In 1994 as a struggling junior Aeronautics major at Dowling College, I got a job as a Direct Care Counselor in a residential setting in NY. While I was there working with teenagers with autism, I received training in Applied Behavior Analysis, (ABA) a type of behavioral modification which uses positive reinforcement and other ideas developed by the late behavioral psychologist B.F. Skinner.
In ABA the A,b, and c were short for Antecedent, Behavior, Consequence. Due to my ABA training, I applied to a school built for research for Columbia University’s Teachers College. We used ABA in this setting to help modify behavior of toddlers and preschool aged children with autism.
Simply put, if you give a command (antecedent) and the child elicits a desirable behavior, you reinforce the behavior using positive social cues or at times something tangible the child really wanted, like a cookie, which is the Consequence. Our work was predicated on finding the function of the behavior. All behavior is functional. We trained the behaviors we wanted, and did our best to replace the maladaptive behaviors with more desirable behaviors. Results could be seen in speech, physical movement, cognitive ability and social interactions. I saw consistent change in all the students I worked with, and miraculous changes in some. Due to the individual nature of the education we provided, we were led to find exactly what would work with each student.
In my private massage practice and bodywork I see similar issues with the structure and function of the Human Body. All of our habits are functional, and adaptive to outside influences or internal health. Some of these habits are desirable, others aren’t.
Using the ABA lens to peer within the mechanical structure of the body, if we sprain an ankle (antecedent) and we attempt to walk on that ankle (behavior) we immediately recoil from pain (reinforcement). So we adapt our posture and gait due to conditions (A) and walk (B) we feel less pain (C).
Taking this point further is to see this gait as a pattern that's reinforced and made a part of our new walking habit. We reinforce this habit, sometimes for years. This is where I come in.
In a myotherapy session, gait and posture analysis is a way of seeing your body’s histories of reinforcement. Through this analysis, we can see how you have changed a smooth easy gait into one that is less desirable, less efficient and often leads to major problems that need surgical repair. Once we see what is moving well and what isn’t, we can use manual therapy to both interfere with the pattern as well as correct and balance the pattern with precision. Within each session we give body tissue specific pressure as an antecedent. The brain picks up on this pressure as a signal (the behavior) and eventually, the tissue changes (consequence), either by releasing or tightening (at times tissue needs to be “awoken”). If this placement and pressure doesn't change the tissue, we adapt until we find a sequence of placement and pressure that leads to desirable state of the tissue as positive reinforcement. Changes can be felt and seen as they happen. This can literally save you and insurance companies tens of thousands of dollars if done before it’s too far gone.
Generally, this balanced state of tissue leads to a healthier lifestyle with increased vitality and longevity. When the body is aligned, it has incredible abilities to self-heal. Western medicine has seen this happen, mostly in the sports and performing arts world where access to the finest Manual Medicine as well as technology has increased performance and longevity for years. Anyone watching the NBA playoffs can see this at work, where LeBron James has capitalized on all that's available for his tissues to recover and work harder than ever. On the other side of this, we also see in Western medicine an incredible use of Opioids that mask the pain, very little to no use of true Manual Medicine, and a gaping hole in finding the root source of pain, which at times may even have an emotional component to them. If you have the financial means, you can have access to the finest care one could buy. Many M.D.’s have left typical insurance based medicine practices for concierge care which caters to a well-educated clientele that wants precise functional analysis of their issues with planned solutions.
Creating new behaviors requires more than just one session. It is a commitment on both therapists and clients to determine what is needed, and for how long. We need to be willing to see if our work together is creating the positive changes or when to make changes. We recommend the use of a multidisciplinary approach that includes Manual Medicine, Therapeutic Yoga, Acupuncture, Alexander Technique and various massage and bodywork approaches for best results.
With our help, we can give the antecedent (our work) to elicit a desirable structural balance (behavior) and voilà, you feel a positive change (consequence).
Eli Peltz BS, LMBT
Board Certified in Therapeutic Massage & Bodywork