The Scientific Method for Medical Massage Therapists

By Ted Nissen M.A. M.T.

Copyright © August 2006 Ted Nissen

 

Ted Nissen M.A. M.T.-holds a master’s degree in education/counseling and has had a successful medical (clinical/orthopedic) massage practice for over 20 years in Long Beach California and can be reached at

questions@anatomyfacts.com

 

Summary=

 

 

Article

Ever observe something and wonder why? It could be anything in your environment from natural phenomena, animal or human behavior, or something within the physical being. It’s a mental itch that wants to know the answer to a question about something you have noticed in your world.  You could just come up with a quick explanation and leave it at that. Many people are satisfied with the gratification that comes with having a strong heart felt opinion without the confusion that close examination of any subject brings. You however are curious and really want to prove or disprove your opinion. Curiosity is probably a character trait of many scientists. Reasoned argument just won’t do as we found in the previous article entitled "A brief History of the Philosophical Basis for the Scientific Method...". Reasoned argument is too susceptible to cultural, personal, and or religious bias. To get at the truth we will need a more rigorous method, which minimizes the effect of our subjective influence. Certainly you would want to read what others have said about the subject as they might have discovered an answer to your question. If they to have followed a rigorous method of inquiry that you can trust then you have your answer. But what if they haven’t answered your question, their methods of inquiry are faulty, and or what they observe is inconsistent with yours. What do you do then?  Certainly by now, after observing and reading what others have said you have some opinions, which explain the phenomena. You need to form some kind of statement of your opinion, which can be tested. This is called the hypothesis. To test your hypothesis you need an experiment, which you can predict, will result in a specific outcome. If that outcome occurs then your hypothesis is true. Get others to follow your experiment and if they get the same results this further strengthens your results. Develop several experiments about phenomena that seem interrelated and put the conclusions together to form a theory. This is the short and simple explanation of the scientific method. The elements of the scientific method are; Observation, Questions, Literature Review, Hypothesis, Prediction, Testing, and Theory.

 

Observation is the first element of the scientific method. Since in many of the healing professions it should be fairly obvious that the patient is the object of the observation. Given the aversion that science has to letting personal bias influence scientific judgment often the patient is shuttled from Doctor to lab and back again before tentative conclusions are achieved. Massage Therapists and for that matter many other soft tissue and Eastern medical professionals may have to rely at least initially on their 4 senses (Seeing, Smelling, Touching, and Hearing). Based on what we observe we develop characterizations. These characterizations are tentative descriptions of observed phenomena, which attempt to categorize, define and measure. Problem is we can’t observe what we see directly. We must use the symbol system that we humans uniquely possess. We weave together visualization, vocalization, and feeling to form cognitive maps of our world and descriptions of the clients we see before us. That is we see thru our cognitive filters. Scientific method has underlined the need to use objective empirical measurement where possible to avoid bias.  That is what you expect to observe in the world may affect what you do observe. Remember Plato’s dumb idea from the last article. "A brief History of the Philosophical Basis for the Scientific Method...". That lesson was remembered by modern science. The observation of phenomena is always biased by the world as we experience it. In fact German philosopher Immanuel Kant (22 April 1724 – 12 February 1804) would argue that phenomena constitute the world as we experience it. That we cannot know the world, as it is (Noumenon) “independently of our experiences (thing-in-themselves, 'das Ding an sich')”. This is very similar to Buddha (Siddhārtha Gautama) (563-483 BCE) who believed we couldn’t know the world as it really is. Our passions, desires, and suffering blind us to objective truth. Socrates also echoed this sentiment that we really could not know anything for certain. The Scientific Method is a way to gain some measure of objective truth. With this it becomes clear why laboratory measurement is so prized by medicine. Measurements considered objective, are less prone to bias error. Although we must acknowledge that even so called objective measurements may be subject to the distorting effects of the cognitive filter. There is a certain amount of interpretation to some laboratory tests such as X-Rays and even MRI’s. However by and large if we can get a lab to analyze blood, or a machine to make images we are less likely to see the effects of personal bias and the distortions that sometimes occur with a cognitive filter. Fact is much of the misery people experience may not be pinned so easily to test results from blood work or MRI images. Bottom line is soft tissue therapists or eastern medical practitioners rely less on the laboratory and more on their own assessments. Some of these assessments are more “objective” than others. Sensing or seeing auras, feeling (with the hands) an energy field, is probably less objective than measuring ROM. Asking a client to rate their pain using a research tested pain scale is probably a more objective measurement than asking them to put a color to their pain. What do we really mean by the words objective and subjective. An object is something we can all observe as independent of our individual (subjective) thought. Get an object in the external environment lets say an apple and gather your friends around to make their object (ive) observations. Everybody may agree that this is an apple sitting on a tree stump in the forest. They may disagree on how red the apple is or when it fell from the tree. Subjective assessments are “conditioned by personal mental characteristics or states, arising from conditions within the brain or sense organs and not directly caused by external stimuli.” Subjective observations cannot be confirmed by others because the object of observation is within the persons mind.

 

 

Notes

In science you can create two buckets. One has all of the things we absolutely know for a fact. The other bucket includes things we don’t know but believe. Sometimes passionately believe. The scientific method helps us determine with probable certainty, which is which. Compared to the vastness of the universe and complexity of the natural world we inhabit, the knowledge bucket has almost nothing in it. Although we get along better if we have respect for each other’s beliefs, science asks that we not treat beliefs as if they were facts. We tried that for a very long time in our history (Denying science that is) and it was called the “DARK AGES”. It wasn’t much fun. In bodywork or for that matter most soft tissue work, the facts are few. You can get people (including Doctors) to believe things are facts by making them sound reasonable. For example no M.D. would argue that sprain or strain is causing a person pain. Do we know that for certain? Probably not. It is within that doctors belief system (what they learned in school) so they allow unverified information to pose as a fact. We simply could not operate effectively in the world without our unverified beliefs. If you are marketing a business you rely on people’s capacity to accept beliefs and supposition as if they were facts.

 

Would doctors or other professions buy the belief that energy causes healing. Probably not. This is not something they learned in school. Could we get them to believe that energy work had a suggestive efficacy. Probably yes. This photon emissions detector has the potential of verifying the effects of energetic healing but we need to collect and analyze the research. It will take a lot of really good research on the positive effects of energetic healing before it will be accepted. It still would not prove that it is the photons that are healing people.

 

CURIOUS OBSERVATION

 

IS THERE A PROBLEM ?

 

GOALS & PLANNING

 

SEARCH, EXPLORE, & GATHER THE EVIDENCE

 

GENERATE CREATIVE & LOGICAL ALTERNATIVE SOLUTIONS

 

EVALUATE the EVIDENCE

 

MAKE THE EDUCATED GUESS (HYPOTHESIS)

 

CHALLENGE THE HYPOTHESIS

 

REACH A CONCLUSION

 

SUSPEND JUDGMENT

 

TAKE ACTION

 

CREATIVE, NON-LOGICAL, LOGICAL & TECHNICAL METHODS

 

PROCEDURAL PRINCIPLES AND THEORIES

 

ATTRIBUTES & THINKING SKILLS

 

The SM-14 Formula

for the General Pattern of the

Scientific Method

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MAJOR STAGES

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PART I - Observation through Hypothesis

 

 1. Curious Observation

 2. Is There a Problem?

 3. Goals and Planning

 4. Search, Explore, and Gather

     the Evidence

 5. Generate Creative and

     Logical Alternatives

 6. Evaluate the Evidence

 7. Make the Educated Guess

     (Hypothesis)

 

PART II - Challenge through Suspend Judgment

 

 8. Challenge the Hypothesis

 9. Reach a Conclusion

10. Suspend Judgment

 

PART III - Implementation, Peer Review

 

11. Take Action

 

 

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SUPPORTING INGREDIENTS

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12. Creative, Non-Logical,

      Logical, and Technical

      Methods

13. Procedural Principles and

      Theories

14. Atributes and Thinking Skills

 

Observation

Clearing your mind of all knowledge was the first step. The less you think you know the better. Carefully observe with an open mind (leave your opinions at the door). Record those things that spark curiosity.

Carefully observe your subject.

Literature Review

Read what others have said, analyze incongruities and don’t be afraid to question authority. Logically analyze inconsistencies. Be wary of those who have quick answers based on tradition. sometimes really smart and charismatic people have dumb ideas. This is why authority needs questioning to clear away the rubbish so that science as a whole can move on. Socrates might agree that complexity does not always equate with truth. Complexity may only confuse the underlying fallacy with truth. The simple dictums; 1.) Don’t complicate the simple 2.) Simplify the complex might have avoided this obvious folly. Very smart, charismatic, administratively adept, people (Plato, Aristotle ect) can be absolutely and objectively wrong. If they produce a body of work (Plato & Aristotle produced volumes) and are able to draw followers (charismatic) and establish schools (administratively adept) stupid ideas can be promoted and innovation discouraged. Social pressure would force subsequent thinkers to begin their inquiry with certain assumptions they did not question. This is curiously similar to what many religions demand; Thomas (Doubting Thomas wanted to poke his finger into the spear hole of the risen Christ to prove it was him.) did your doubting for you and you can just believe. We all want to be accepted by the group and this may indeed be a successful evolutionary strategy; Groups survive better than individuals. Our outsized brain gave us the capacity to believe something and shared beliefs make for stronger and thus more survivable groups. Evolutionary pressures would certainly favor “Group Think” because it organizes to fight off predators, gather and hunt food. Questioning tradition, something Socrates would recommend, is both socially and personally difficult. The combined written work of Plato and Aristotle alone would be enough to intimidate even the bravest hearts among us. Aristarchus of Samos may have succeeded precisely because he was trained in the Pythagorean School of astronomy, which was free of the nonsense being taught, by Aristotle (The First Lyceum) and Plato (The Academy). This underlines the lesson first taught by Socrates, question authority. The volume of written work, number of people who believe in its validity, number of schools dedicated to teaching the ideas does not necessarily equate with truth telling. Tradition and authority must be questioned if careful observation reveals inconsistencies. Another pit fall when careful observers ignore incongruities between observation & theory. If you ignore something for long enough, it becomes a traditional way of thinking and eventually accepted scientific fact. Many scientific professions probably have unexamined intellectual traditions, which fall into this category. Every profession probably needs to do its housecleaning.

Question

Ask the questions that arise from observation and reading what others have said or from what seems curious. The question might suggest an experiment that can answer the question.

Don’t be afraid to question authority

Hypothesis

A hypothesis is a suggested explanation of a phenomenon, or alternately a reasoned proposal suggesting a possible correlation between or among a set of phenomena.

Draw your conclusions tentatively. This is a tentative answer to the question: a testable explanation for what was observed. The scientist tries to explain what caused what was observed. In a cause and effect relationship, what you observe is the effect, and hypotheses are possible causes. (“educated propositions” about cause) and the work of others. Hypotheses are based on previous knowledge, facts, and general principles. Your answer to the question of what caused the observed effect will be based on your previous knowledge of what causes similar effects in similar situations.

Prediction

Experimenter uses deductive reasoning to test the hypothesis.

Deductive & inductive reasoning

Inductive reasoning goes from a set of specific observations to general conclusions: I observed cells in x, y, and z organisms, therefore all animals have cells.

Deductive reasoning flows from general to specific. From general premises, a scientist would extrapolate to specific results: if all organisms have cells and humans are organisms, then humans should have cells. This is a prediction about a specific case based on the general premises. A prediction is the expected results if the hypothesis and other underlying assumptions and principles are true and an experiment is done to test that hypothesis. For example, in physics if Newton’s Theory of Motion is true and certain “unexplained” measurements and calculations pointing to the possibility of another planet are correct, then if I point my telescope to the specific position that I can calculate mathematically, I should be able to discover/observe that new planet. Indeed, that is the way in which Neptune was discovered in 1846.

Testing

Then, the scientist performs the experiment to see if the predicted results are obtained. If the expected results are obtained, that supports (but does not prove) the hypothesis.

 

In science when testing, when doing the experiment, it must be a controlled experiment. The scientist must contrast an “experimental group” with a “control group”. The two groups are treated EXACTLY alike except for the ONE variable being tested. Sometimes several experimental groups may be used. For example, in an experiment to test the effects of day length on plant flowering, one could compare normal, natural day length (the control group) to several variations (the experimental groups).

 

When doing an experiment, replication is important. Everything should be tried several times on several subjects. For example, in the experiment just mentioned, a student scientist would have at least three plants in the control group and each of the experimental groups, while a “real” researcher would probably have several dozen. If a scientist had only one plant in each group, and one of the plants died, there probably would be no way of determining if the cause of death was related to the experiment being conducted.

 

The experimenter gathers actual, quantitative data from the subjects. For example, it’s not enough to say, “I’m going to see how the dog reacts in this situation.” Rather, in that experiment, the scientist might have a list of certain behaviors, and record how often each of the dogs tested exhibits each of those pre-defined behavior patterns. Data for each of the groups are then averaged and compared statistically. It’s not enough to say that the average for group “X” was one thing and the average for group “Y” was another, so they were different or not. The scientist must also calculate the standard deviation or some other statistical analysis to document that any difference is statistically significant.

Theory

A theory is a generalization based on many observations and experiments; a well-tested, verified hypothesis that fits existing data and explains how processes or events are thought to occur. It is a basis for predicting future events or discoveries. Theories may be modified as new information is gained. This definition of a theory is in sharp contrast to colloquial usage, where people say something is “just a theory,” thereby intending to imply a great deal of uncertainty.

 

 

 

Abduction, or abductive reasoning, is the process of reasoning to the best explanations. In other words, it is the reasoning process that starts from a set of facts and derives their most likely explanations. The term abduction is sometimes used to mean just the generation of hypotheses to explain observations or conclusions, but the former definition is more common both in philosophy and computing.

 

Deduction and abduction differ in the direction in which a rule like “a entails b” is used for inference (see also logical reasoning for a comparison with induction):

 

Deduction 

allows deriving b as a consequence of a; in other words, deduction is the process of deriving the consequences of what is known;

Abduction 

allows deriving a as an explanation of b; abduction works in reverse to deduction, by allowing the precondition a of “a entails b” to be derived from the consequence b; in other words, abduction is the process of explaining what is known.

 

In traditional Aristotelian logic, Deductive reasoning is reasoning in which the conclusion is necessitated by previously known facts - the premises: if the premises are true, the conclusion must be true. This is as opposed to abductive and inductive reasoning, where the premises may predict a high probability of the conclusion, but do not ensure that the conclusion is true.

 

Deductive reasoning may also be defined as inference in which the conclusion is of no greater generality than the premises or inference in which the conclusion is just as certain as the premises.

 

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