There was an article in The Conversation recently titled After a year of digital learning and virtual teaching, let’s hear it for the joy of real books that gave us another indication of one of the really positive things that might come out of this awful pandemic. Things like people valuing face-to-face meetings again, whilst really appreciating the value of digital connection; people going for walks and gardening; and people reading books again.
Perhaps one of the most challenging things for people when they can move freely again will be how comfortable they are being touched by strangers. The Spectator magazine asked recently whether the handshake was dead. Reviewing Ella Al-Shamahi’s new book The Handshake: A Gripping History, the magazine suggested that your hands might actually be a ‘horror story’;
Your hand, says the Mayo Clinic, is a lethal bio-weapon crawling with pathogens as yearning to contaminate as those scary airborne droplets.
But even before COVID, some physiotherapists were decrying hands-on physiotherapy as low-value care (see references), returning physiotherapy, once again, to a time when touch is ‘out’ and activity is ‘in’.
Of course, therapeutic touch, massage and manipulation, mobilisation and hands-on physiotherapy have been out of favour before. After World War I it was realised that the heavy hands-on work being done by reconstruction aids and masseuses was unsustainable given the vast numbers of heavy casualties. Europe and America were also very much under the influenced by eugenics and physical culture after the war too, and these placed a lot more emphasis on the individual’s strength and movement.
A similar decline happened with the advent of consumer-grade electrotherapy devices in the 1960s and 70s. But after all such ‘declines’, touch always seems to come back.
Today, the driver is neoliberalism and self-care. People are expected to look after themselves, and government is supposed to be small. Help, social care, and community are out, personal responsibility and self-care are in.
And so touch recedes.
But in a Post-COVID world, one of the things people will crave most will be caring touch. And they will want touch from someone with skill and someone they can trust.
And so, for the last few months the team on the CPN Exec have been talking about a campaign to focus on the value of touch: what it means for human flourishing and co-dependency; how we, as therapists, miss touch; the real meaning of high- and low-value care; touch as care, and as a resistance to the logics of neoliberalism; touch as the ultimate low-carbon therapy; and so on.
We’ll be sending out more information shortly, but if you have any thoughts about how you’d like this project to progress, email us at david.nicholls@aut.ac.nz, and we’ll be in touch. Digitally, if not digitally.
References
Adrian C, Traeger RM, Maher CG. Wise choices: making physiotherapy care more valuable. Journal of Physiotherapy. 2017. http:// dx.doi.org/10.1016/j.jphys.2017.02.003
Gardner CG, Moseley L, Karran EL, Wiles LK, & Hibbert P. Implementing high value back pain care in private physiotherapy in Australia: A qualitative evaluation of physiotherapists who participated in an “implementation to innovation” system. Canadian Journal of Pain. 2020;4:1,86-102, https://doi.org/10.1080/24740527.2020.1732808
Lystad RP, Brown BT, Swain MS et al. Service utilisation trends in the manual therapy professions within the Australian private healthcare setting between 2008 and 2017. Chiropractic Manual Therapy. 2020;28,49. https://doi-org.ezproxy.aut.ac.nz/10.1186/s12998-020-00338-1
Zadro J, Maher C, O’Keeffe M. Overdiagnosis, overtreatment and low-value care in physiotherapy: a scoping review. BMJ Evidence-Based Medicine.2018;23:A10-A11.
Leave a Reply
You must be logged in to post a comment.