Issue link: https://www.massageandbodyworkdigital.com/i/1315831
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 91 WL: So, the people who said they expected to recover had the largest change in outcome? MB: Yes sir. That's a very general expectation. That has nothing to do with what we actually did. That [has] everything to do with what you think before you even get treatment. There are some great examples of context and expectations in the placebo literature with people in a hospital in pain, randomized to two groups. 4 One group has a health professional walk up in a white coat. The person in the bed can see the injection going into the IV bag. And you get a great response after the injection. When you give the same injection from behind the screen, so the person doesn't know when it's administered, in some drugs used for pain you actually eliminate the effectiveness. So, the effectiveness of that particular medication was all context. TL: That makes me think about practitioners whose focus may be general self-care, relaxation, and stress relief, rather than pain per se. Do you see any reason these effects wouldn't apply there as well? MB: They do apply. In fact, in exercise studies, expectation of benefit predicts performance improvement. Your ability to run faster is influenced by your confidence in the training program and your expectation that you will run faster. People with high expectations report lower exertion than people who don't expect it to help. It's that old adage about if your head's not in the game, you are not putting in the effort. So, as with exercise, if I go to see you expecting benefit in the forms of relaxation or stress relief, I will experience more relaxation and stress relief. In an upcoming excerpt of their conversation, Til and Whitney talk with Dr. Bishop about ways practitioners can put these ideas to use, about managing client expectations during a pandemic, and more. Thanks to Alexandra Hammer for superlative editing and improvements to the original transcription. Notes 1. Mark D. Bishop, PT, PhD, FAPTA, is a faculty member in the Department of Physical Therapy, with affiliations in the Center for Pain Research and Behavioral Health, and the Pain Research and Intervention Center of Excellence, at the University of Florida. 2. Mark D. Bishop et al., "Patient Expectations of Benefit from Interventions for Neck Pain and Resulting Influence on Outcomes," Journal of Orthopaedic and Sports Physical Therapy 43, no. 7 (July 2013): 457–65, https://doi.org/10.2519/jospt.2013.4492. 3. Mark D. Bishop et al., "Patient Expectations of Benefit from Interventions for Neck Pain and Resulting Influence on Outcomes." 4. Martina Amanzio et al., "Response Variability to Analgesics: A Role for Non-Specific Activation of Endogenous Opioids," Pain 90, no. 3 (February 2001): 205-15, https://doi. org/10.1016/s0304-3959(00)00486-3. Til Luchau is the author of the Advanced Myofascial Techniques books and training series, a Certified Advanced Rolfer, and a member of the Advanced-Trainings.com faculty, which offers online learning and in-person seminars throughout the United States and abroad. He and Whitney Lowe host the Thinking Practitioner Podcast. Luchau invites questions or comments via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His text and programs have been used by professionals and schools for almost 30 years. Learn more at academyofclinicalmassage.com. Learn More • Learn more about Mark Bishop, PT, PhD, FAPTA, and his work at https://pt.phhp.ufl.edu/about-us/faculty/mark-bishop. • Listen to Til Luchau and Whitney Lowe's entire conversation with Mark Bishop in Episode 23 of the Thinking Practitioner Podcast, sponsored by AMBP, at a-t.tv/ttp. THE SOMATIC EDGE SCAN AND WATCH "How Client Expectations Shape Results"