When we look at the the neuromatrix, and the three inputs to body–self, we need to be aware of the existence, and potential impact, of cognitive related brain areas, sensory signaling systems and emotion related brain areas. It seems as though the operator is only concentrating on the sensory signaling systems, without direct regard for cognitive related brain areas or emotion related brain areas. In short, the operator is only concerned with exteroceptive input, often unaware that interoceptive input plays a role in the patient’s pain experience at all. It is by coincidence only that they may reduce attention to a patient’s pain experience for only a short period of time.
Meanwhile, it is the true interactor who addresses all three aspects of neuromatrix inputs simultaneously, a goal that every clinician who deals with patients in pain should strive for.
All others are guilty of larceny, stealing from the patient something that is intrinsic to them and may never be replaced; leaving behind a void to be filled only with fear, anxiety, pain and a lifetime of co-pays.
Therapist as operator or interactor? Moving beyond the technique by Diane F Jacobs, PT and Jason L Silvernail, DPT, DSc, FAAOMPT