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Human Nature Review 2002 Volume 2: 416-417 ( 9 October )
URL of this document http://human-nature.com/nibbs/02/handle.html
The Churkendoose Anthology: True Stories of Triumph Over Neurological Dysfunction
Edited by Lisa Brenner
The Handle Institute, Seattle, Wa. 190pp $12-95
Reviewed by Roy Sugarman PhD, Senior Clinical Neuropsychologist, Glenside Campus/RAH, Clinical Lecturer, Dept of Psychiatry, Adelaide University, P O Box 17, Fullarton SA 5063, Australia.
Sigh: it was the cutesy title that put me off for a start, but I can forgive that. What follows is a succession of washing powder adverts, or rather testimonials to the efficacy of the HANDLE approach developed by Judith Bluestone. The approach "services children and adults experiencing cognitive, motor, and behavioural difficulties on five continents" (so goes the blurb on the back cover). These heartfelt and clearly true stories wax lyrical about the effects of turning to a series of graded exercises copyrighted by The Handle Institute, a nonprofit organisation.
The general public would find this little book heart-warming, but professionals would find nothing illuminating, except for a huge scepticism for the clinical outcomes of face tapping, hug and tug of the second digits, and sucking through a straw. So these warm anecdotes, this kind of naturalistic research, will fall largely on deaf ears in the therapeutic communities we mostly work in. When our own patients provide such stories for us, we generally maintain a nice and caring facade, but in our hearts we are well trained into best practice and outcome measures, rather than anecdotal accounts of minor miracles and recovery of function beyond the neurologically spontaneous. Apart from the placebo effect, just asking parents to make different approaches to contact, physical and didactic, often makes a difference: many play therapists I know train the parents to do play therapy and get wonderful results.
The techniques are all individually tailored and non-invasive, the metaphors, such as teaching a duck to tap dance, are sweet enough. What is obviously missing is the rationale for how this works, how the neural pathways are strengthened, how short-circuits are unshorted, how any of this makes a real difference, all of this is just not clear. My experience in life in rehab is that when things are done, it is freely explained to us what the mechanism is. Without a mechanism being clear, how does one evaluate the gushy prose: “Who are the people HANDLE cannot help?.. At first, I had difficulty answering this question, since I, too, am in awe of the scope of issues that HANDLE practitioners are helping to resolve” Judith Bluestone page 175.
Treatments are not snake oil, they work or they don’t, and with the wide disparity of conditions, with the multiple genes and organs and organisms involved, how does one give any credibility to a cure-all? Mechanism for all means mechanism specific to none, and that is hard to digest.
But, the people are happy, they have found a Gentle Enhancement lifeline, a non-invasive technique that soothes and gentles their skins and all that it contains, and who is to argue? This nonprofit organisation copyrights its face tapping, straw sucking, hugging and tugging exercises, one presumes to keep them in-house and provide for quality control: I have no idea why. Savaged parents, the victims of cold doctrinal medicine, find salvation and healing elsewhere, a nice story, fulfilling for some, but not for me.
Thinking I am too jaded for this, I gave the book to a colleague, non-neurological, a pure psychologist: his comments are the same as mine.
They seem to do nice work, I just cannot see how, without resorting to metaphors, without sawing a big elephant in half to get two small ones (Judith Bluestone, page 139): reductionism has its place y'know...
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© Roy Sugarman.
Sugarman, R. (2002). Review of The Churkendoose Anthology: True Stories of Triumph Over Neurological Dysfunction edited by Lisa Brenner. Human Nature Review. 2: 416-417.