Whitney: Hi, I’m Whitney Lowe, and this Episode 2 of the Thinking Practitioner Podcast. We’ll be continuing the conversation the conversation Til Luchau and I started last time about our roots and influences. But first, Til’s going to tell us about today’s opening sponsor.
Til: This episode is sponsored by Handspring Publishing. When I was looking for a publisher for my book, I was lucky enough to have two offers: one from a giant international media subsidiary, and the other from Handspring, a small publisher in Scotland run by four lovely people. I’m glad I went with my gut and chose Handspring, as not only did they help me make the books I wanted to share, but their catalog has emerged as one of the leading collections of professional-level books written especially for bodyworkers, movement teachers, and all professionals who use movement or touch to help patients achieve wellness.
Handspring has done a great job of expanding offerings for the movement and manual therapy professions. Their author list reads like a who’s who for many of the leading thinkers in our fields. Head on over to their website at handspringpublishing.com and browse this excellent catalog. When you find the gems you must have, use the code “TTP” at checkout for a discount.
Whitney Lowe: So picking up on that history from where we’ve come from, we’re moving ourselves through that timeline, tell me what’s happening now in your practice, your life, in terms of your professional life. How do you break up the time? Because I know you’re doing a lot of things with teaching, and practice, and everything, how is that broken up now?
Til Luchau: Well, yeah, now these days, I have a small practice. I see a few clients, I really enjoy it, it helps me stay honest, it helps me use and play with the ideas that I’m working with. But I’m lucky enough to spend a lot of time learning, researching, digging into stuff, trying to find ways to express it or bring it back out into writing, or a course or something. So it’s really, I just feel so privileged to be able to follow my interests. They do still align along this body/mind direction. A few years ago, I had a big placebo and contextual effects kick where I was diving into that. The last year and a half or so has been about inflammation, and how we as hands on therapists can work with inflammation.
Til Luchau: And the next topic is still to emerge, but the candidates include things like motivation, change, what’s the impulse to change that people come to a manual therapist with, and how can we encourage that as manual therapists? That’s essentially the question. How do we continue the effects of what we do off the table? That’s puzzle. So I kind of just see myself diving into one of these questions as it emerges, and making it the focus of my work.
Til Luchau: I travel a lot. I travel once or twice a month, spend a month or two abroad each year to teach these things, and have a nice home life as well. Come back here to Boulder, where I still live with my wife, and we have a lot of open space around us and do a lot of hiking and relaxing here at home.
Whitney Lowe: It sounds like a wonderful balance.
Til Luchau: Pretty good, can’t complain.
Whitney Lowe: Right. Well you know, those things I think, are particularly interesting of how they bring us into the places where we were. Often times it’s unintentional, in terms of what takes us down these various different paths of a lot of things. I was doing quite a bit of clinical practice early on, but also teaching in massage school, and noticed that I was getting very interested in education, as I had noted earlier. Things really changed significantly for me when I started diving into the education question in a lot more depth, because I realized also at a point later on that while I was really passionate and fascinated in all kinds of things related to kinesiology and orthopedics and biomechanics, I was also really fascinated with education, and that’s become a dominant piece for me.
Whitney Lowe: Especially looking at things like how people learn, what are cognitive strategies that help people remember things? Because as a teacher in the classroom, I was getting frequently frustrated, and this has a lot to do with the context, too, which is, like you I was teaching a lot of weekend workshops from the mid to late 90s on into the 2000s, and a lot of the intensive process, come in and get a blistering amount of information over two days and then blow off and leave, and be gone. And I would try to convey things that were relatively complex topics, like clinical reasoning processes, how you figure out what’s going on with somebody’s pain and injury complaint. And that’s not easy stuff to transmit in a short period of time, and so for me I started really looking into the whole process of how people learn and how we get things, and recognize that there’s not a lot of emphasis in our field on educating educators, or teaching people about education, how that actually colors what we do.
Whitney Lowe: And so that became another real serious passion of mine, is looking at the educational process and how we learn things. Because it really seems to me to be at the root of how we transmit the future knowledge base to practitioners coming down the pipe, or how we’re helping people learn about these things that they need to learn. And there’s often an emphasis on trying to master or memorize a lot of information, like in entry level training for your licensure test, or for various different exams or certification programs there’s always a crush of information you’re trying to memorize. But how long does it really stick? That’s what I was really interested in. How is this going to translate into something that you can do with your client in a treatment room two and a half years from now, after this is all over?
Til Luchau: The key phrase I heard you say was clinical reasoning process, it sounds like that’s been your question, is how do I help people think things through. Not just knowing information, but actually use what they know.
Whitney Lowe: Absolutely, yeah. And its’ interesting that we landed on this title for this podcast, because I have for years in the classroom been talking to people about trying to get them to become the thinking practitioner. Not somebody who follows routines or recipes, or just do this thing five times to somebody’s shoulder and everything will be better, but what if it doesn’t? What do you do? You have to become the thinking practitioner, you have to be that individual who can reason through different kinds of processes.
Whitney Lowe: So again, getting back to how this is informing what we are doing right now, tell me some more about how that work with the Rolf Institute has really informed what you’re doing now?
Til Luchau: Yeah, well like I said I was there 20 years, and that was my main gig. And as my thinking evolved, and as the field evolved, really began to get interested in how to bring the great work that was being done there out into the field as a whole.
Til Luchau: Yeah. Well, I really enjoyed working at the Rolf Institute, and learned a ton. And as I evolved, and as the field evolved, I really began to get interested in ways to bring what I was doing out into the field as a whole, and to have conversations across disciplines, and really understand how what we do affects the whole person, I’ll put it that way. So I think even though I get really geeked out on something like the sacroiliac joint, which I hope to pick your brain about too, I’m curious about how does this happen in a hands on therapy session in a context that involved the relationship, in a context that involves the client’s, say, pain, or their interest in feeling better. How do we manage that, how do we catalyze that, how do we help good things happen?
Til Luchau: And across disciplines. A lot of people, they come to my classes, in this country of massage therapists there’s a good number of Rolfers, there’s a good number of physical therapists, and then when I go abroad it’s all different professions, but there is some universal processes there that really involve listening, working, thinking, that allow good things to happen.
Whitney Lowe: So I’m curious about because you’ve done so much international teaching with other fields and disciplines in other parts of the country, how would you say, for example, the predominant group of manual therapists that we’re probably speaking to in this podcast, I would say, is most likely massage therapists. How would you say, for example, their preparation or their work approaches and their perspectives, are there really key differences or things that you would notice of those in other countries in comparison to what you see with the practitioners you work with here?
Til Luchau: Well, that’s the big question, you’re asking both about international differences and professional differences between disciplines, because I think you’re right. I think a lot of massage therapists will tune in, but I think we’ll probably get a lot of others, too, that don’t necessarily identify as massage therapists. So I am always trying to remind myself that as I speak, and you and I both write for Massage and Bodywork Magazine, one of our sponsors here, and all that kind of stuff. So for me it’s always looking for what’s universal. And I think we tend to focus a lot on the distinctions. I know it’s a big discussion within the field of structural integration is “how are we not massage.” Both to distinguish themselves as practitioners but then also to distinguish the work itself. But there’s a whole lot of it that’s pretty common and pretty universal, and useful, across that continuum, no matter what context you have or what the clients come in expecting.
Til Luchau: And probably the same is true internationally as well. There’s huge cultural differences, I’m about to go off to Norway, and Poland, and then London and Ireland in the same trip. And those are all north western Europe, well I guess Poland isn’t northwestern, Poland is Eastern Europe. But culturally, they’re all over the map in terms of their learning styles, education backgrounds, the type of professions that end up coming to my trainings.
Whitney Lowe: Yeah.
Til Luchau: So it’s a great exercise in trial and error, really. Finding what people find useful, what lights their fire, what makes their eyes open up, and they can ask more questions about.
Whitney Lowe: Yeah, certainly from an educator’s perspectives it seems like that would pose a lot of interesting challenges, because you cannot rely on backgrounds being assumed to be one particular way, or what everybody’s training even is in there, that they’ve gotten certain basic concepts or ideas that you might assume to be foundational and present with everybody might not necessarily be there. So that certainly seems like something that could be challenging.
Til Luchau: Yes and no. Yes, in that, well, here’s an example. For years, I taught Rolfers and structural integration practitioners in this country, and then I went to Spain for some of my first international teaching, back in the mid 90s. I was teaching mostly physical therapists. So here in this country, anything orthopedic was like mind blowing to the practitioners here, the massage therapists, structural integrators. There, I’d got there and talk about something orthopedic, they’re like, “Oh yeah, I know that, I know three studies that show that, argue that, and debate it.” So it was about finding something that wasn’t orthopedic or wasn’t information based. In that case, it was more the interaction or the proprioceptive sensory aspects of the work.
Til Luchau: It turns out, and I bet this is true for you, too, just the nature of the work itself has so many dimensions to it that people find what’s in it. If it’s presented well, if it’s interesting, if it’s compelling, it’s useful, people find a dimension to it that makes it really interesting and useful, no matter what their background is.
Whitney Lowe: Yeah, yeah. And those kinds of classroom experiences, I think, provide rich opportunities, too, for the blending of understanding amongst these different professions. Because certainly one of the things that I think we have a big challenge with across the whole healthcare landscape, certainly in this country and I would assume is probably similar in other countries as well, is the problem of interprofessional silos, where we don’t have a great deal of understanding, for example, what often happens in other perspectives from other people’s treatment methods or modalities, or perspectives that are different from our own. certainly we all could benefit with, a great deal.
Til Luchau: We all suffer from this we are special kind of thinking. Certainly at the Rolf Institute; I had it at Esalen, I lived on a couple different islands at different points in my life, it’s like a kind of island mentality. There’s the rest of the world, and there’s us. And I’m more aware of how we are different than I am how we’re the same. And once you get off the island a little bit you realize, “Oh jeez, we’re all people here.”
Whitney Lowe: Right, it’s that same sort of thing like, well you can place your hand on the person’s body and start doing something, and the cells don’t know if you’re doing Rolfing or if you’re doing myofascial release, or if you’re doing active engagement techniques or whatever it is. They don’t know nor do they care. They have a physiological, emotional, psychological, biopsychosocial reaction, somehow or other, to what we do. And that’s where it really comes down to.
Til Luchau: I like it.
Whitney Lowe: Yeah. So tell me, another question I was going to ask, and we talked about this a little bit, there’s so many things that are changing in our field, and I’ll say fields, plural, because lots of this is happening across the landscape in so many manual therapy disciplines. As research comes about, we learn some things that are maybe shifting and changing our perspectives a bit. Tell me something that maybe you used to think was really important, or really a key relevant factor, that seems less important now than what it used to.
Til: That’s a good one Whitney. Be Let’s do our half-time sponsor spot first.
Til: This episode is sponsored by ABMP, Associated Bodywork & Massage Professionals. ABMP membership combines the insurance you need, the free CE you want, and the personalized service you deserve. Featuring the dynamic new Five-Minute Muscles review app, with muscle-specific palpation and technique videos, and the award-winning Massage & Bodywork magazine, where we are both frequent contributors.
Whitney: It’s easy to see why members love ABMP. I have been a member for years and it’s clear the organization is driven to offer loads of key benefits to their members and their primary focus is on delivering exceptional opportunities and services. Listeners who join ABMP as new members save $24 at www.abmp.com/thinking. ABMP—expect more.
Whitney: Ok Til. So before we thanked ABMP, I asked you about something you used to think was really important, that seems less relevant now than it used to.
Til Luchau: Yeah, there’s so much. There’s so much that was the way I learned, and you learned how to do it, and you did it that way. And then it turns out that the way you do it is a protocol that’s communicating some principles or some larger goals, and everyone I think encounters this at some point if you practice long enough. The way you do it becomes less important, well let me put it this way. What you do becomes less important than the way you do it. So the order I do the techniques in, or whether I’m going down the back or up the front or whatever, those have interesting principles behind them, but they become less important as doctrines and more important as principles as time goes on.
Whitney Lowe: Yeah, and I think often times those may be initially transmitted, and as you noted, taught to us as doctrine things, because they’re presented in a system, and this is what makes my system different from somebody else’s system, and why I get to trademark my system and charge more money for my system, because we go from right to left instead of left to right, or something like that. And those things often have an interesting narrative associated with them, but often I think what we’re encountering is many of those narratives don’t always stand up to the test of time quite so well when we start digging into some of the deeper things below it.
Til Luchau: Or I could say for me, they made less sense to me personally as I went on, and I got more interested in getting down to the principles underneath them, about when I got some great results, what was happening there.
Whitney Lowe: Yeah.
Til Luchau: And so yeah, the deeper I go, the less I believe in the original protocols or doctrines, and the more I get curious, and maybe the less I know, but the more I get curious about what is it that really catalyzes change. I should say that something I said just now is a debate. There is a tension in our field, or maybe in the world, between doing it the right way and doing it the way that makes sense, between absolutism and relativism, you could say. That’s just a fundamental split in the world right now. So I’m articulating a relativist point of view, which isn’t the only point of view, but it’s the one that does seem to make sense for me.
Whitney Lowe: And I think it’s important for us to recognize, too, that there are gray areas in that particular perspective about looking at the way that you do things. Because there are, in fact, reasons that you would not want to do certain things a certain way, because it’s actually dangerous.
Til Luchau: There you go.
Whitney Lowe: And we have to recognize that, okay is this a time when the reason that we’re being encouraged to do something or not do something is really for a serious health reason, or is there just a pet theory that we’re attracted to that makes us follow this particular protocol or process? And that’s a challenging one for us, is to know, sometimes when we are in those different places of why do we do the things that we do, and that’s something that I’ve always been really trying to push a lot with the students as I work with them in class.
Til Luchau: Yeah, tell me.
Whitney Lowe: Because the way that so many of our education programs are presented to students is usually, instructor talks about something, instructor demonstrates something, students practice what instructor demonstrated the way that the instructor demonstrated it. So do this the way I’m showing you here now, and that will achieve X result. Which, then again, back to that whole idea of the reasoning process, it limits some of that reasoning a little. Because what I frequently will do in the classroom, and started doing this and finding an interesting experiment I would do numerous times, for example, present a principle to the students, a particular way. And then when we get to the practical application where they go back to their tables and they start practicing something, I’d ask them a question that would flip that whole thing into a completely different scenario that I didn’t talk about. And ask them, “Okay now what we should do here?” And there were so many instances in which there was just this deer in the headlights look, because, “Well I don’t know, you didn’t tell us that yet.”
Til Luchau: Off the map.
Whitney Lowe: Right. But that’s clinical reality. That’s what happens when you’re in the clinic treatment room, it’s not all going to look just like it did in the demonstration, nor the way it looked in the textbook or anything like that. And that’s why the whole reasoning process is so very important to have to think through some of these things. And we’re at a place now where there’s a lot of people who are less comfortable with uncertainty, and some of this has to do with insecurity as an instructor or insecurity in their particular positions, and feeling like they have to have all of the answers, and that’s a challenging and somewhat dangerous place to be in. Because it leads you down this road of feeling like you have to say something and have an answer for all kinds of questions, when there’s a whole lot of questions that come up that I don’t know the answer to.
Whitney Lowe: I joke with students frequently, “Back in the old days, when we were in the classroom, you could get away with some line of bull for maybe a week or two after you said something before someone might find the inspiration to go look it up. But nowadays, you’re going to get Googled within a matter of seconds.”
Til Luchau: People are in the back of the room typing into their phones as you speak, yeah, checking it out. It’s true.
Whitney Lowe: Yeah, so don’t get into this thing of feeling like you have to answer everything and have an answer for everything, because uncertainty is not bad, it’s actually something that leads us in good directions of questioning things a lot.
Til Luchau: Yeah. That’s right. That’s right. And there’s probably a stage to it, as an educator. I learned that, at least as a strategy, if I came in too early and says, “Okay, let’s just work from principles,” or “Let me just show you something and you go try it,” that worked for some people, but a lot of people it really freaked them out if I didn’t give them a protocol. And eventually after a couple years of fighting that, I go, “Okay, let me give you step by step,” knowing that that’s not the end purpose here, that’s just a way to practice or learn or whatever, “let me give you a step by step,” and that actually calmed people down quite a bit. So when people are lost, that step by step helps. But the step by step isn’t the point. It’s just the framework.
Whitney Lowe: Yeah, that’s the essential thing, it’s something that you have to use to get started. But then you also have to know when to let go of it. It’s just like, in some respects, it’s like grammar. You have to learn basic grammar in order for us to communicate accurately, but once you start writing poetry, grammar is probably going to go out the window there, to a certain degree. But if you don’t know it to start with, then you can’t just take a jumping off leap from it and just be wild and unrestricted in the things that you’re doing there.
Til Luchau: Yeah, I’m looking it up here, Picasso, his quote. I can’t find it, I’m going to make it up. He said something like, “Learn the rules like a pro, so that you can break them like an artists.”
Whitney Lowe: I like that, yeah.
Til Luchau: Something like that. We’ve got to know, we’ve got to know the protocols, got to know the rules, for sure the contraindications, the dangers.
Whitney Lowe: And we have to know how to notice when we’re getting lost or stuck in each one of those, also. Notice when we’re getting stuck in the rules and the guidelines, and the foundation principles, or also notice when we’re getting stuck in just abandoning them willy nilly all together, and jumping into something because somebody said this esoteric idea and you thought it sounded cool, and so now that’s the way everything is. So yeah, I think it’s really important that we be able to recognize when we’re, ourselves, getting pulled into those vortexes, or vortices.
Til Luchau: It’s good. Well what are you working on these days, or what’s capturing your interests or your passions most, would you say?
Whitney Lowe: Yeah, right now, at least at the moment, the big project on my plate is a revision of my book on orthopedic assessment, which has been out since 2006, so it’s a long time coming with another second edition of this book. Most of the book turnaround times are much shorter. That gets us into a whole different topic of publishers forcing edition updates, which we’ll get to that. And this one I didn’t have to because I self published the book, but this new edition of the book is something where I’m really trying to bring in educational principles, because the world of publishing has changed so dramatically now. And when we talk about classroom learning aides, a textbook is good for certain types of things, and not so good on other types of things. And I’ve gotten very much enmeshed in online education and looking at ways to help people get outside of the traditional learning formats and experimenting a great deal in that whole area, ever since the early 2000s.
Whitney Lowe: So this new book is going to be an interesting multimedia workbook, is the way I’m describing it. Most textbooks have a website bolted onto the textbook that is in addition to what the textbook is, but the textbook can live independently. But this is going to be a little bit different because it will not really be independent of the online components, there’s going to be a lot of stuff that just will simply not be in the book that is online, because certain things are better to be transmitted in a multimedia format, like showing technique things through video is way better than a still picture in a book. Or, when we talk about clinical reasoning activities, getting people to understand recognizing patterns that might indicate a particular shoulder pathology, you can have them go through those activities and get experimental processes or testing the reasoning processes, and getting immediate feedback of yes, this was accurate, no that wasn’t quite so accurate when you did this, and that’s how you actually shape and form those learning processes more.
Whitney Lowe: Because you can’t teach clinical reasoning really effectively with textbook, written text only. And it’s something that really needs to be taught much more extensively, I think, by practice-involved practice and error. Error is a crucial part of learning those kinds of things. It’s like, well if this isn’t right, what would be, and why do you do what you do, or why did you figure that out, why did that group of signs or symptoms point you in the direction of thinking something like this was present? So that’s really where I’m enmeshed right now, is in this book revision, and continuing to push the envelope with online education, and trying to bring that into the manual therapy world a bit.
Til Luchau: You’ve always been pushing that envelope. I know you’ve been looking for ways to make it as useful and real as possible, so that sounds like a really fascinating, revision you called it, but you’re talking about a higher level integration between the online world and the text world, that clinical reasoning piece.
Whitney Lowe: Yeah, absolutely. And I got into the whole online education thing back in the late 90s and early 2000s before it was really a big bubble that it’s turned into, simply because I was curious about how we could do a better job of teaching clinical reasoning processes than I was doing in the classroom weekend workshop format. And studied a lot of what was happening in the world of online education, and that took me down a huge different rabbit hole of multimedia learning theory and instructional design, and all kinds of things that have to do with what you’re doing when you’re creating multimedia learning experiences, and really thought that there was a tremendous amount of potential for bringing this into the massage world for teaching all kinds of stuff. Not necessarily as much about teaching people technique, but teaching lots and lots of the cognitive elements of what we’re doing, and the critical thinking elements of what we’re doing.
Whitney Lowe: And that’s what I would love to see happening if I can have one bucket list professional wish before I’m hanging up my cleats is that I would like to see more of that high quality potential educational versatility making its way into our training programs, and we’re still quite a long way from there. But that’s a lot of what I’m enmeshed in right now, is trying to make that happen.
Til Luchau: That’s great. And there is so much potential there for the online world, and I think you and I talked about this awhile back, I got inspired also, way back, it was the year 1999, I taught my first teleconference course. And it’s been the same question all these years, how do we integrate that into a full spectrum learning experience? And no, you can’t duplicate the in person learning experience, but you’ve really led the pack, and I know you have a tremendous number of offerings there, and this bucket list item you have of really seeing that take shape, I’m behind you, I’m with you.
Whitney Lowe: Good, all right, well we’ll see if it happens. There are lots of days when it feels like I’m pulling a freight train up a hill, but that’s how those things happen. They happen little bits at a time. So what’s on your plate nowadays that you’re focusing on?
Til Luchau: Well, I mentioned the question of motivation and change off the table, that’s looming on my horizon. And the short term is just getting our new website finished, we have a bunch of new online courses there, and there’s a whole directory and CE tracking system there that is just about getting finished. We have a couple of great retreats coming up that I’m getting ready for. But yeah, I think in terms of topics, we’ll see what really grabs my interest. I think it is something around the question of change, how do we really catalyze deep change in our clients?
Til Luchau: And then for me, as an educator, how do I catalyze, or invite, or inspire, deep change in the students that come through our trainings or do our online things? That’s the biggest one for me. It’s working at the next level with the people already in our program, and there’s always people coming in, so how to engage them in a way that’s most meaningful, how to keep what we’re teaching up to date and interesting, and honestly, if I had to make it off the top of my head, our mission statement is basically to blow peoples’ minds.
Whitney Lowe: Now there you go, I like that.
Til Luchau: Yeah. And so just look, continuing that process of blowing my own mind and looking to how to do that for people that come to us for trainings. That’s the challenge that’s facing me, personally.
Whitney Lowe: Yes, indeed. So we will continue to explore lots of those topics, here on the podcast, and I think we’ll maybe dish some of those up here in the next couple of episodes as we’re coming down to take a look at them.
Til Luchau: I look forward to getting really specific and digging into some of these things we’ve mentioned today, but also things we have on our wish list here. This is going to be interesting and fun.
Whitney Lowe: It is, yeah. Well it was an absolute joy talking with you today, and we will look forward to continuing the conversation.
Til: Me too, Whitney. Next time, we’re talking about the challenges and opportunities we see facing or field, so be sure to check that out. Before we go, I should invite the listeners to stop by the podcast site for show notes, CE credit updates, and extras: www.thethinkingpractioner.com. Or, at my site, Advanced-Trainings.com. They’re on your site too, Whitney. What’s the address?
Whitney: AcademyOfClinicalMassage.com. We’d love your thoughts or questions at [email protected], or via social media,
Til: Rate us on Apple Podcasts and wherever else you listen, and tell a friend! Thanks Everyone, see you next time.