MODELS
In a recent discussion with a father and his 15 year old son on how we create models to understand complex things, the son startled us by saying “Models are used to tell lies to children”.
It made me laugh. This idea was originally put forward by Ian Stewart and Jack Cohen in a book called Figments of Reality (1997), and a gentleman named Andrew Sawyer explains it as “the necessarily simplified stories we tell children and students as a foundation for understanding so that eventually they can discover that they are not, in fact, true.”
Okay. It would have been nice if someone would have explained that to me earlier, like maybe in kindergarten. As we learn and our understanding of something grows our models need to be updated, advanced, or discarded. When we keep operating out of the starter-level model we risk believing that the model is truth.
We create models for all kinds of things. Some of the models are better than others. Knowledgeable, creative people are constantly updating models that aren’t serving us, with remarkable results. For example, Esther Perel has updated models of love and relationship. Brené Brown has done the same with how we deal with shame and vulnerability. Francis Weller has updated our approach to processing grief. Examples are everywhere, in all fields, in all disciplines.
But the model that is used to explain how we move and exercise, physically breakdown and heal has remained alarmingly unchanged for over 100 years. In its simplification of the body this model heavily biases muscles and joints as the sources of movement problems, and somewhere along the way we started thinking of this as truth – despite the clinical and scientific evidence. The assessment and treatment techniques that professionals are taught and use to approach pain and movement problems, the language they use to explain their findings and theories, and the research that is done still comes directly out of this entry level model. Why?
Well, the body is immensely complex. There is a lot to learn. Professional health training requires years of intense guided study and learning just to encompass what the basic model contains. There is much that gets left out. Once graduated, it takes 12 – 15 more years of clinical practice to see where the omissions and simplifications of the model are letting us down.
There isn’t a mandatory “recall” for Physicians, Nurses, Physio’s, and Massage Therapists after 15 years of practice to study intensely in the middle of their careers to upgrade to the next level. It is left up to the individual practitioner to do this on their own in little bits and pieces. Everybody does what they can. Life gets in the way. Upgrading frequently falls short.
The result is a persistence of mediocre therapies and medical and exercise prescriptions in approaching pain and suffering. Interventions that have long been proven to be ineffective or incomplete are still used. As consumers of health services, we need better. We’re living longer, and too few of us arrive into later life with bodies that still work well. We need next-level models and the skilled practitioners to use them. The body is complex. It is time we stopped pretending it wasn’t.
Of course there are people doing next- level work out there. They are a distinct minority. We could increase their numbers with better support from educational institutions and funding sources, and set up mentoring programs. These next-level people have built upon basic concepts and filled in major omissions in models. Their ideas are good, forged and tested in years of clinical trial and error. They are helping people attain better results. Seek them out. Perhaps you’ll be one of the few that arrives into later life with a body that works.
But for now children, the lies will continue and the models will persist until we collectively demand better. Or we can remain passive and just hope that some kind of Messiah will come along and lead us out of mediocrity.
Jeff Harvie – Physiotherapist
Bluewaterphysio.ca
