The Knowledge Iceberg

December 2, 2022

I first saw the iceberg image in a post by NOI  in their Neuroscience Nuggets series, a regular and witty bit of writing by Lorimer Moseley and/or David Butler. They are writing primarily for an audience of people who work with people in pain, namely Physical Therapists. However, their thoughts are also applicable to us in the Trager Approach.

In order to be able to take advantage of a learning moment with a client during a Trager session by presenting a nugget of applicable information (the tip of the iceberg), there needs to be a much larger base of knowledge (what is not visible below the surface of the ocean). One of the aims in Tragerology is to provide knowledge that contributes to the hidden part of the iceberg and assist you with sharing knowledge with clients or potential clients.

Here’s an example that comes up often with clients. Imagine a client returning from a wonderful vacation and saying “I was surprised that I didn’t have any pain while I was on vacation, and I noticed as soon as I returned home, the pain returned”. This is a statement that could be met on my part with “that’s an interesting observation” and be left at that. Or I could pass it off as the effect of relaxing while on vacation. Or I could ask the client what activities are different at home vs on vacation.

However, if as a teacher I would like to use this as a teaching moment, I could draw on the reservoir of knowledge which is in the hidden part of the iceberg.

What exactly might that sound like? Here’s one possibility. “That’s a great observation! What do you suppose is the reason?”

Depending on what they say you could add  “This is a good illustration of the biopsychosocial nature of pain. Most people think of pain as originating in tissues through information from nociceptors. Pain is really much more complex, and involves past experiences, emotions, thoughts, beliefs, cultural influences, etc.

If the client seems interested and on board with this, I might continue. "And in the end, pain is an output of the brain as it weighs all these factors and comes to the conclusion that you are in danger and in need protection. I’m guessing there aren’t many aspects of your vacation situation that create danger messages. Would you like to explore what some of those are in your daily life?” You could then refer the client to the Protectometer from NOI, or give them the framework from the Tragerology Nociception module so they can identify DIMs and SIMs on their own. They could then find ways to increase SIMs and decrease DIMs.

How does this land in you? Have you had experience applying some of the concepts from the two Tragerology modules (February and May 2021)  that  directly relate to pain? How did it go?  I’m curious to know if you felt the reservoir of your knowledge below the surface was satisfactory.

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