The collaboration and its setting
Silverman's place in the advanced classes was unusual. He was not a practitioner; he was a sensory psychophysiologist whose research concerned how the nervous system makes order out of stimulation, how individuals modulate strong input, and how perception shifts under altered states of consciousness. His sensory-deprivation and psychedelic-drug studies had given him a framework for thinking about what happens when the body is bombarded with a kind of input it has no ready category for. Deep myofascial pressure was exactly such an input. He came into the classes — Big Sur in 1973, the Mystery Tapes recordings of 1971-72 — to give a multi-hour lecture that Ida treated as foundational pedagogy, not as a guest appearance. She read from a draft she was writing on pain, and Silverman delivered his own lectures across two long sessions, returning the following year to refine what he had said.
"The presentation that I gave last year was much more substantial than the one I want to give this year simply because it doesn't seem worthwhile to review all of this work again. There is a take that I think is a really good one. What I would like to do is to simply go over it in a general way, some of the work on painting that has been done. The most, some of the specifics, you can pick up that tape and listen to it. We had a really good discussion last year, I don't know what is going to happen this year. What I would like to do is modify that presentation last year only in so far as some more recent work on specificity models of pain. So what I am trying to do is sort of apologize for giving an honest response to this thing, but once I get going it will be alright. It is going to be fairly technical, so if you can get your heads into a different place for this than what you've been doing, bear with me, and as we get more and more into it, I think we'll pick up what I'm trying to do. Also, for a little while, I'm gonna read, and I'm gonna read on and off for a while because otherwise, I won't be able to cover the kind of the feeling. I have been interested in pain in relation to my research as a sensory psychophysiologist."
Silverman opens his 1973 Big Sur lecture by locating his work and naming his assumptions about how the nervous system handles stimulation:
What Silverman brought into the room was a way of distinguishing levels — biochemical, neurophysiological, perceptual, cultural — and a clear assertion that the practitioner's hands act on all of them at once. He also brought, crucially, a respect for the work that came from having been on the table himself. The collaboration ran in both directions: Ida used Silverman's vocabulary to refine her writing about pain, and Silverman used the classes to develop a model of pain that took myofascial tissue change seriously as a research variable.
The first formulation: resistance to change
The first frame Silverman offered — and the one Ida absorbed most deeply into her own writing — was that pain is, at base, a resistance to change. In the Mystery Tapes recording, Ida reads aloud from a chapter she is drafting that opens with this framing. The argument is that organisms, all the way down to the animal level, protect their existing arrangement. They have, as she puts it, made it under the current circumstances; they have no assurance they will make it under a different set. The pain that arises during deep tissue work is, in this reading, not principally a damage signal. It is the organism's notification that the configuration it has been defending is being asked to move.
"Some deep sea and instant decays that somehow they've made it under existing circumstance. What assurance do they know they have continued to make it given a different set of circumstances? Conservatism can be seen throughout the animal kingdom, the tendency to maintain and protect the status quo, to avoid the unknown, to avoid change, is universal. Attempting to label some of these phenomena, we refer to our more superficial conservatisms as habit patterns. Resistance to change is both understandable and predictable, but change so often manifests as pain. Sophisticated people recognize that their use of the word pain covers different phenomena. Moderns, verbalizing their own, quote, pain, are often not of describing a response to a something going on in their emotional world. They don't have to call any negative response, even a mere reaction to change, pain. This negative pain can be very intense and may cause significant physiological change. A negative shock, sufficiently severe, can knock out normal physiological functioning, causing loss of consciousness, even death. The apparent mechanism of psychic shock is often myofascial. Now this is where this becomes important to us. The important mechanism of psychic shock is often myofascial."
Ida reads the opening of her draft chapter aloud to the class:
Ida pushes the formulation harder than the draft itself does. In the back-and-forth that follows the reading, a student offers back the thesis in clarified form, and she accepts it. The work of the practitioner, in this reading, is to help the client distinguish between the pain that means damage and the pain that means change is occurring. The second kind, she insists, is what most people on the table are experiencing — though they have only one word for it.
"There's been a great change in certainly in my mind and I suspect in everyone's willingness to accept the sensory input of this work as it's being given to us. To lie down on the bed and accept this work and the way in which it's been accepted has changed tremendously from the beginning to now. All of this is true and all of these ideas are things which you need to have at your tongues pit so that as you begin to deal with somebody like a screamer, you can fish out something which seems to tell him or her, that there is a something that we don't have to make or love, etcetera, etcetera. That really starts to tie together the observable, the fact that many, many people as they go through this process, at first they regard, they kind of have no differentiation, they just have pain. There's no, not many different kinds of pain. They can describe to you twelve, eighteen different kinds of pleasure but it's just pain. And there's kind of a non specific no as a response just to get out of there, I don't want any part of that. And as it goes on, at some point they become interested in the differentiations that Well, they're able to you see that point is defined here by this in this book, Nauticos. Pain is experienced when stimuli, whatever their nature, exceeds certain limits. Pleasure is experienced when a system is resilient and is bombarded by the same number of stimulants."
Pressed to clarify, Ida lays out the multi-dimensional view of pain she is teaching her students to hold:
The neuroanatomical model
Having established the broad frame, Silverman walked the class through the neuroanatomy of pain transmission. The lecture moved from the early-twentieth-century 'specificity theory' — that pain travels along dedicated nerve pathways from specialized receptors to a pain center in the brain — to the more recent gate-control model of Melzack and Wall, in which large and small fibers play opposing roles and central modulation can change what reaches awareness. The technical content matters here because it changed how the practitioner thought about what the hands were doing. If pain is not a simple signal from a damaged receptor but a central summation of inputs subject to attentional and emotional modulation, then the practitioner's behavior — pace, contact, surrounding pressure — is itself part of the pain signal.
"This reports to the individual as negative emotional response. The man who operates in a narrow margin of chemical safety is rapidly exhausted by this physical environment. The state known as physical pain, the sensory dimension, has been examined by many of our most skillful investigators. It has long been brought that the sensation of pain travels along desolate nervous pathways. This extent, pain resembles sight, glaring, touch. To this extent, it is a sensation and presumably transmitted from sensory receptor endings which can be seen just under the skin. Two types of fibers seem to be involved in transmission. A sheath or myelinated fiber, so called A fibers, which transmit the impulse very rapidly, 100 miles per second, and which is found as sharp, bright pain. And an unmyelinated C fiber, the lateral much smaller in dimension and conduct impulses of low amplitude. And conduct impulses of low amplitude at a rate of about one meter per second. There has been speculation that these large and small fiber systems have opposing roles. Both types of impulse are transmitted through the spinal cord. In the thalamus, there seems to be a relay station from which they are distributed to various cortical and sub cortical levels of the brain. Like other sensory systems, these signals are interpreted in cortical levels. Such straight through transmissions from receptor in the periphery to pain center in the brain, called specificity theory, was the accepted map of pain as late as the middle of the twentieth century. But many contradictions challenged this theory and have caused reexamination of its elementary premises. 1950 to 1960 produced evidences that there were, in fact, very few high threshold fibers, and there was no evidence that there were always people who came. As early as the turn of the century, Sherrington, a master physiologist, defined pain as a psychical process. Today, in spite of our sophisticated measuring devices, we do not know at what point in the chain of events the physiological process becomes psychic. Physicians as well as psychologists know that pain is modified by the interpretation given to it, that what we perceive is not to be equated with the reality stimulus carried to the body by the individual nerves. Rather, the perceptor is a summation of past experiences."
Reading from the draft, Ida walks through the classical neuroanatomy of pain transmission:
Silverman did not present the A-fiber/C-fiber model as settled doctrine. He framed it as one of two competing accounts — the older specificity theory and the newer gate-control formulation — and in his 1973 follow-up he predicted that neither would turn out to be wholly correct, just as neither the wave nor the corpuscular theory of light was wholly correct. The practitioner did not need to resolve the controversy; the practitioner needed to understand that the body's pain signal is something the practitioner's own actions can modulate.
"In response to this necessity, modern ideas about pain advance a pattern theory, postulating that the pain impulse is produced by intense stimulation of non specific receptors, that there are neither specific fibers nor specific endings. Saxon assumption permits the inclusion of Padlov's classical observations. This investigation subjected dogs to electric shocks, burns, and cuts, but followed tissue insult consistently consistently with the presentation of food. Presently, these stimuli were accepted by the animals as a call to food. At this point, the dogs evidence no pain, no withdrawal. At present, pain is regarded as a central summation of impulses, and physiologists tend to accept the idea of an input controlling mechanism which prevents too great an intensity. This mechanism, called by its author a gate control system, has to do with the working relationship of large and small fibers. In this way, attention, memory, and emotions are able to monitor sensory input at various levels. But the word pain, according to Wellesack and Wall, is a linguistic label for a rich variety of experiences and responses. In structural integration, we see something of this variety, another confusion with which it is reported to the individual. It could hardly be expected that the profound tissue changes reported in the photographs, changes in position, changes in tone, could be accomplished without a dramatic report submitted by the tissue to the central awareness that we call the man. Many people refer to this report as pain, but even these people are quick to acknowledge that this report differs from what they ordinarily call pain. For one thing, it is too transitory. The minute the pressure is removed, the pain is gone."
Silverman's text moves from specificity theory to the gate-control model:
The Norman quotation: pain as too much
The most-quoted single sentence to come out of the collaboration was not Silverman's but one he and Ida together appropriated from a book she calls Nauticos, attributed to a writer she names as Norman. The line — pain is experienced when stimuli, whatever their nature, exceed certain limits — became Ida's preferred shorthand for the entire neurophysiological argument. It allowed her to say in one sentence what the technical apparatus took an hour to deliver: that pain is not a quality of the stimulus but a function of the system's capacity to receive it. The same number of stimuli will be received as pleasure by a resilient system and as pain by a rigid one. The practitioner's job is to change the resilience.
"Naturally, he names this intense experience as pain. But is it modern both the detrimentary, the kind of pain as the label replaced on sensation when a rigid system is bombarded by an excessive burden of stimuli, which, because of the nature of its rigidity, it cannot cope with. Pain is experienced when stimuli, whatever their nature, exceeds certain limits. It is therefore not quantitative. Might it not be simply stated that pain is too much? Pleasure is experienced when the system is resilient and is by modded by the same number of stimuli. Thus we see that any evaluation of the man as a whole requires an understanding of his psychophysical response of the rich sensational fabric through which he perceives his world, or the interrelation of psyche and soma, and the necessity for understanding their expressions and their interplay. An earlier generation used faith as an open sesame for spiritual and physical serenity."
Reading her own gloss on the Norman quotation, Ida arrives at the formulation that became her preferred shorthand:
Silverman picked up this formulation in his own lecture the following year and named it as the one he liked best. He extended the implication: if you can get the system less rigid, you change the pain reception and the whole arrangement that surrounds it. The musculoskeletal adjustment is, in this reading, not a coping strategy that the practitioner imposes — it is the mechanism by which the system's threshold for 'too much' is reset. This is precisely the territory the work claimed for itself. Silverman's contribution was to give that claim a vocabulary that could survive in conversation with research neurophysiology.
"The label we place on sensations in a rigid system bombarded by an excessive burden of stimulation. Stimulation. Now you see, by implication he says if you can get that system less rigid, you change the pain and the pain reception and the whole trip. Now that's where we live. And the end of that first sentence is, when rigid system is bombarded by an excessive burden of stimulation, because of the nature of its rigidity, cannot cope with. That's another, coping is a musculature adjustment, a musculoskeletal adjustment. Pain is experienced when stimuli, whatever their nature, exceeds certain limits. It is therefore not qualitative. Might it simply not be stated that pain is too much? Pleasure is experienced when a system is resilient although it may be bombarded by the same number of stimulants."
Silverman names the Norman quotation as his preferred formulation and draws the practical implication:
Stimulus, intensity, and the rigid system
Sitting around the discussion table after one reading, Ida and a student worked out a subtlety in the Norman formulation that Silverman had not pressed himself. The student suggested that the issue was intensity of stimulus, not uniqueness. Ida pushed back: the issue is intensity of stimulus relative to a rigid or non-rigid structure. The same pressure that overwhelms a chronically tight quadratus passes through a freed one without registering as pain. This is the cause-and-effect chain the practitioners needed: tissue rigidity sets the threshold, the threshold determines what registers as pain, and the work changes the threshold by changing the tissue.
"And that some of the issues here are the intensity of the stimulus rather than the uniqueness of the stimulus. It isn't really the intensity of the stimulus but it's the intensity of the stimulus to rot, to a rigid or to a non rigid structure. And this, as you see, is the first draft. Now I suppose as I go into the second draft, I'll add some of these simplifications. Well, as the body begins to undistress as you get into the process, it becomes resilient enough, as Peter was saying, experience to input as something other than pain. They'll That's feed back to you that pain, when I feel that pain I know that something's moving, you know. It might also be an idea for you people, as you work with them, to call their attention to the different qualities of pain. You all know that there is a pain of stretching fascia, but you also know that if you get on a vertebra which is badly distorted, there is a pain which is not that pain at all. It's a sick pain. Well, it's more than deep, it's just thick. Reports to you that there is something very wrong here."
In discussion, Ida refines the Norman formulation and connects it to the language of pain qualities the practitioner learns to read:
Ida pressed this discrimination further in a discussion of the pectoralis major and minor. The same hand contact reported a different quality of pain depending on which layer it reached. Sharp, unadulterated pain over the ribs against the thoracic spine; a burning sensation when the hand moved between the major and the minor. She and her student speculated that the burning might be a fascial signal, not a C-fiber signal — that the conduction pathway might be the fascia itself rather than the nerve. The speculation was hers, offered tentatively; the technical resolution belonged to Silverman.
"yeah, yeah. I remember Stan Johnson trying to tell me there's muscle fibers and bundles and what have you. There's certainly a difference in the type of pain. Been working my experience with people on the pectoralis major and the minor. As you go in over the thoracic, right against the thoracic, over four, five, and six on the minor, it's pure unadulterated pain, it's sharp, it hurts. As you put your hand up and get it between the major and the minor, it's almost always a burning sensation. So that's the partial opening? I mean that's just the partial opening, so there's certainly a different sensation in those two's particular areas and people interpret that and they feel it as different. Well, in this description here about A fibers and C fibers, what the C fibers, the smaller fibers, report is often described as burning pain. And I don't think that has to do with C fibers, I think that has to do with interference with fracture. And I think lots of times when you have a burning pain, like chronically you have a stomachache due to an engorged engorged stomach and you say it's a burning pain or something of this sort or a burning pain in some area which is engorged."
Working a clinical example through the A-fiber/C-fiber framework, Ida speculates that fascia itself may be the conduction medium:
Resistance, pleasure, and the moment they meet
A subsidiary thread in Silverman's lecture concerned the relationship between pain and pleasure. The Norman formulation made them symmetrical — same input, different system. Ida read into the draft a reference to a book on death and eroticism that pushed the symmetry further, claiming that pleasurable feelings at high intensity become indistinguishable from pain. The point was not metaphysical. It was that the practitioner should expect, in a body undergoing the work, a sequence in which sensation passes through pain and arrives at something the client cannot at first name. Many clients call it pain because they have no other word; the work waits for the differentiation to arrive.
"refer to this report as pain, but even these people are quick to acknowledge that this report differs from what they ordinarily call pain. For one thing, it is too transitory. The minute the pressure is removed, the pain is gone. In the majority of people, it is superseded immediately by a feeling of physical joyousness, which is meant entirely different from the pain following hurtful damage of some sort. The sensation following nervous bombardment, a toothache for example, is one of exhaustion. I'll be better after a good night's sleep. But the sensation after the integrational fascial restoration has none of this quality. It is a high, a sense of great well-being, totally enveloping the individual. Since the earlier part of this experience is felt by the individual as an unknown experience, as it changed, it turns on his anxiety. And change, he remembers subconsciously, is something he must resist at all costs. Naturally, he names this intense experience as pain."
Ida reads the passage on what the client actually experiences once the deep pressure releases:
What this passage makes possible, for the practitioner, is patience with the client's verbal report. The first reports will be pain; the practitioner does not adjust the work in response to the word but to the actual tissue event. As the client learns to differentiate, the reports themselves change. This is the long arc of training the client's perception that Ida treated as central to the work and that Silverman gave her a neurophysiological vocabulary to defend.
The myofascial mechanism of psychic shock
Silverman's lecture extended in directions Ida cared deeply about. One was the relationship between emotional state and myofascial tone. The draft made an unusually direct claim: that the mechanism of psychic shock is itself myofascial. The soldier confronted with battle vomits; the child encountering bitter food makes the same musculofascial gesture of rejection. Emotional rejection patterns are mediated through the same tissue the practitioner is working. A body in reasonable myofascial balance has elasticity to recover from emotional shock; a body at the edge of physical balance has no margin to draw on. The implication, which Ida pressed without quite stating, was that the work's effect on emotional life is not a side benefit. It is the direct consequence of changing the tissue that mediates emotional response.
"A negative shock, sufficiently severe, can knock out normal physiological functioning, causing loss of consciousness, even death. The apparent mechanism of psychic shock is often myofascial. Now this is where this becomes important to us. The important mechanism of psychic shock is often myofascial. For example, the soldier exposed to the grim reality of battle all too often responds by vomiting, a muscular response dramatizing emotional rejection. Even a child finding something bitter on his tongue instead of the expected jam responds by non facial rejection expressed through the musculofacial pattern. The medium through which the individual can respond to change of any sort is myofacial, and his safe and speedy escape from emotional rejection patterns is dependent on the resilience of these systems. A man whose myofascial components are in reasonable balance is able to recover his emotional equilibrium thanks to physical elasticity. A man at the edge of physical balance has no margin of safety on which to rely. The average human is not really interested in the verbal abstraction equipoise, but he's widely concerned in lessening his pain. When he uses the word, he's usually referring to his own perception of his emotional level."
The draft makes its strongest claim about the relationship between tissue state and emotional resilience:
Reading the passage in context, the practitioner understands that the emotional outbursts they will encounter on the table — anger, grief, depression voiced by clients as the work proceeds — are not separate from the tissue events. They are reports from the same system, expressed in a different vocabulary. The practitioner does not have to choose between attending to the body and attending to the emotional life; attending to one is attending to the other.
"In other words, we see that any man in his emotional crises is responding not to the emotion which he thinks is driving him, but to chemical and physiological changes going on inside his skin. At this level, psychology cannot be seen as the primal driving force. Its place has been taken over by physiology. Sadly, this displacement has not vanished cytology into an outer darkness. It has displaced it to a deeper level. At the level of everyday problems, psychological organization of emotion can be immeasurably fervoured by any system able to create or restore more vital physiological response. This is the level at which we realize that although psychological hang ups occur, they are maintained only to the extent that free physiological response is impaired. Obviously, this can happen at any of several levels, glandular, neuro, myofascial, etcetera. Restoration of funtooth can be initiated at many levels as well. But establishment of myofascial equipoise is one of the most potent, one of the most obvious, one of the most speedy approaches. Only to the extent and at the speed that restoration of physiological flow occurs can the hang up be erased. All of this, however, is an exploration of change. What change is in terms of human beings. Humans, as we said, tend to resist change. Their resistance verbalizing as pain, emotional or physical. All too often their emotional pain, their depression, their grief, even their anger, is a perception of a physiological imbalance, an awareness of chemical lacks or overloads in blood and tissue. These may be at macro or micro levels, down to and including the cellular. The emotional, affective dimension of this imbalance negative, withdrawing, destructive may be thought of as one facade of pain."
The draft pushes further, making the psyche-soma relationship a question of which is downstream of which:
The clinical implication: grounding the work
Silverman did not stop at theory. He spent part of his 1973 lecture drawing out specific clinical implications for how the practitioner places hands on the body. The gate-control model implied that surface stimulation could close the gate on deeper pain — that the practitioner who reaches deep into the gut with one hand should be stimulating the surrounding surface with the rest of the hand. The mechanism was studied in phantom-limb research: massaging the stump of an amputated limb reduced reported pain in the missing ankle. The practitioner's body-wide contact was not, in this account, a comforting bedside manner. It was a specific neurophysiological intervention.
"But besides that, the notion was that what we were going to do is have some kind of sensitivity on the part of the rolfa given all this information about how pain stimulation does its thing, how the individual modifies stimulation. To get the rolfar in relation to the body in such a way that it doesn't cause a pain where pain doesn't have to be caused. For example, what came out of the lecture last year, and then you guys, we may not get to that at all this year, but if you go deep into the body without stimulating surface areas of the body where certain other discrimination fibers, so called, are available that turn on turn off to the pain intensity, then you are going to increase the painful experience. So what you have to do is know that as you are going in deep, surrounding areas ought to be gentle. We know from studies of phantom limb pain control that things like massage works. Just massaging the phantom limb, the end of the, a guy's got a, he's been cut off over here. And now you are telling him that his leg doesn't hurt but he says he has got pain in his ankle. Now how are you going to get rid of that pain in his ankle? Well what they found was in doing these kinds of studies that massaging the stump eliminated or greatly reduced the pain in the ankle. And this fits in with what is known about the neurophysiology of the pain receptors and the pain control mechanisms. So, getting back to a rolfing situation in which you may be going deep into the gut, it makes sense to be able to be stimulating around that gut area on the surface with as much of your hand as you can be. And getting, we talk about this as grounding or whatever, so that you are not turning on those so called C fibers, those D fibers, and eliminating the control that these so called A fibers have over the total experience of sensory overload. Getting rid of the pain, of course, all the kinds of things that you've been doing here, it doesn't make sense to get rid of pain, that's why you didn't want to drug them over to you. The pain is information. It tells you about holding, it tells you about a kind of an adjustment on a life style. God knows what you'd lose if you got rid of that painful response."
Silverman draws out the practical implication for the practitioner's hands:
Silverman closed this section of his lecture with a warning the practitioners welcomed: pain is information. It tells the practitioner about holding, about life-style adjustment, about what the client cannot release. The temptation to drug it out of existence — which the medical culture of the period made readily available — would lose the information the work depends on. The practitioner's job was not to eliminate pain but to make it intelligible: to teach the client to read it as report rather than as verdict.
The follow-up year and the unresolved questions
Silverman returned to Big Sur in 1973 to refine what he had said the year before. He was franker in the follow-up about what neurophysiology could and could not yet settle. The controversy between response-specificity theorists and gating theorists, he predicted, would not be resolved by one side winning. It would be resolved the way the wave-versus-corpuscle controversy in physics had been resolved — by recognizing that both descriptions hold in different circumstances. The practitioner did not need to wait for resolution. The practitioner needed to understand that pain involves multiple fiber systems interacting, that surface and depth signal through different pathways, and that the work is operating on more than one of those pathways at once.
"I looked at him and said, Fritz, you know, some people take him The only thing I would say about the pain that I think requires some modification is that in understanding the pain, the neurophysiologic pain theory, that there is controversy still raging and I don't know how it's going be resolved between people who go in for the so called response specificity theory which says that there are certain receptors that are pain receptors in the body and that understanding how these work and where they are is going to be the answer to understanding the problem of pain. There are other people like Melzak, the guy he has worked with, who formulated complicated notions of the pain mechanism, the pain adjustment mechanism. The gating theory which is described pretty well in the paper last year which has to do with this on off response when certain fibers are triggered, others are shut down. So that relation to your working, these fibers in the surface areas of the body have a kind of a turning off function in relation to the different kinds of fibers that get activated say deep in the body, which have different sides, one is myelin and one is unmarried, etc. But to understand the nature of pain control, you have to understand how these different sized fibers work in relation to each other. Now, it is probably going to wind up being for me the way it did in physics when to understand light as a process and energy transmission you had to go and understand not the corpuscular theory of life or the wave form theory of life but that they both work in a certain circumstances and not others. And this is probably what is going happen in understanding the plane characteristics of the body. But overall, recommend the more technical aspect in terms of what I did in bringing in the LSD research and I surveyed and brought that in relation to the Ralphie research that we did here and in relation to the cybernetics and neurophysiological work."
Silverman returns the following year with a caveat about how the theoretical controversy will likely resolve:
Ida used the unresolved status of pain neurophysiology to make a different argument. If even the textbooks could not agree, the practitioner's empirical observations were not subordinate to theory; they were data. She pressed students to attend to the different qualities of pain they elicited and to refuse the medical generalization that pain is simply pain. The work, in her teaching, was producing observations that the textbooks had not yet caught up with.
"I mean, is the evidence you get a different type of sensation as you do the stretching of fibers that you do in the course of the wrong way. And it's not typical thing. And one of the things that interests me very much and I don't see anybody else really looking into it particularly carefully is the different qualities you hear me ask of pain which are brought to your attention in the course of wrong work. I mean the wrong thing experiences entirely different quality systems. And of course with these people who have never paid any attention to themselves and their responses, you will have a terrible time with them because you say to them, what kind of a pain is that? Oh, I don't know, it's pain. They don't know what kind it is, they don't know how much it is. They're really applying those good four, that nice four letter word to anything that is sensation, not pain. And you cannot quickly get them trained to the place where they understand the difference between sensation and pain. Can't imagine what's going on inside their skin as they've got so much jumping. Out of that whole thing you can take perhaps 50% of it and you can say this is so called pain which has a quality for which I can't find words but which I recognize as a pain. And I think that that pain has to do with connective tissue. It does not have to do with transmission of gray matter or white matter or lipoproteins etc. It has to do with connective tissue. And it isn't properly But we have a lack of words in which to report. So we call it pain."
In conversation with Silverman, Ida names the practitioner's clinical observation as primary data that the existing anatomy does not account for:
Pain, learning, and cultural shaping
The third strand of Silverman's lecture, which received less attention in the immediate discussion but which Ida absorbed into her writing, was the cultural and learned dimension of pain. The neurophysiology described a mechanism; what arrived as a verbal complaint was shaped by family, culture, and learning. The practitioner working with someone whose family had taught them that complaint was unmanly, or that any sensation deserved an outcry, would encounter very different verbal reports of the same tissue event. This was not a reason to discount client report. It was a reason to read it as one data stream among several.
"or to dominate and all of these things you see when you are working with your guys. While the pain response is an innate response to physical stress, the associated verbal complaint is elaborated and modified by a learning process established in the family and in the culture. So you have the basic response to sensory stimulation that is strong and then you have a whole host of non sensory aspects to the pain experience. Okay, this is not to say that when someone says Ouch! You don't believe them, or that you do believe them. It's simply to point out that anxiety and motivation and all kinds of learning variables determine the compared to 10. Now just another aside, the kinds of things you guys do seem to be associated to a significant extent with a complaint of pain in one form or another. And so my understanding when we first did this last year, and it turned out to be a worthwhile thing to have done, is that if you begin to gain some appreciation of pain, not only as an experience that you have or the individual has, but as some kind of a process that has neurophysiologic basis, that has learning basis, that has biochemical basis, then you can be a little more sensitive to what is going on in that individual as you are putting your hands on him. And also later on there will be some specific implications emerging from the consideration of the neurophysiologic research. So, what I propose to do is present several formulations of pain. And the formulations are different ways of looking at this particular experience, this particular phenomenon. One is a straight forward neuroanatomical neurophysiological."
Silverman lays out the learning and cultural dimensions of pain experience:
Silverman ended with a warning about how easily one could be misled by the news cycle. Articles regularly appeared claiming this or that scientist had cured pain — implanted devices, new drugs, novel relaxation techniques. He took these seriously where they were serious. But he also urged the practitioners not to abandon the slow patient discrimination they were doing with their hands for a faster mechanical answer. The work was a long inquiry. Its findings were unlikely to arrive as a headline.
Coda: what the collaboration left behind
Reading the Mystery Tapes and the Big Sur recordings together, the collaboration with Silverman appears as a sustained intellectual exchange across several years. Ida brought the clinical observations and the conviction that tissue change was the upstream variable. Silverman brought the sensory-psychophysiology research, the gate-control vocabulary, and the willingness to take the practitioner's reports seriously as data. The chapter Ida read aloud in the Mystery Tapes — which she described as a first draft and revised at least once with Silverman's input — became the source of much of how she taught practitioners to think and speak about pain for the rest of her career.
"not the kind that's perceived by a burning or by the outer trauma that goes on in Well, it's the true. On the other hand, you are perceiving the faction of pain that's fairly superficial as compared with the pain, for instance, of something with some deterioration of the gut or something of this sort. There have been some other pathways suggested other than neurocaine transmission. Andre Kouharaj written has some of this stuff up, which he sees several different kinds of phenomenon occurring in some specific protein molecules that are in connective tissue. For instance, keratin exhibits or pizoelectric effects, means that it can change mechanical energy or sound energy to electrical, vice versa. And also some semiconductor effects, so they've demonstrated this to the effect of actually making a hearing aid that fits into a vacant area where a tooth has been extracted somewhere from the mouth and it directly conducts to the auditory nerve. Specific to hasn't He hasn't published any. He talked to me a little bit about it. I know. His sense is that the whole body is a mechanical transducer in the same way that the mechanism of the ear is, that the whole body is an ear and transmits this information, it's just a matter of how the programs are connected in the cortex. And so it's quite possible that there may be some pathways that are ultrasonic, of course, moving through the myofascial. I mean, it's a suggestion. The trouble with the suggestion is it's too that I'm good at suggestion but it's only good to the people who have thought about pain. Yeah. I mean you can't just hand it out."
Closing the discussion, Ida returns to her central problem — finding a vocabulary the layman can use:
What is most striking, reading the chapter and the lectures together, is how unfinished the collaboration was. Silverman's text included passages Ida found awkward — at one point she stops mid-reading to admit the simplifications she will add in a second draft. She left questions open about whether fascial pain conducts through nerves at all. She and Silverman never agreed about the relative weight of A-fiber and C-fiber transmission. They left these questions open because they were genuinely open and because their joint project was not closure but the equipment of practitioners with workable concepts. The result is one of the most intellectually serious encounters between Ida's circle and a research scientist preserved in the archive — and the durable source of the work's vocabulary for one of its most difficult clinical problems.
See also: See also: Julian Silverman's 1973 follow-up lecture on the relation of his pain research to psychedelic-drug studies — included as a pointer for readers interested in how Silverman's sensory-psychophysiology background informed his approach to the work. BSPAIN2 ▸