science literacy for massage therapists

Science Literacy

science literacy for massage therapists

What is Science Literacy?

Science Literacy is the knowledge of key concepts in science and understanding the process of science. The origin of literacy is letra, Latin for letter, and literacy once very simply referred to the capacity to recognize letters and decode letter strings into recognizable words,
along with the concomitant capacity to write words and sentences.

Understanding what science is and isn’t can help us make better, more informed decisions on just about everything we do and say. It can also help you to build a massage business where clients are informed on how and why massage helps. Informed consent is one of the keys to building connection with clients that make them want to see YOU above all others and will help them when deciding whether or not to come back to you repeatedly and send all their friends and family members to you.

It started with me taking a Free class called Science Literacy (on www.coursera.org) which brought much clarity to me on the whole issue of why the skeptics are so skeptic on the many Facebook pages and groups.

We have to learn how to differentiate between science and pseudoscience. It isn’t a bad thing that many claims are based on pseudoscience (beliefs, antidotes, traditional knowledge, wishing makes it so). Our beliefs are created from taking in info from the senses and the brain looks for patterns to make sense of the world to help us try to explain how and why things happen. They become ingrained personal beliefs and our brains continue to find supporting evidence. Our beliefs become truths without any actual true evidence – evidence that is repeatable, unbiased and falsifiable. Science is just a process of evaluating evidence.

Science is never done collecting and evaluating and the questions are never truly answered but are always a work in progress. Science is self-correcting and science updates us regularly. It is a process.

Science is an attempt to understand the world, get a grip on life, and get ahold of ourselves. It is far from perfect, but it is what we have. When we are uncritical, we confuse hopes and facts, we slide between pseudoscience and superstition. (Rephrasing Carl Sagans Demon Haunted World)

If you do not understand what science is and does, you won’t be able to see how you are embracing pseudoscience.

Science or Non-Science.

What is it that makes something scientific?
In philosophy this question has been called the demarcation problem. To demarcate something is to set its boundaries or limits, to draw a line between one thing and another. For instance, a white wooden fence demarcates my backyard from the backyard of my neighbour, and a border demarcates the end of one country’s territory and the beginning of another’s. The demarcation problem in the philosophy of science asks:

What is the difference between science and non-science?
Introduction to History and Philosophy of Science by Hakob Barseghyan, Nicholas Overgaard, and Gregory Rupik is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

How do we gather knowledge?

Indigenous Wisdom is traditional knowledge and experience, oral tradition passed on by word of mouth and watching others.

An anecdote is a very short story that is usually interesting or amusing, and concerns real people and real incidents. They are casual observations that are passed along by word-of-mouth with no scientific analysis. It can be the personal experience of the massage therapist that has see things happen on the massage table or experiences of getting a massage therapy session.

It can help inform science community of things to be studied. Many types of massage are based on tradition and word of mouth. Many various theories about massage and how it works is based on this type of knowledge. These stories or anecdotes are a good way to share information, but they need to be backed up by systematically collected, scientific evidence that supports the story. That’s science.

Scientific knowledge tests, evaluates, validates and implements knowledge.  Scientists break things down into data. It is a very slow process of collecting evidence/information and analyzing it.  Scientists are trained to make use of evidence that was collected systematically to build theories, knowledge or understanding, but maybe overlooking the value of shared observations that were not empirically collected. What massage therapists see happen on the massage table and as a result of receiving massage is not easily collected into data. The relationship that happens between a massage therapist and a recipient of massage is difficult to categorize into data because there is more to it than just massage this leg/arm/back and get this result. The relationship varies so greatly from person to person and even the same person getting a massage from the same person repeatedly will have variations in the relationship. How do you measure that?

The specific systematic process of science, may blind us to ongoing observations within an experience, which may be useful in building or updating our knowledge as a whole. So the best way to acquire and update your knowledge is to keep an open mind to new information gained from science, media, or your own experience.

What information is trustworthy?

As massage therapists, many of the things that have been taught in massage school have been based on tradition, stories or anecdotes, and the lack of scientific research. Some of the traditions handed down in massage school are things like:

  • Massage should not be done in the first trimester of pregnancy
  • Pressure points should be avoided during pregnancy
  • Massage releases toxins
  • Does massage decrease cortisol?
  • Does massage increase circulation?
  • Reflexology and the zones on the hands and feet
  • Craniosacral therapy
  • Cupping therapy
  • Acupressure, Shiatsu and any other meridian based traditional healing
  • Does massage work and how does it work?
  • Conditions treated with massage – what works and what doesn’t?
  • Does taping work?
  • Does foam rolling work?

As we have learned more, we now know you can massage women during the first trimester of pregnancy and the pressure points do not induce labor. As far as toxins, the debate starts with the definition of the word and how it is used. It has become a marketing term to describe the waste products of normal cellular metabolism. Toxins can also be defined as chemicals that interfere with the body’s processes like pesticides, hormones, toxic air pollution and such.

Many of the various types of massage are handed down through tradition – even basic Swedish Massage. We get attached to the things we learn thinking we paid good money for this so it must be correct. Many schools are moving toward evidence informed massage but people who have gone to school a long time ago may have not kept up with the latest research.

How do we process knowledge?

Heuristic processing is the process of relying more on your instincts or gut feelings rather than really thinking about something. When times are uncertain and more fearful, people tend to rely on their instincts or gut feelings.  When we have more concrete information and have higher levels of certainty, we are more able to take the time to think more carefully- more elaboratively.   The unfortunate news is fear works.

 Making decisions based on biases is problematic, as it can perpetuate intuitive thinking and cause us to improperly make predictions or modifications in the real world.  It’s really, really hard, especially when people it’s become part of their identity.

The massage profession is full of metaphysical reasoning that tries to explain the unexplainable. They try to answer questions that are just not testable such as being, knowing, substance, cause, identity, time, and space.

What makes evidence scientific?

People and their opinions make for lively conversations mostly in one’s that no one is really listening and they want their opinion to be known and recognized as truth. With Science, we collect information in a systematic way and use systematic observations to evaluate a specific theory or hypothesis.

Science is a process of evaluating evidence

 Getting the Evidence out to the massage profession.

So how do we change people’s minds who hold onto tradition without having the evidence to support it? People may have evidence that it works on the massage table and they see it all the time. You can’t convince anyone otherwise and trying just makes it worse usually (as seen in the many online discussions where the science based massage therapists are battling the opinions and evidence found at the massage table. Instead of the constant criticizing and arguing, could there be a better way to educate massage therapists and create more evidence informed practices?

You have to consider what language will work for your audience, what kind of evidence will be persuasive, and how you can present that evidence in the most convincing manner possible. If you offend your audience, your audience members won’t listen to what you have to say. Massage therapists tend to be more metaphysically inclined, without a scientific background and are strongly holding onto their beliefs. They paid what they think is a lot of money for massage school and trust their source of information. They put in a lot of time and energy to learn what massage school teaches them.

If you offend your audience, your audience members won’t listen to what you have to say. While you may not be able to always convince your audience to see your side of an issue, you should at least be able to get them to listen to you and consider your points. ~ Argument and audience at Excelsior Writing Lab.

This has been one of the main issues in the massage profession as the science minded and skeptics try to teach massage therapists about science—they offend people (whether they intend to or not) and it closes people’s minds.

Creating Convincing Arguments

One of the first steps in getting the message out to people who do not understand science literacy and the scientific process is to know your audience and what they can process.

Aristotle taught about three basic modes of persuasion and it is still used today. A model for creating a well rounded argument includes 3 things (Rhetoric) :

  1. Ethos – This is one of the most powerful means of persuasion. It is about your credibility in the community and on the topic. The way to build credibility starts with being able to reach your audience with stories and anecdotes based on the scientific information or specific experience that you want your audience to consider. Try to keep people’s emotions from getting triggered and use systematically collected evidence. based on reputation; credibility; trustworthy; what you are known for.
  2. Pathos -This writing or speaking that does appeal to the emotions and the intention is to create an emotional reaction and an emotional connection which is needed to be able to persuade someone of something that they hold dear. It is important to not go overboard though which will make your messaging be seen as not credible. Pathos has to be carefully balanced with Logos in order to maintain your connection or ethos.
  3. Logos – The idea or concept needs to make sense from the listener or viewers perspective. They already have a preconceived idea based on tradition which is very closely held belief. It is personal to people. It is usually different from the scientific view. The theory or concept needs to make sense to the person. Logos is presenting a line of reasoning by using statistics and logic in our arguments that is straightforward.  You have to keep the logical fallacies out of it.

    This is a great video that explains it:

Intuition and Common Sense

Many massage therapists make claims about using their intuition during massage therapy sessions rather than relying science. First we need to clarify the definition of intuition. Intuition is the ability to bring subconscious information into conscious awareness. It is how some massage therapists just know instinctively where and how to work on someone. It happens when something is practiced over and over and the concepts of anatomy, physiology, kinesiology and pathology are ingrained in the repetition. It is what makes massage therapy also an art form.

Some people confusingly use the word intuition to mean a psychic experience or other metaphysical experience.

In his lecture, “Stress without Distress: Evolution of the Concept,” renowned researcher Hans Selye emphasized the importance of both science and intuition. Unless there is first an idea (intuition), Dr. Selye said, there is nothing to research, and without research (science), an idea does not develop form and usefulness. One does not function without the other.

Fritz, Sandy; Fritz, Luke. Mosby’s Fundamentals of Therapeutic Massage – E-Book (Kindle Locations 9716-9719). Elsevier Health Sciences. Kindle Edition.


Bias

A bias is a tendency, inclination, or prejudice toward or against something or someone. Biases are often based on stereotypes, rather than actual knowledge of an individual or circumstance. Biases can be innate or learned. People may develop biases for or against an individual, a group, or a belief. We all have it to some degree. People like to be right. Scientists are trained to think critically but they are not immune to bias. There are many different types of biases that I won’t go into here,

When thinking intuitively, we rely on heuristics or stereotypes, which allow us to make faster reactive decisions. Sometimes these instincts are correct but for the most part they are not correct. When there are high levels of fear or stress, most people rely on their stereotypes. What’s familiar to us, however, is biased by our past experiences and our current level of knowledge. Just being exposed to information will make whatever that bit of information is seen more believable. It’s called the mere exposure effect.

Confirmation Bias means we find evidence that supports our own theories. People also tend to find information and interpret it as supporting their own position. This is usually what happens when deeply held beliefs are being examine.

Belief perseverance is another type of bias that occurs when we stick to our initial belief despite opposing evidence. Because our beliefs are difficult to overwrite, even when we are told we are wrong.

Hindsight bias isn’t after the fact understanding. You’ve probably heard the phrase hindsight is 2020, which suggests that it’s easy to know what would have happened when you already know the outcome. This bias overestimates how well we can predict the future after it’s already happened. It can only provide after the fact feedback about what would, could or should have happened if things had been different.

It’s easy to recognize bias and others, but many of us seem to be blind to our own. This is called our bias blind spot. It when you can see something in others that you can’t see in yourself. It is when you think you know what someone else should be doing or saying, when it is you who should be looking at that in yourself. You can learn more about bias and blind spots in this book called “Blind Spot: Hidden Biases of Good People ” (Amazon Affiliate link). Also read more about confirmation bias on Wikipedia.

Relying on biases and intuition is not a viable route for all of our decision making. One thing that scientific evidence is generally protected against is bias. Decisions based on biases can perpetuate intuitive thinking which could lead to inaccurate predictions and modifications of procedures.

When you make decisions based on your own bias and beliefs, it can make it so we make predictions that are not accurate. It is really difficult to change when it so a part of our identity.  

Bias can also be a good thing when we know our own biases.

How do we process knowledge?

Heuristic processing is the process of relying more on your instincts or gut feelings rather than really thinking about something. When times are uncertain and more fearful, people tend to rely on their instincts or gut feelings.  When we have more concrete information and have higher levels of certainty, we are more able to take the time to think more carefully- more elaboratively.   The unfortunate news is fear works.

 Making decisions based on biases is problematic, as it can perpetuate intuitive thinking and cause us to improperly make predictions or modifications in the real world.  It’s really, really hard, especially when people it’s become part of their identity.

The massage profession is full of metaphysical reasoning that tries to explain the unexplainable. They try to answer questions that are just not testable such as being, knowing, substance, cause, identity, time, and space.

Isn’t Science just a theory?

Science is a process. It is an approach to making sense of evidence. In our everyday conversations we tend to use the word theory for our own hunches and instincts on the way the world works. In Science, it is much more ….well scientific. It can’t be just one event or one observation. Science takes all of the evidence available to make the best possible conclusion. That is why we need more evidence and research in the massage profession.

Science doesn’t set out to ‘prove a theory’. In fact, there is no such thing as ‘just a theory’ which insinuates that it might be a guess. A theory is a general explanation of all the available scientific evidence accumulated over time. It cannot be just one single study, event or observation. The more evidence we get, we can make better decisions about the accuracy of the theory. Theories are constantly overturned like the theory that massage reduces cortisol. The strongest evidence we have on this topic is a metanalysis done by Chris Moyer that show that massage DOES NOT reduce cortisol.

In science, there is no such thing as just a theory. A theory isn’t just a guess. It is a general explanation of the available scientific evidence. To be considered a scientific theory, they must be based on an accumulation of scientific evidence. Theories are created from multiple pieces of evidence, and can’t be based on a single event or observation. A biased theory is not “Just a theory,” it’s an opinion because it’s not accounting for all of the available evidence. A good theory will create good hypotheses. 

Does massage therapy reduce cortisol? A comprehensive quantitative review Christopher A. Moyer, Ph.D  ,Lacey Seefeldt, B.A. Eric S. Mann, B.A. Lauren M. Jackley DOI:https://doi.org/10.1016/j.jbmt.2010.06.001

Read the full series of articles

  1. Science Literacy
  2. Metaphysics, Magical Thinking
  3. Traditional Medicine
  4. Science vs Pseudoscience
  5. Critical Thinking
  6. What gets in the way of critical thinking?
  7. Logical Fallacies
  8. Scientific Method
  9. The Art of Massage
  10. Being Skeptical in the Massage Profession