Groundbreaking advancements too radical to receive a Knighthood.
“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most adaptable to change.”
Charles Darwin
This quote is set in brass in cement on the main floor at the San Francisco Academy of Sciences, Golden Gate Park SF.
ADAPTIVE CAPACITY AND MANUAL THERAPY
I am continually struck by Darwin’s understanding of FITNESS as the ability or capacity for change. This is also a useful treatment model for Manual Therapists. Dysfunctions are considered restrictions in the body’s innate ability to respond to stress, and these restrictions are then manipulated in ways that improve the body’s adaptive responses. Approaching a client intervention with the question “What can we do to enhance this person’s capacity to adapt” is perhaps the most powerful therapeutic strategy.
In a session if a therapist exceeds their client’s adaptive capacity the client will collapse into a protective distress response, hopefully just for a short time. If the therapist is too conservative and does not push up against the client’s adaptive capacity they will not benefit from the therapy. This benefit is called Eustress. From an engineering perspective, Young’s Modulus, for characterizing the point at which a deformed structure loses its resilience, and Hooke’s Law, for modeling elasticity, are useful frameworks here. If you observe a sudden change of state in your client – an activation of autonomic response like flushing, it is time to back off and let things settle. They have absorbed what they can take.
The therapist does not change the client. Their role is to contribute enough energy(stress) that the client’s innate capacity to change/heal/regenerate is activated. This point of activation is unique for every client and also unique to the client’s current situation – what else they are dealing with at the time of the session. Evaluating the client’s stress response-ability is a key attribute of successful manual therapy interventions, and the skill takes some time to develop.
EUSTRESS AND DISTRESS
Human beings inherently evaluate stimuli as either positive or negative, determining our reaction to stressors within the concept of Adaptive Capacity, our resilience against life’s pressures. This capacity hinges on whether the challenges we face are within our perceived energy limits – our psychological “energy budget.” When demands are manageable within this budget, we experience Eustress, a beneficial form of stress that is felt when we positively engage with challenges, resulting in feelings of accomplishment and growth. Eustress1 is the driving force behind learning, curiosity, and playfulness; it’s the adrenaline rush in competitive sports and the exhilarating decision to fight or flee. This positive stress is a catalyst for development, propelling us to explore and learn.
In contrast, when demands exceed our energy budget, we encounter Distress. This negative stress leads to protective responses that inhibit growth. Under Distress, our ability to learn is compromised as our system shifts towards survival mode, potentially resulting in a ‘freeze’ response akin to feigning death – an extreme manifestation often associated with traumatic stress disorders.
Eustress is crucial for expansion; it pushes us to stretch our capabilities and explore our boundaries, particularly through play – a state where we’re open to new experiences and learning opportunities. On the other hand, Distress triggers a constriction of our sensory input, a survival mechanism that focuses our attention on immediate threats and often leads to repetitive cycles of unproductive rumination, impeding our ability to process and learn from the experience.
The delicate balance between Eustress and Distress is a dance of our psyche, determining whether we thrive and learn or simply survive. Understanding this balance and how we respond to challenges can pave the way for better mental resilience and a fuller engagement with life.
MASLOW’S HIERARCHY OF NEEDS
Another tool for assessing a client’s capacity for adaptation is Maslow’s Hierarchy of Needs. Maslow’s Hierarchy of Needs is a psychological theory that outlines a five-tier model of human needs. It begins with the most basic needs that must be satisfied for survival: physiological needs like food and water. Safety needs follow, including personal and financial security. Social belonging comes next, emphasizing love, friendship, and community. Esteem needs, comprising respect, self-esteem, and recognition, are the fourth level. The final and highest level is self-actualization, where individuals realize their potential, seek personal growth, and express creativity.
Maslow suggested that higher-level needs become motivational
only when lower-level needs are satisfied.
The lower the client is on the tier, the lower their adaptive potential will be, and consequently the more basic the intervention. For example, if someone is dealing with life at the physiological level, it might be best to deal with a severe sprain by using a cast to allow the connective tissues to heal. However, if they are near the apex, they can use the sprain as a learning experience and develop regeneration with much more refined techniques, thereby sidestepping the limitations of healing within the movement restrictions imposed by a cast.
INCREASING SOCIAL ADAPTIVE CAPACITY
Diminished biomechanical capacity at a societal scale correlates with issues relating to the further evolution of our species and our role within the living web. As we grow more physically dependent upon and embedded within our infrastructure, the more complex and rigid it becomes, and the more protective we become of its established parameters, regardless of their sustainability. Communally, we are easily trapped inside a feedback loop between our biomechanical insufficiencies and their technological compensations and will tend to persist in driving the system in its established vector indefinitely, even if that vector is potentially off of a cliff.
Cultivating societies towards sustainable, altruistic, and equitable vectors is untenable without concurrently maturing neuromotor scope at a societal level. A society’s capacity to adapt rests on the resilience of its inhabitants – our consciousness rests on the status of our physiology. No matter how broad the consensus that change should occur, change will be challenged if perceived as beyond the society’s member’s limitations. For example, for someone with poorly matured neuromotor competencies, riding a bicycle is stressful and they may feel safer traveling by car. It will be challenging to enroll them in a bicycle-based community until they have a painless, preferably fun option for enhancing movement maturation. All such examples embed the premise that biomechanical insufficiency retards the ascension of Maslow’s Hierarchy, circumscribing tolerable change. People will tend to do what they are comfortable doing and will defend against being challenged to do something perceived as beyond their scope.
Among the many strategies for extending adaptive capacity, activities that assist further maturation of our innate neuromotor competencies play an essential role. One activity is the Gait Efficiency Feedback protocol discussed in the associated papers2. This simple algorithm proffers dynamic guidance for neuromotor enhancement, that can be embedded within a game, therapeutic appliance, or health metrics app, configured for any demographic from early childhood to old age. The existing work on this project is published prior-art (available to the commons). Current project goals are validating research and connecting across professional “silos” to demonstrate efficacy – planting the seed where it might sprout. The vision is that this simple application will be creatively widely adopted and culturally embedded.
FOOTNOTES
- The term “Eustress” was coined by Hans Selye (1907-82). ↩︎
- SPRIKE: A GAIT TRAINING APP ↩︎