The
Scientific Method for Medical Massage Therapists
By
Ted Nissen M.A. M.T.
Copyright ©
August 2006 Ted Nissen
Ted Nissen M.A. M.T.-holds a
master’s degree in education/counseling and has had a successful medical
(clinical/orthopedic) massage practice for over 20 years in Long Beach
California and can be reached at
Summary=
Article
Ever observe something
and wonder why? It could be anything in your environment from natural phenomena,
animal or human behavior, or something within the physical being. It’s a mental
itch that wants to know the answer to a question about something you have
noticed in your world. You could just
come up with a quick explanation and leave it at that. Many people are
satisfied with the gratification that comes with having a strong heart felt
opinion without the confusion that close examination of any subject brings. You
however are curious and really want to prove or disprove your opinion.
Curiosity is probably a character trait of many scientists. Reasoned argument
just won’t do as we found in the previous article entitled "A brief History of the
Philosophical Basis for the Scientific Method...". Reasoned
argument is too susceptible to cultural, personal, and or religious bias. To
get at the truth we will need a more rigorous method, which minimizes the
effect of our subjective influence. Certainly you would want to read what
others have said about the subject as they might have discovered an answer to
your question. If they to have followed a rigorous method of inquiry that you
can trust then you have your answer. But what if they haven’t answered your
question, their methods of inquiry are faulty, and or what they observe is
inconsistent with yours. What do you do then?
Certainly by now, after observing and reading what others have said you
have some opinions, which explain the phenomena. You need to form some kind of
statement of your opinion, which can be tested. This is called the hypothesis.
To test your hypothesis you need an experiment, which you can predict, will
result in a specific outcome. If that outcome occurs then your hypothesis is
true. Get others to follow your experiment and if they get the same results
this further strengthens your results. Develop several experiments about
phenomena that seem interrelated and put the conclusions together to form a
theory. This is the short and simple explanation of the scientific method. The
elements of the scientific method are; Observation, Questions, Literature
Review, Hypothesis, Prediction, Testing, and Theory.
Observation is the
first element of the scientific method. Since in many of the healing
professions it should be fairly obvious that the patient is the object of the
observation. Given the aversion that science has to letting personal bias
influence scientific judgment often the patient is shuttled from Doctor to lab
and back again before tentative conclusions are achieved. Massage Therapists
and for that matter many other soft tissue and Eastern medical professionals
may have to rely at least initially on their 4 senses (Seeing, Smelling,
Touching, and Hearing). Based on what we observe we develop characterizations.
These characterizations are tentative descriptions of observed phenomena, which
attempt to categorize, define and measure. Problem is we can’t observe what we
see directly. We must use the symbol system that we humans uniquely possess. We
weave together visualization, vocalization, and feeling to form cognitive maps
of our world and descriptions of the clients we see before us. That is we see
thru our cognitive filters. Scientific method has underlined the need to use
objective empirical measurement where possible to avoid bias. That is what you expect to observe in the
world may affect what you do observe. Remember Plato’s dumb idea from the last
article. "A brief History of the
Philosophical Basis for the Scientific Method...". That lesson
was remembered by modern science. The observation of phenomena is always biased
by the world as we experience it. In fact German philosopher Immanuel Kant (22
April 1724 – 12 February 1804) would argue that phenomena constitute the world
as we experience it. That we cannot know the world, as it is (Noumenon)
“independently of our experiences (thing-in-themselves, 'das Ding an sich')”.
This is very similar to Buddha (Siddhārtha Gautama) (563-483 BCE) who
believed we couldn’t know the world as it really is. Our passions, desires, and
suffering blind us to objective truth. Socrates also echoed this sentiment that
we really could not know anything for certain. The Scientific Method is a way
to gain some measure of objective truth. With this it becomes clear why
laboratory measurement is so prized by medicine. Measurements considered
objective, are less prone to bias error. Although we must acknowledge that even
so called objective measurements may be subject to the distorting effects of
the cognitive filter. There is a certain amount of interpretation to some
laboratory tests such as X-Rays and even MRI’s. However by and large if we can
get a lab to analyze blood, or a machine to make images we are less likely to
see the effects of personal bias and the distortions that sometimes occur with
a cognitive filter. Fact is much of the misery people experience may not be
pinned so easily to test results from blood work or MRI images. Bottom line is
soft tissue therapists or eastern medical practitioners rely less on the
laboratory and more on their own assessments. Some of these assessments are
more “objective” than others. Sensing or seeing auras, feeling (with the hands)
an energy field, is probably less objective than measuring ROM. Asking a client
to rate their pain using a research tested pain scale is probably a more
objective measurement than asking them to put a color to their pain. What do we
really mean by the words objective and subjective. An object is something we
can all observe as independent of our individual (subjective) thought. Get an
object in the external environment lets say an apple and gather your friends
around to make their object (ive) observations. Everybody may agree that this
is an apple sitting on a tree stump in the forest. They may disagree on how red
the apple is or when it fell from the tree. Subjective assessments are
“conditioned by personal mental characteristics or states, arising from
conditions within the brain or sense organs and not directly caused by external
stimuli.” Subjective observations cannot be confirmed by others because the
object of observation is within the persons mind.
Notes
In science you can create two buckets. One has all of the
things we absolutely know for a fact. The other bucket includes things we don’t
know but believe. Sometimes passionately believe. The scientific method helps
us determine with probable certainty, which is which. Compared to the vastness
of the universe and complexity of the natural world we inhabit, the knowledge
bucket has almost nothing in it. Although we get along better if we have
respect for each other’s beliefs, science asks that we not treat beliefs as if
they were facts. We tried that for a very long time in our history (Denying
science that is) and it was called the “DARK AGES”. It wasn’t much fun. In
bodywork or for that matter most soft tissue work, the facts are few. You can
get people (including Doctors) to believe things are facts by making them sound
reasonable. For example no M.D. would argue that sprain or strain is causing a
person pain. Do we know that for certain? Probably not. It is within that
doctors belief system (what they learned in school) so they allow unverified
information to pose as a fact. We simply could not operate effectively in the
world without our unverified beliefs. If you are marketing a business you rely
on people’s capacity to accept beliefs and supposition as if they were facts.
Would doctors or other
professions buy the belief that energy causes healing. Probably not. This is
not something they learned in school. Could we get them to believe that energy
work had a suggestive efficacy. Probably yes. This photon emissions detector
has the potential of verifying the effects of energetic healing but we need to
collect and analyze the research. It will take a lot of really good research on
the positive effects of energetic healing before it will be accepted. It still
would not prove that it is the photons that are healing people.
CURIOUS OBSERVATION
IS THERE A PROBLEM ?
GOALS & PLANNING
SEARCH, EXPLORE, & GATHER THE
EVIDENCE
GENERATE CREATIVE & LOGICAL
ALTERNATIVE SOLUTIONS
EVALUATE the EVIDENCE
MAKE THE EDUCATED GUESS (HYPOTHESIS)
CHALLENGE THE HYPOTHESIS
REACH A CONCLUSION
SUSPEND JUDGMENT
TAKE ACTION
CREATIVE, NON-LOGICAL, LOGICAL &
TECHNICAL METHODS
PROCEDURAL PRINCIPLES AND THEORIES
ATTRIBUTES & THINKING SKILLS
The SM-14 Formula
for the General Pattern of the
Scientific Method
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MAJOR STAGES
--------------------------------------------------------------------------------
PART I - Observation through Hypothesis
1. Curious Observation
2. Is There a Problem?
3. Goals and Planning
4. Search, Explore, and Gather
the Evidence
5. Generate Creative and
Logical Alternatives
6. Evaluate the Evidence
7. Make the Educated Guess
(Hypothesis)
PART II - Challenge through Suspend
Judgment
8. Challenge the Hypothesis
9. Reach a Conclusion
10. Suspend Judgment
PART III - Implementation, Peer Review
11. Take Action
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SUPPORTING INGREDIENTS
--------------------------------------------------------------------------------
12. Creative, Non-Logical,
Logical, and Technical
Methods
13. Procedural Principles and
Theories
14. Atributes and Thinking Skills
Observation
Clearing your mind of
all knowledge was the first step. The less you think you know the better.
Carefully observe with an open mind (leave your opinions at the door). Record
those things that spark curiosity.
Carefully observe your
subject.
Literature Review
Read what others have
said, analyze incongruities and don’t be afraid to question authority.
Logically analyze inconsistencies. Be wary of those who have quick answers
based on tradition. sometimes really smart and charismatic people have dumb
ideas. This is why authority needs questioning to clear away the rubbish so
that science as a whole can move on. Socrates might agree that complexity does
not always equate with truth. Complexity may only confuse the underlying
fallacy with truth. The simple dictums; 1.) Don’t complicate the simple 2.)
Simplify the complex might have avoided this obvious folly. Very smart,
charismatic, administratively adept, people (Plato, Aristotle ect) can be
absolutely and objectively wrong. If they produce a body of work (Plato &
Aristotle produced volumes) and are able to draw followers (charismatic) and
establish schools (administratively adept) stupid ideas can be promoted and
innovation discouraged. Social pressure would force subsequent thinkers to
begin their inquiry with certain assumptions they did not question. This is
curiously similar to what many religions demand; Thomas (Doubting Thomas wanted
to poke his finger into the spear hole of the risen Christ to prove it was
him.) did your doubting for you and you can just believe. We all want to be
accepted by the group and this may indeed be a successful evolutionary
strategy; Groups survive better than individuals. Our outsized brain gave us
the capacity to believe something and shared beliefs make for stronger and thus
more survivable groups. Evolutionary pressures would certainly favor “Group Think”
because it organizes to fight off predators, gather and hunt food. Questioning
tradition, something Socrates would recommend, is both socially and personally
difficult. The combined written work of Plato and Aristotle alone would be
enough to intimidate even the bravest hearts among us. Aristarchus of Samos may
have succeeded precisely because he was trained in the Pythagorean School of
astronomy, which was free of the nonsense being taught, by Aristotle (The First
Lyceum) and Plato (The Academy). This underlines the lesson first taught by
Socrates, question authority. The volume of written work, number of people who
believe in its validity, number of schools dedicated to teaching the ideas does
not necessarily equate with truth telling. Tradition and authority must be
questioned if careful observation reveals inconsistencies. Another pit fall
when careful observers ignore incongruities between observation & theory.
If you ignore something for long enough, it becomes a traditional way of
thinking and eventually accepted scientific fact. Many scientific professions
probably have unexamined intellectual traditions, which fall into this
category. Every profession probably needs to do its housecleaning.
Question
Ask the questions that
arise from observation and reading what others have said or from what seems
curious. The question might suggest an experiment that can answer the question.
Don’t be afraid to
question authority
Hypothesis
A hypothesis is a
suggested explanation of a phenomenon, or alternately a reasoned proposal
suggesting a possible correlation between or among a set of phenomena.
Draw your conclusions
tentatively. This is a tentative answer to the question: a testable explanation
for what was observed. The scientist tries to explain what caused what was
observed. In a cause and effect relationship, what you observe is the effect,
and hypotheses are possible causes. (“educated propositions” about cause) and
the work of others. Hypotheses are based on previous knowledge, facts, and
general principles. Your answer to the question of what caused the observed
effect will be based on your previous knowledge of what causes similar effects
in similar situations.
Prediction
Experimenter uses
deductive reasoning to test the hypothesis.
Deductive &
inductive reasoning
Inductive reasoning
goes from a set of specific observations to general conclusions: I observed
cells in x, y, and z organisms, therefore all animals have cells.
Deductive reasoning
flows from general to specific. From general premises, a scientist would
extrapolate to specific results: if all organisms have cells and humans are
organisms, then humans should have cells. This is a prediction about a specific
case based on the general premises. A prediction is the expected results if the
hypothesis and other underlying assumptions and principles are true and an
experiment is done to test that hypothesis. For example, in physics if Newton’s
Theory of Motion is true and certain “unexplained” measurements and
calculations pointing to the possibility of another planet are correct, then if
I point my telescope to the specific position that I can calculate
mathematically, I should be able to discover/observe that new planet. Indeed,
that is the way in which Neptune was discovered in 1846.
Testing
Then, the scientist
performs the experiment to see if the predicted results are obtained. If the
expected results are obtained, that supports (but does not prove) the
hypothesis.
In science when
testing, when doing the experiment, it must be a controlled experiment. The
scientist must contrast an “experimental group” with a “control group”. The two
groups are treated EXACTLY alike except for the ONE variable being tested.
Sometimes several experimental groups may be used. For example, in an
experiment to test the effects of day length on plant flowering, one could
compare normal, natural day length (the control group) to several variations
(the experimental groups).
When doing an
experiment, replication is important. Everything should be tried several times
on several subjects. For example, in the experiment just mentioned, a student
scientist would have at least three plants in the control group and each of the
experimental groups, while a “real” researcher would probably have several
dozen. If a scientist had only one plant in each group, and one of the plants
died, there probably would be no way of determining if the cause of death was
related to the experiment being conducted.
The experimenter
gathers actual, quantitative data from the subjects. For example, it’s not
enough to say, “I’m going to see how the dog reacts in this situation.” Rather,
in that experiment, the scientist might have a list of certain behaviors, and
record how often each of the dogs tested exhibits each of those pre-defined
behavior patterns. Data for each of the groups are then averaged and compared
statistically. It’s not enough to say that the average for group “X” was one
thing and the average for group “Y” was another, so they were different or not.
The scientist must also calculate the standard deviation or some other
statistical analysis to document that any difference is statistically
significant.
Theory
A theory is a
generalization based on many observations and experiments; a well-tested,
verified hypothesis that fits existing data and explains how processes or
events are thought to occur. It is a basis for predicting future events or
discoveries. Theories may be modified as new information is gained. This
definition of a theory is in sharp contrast to colloquial usage, where people
say something is “just a theory,” thereby intending to imply a great deal of
uncertainty.
Abduction, or
abductive reasoning, is the process of reasoning to the best explanations. In
other words, it is the reasoning process that starts from a set of facts and
derives their most likely explanations. The term abduction is sometimes used to
mean just the generation of hypotheses to explain observations or conclusions,
but the former definition is more common both in philosophy and computing.
Deduction and
abduction differ in the direction in which a rule like “a entails b” is used
for inference (see also logical reasoning for a comparison with induction):
Deduction
allows deriving b as a
consequence of a; in other words, deduction is the process of deriving the
consequences of what is known;
Abduction
allows deriving
a as an explanation of b; abduction works in reverse to deduction, by allowing
the precondition a of “a entails b” to be derived from the consequence b; in
other words, abduction is the process of explaining what is known.
In
traditional Aristotelian logic, Deductive reasoning is reasoning in which the
conclusion is necessitated by previously known facts - the premises: if the
premises are true, the conclusion must be true. This is as opposed to abductive
and inductive reasoning, where the premises may predict a high probability of
the conclusion, but do not ensure that the conclusion is true.
Deductive
reasoning may also be defined as inference in which the conclusion is of no
greater generality than the premises or inference in which the conclusion is
just as certain as the premises.
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