? how well?); and 3) considers health (or disease) as an emergent acupuncture, qi gong, acupressure and outcome (the results of the intervention). property of the person in an environmental environmental interventions to address context, conceptualized as an intact, systemic disturbance patterns in a given Structure indivisible dynamic system. Integrative patient. In acupuncture-only research, Clinical research generally sets randomized medicine is a complex dynamic, higher- the effect sizes are often modest, and it is controlled trials as the gold standard. It order system of systems, conventional and reasonable to hypothesize that the effect is possible to establish strong causality CAM (Bell et al. 2002). sizes of the full treatment program would through enhancing internal validity, but be more clinically significant if studied as In the twenty-five years since Engel it does not allow for generalizability, used in practice (Bell et al. 2002). published his seminal article on the which is especially challenging with CAM biopsychosocial model for medicine, a and integrative medicine research where Western thought has a predisposition few theoreticians have tried to point out practices are so diverse and practitioner toward pragmatism. Conventional the relevance of dynamic systems theory, competency is far from being well defined. medicine supports the belief that only chaos theory, and complexity theory for outcome results that are persuasive enough Process conventional medicine, psychology, and will constitute acceptable evidence and will CAM. However, medicine as a field has only support one health policy over another Problems arise from two sources of potential not yet incorporated these ideas on a wide when justified by those results. Worldviews biases and limitations: 1) who would do the scale. It is the challenge of health outcomes and the values placed on different health final evaluation? – complementary and research to prove or disprove the relevance outcomes are closely related. The values alternative medicine practitioners who are of this integrative, systemic worldview that underlie medical care shape the not stakeholders but who are well skilled to the field of medicine and to test the scientific questions that researchers ask, the in the scientific method are hard to find; feasibility of its emergence as a practical health outcomes they measure, and their and 2) the criteria and measures used and desirable way to provide clinical care interpretation of the results. (i.e., allopathic or alternative). These two (Bell et al. 2002). practical problems of integrative research In contrast to conventional medicine, are especially challenging partially because Where Do We Go from Here? many different systems of CAM share the conventional and CAM providers often belief that a given disease may manifest Rolfers pride themselves on constantly speak ‘different languages’ and value at the spiritual level as well as on the challenging the norm, whether in society different outcomes. physical plane. Integrative medicine or within themselves. We must act proposes that the origins of disease are Outcome as responsible members of a healing multifactorial more than hierarchical, profession to adapt to societal trends and Should the primary goal of a physician and include genetic, physical, emotional, take up the role of being prime movers, be solely to eliminate disease, or should it psychological, and spiritual issues (Bell et rather than reactionaries to changes in also be to optimize well-being? According al. 2002). An integrative medicine approach healthcare. To do so will require moving to Arnold S. Relman, M.D., “Medicine seeks to discern multiple perceived origins out of our individual ‘comfort zones’ cannot be expected to make unhappy of a disease process and addresses them and being willing to assimilate into more people happy, or frightened people calm” all. Integrative medicine assumes that the conventional realms so as to increase our (Relman and Weil 1999). Is it a proper role individual has the potential for healing input, and thereby facilitate change in for a physician to assist a patient toward at the spiritual level, even when physical a more integrative process-driven way. growing in inner peace and spiritual well- healing does not take place. Dr. Rolf challenged the established norms being, in addition to subduing the disease of her time, and we can do no less than to

www.rolf.org Structural Integration / December 2016 43 ROLFING SI AND HEALTHCARE tackle established resistance and assist the Endnote apparent transformative process currently going on in medicine. 1. Research gathered by Dan Buettner for National Geographic identified longevity We can give money to fund the efforts of hotspots around the world (Blue Zones) the Rolf Institute® Research Committee where people lived longer with an excellent In Memoriam and stay informed. We can reach out quality of life. Nine principles or practices, Structural Integration: The Journal of to other healthcare practitioners in our the Power 9, were common to some or all the Rolf Institute® notes the passing communities, whether by beginning of the communities. Healthways, Inc. is of the following member of our to dialogue as colleagues, by making a company that adopts towns or cities as community: referrals, or engaging in a more formal Blue Zones Projects in order to facilitate the Evelyn Lehner, Certified Rolfer™ way by seeking to combine our practices communities adopting healthier lifestyles with healthcare facilities. Each one of us by transforming the environment in which has particular gifts that will help increase people live. awareness within the communities in which we live. I am currently involved with the Bibliography ® Blue Zones Project , which is helping Bell, I.R., O. Caspi, G.E.R. Schwartz, K.L. transform communities across the US into Grant, T.W. Gaudet, D. Rychener, V. Maizes, areas where the healthy choice is the easy and A. Weil 2002. “Integrative Medicine and choice, and people live longer with a higher Systemic Outcomes Research.” Archives of 1 quality of life. Internal Medicine 162(2):133-140. Healthcare has changed dramatically Feitis, R. (Ed.) 1978. Ida Rolf Talks About since I first began my professional career Rolfing and Physical Reality. New York, NY: (Affordable Care Act, anyone?), and I Harper & Row. am excited to see what the next ten years will bring. I believe in what Rolfing SI Relman, A.S. and A. Weil. “Is Integrative can bring into the lives of individuals, medicine the medicine of the future?” and I plan on devoting any future efforts A debate presented at the University of toward impacting the population of my Arizona; April 9, 1999; Tucson, AZ. community as well. Dr. Rolf once said that presenting the concept of Rolfing SI required “compound essence of time . . . to really understand a Rolfer’s function in the community, you need to understand people’s difficulties and why they are resisting the ideas of Rolfing [SI]” (Feitis 1978). I truly believe the time has come for us to seize the opportunity and act, as the resistance against integrative medicine is shifting in a favorable way. Linda Loggins is a medical technologist certified by the American Society of Clinical Pathology (ASCP) and a Board Certified Structural Integrator. She graduated from the Rolf Institute in 1993, became a Certified Advanced Rolfer in 2002, and completed her Rolf Movement certification in 2006. She graduated with a master’s degree in public health in 2014. She walked the Komen Breast Cancer three-day sixty-mile walk for the third time this year. She especially enjoys being a grandmother to a wonderful two-and-a-half-year-old boy named Trevor.

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OFFICERS & THE ROLF INSTITUTE® AUSTRALIAN GROUP BOARD OF DIRECTORS 5055 Chaparral Ct., Ste. 103 The Rolf Institute Boulder, CO 80301 5055 Chaparral Ct., Ste. 103 Richard Ennis (At-large/Chairperson) (303) 449-5903 Boulder, CO 80301 [email protected] (303) 449-5978 fax USA www.rolf.org (303) 449-5903 Amy Iadarola (Western USA/Secretary) [email protected] (303) 449-5978 fax [email protected] www.rolfing.org.au Linda Grace (At-large/Treasurer) [email protected] [email protected] ROLF INSTITUTE STAFF [email protected] Christina Howe, Executive Director Ellen Freed (Faculty) Anne Clifton, Director of Financial Aid [email protected] Colette Cole, Director of Membership BRAZILIAN ROLFING® Les Kertay (Central USA) & Placement Services ASSOCIATION [email protected] Mary Contreras, Director of Admissions Dayane Paschoal, Administrator & Recruitment R. Cel. Arthur de Godoy, 83 Larry Koliha (Faculty) Pat Heckmann, Director of Faculty Vila Mariana [email protected] & Student Services 04018-050-São Paulo-SP Jaslee Lord-Burgardt, Office Manager Ron McComb (Eastern USA) Brazil Susan Winter, Director of Communications [email protected] +55-11-5574-5827 & Education Systems +55-11-5539-8075 fax Hubert Ritter (Europe) TBA, Clinic Coordinator www.rolfing.com.br [email protected] [email protected] Keiji Takada (International/CID) [email protected] EUROPEAN ROLFING ASSOCIATION E.V. EXECUTIVE COMMITTEE Laura Schecker, Executive Director Rich Ennis Saarstrasse 5 Amy Iadarola 80797 Munchen Linda Grace Germany +49-89 54 37 09 40 +49-89 54 37 09 42 fax EDUCATION EXECUTIVE www.rolfing.org [email protected] COMMITTEE Russell Stolzoff, Chair Carol Agneessens Tessy Brungardt JAPANESE ROLFING Ellen Freed ASSOCIATION Larry Koliha Yukiko Koakutsu, Foreign Liaison Meg Mauer Omotesando Plaza 5th Floor Adam Mentzel 5-17-2 Minami Aoyama Michael Murphy Minato-ku Tokyo, 107-0062 Japan www.rolfing.or.jp [email protected]

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