Following on from my post the other day (No sex please, we’re physiotherapists), I thought I would recount one of my favourite stories that illustrates just how implicit sexuality is in the work that physiotherapists do.
A few years ago, I interviewed Brian Mulligan, the famous Kiwi physiotherapist, whose work has made him one of the world’s most well known and well regarded practitioners. His Mobilisation with Movement approach to musculoskeletal physiotherapy, developed in the 1980s, is now followed by thousands of physiotherapists, and he is still teaching and examining all over the world. More than that though, he is one of nicest people you could care to meet; genuinely charming and a great storyteller.
I was interviewing him as part of New Zealand’s physiotherapy centenary celebrations (you can hear Brian talk about his work and practice life here), and as part of that interview I asked him about two quite famous pictures that appeared in the 4th edition of his book ‘Manual Therapy: “NAGS”, “SNAGS”, “PRP’S” etc.’ If you turn to pages 64 and 82 of that edition, you will be confronted by these two rather arresting pictures:
By 1998 Brian’s books had become incredibly popular, and he was in demand as a speaker all over the world. His American publishers asked him if he would consider a slight change to the next edition, including a couple of images with female models, where the technique was, shall we say, ‘sensitive.’ Brian’s books almost exclusively used male models, and American physical therapists – fearing law suits – wanted visual evidence of how one was supposed to perform a “SNAGS” technique for anterior chest pain with extension. They wanted evidence that you really do need to place your hands across the breasts to perform the technique safely and effectively.
Brian agreed, but not wanting to use a relative for the pictures, decided to phone a local massage parlour and hire a prostitute for the pictures.
The woman arrived with her minder (the man holding the leg in the picture on p. 82), took off her clothes and posed for the pictures. These were her ‘working clothes’ as Brian put it, and so they took the pictures in situ and thought nothing of it.
Brian had long held the view that we were too prudish about images of naked bodies, and knew that some skin-to-skin contact was essential if one was going to be effective with some techniques. Little did he realise the fuss these images would cause.
Suffice to say, the images were removed from the 5th edition and replaced with a picture of a male model who caused no-one any offence.
One thing that always struck me about these ‘scandalous’ pictures is the use of black boxes to hide the model’s appearance. They have the effect of making the pictures seem really seedy. It doesn’t help that Brian’s face is hidden behind the model in the first picture, and that she is looking away from the camera. I imagine that if you took this picture out of the book and showed it to people who didn’t know any better, they would say it had been lifted from an old pornographic magazine.
The second picture is even more strange. Not only was no effort made to change the model’s ‘working’ clothes, but a black box has been placed over the right cheek of her buttocks. I was totally confused by this, until Brian told me that it was because she had a tattoo on her bottom and the publishers didn’t think that it would be appropriate to show this in the book. It’s surprising, given their sensitivity, that they didn’t feel the same about having a half-naked prostitute being manipulated by two men in a photo shoot that took 20 minutes and resulted in a financial transaction that bore all the hallmarks of her normal day-job.
I find it deeply ironic, given how we have to be so careful about how we regulate the sensuality of touch, that Brian should have chosen to use a prostitute to demonstrate a technique that is used every day by practitioners around the world. Brian did a fine thing in printing these photographs because he inadvertently raised a question about how physiotherapy views the sensuality of its practice. I’m not sure if he’d do it again, if he knew how people would react, but I think that says more about some of the people in the profession than it does about him.